Health Economics Commons^™

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 …

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

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 …

Estimating The Costs Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medicine recommended in 2012 that the federal government undertake work to identify the components and costs of a "minimum package" of public health programs, services, and capabilities that should be available in every American community. This presentation summarizes work that is currently underway through the Robert Wood Johnson Foundation-supported Public Health Practice-Based Research Networks (PBRN) Program to estimate the costs of public health delivery.

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 …

New Health Delivery Networks: Merging Public Health And Health Care Systems, Glen P. Mays

Health Management and Policy Presentations

Incomplete coordination between medical care and public health delivery systems can result in significant missed opportunities for improving population health and constraining overall resource use. This lecture uses insight from the field of public health services and systems research (PHSSR) to examine: (1) why medical care and public health systems often fail to connect; (2) what are the potential health and economic consequences of these failures; and (3) what are the opportunities for connecting medical care and public health delivery to improve population health.

Recessions, Risks And Reforms: Changes In Inter-Organizational Activities To Improve Public Health, 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. 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 nature of change in inter-organizational contributions to public health activities, with a focus on hospitals, insurers, employers, and primary …

Who Benefits From Public Health Spending And How Long Does It Take: Estimating Community-Specific Spending Effects, Glen P. Mays

Health Management and Policy Presentations

Objectives: Spending on public health and prevention strategies varies widely across states and communities. The Patient Protection and Affordable Care Act of 2010 (ACA) authorized the largest expansion in federal public health spending in decades, with the goals of improving population health and helping to moderate growth in medical care spending. To produce evidence needed to inform these investments, this study (1) estimates the effects of public health spending patterns within communities on preventable mortality and subsequent medical care spending; and (2) uses the methods of local instrumental variables developed by Heckman and Vytlacil and Basu to estimate how the …

Update On Public Health Financing & Economic Studies From The Phssr And Pbrn Programs, Glen P. Mays

Health Management and Policy Presentations

As part of the Public Health Financing Roundtable at APHA, this session provides an update on public health financing and economics studies underway through the Public Health Services and Systems Research (PHSSR) Program and the Public Health Practice-Based Research Networks (PBRN) Program, supported by the Robert Wood Johnson Foundation.

Public Health Services & Systems Research: Building The Science Of Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

The extreme heterogeneity in how public health activities are organized, financed, and implemented across U.S. states and communities provides compelling opportunities for research on the comparative effectiveness and efficiency of public health delivery. This talk highlights some of the most compelling and policy-relevant opportunities for research on public health organization and financing issues, and examines some of the ongoing studies in the field.

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

Cost Estimation Methods And Foundational Public Health Capabilities, Glen P. Mays

Health Management and Policy Presentations

The National Academy of Sciences Institute of Medine recently recommended that the federal government identify the components and costs of a "minimum package of public health services" and "foundational public health capabilities" that should be universally available across the U.S. This presentation reviews costing methods that can be used for identifying the costs required to establish "foundational public health capabilities" at state and local levels within the U.S. public health system.

Factors Explaining Obesity In The Midwest: Evidence From Data, Josh Matti, Hansol Kim

Undergraduate Economic Review

This paper attempts to determine the factors explaining obesity in the Midwest by using standard OLS multiple regression analysis and cross-sectional data. We examine independent variables related to built environment and determine effects on obesity. This study finds that some factors influencing calories consumed, such as percent of restaurants that are fast food, are consistent with the prior literature. However, other factors, such as the number of fast food restaurants per 1000 people, yield surprising results. The results of this study suggest that obesity is a multifaceted issue that is not close to being fully explained.

Public Health Services & Systems Research: Concepts, Methods, And Emerging Findings, Glen P. Mays

Health Management and Policy Presentations

The field of public health services & systems research (PHSSR) increasingly is addressing the question of how to assess the value of investments in public health programs, infrastructure, and delivery systems. Progress in quasi-experimental research designs, measurement, estimation techniques, and data sources are yielding important insight.

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.

Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii

Research Collection School Of Economics

Applying the small-area estimation methods to Cambodia data, we decompose the total inequality in wealth (consumption) and health (child undernutrition) indicators into within-location and between-location components. Because the knowledge of the pattern of spatial disparity in poverty and undernutrition is important for the geographic targeting of resources, we conduct a geographic decomposition of the variance of the Foster-Greere-Thorbecke index in addition to the standard decomposition exercise based on the generalized entropy measures. We find that a sizable proportion of wealth inequality is due to between-location inequality, whereas health inequality is mainly due to within-location inequality.

Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii

Research Collection School Of Economics

The small-area estimation developed by Elbers, Lanjouw and Lanjouw (2002, 2003), in which a census and a survey are combined to produce the estimates of welfare measures for small geographic areas, has become a standard tool for poverty analysis in developing countries. The small-area estimates are typically plotted on a map, which are commonly called a poverty map. Poverty maps proved useful for policy analysis and formulation, and have become increasingly popular among policy-makers and researchers. In Cambodia, poverty maps have been used by various international organizations, ministries and non-governmental organizations for analyzing the poverty situations for their operation areas, …

Nutrition Political Economy, Pakistan. Province Report:Sindh, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Rozina Mistry, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Nutrition Political Economy, Pakistan. Province Report: Khyber Pakhtunkhwa, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Abdul Wajid, Gul Nawaz, Kashif Nazeer, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Nutrition Political Economy, Pakistan. Provincial Report: Balochistan., Shehla Zaidi, Zulfiqar Ahmed Bhutta, Suleman Qazi, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Fanta Fanafody: Malagasy Traditional Medicine In A Globalized World, Mary Buswell

Independent Study Project (ISP) Collection

This study investigates the relationship between traditional medicine and globalization in Madagascar. Information from interactions and interviews with both traditional and allopathic healers is used to study the current healthcare system and provide direction for the establishment of an Integrated Health Care System (IHCS). This study finds that traditional medicine and globalization have a closer and more reciprocal relationship than it would initially appear, and that traditional medicine is very adaptable to change. Because of this, it is proposed that globalization and technology could be tools to bring traditional and allopathic medicine together in an IHCS to resolve the health …

The Consequences Of A Public Health Insurance Option: Evidence From Medicare Part D Prescription Drug Markets, Daniel P. Miller, Jungwon Yeo

Research Collection School Of Economics

This paper examines a public option competing alongside private insurers in Medicare Part D. We estimate a random coefficient demand system and oligopoly supply-side model with endogenous premium subsidies and risk adjustment payments. If the public option does not affect health risk sorting, counterfactual results show modest competitive benefits. However, increased subsidy payments eliminate welfare gains regardless of the public option's cost position. If the public option adversely selects -- facilitating insurers' ability to cream-skim favorable risk -- the risk adjustment mechanism creates a downward pricing distortion, amplifying competitive benefits. Despite greater selection, total surplus may increase, but the division …

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.

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 …

Hospital Contributions To Public Health Activities Before And After Aca: Incentives, Constraints & Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created enhanced IRS requirements for not-for-profit hospitals regarding the provision of community benefits, potentially stimulating new approaches to community health needs assessment, priority setting, and engagement with public health agencies and other community stakeholders. Yet the economic downturn has constrained hospital earnings and increased demand for uncompensated care, potentially crowding out hospital contributions to public health activities. This study uses data from 1998-2012 on a national cohort of communities to examine: (1) the extent and nature of change in hospital contributions to public health activities; and (2) the economic, institutional, and policy-related factors that …

Analyzing Return On Investment In Public Health: Implications And Future Directions, Glen P. Mays

Health Management and Policy Presentations

Return on investment (ROI) analyses of public health programs, policies, and services are being undertaken with increasing frequency to provide assessments of the value of these activities. This presentation reviews current initiatives and future directions for improving the quality of ROI studies and their application to real-world public health policy and administrative decisions.

Harnessing The Power Of Public Health Systems For Injury Prevention & Control, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Public Health Delivery Systems And Population Health, Glen P. Mays

Health Management and Policy Presentations

Despite high overall health expenditures, the U.S. continues to fall behind other high-income countries on many measures of population health. While health care delivery systems are now studied intensively for solutions to U.S. cost and quality problems, the nation's delivery systems for public health programs and policies are only now becoming the subject of rigorous empirical study. This presentation examines recent studies of public health delivery systems and important directions for future inquiry.

Estimating Return On Investment: Approaches And Methods, Glen P. Mays

Health Management and Policy Presentations

Continuing fiscal constraints in the public sector and large-scale policy changes associated with health reform implementation in the U.S. are giving heightened attention to questions about the health and economic value of public health programs, services, and policies -- strategies designed to protect health and prevent disease and injury on a population-wide basis. This session provides an overview of approaches for conducting return-on-investment (ROI) analyses and related economic evaluation studies in public health settings in order to inform policy and administrative decision-making. New opportunities and resources created through CDC's National Public Health Improvement Initiative (NPHII) and RWJF's Public Health Practice-based …

Optimizing The Value Of Public Health Services: Lessons From Research & Practice, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health programs and policies holds considerable potential for improving population health and constraining the growth in health care spending. Achieving such expansions efficiently, particularly in low-resource settings, requires careful attention to interorganizational and intergovernmental relationships in public health delivery.