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Legal, Policy, And Environmental Scholars Discuss Global Food Systems At Indiana Law Symposium, James Owsley Boyd

Keep Up With the Latest News from the Law School (blog)

The Indiana University Maurer School of Law and its Indiana Journal of Global Legal Studies are hosting scholars from around the country Friday and Saturday (Jan. 19-20) for an interdisciplinary discussion on one of the world’s most prevalent problems—food insecurity.

Data from the World Bank estimate more than 780 million people around the world suffered from chronic hunger in 2022. As climate change affects agricultural production and water accessibility, the problem could worsen in coming years.

“A Fragile Framework: How Global Food Systems Intersect with the International Legal Order, the Environment, and the World’s Populations” will bring together legal, policy, …

Pilot Implementation Of A Nutrition-Focused Community-Health-Worker Intervention Among Formerly Chronically Homeless Adults In Permanent Supportive Housing, Jane E Hamilton, Diana C Guevara, Sara F Steinfeld, Raina Jose, Farrah Hmaidan, Sarah Simmons, Calvin W Wong, Clara Smith, Eva Thibaudeau-Graczyk, Shreela V Sharma

Faculty, Staff and Student Publications

Food insecurity is a known health equity threat for formerly chronically homeless populations even after they transition into permanent housing. This project utilized a human-centered design methodology to plan and implement a nutrition-focused community-health-worker (CHW) intervention in permanent supportive housing (PSH). The project aimed to increase access to healthy foods, improve nutritional literacy, healthy cooking/eating practices, and build community/social connectedness among 140 PSH residents. Validated food-security screening conducted by CHWs identified low or very low food security among 64% of 83 residents who completed the baseline survey, which is similar to rates found in a previous study among formerly homeless …

Budget Capping Health Care: Its Impact On Health, Susan Chen

Theses and Dissertations

The goal of a budget cap on healthcare is to constrain total healthcare expenditure without compromising quality. This paper examines the impacts of budget capping on health and behavioral health outcomes, exploiting the completed Maryland All-Payer Model and the ongoing, extensional Maryland Total Cost of Care model, both of which capped healthcare budgets in Maryland. I use data from 2011-2021 surveys of the Behavioral Risk Factor Surveillance system and generalized difference-in-difference regression models to find that budget capping improves health and behavioral health outcomes with a greater favorable effect during the Maryland Total Cost of Care model.

Beyond Patient Care: Economic Impact Of Pennsylvania Hospitals, Ayse Yilmaz, Obaid Zaman Obaid Zaman, Sushma Sharma

Pennsylvania Economic Review

The Hospital Association of Pennsylvania’s (HAP) analysis of FY 2021 data reveals that Pennsylvania hospitals—both directly and through the ripple effects of their economic activity—benefitted their communities and the commonwealth by: Contributing $168 billion to the state and local economies; Supporting 590,000 jobs throughout the entire Commonwealth; and Generating $38 billion in wages, salaries, and benefits. In addition, the state’s hospitals attracted highly competitive federal research dollars to the Keystone State, played a crucial role in training tomorrow’s healers, and provided extensive charity and unreimbursed care to their communities.

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Medical Expenditures And The Measurement Of Poverty In The United States, Luke Petach, David Wyant

Faculty Scholarship

Using data from the Medical Expenditure Panel Survey (MEPS) we estimate the fraction of the US population that is health poor. A person is health poor if their income prior to paying health insurance premiums and out-of-pocket healthcare costs is above the poverty line, but their income net-of-premiums and out-of-pocket healthcare costs is below the poverty line. Because resources used to finance health insurance premiums and out-of-pocket costs are (A) lexicographically preferred and (B) cannot be used to maintain an individual’s standard of living, they should be excluded from official poverty estimates. Approximately 1% to 2% of the US population …

The Effect Of Postpartum Depression On New Mothers' Return To Work Decisions, Nicole Walutes

