Health Policy Commons^™

Social Determinants Of Health: The Impact On Health Outcomes And Hospital Profitability, Danielle Mcpherson

Doctor of Business Administration Dissertations

Hospitals are experiencing decreasing profitability due to increasing healthcare cost. In this paper, I demonstrate that there is financial value to hospitals by addressing social determinants of health (SDOH) as this strategy improves health outcomes and yields cost savings. I estimate the impact of SDOH on the health outcomes using an IV probit regression analysis and estimated the impact of health outcomes on cost using a basic linear regression. I estimate that improving SDOH by one standard deviation will result in hospital cost savings as follows: addressing Violent Crime will decrease hospital cost between 0.16% and 0.21%, addressing Supplemental Nutrition …

The Affordable Care Act And Entrepreneurship Lock: An Updated Examination Of Employer-Based Healthcare’S Effect On Self-Employment By Demographic Group, Sean Ruddy

Undergraduate Economic Review

This paper capitalizes on a natural experiment created by differences in Medicaid expansion under The Patient Protection and Affordable Care Act (ACA). A difference and difference model comparing states that did and did not expand Medicaid is conducted to investigate if providing an alternative and low-cost source of health insurance affects self-employment rates overall and across different demographic groups. The results suggest that living in a state that expanded Medicaid was associated with a 1.4 percent increase in the likelihood that an individual will be self-employed and that this effect is heterogeneous across different demographics, being largest among African Americans.

The Las Vegas Medical District And The Unlv School Of Medicine: An Economic Analysis And Tax Revenue Study, Jaewon Lim, Robert E. Lang, Sabrina Wang

Policy Briefs and Reports

In the 2011 report, “Unify, Regionalize, Diversify,” The Brookings Institution, SRI International, and Brookings Mountain West detailed Las Vegas’s experiences during and after the Great Recession, and identified the health and medical industry as a particularly potent opportunity for economic diversification – one that could improve health outcomes while also generating sustainable economic activity and high-quality jobs. The Las Vegas Metro medical industry began growing in 2006, grew during the Great Recession, and is expected to continue to grow for the next 10-year period spurred by the rapidly growing population in Southern Nevada. The establishment and launch of the UNLV …

Predictors Of Social Distancing And Mask-Wearing Behavior: Panel Survey In Seven U.S. States, Plamen Nikolov, Andreas Pape, Ozlem Tonguc, Charlotte Williams

Economics Faculty Scholarship

This paper presents preliminary summary results from a longitudinal study of participants in seven U.S. states during the COVID-19 pandemic. In addition to standard socio-economic characteristics, we collect data on various economic preference parameters: time, risk, and social preferences, and risk perception biases. We pay special attention to predictors that are both important drivers of social distancing and are potentially malleable and susceptible to policy levers. We note three important findings: (1) demographic characteristics exert the largest influence on social distancing measures and mask-wearing, (2) we show that individual risk perception and cognitive biases exert a critical role in influencing …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Room To Grow: A Comparative Analysis Of Cannabis Regulation Models In Europe, Amanda H. Cronin

Independent Study Project (ISP) Collection

Debilitated by years of economic instability, the Spanish economy has not fully rebounded to its once strong place in the European market. And now, in the aftermath of a devastating pandemic, the nation will be searching for new sources of wealth. The lucrative market potential of controlled cannabis in medicinal and recreational settings is an attractive industry gaining popularity across Europe. This paper explores the various policy models and legal systems in Portugal, Germany, and the Netherlands. Combining a variety of sources, I seek to ascertain the best plan for Spain. Ultimately, analysis shows that a multi-pronged approach is the …

Treatments For Cancer Given Orally: Patients' Perceptions Of Distress Due To Financial Toxicity, Ellen Carr

Dissertations

Purpose/Aims: For adult participants who have received or are receiving treatment for hematologic and solid tumor malignancies given orally, this study describes the relationship between participants’ experience of financial toxicity (FT), the participants’ perception of distress associated with FT, and participants’ self-identified adherence to prescribed treatments in the context of FT.