Honors Theses

Postpartum depression rates in the United States have doubled since 2010, with potentially significant economic consequences. In this study, I examine the relationship between postpartum depression and new mothers’ labor force participation using a national longitudinal dataset of 738 new mothers. I examine two labor force participation outcomes: whether or not a new mother returned to work postpartum, and the number of days it took for her to do so if she returned. I include a detailed set of demographic and social control factors. I find that conditional on these controls, having postpartum depression relates to a statistically insignificant 4.73 …

Medical Expenditures And The Measurement Of Poverty In The United States, Luke Petach, David K. Wyant

Funded Scholarship

Using data from the Medical Expenditure Panel Survey (MEPS) we estimate the fraction of the US population that is health poor. A person is health poor if their income prior to paying health insurance premiums and out-of-pocket healthcare costs is above the poverty line, but their income net-of-premiums and out-of-pocket healthcare costs is below the poverty line. Because resources used to finance health insurance premiums and out-of-pocket costs are (A) lexicographically preferred and (B) cannot be used to maintain an individual’s standard of living, they should be excluded from official poverty estimates. Approximately 1% to 2% of the US population …

Armed Conflict And Household Water Sources, George Naufal, Michael A. Malcolm, Vidya Diwakar

Economics & Finance Faculty Publications

Access to safe drinking water is among the most important determinants of public health outcomes. We pair household-level data from Iraq together with data on armed conflict and adopt a generalized difference-in-differences approach to study the relationship between household drinking water sources and armed conflict intensity. We find that households located in conflict-affected areas are more likely to use piped water accessed at their homes or bottled water as their primary source of drinking water, but are less likely to use public water sources or tanked water delivered on trucks and carts. We explore the temporal dynamics of these adjustments …

Evaluating The Early Impacts Of The Snap Online Purchasing Pilot, Kyle Jones

Theses and Dissertations--Economics

This dissertation consists of three chapters that evaluate how a change in the redemption of Supplemental Nutrition Assistance Program benefits impacted grocery purchasing behavior and food consumption to provide some of the first estimates of the impacts from the pilot. The SNAP Online Purchasing Pilot (OPP) allowed recipients to use their benefits online for participating retailers which was initially planned for 8 participating pilot states with a few participating retailers but massively expanded during the COVID-19 pandemic. The first two chapters evaluate how the SNAP OPP impacts grocery purchasing behavior with the first chapter evaluating before the COVID-19 pandemic and …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Driven By Change: The Impact Of Macroeconomic Shifts And Covid-19 On New Vehicle Sales, Jackson Aldrich

CMC Senior Theses

This paper examines the impact of macroeconomic factors and the COVID-19 pandemic on new vehicle sales. In order to address these two topics, a two-pronged approach was used with separate regression models. The macroeconomic variables include monthly supply of new homes, CPI for urban public transportation, unemployment rate, disposable personal income, inflation expectation, consumer sentiment, average gas prices, and total vehicle miles traveled which were regressed on total vehicle sales from 1978-2022. The regression results confirmed and supported current literature and highlighted the importance of the housing market and unemployment rate on new vehicle sales. The COVID-19 pandemic model variables …

The Role Of Place Of Birth And Residence In Puerto Rican Health Disparities: Evidence From Disability Prevalence Among Archipelago- Vs. Mainland-Born Puerto Ricans, Mara Getz Sheftel, Frank W. Heiland

Publications and Research

Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health.

Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans.

Results: Mainland-born/ mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity.

Discussion: …

Enhancing People's Subjective Wellbeing: Assessing The Impact Of Universal Health Coverage Through Wellbeing Adjusted Life Years, Ryan Joseph R. Dizon

Economics Department Faculty Publications

The establishment of public health programs, such as universal health coverage (UHC), aims to ensure health and wellbeing for all throughout the life course. These health programs have far-reaching impacts that extend beyond physical health. This study examines the impact of UHC on people's subjective wellbeing through a cross-country analysis using a multidimensional measure of health: the wellbeing adjusted life years (WALYs). WALYs are derived from life satisfaction data from the European Values Study and World Values Survey (1990–2014). The study employs an instrumental variable approach and Lewbel's method—a heteroscedasticity-based identification strategy, and additionally incorporates personality into the model. Findings …

A Stock Optimization Problem In Finance: Understanding Financial And Economic Indicators Through Analytical Predictive Modeling, Aditya Chakraborty, Chris Tsokos

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Given the significant impact of healthcare stock changes on the global economy, including its GDP and other financial factors, we endeavored to create an analytical prediction model for forecasting the annual percentage change of these stocks. Our model, which is nonlinear, incorporates five key discoveries. We focused on predicting the average weekly closing price (pWCP) of AbbVie Inc. (North Chicago, IL, USA)'s healthcare stock (ABBV) from 1 August 2017 to 31 December 2019. The stock was chosen based on the low beta risk, high dividend yield, and high yearly percentage return criteria. Alongside predicting the weekly stock price, our model …

The Geometry Of Dynamic Time-Dependent Best-Worst Choice Pairs, Sasanka Adikari, Norou Diawara, Haim Bar

Mathematics & Statistics Faculty Publications

There has been increasing interest in best–worst discrete choice experiments (BWDCEs) in health economics, transportation research, and other fields over the last few years. BWDCEs have distinct advantages compared to other measurement approaches in discrete choice experiments (DCEs). A systematic study of best–worst (BW) choice pairs can be traced back to the 1990s. Recently, new ideas have been introduced to the subject. Calculating utility helps measure the attractiveness of BW choices. The goal of this paper is twofold. First, we extend the idea of the BW choice pair to include dynamic, time-dependent transition probability and capture utility at each time …

Essays On Urban Transportation And Health Economics, Alexander P. Tsiukes

Graduate Theses, Dissertations, and Problem Reports (ETD)

The first chapter analyzes how Premier League games in London impact demand for the city’s bike-sharing system. Bike-sharing systems affect mode choice for within-city transportation. Using bike rental data from Transport for London, this chapter exploits the plausibly-exogenous timing of Premier League games to identify how proximity to stadiums affects demand for London’s bike-sharing system. Results indicate games at Stamford Bridge (stadium) cause a 24.36% increase in the number of bike trips arriving within 0.5km of the stadium, with effects diminishing as distance increases. In contrast, games at London Stadium decrease nearby bike-sharing use and may actually crowd out would-be …

Three Essays In Urban, Health And Public Economics, Dinushka Paranavitana

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation “Three Essays in Urban, Health and Public Economics” contains three chapters which explore urban, health and public economics. The first two chapters focus on examining the unexpected consequences of urban and health related policies, while the third chapter explores the nuanced relationships between health policies and religion. The first chapter examines the impact of NFL and NBA games, beyond the reach of stadium walls and arenas, extending to how it affects driver behavior after games. In this paper I analyze how game outcomes for professional level football and basketball games have an impact on affecting the rate of …

Three Essays On Misinformation, Mistrust And Their Influence On Public Health Policy, Eli Kochersperger

Graduate Theses, Dissertations, and Problem Reports (ETD)

In the first chapter I identify the impact of fentanyl exposure misinformation- namely, the erroneous belief that momentary, passive contact with the potent opioid fentanyl can be seriously harmful- on first responder behavior during overdose events, and on overall opioid-related mortality. I examine changes in opioid-related mortality following one particularly well-covered episode involving an Ohio police officer in 2017, wherein the officer appeared to experience an acute opioid overdose after touching what was believed to be fentanyl. Employing a synthetic differences-in-differences identification strategy, I find areas with greater media exposure to this misinformation exhibit marked increases in opioid overdose deaths; …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Pengaruh Kepemilikan Asuransi Kesehatan Pada Kelompok Miskin Terhadap Utilisasi Pelayanan Kesehatan Di Indonesia: Sebuah Studi Retrospektif, Dian Ira Wanti

Jurnal Ekonomi Kesehatan Indonesia

Health is the main priority of the Indonesian government in order to improve the health status of the Indonesian people in order to become a healthy, qualified and productive society. Health insurance is one of the programs held by the government to make this happen. Health insurance ownership from year to year continues to increase, but this increase is not accompanied by high utilization of health services, both outpatient and inpatient. The low utilization of health services raises the questions of how health insurance ownership affects the utilization of health service utilization. Therefore, this study aims to analyze the impact …

Pengaruh Kesehatan Mental Ibu Terhadap Status Gizi Anak Di Indonesia, Yuyu Pertiwi, Elda L. Pardede

Jurnal Ekonomi Kependudukan dan Keluarga

Malnutrition in children is still a problem in low and middle-income countries, including Indonesia. This research aims to assess how the mother's mental health influences the child's nutritional status, measured by stunting and underweight status, in the short term (when the child is 0-5 years old) and long-term (when the child is 7-12 years old). Using the Indonesia Family Life Survey 2007 and 2014 data, the logistic regression results shows that children of mothers with mental health problem have a greater tendency to experience underweight nutritional status in both the short and long term. However, the influence of maternal mental …

Menakar Kesiapan Puskesmas Dalam Penuntasan Penanganan Penyakit: Analisa Data Riset Fasilitas Kesehatan 2019, Harimat Hendarwan, Suparmi Suparmi

Jurnal Ekonomi Kesehatan Indonesia

The completion of disease treatment at the health center was important for payment of Capitation Based on Fulfillment of Service Commitment (PCFSC/KBPKP) and the Non-Specialist Case Outpatient Referral (NSOR/RRNS) was one of the key indicators. This study aimed to assess public health center readiness in the completion of disease treatment for those stipulated in Ministerial Decree number 514 of the year 2015. This study used Health Facility Research (Rifaskes) data conducted in 2019 with a total of 9831 health centers as observations. Analysis was conducted by comparing the availability of equipment, laboratories, and medicines with existing regulations. Health center readiness …

Estimasi Biaya Produktivitas Yang Hilang Akibat Kematian Dini Pasien Covid-19 Di Rs Pku Muhammadiyah Gamping, Yuni Andriani, Sugiyono Sugiyono

Jurnal Ekonomi Kesehatan Indonesia

COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 virus infection has had an impact on the global health and economic system, including in developing countries. This research is an observational study by estimating the indirect costs of lost productivity due to premature deaths in COVID-19 patients at PKU Muhammadiyah Gamping Hospital in 2021 and knowing the characteristics of the patients. This hospital was chosen as the research site because the percentage of Bed Occupancy Rate (BOR) was the highest in Sleman Regency in 2021, reaching 68.94%. The results of the research show …

Who Marries Whom Matters: Kesamaan Pendidikan Orangtua Dan Berat Badan Saat Lahir Di Indonesia, Mudya Johanna, Omas Bulan Samosir

Jurnal Ekonomi Kesehatan Indonesia

Despite ongoing efforts and commitment to reducing Low Birth Weight (LBW) babies, globally, the incidence of LBW has stagnated. This study uses a combined factor of maternal and husband/partner education variables to analyze the complexity of LBW incidents. This research uses secondary data from the 2017 SDKI with a multilevel logistic regression analysis method to look at the relationship between the similarity of parental education and the baby's birth weight at the individual and community levels. The results of the research show that mothers who have husbands/partners with equivalent education and higher education (≥high school or equivalent) have a lower …

Kemampuan Membayar Iuran Jaminan Kesehatan Nasional Peserta Penerima Bantuan Iuran (Jkn Pbi) Kota Tangerang Tahun 2023, Darwati Darwati, Pujiyanto Pujiyanto, Budi Hidayat

Jurnal Ekonomi Kesehatan Indonesia

The number of National Health Insurance (JKN) participants receiving Contribution Assistance (PBI) in Tangerang City from regional funding continues to increase by around 8.85% per year. On the other hand, the number of JKN participants who are non-wage earners (PBPU) and non-workers (BP) who pay contributions independently has decreased by around 0.7% per year from 2017-2022. One of the implications of this phenomenon is that the regional budget to finance JKN contributions for PBI participants is much larger than the budget for other programs. In 2020, JKN contribution payments for Tangerang City APBD PBI participants amounted to 57.81%, in 2021 …

Pelayanan Kesehatan Primer Sebagai Gatekeeper Dan Kebijakan Diskusi Peer Review: Antara Kualitas Dan Realitas Untuk Menurunkan Kasus Rujukan Non Spesialistik, Zahrina Zahrina, Royasia Viki Ramadani, Khairun Nisa Il Hulwah, Siti Nurlatifah, Aldi Andalan, Ascobat Gani, Golda Kurniawaty, Ery Setiawan

Jurnal Ekonomi Kesehatan Indonesia

Almost 80% of the source of funds is spent on hospital. This situation indicates the failure of the gatekeeper function in primary health care. Performance-based capitation is implemented to ensure the cost and quality of primary care, with non-specialist referral rate as one of the particular parameters. The peer review policy is a discussion between BPJS Health, District/City Health Services, IDI, provincial and branch Team of KMKB and other relevant stakeholders to determine which diagnoses must be handled at FKTP also to accommodate and improve the capacity of FKTP to handle patients and minimize referral cases. This study aims to …

Analisis Case Mix Index Pelayanan Rawat Inap Rumah Sakit Yang Bekerja Sama Dengan Bpjs Kesehatan Tahun 2019-2020, Anna Tirawani Ambarita, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

BPJS Health experienced various challenges in achieving Universal Health Coverage / Jaminan Kesehatan Nasional (JKN), including a referral system. According to the 2018 National Health Account, curative spending costs reached 69.1%. The Case Mix Index (CMI) is a benchmark for hospital performance abroad, but Indonesian hospitals have not used it. In 2019, BPJS Health tested CMI in 30 hospitals. The research uses sample data from 2019-2020 based on province, hospital type and ownership. The methods used are anova test, independent T, linear regression and multiple linear regression. The research results show a decrease in cases in 2019-2020. The highest CMI …

Comparison And Assessment Of Design, Handling Characteristics, And Efficacy Of Hand Instruments In Calculus Removal, Mohan Kumar Pasupuleti, Krishna Ganesh, Gautami S Penmetsa, Boddeda Anusha, Haripriya Narukurthi, Kommina Mouna Sahith

Journal of Dentistry Indonesia

Objective: primary objective of periodontal therapy is to remove supra and subgingival deposits from the tooth surface to stop disease progression. The purpose of the study is to address the instrument selection and its efficacy in calculus removal. Methods: A total of 50 subjects who fulfilled the criteria were included in the study. Participants were subjected to a complete periodontal examination, and the responses from 50 dental house surgeons were compared based on the instrument design, handling characteristics, and efficacy of calculus removal by using two sets of instruments. Results: The LM instrument was rated as best …

The Effect Of Several Electric Cigarette Puffs On Nanohybrid Composite Resin Surface Roughness, Alvi Rizqi Amaliyah, Haris Budi Widodo, Irfan Dwiandhono

Journal of Dentistry Indonesia

Nanohybrid composite resin is a dental restorative material comprising micro and nano-sized fillers. When accompanied by smoking habits, it can alter the surface roughness of composite resin. Objective: This study aimed to determine the effect of several electric cigarette (e-cigarette) puffs on the surface roughness of nanohybrid composite resin. Methods: This study was conducted in the experimental laboratory with a pretest-posttest control group design using 48 nanohybrid composite resin specimens divided into six groups. Subsequently, the experimental groups were exposed to 75, 150, 225, 300, and 450 puffs of e-cigarette, and the control group was given artificial saliva …