Background: FT has emerged as an additional source of distress for cancer patients. The costs of treatments given orally can be prohibitively expensive for patients. Therefore, these patients may experience considerable distress and may not adhere to treatments as prescribed.

Method: Descriptive cross-sectional correlational design study of a sample …

Poverty In The United States: An Analysis Of Its Measurement And The Long-Term Social And Economic Costs, Abby Magnus

Electronic Theses and Dissertations

This thesis examines the role of poverty in the United States and how it has impacted social and economic systems. It explores how U.S. poverty measurements developed in the 1960s may not be accurately measuring poverty now, and the ways in which these measures could be improved upon. This work also reviews literature on health and educational inequities stemming from socioeconomic class, and the role these play in long-term economic mobility. Finally, it analyzes how larger social institutions like mass incarceration and capitalism have developed around poverty, and the role they play in maintaining its prevalence today. This thesis finds …

Evidence-Based Approach To Drug Crisis, Jiebing Wen

Theses and Dissertations--Public Policy and Administration

I am devoted to health policy research, especially tackling the opioid crisis, and evaluating marijuana laws and newly emerging issues associated with legal recreational drugs. Opioid overdose in the United States continues to jeopardize public health. Meanwhile, the majority of states have legalized medical marijuana and one third of them further liberalized recreational marijuana. Marijuana liberalization, although originally independent of the growing opioid crisis, may be a harm reduction approach to the crisis because marijuana may be a substitute for opioids in pain management at a relatively lower risk. However, marijuana liberalization may also lead to marijuana-related harms, such as …

A Comparative Analysis Of The Price Of Insulin In Canada And The United States, Kimia Z. Badakhshan

Honors Undergraduate Theses

There's frequent discourse regarding the rising cost of insulin in the US. Insulin is a drug that over 7 million people rely on for survival, and it has tripled in cost over the last decade. The pricing regulation of the drug is dependent on multiple stakeholders, including wholesalers, pharmacy benefit managers, and manufacturing companies. Due to the lack of governmental intervention in the process of pharmaceutical cost regulation in the US, data on the price negotiations and the rebate system between these entities is unavailable in public records, making it difficult to determine a primary cause as the root of …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Using A Role-Driven Race Equity Reform Approach To Mitigate The Effects Of America's History Of Racism On Food Insecurity, Kenya N. Washington, Darryl E. Williams Jr.

Professional Agricultural Workers Journal

Abstract

Food insecurity, or the lack of reliable access to sufficient quantities of nutritious food, affects African Americans and other minorities disproportionately. This paper examines how America’s history of racism created and sustains the Nation’s racially disparate food system. Food insecurity contributes to hunger. This paper contemplates disparities in other American systems, including education and criminal justice, as exemplars of the broader ramifications of hunger. Finally, the paper examines the potential of individual action to address problems in any system. It champions the adoption of a role-driven race equity reform strategy as a tool to confront the current food insecurity. …

The Effect Of Citi Bike Introduction On Injury Rates In New York City, Masakazu Hiruma

Theses and Dissertations

This paper tests the hypothesis that the introduction of Citi Bike influences bicycle injuries by observing the gradual expansion of the bike share system in NYC. Data is analyzed from 2012-2018 New York Police Department (NYPD) Motor Vehicle Collisions and Citi Bike Station Feeds (NYC Open Data).

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

British Government Information Resources, Bert Chapman

Libraries Faculty and Staff Creative Materials

Provides an overview of British Government information resources. Contents include basic British economic and political background and information from British Government websites including the Department of Environment, Food, and Rural Affairs (DEFRA), Brexit related material produced by British government agencies such as the Department for Exiting the European Union,, the Ministry of Defence, the National Museum of the Royal Navy, the Home Office Visas and Immigration Section, the Office of National Statistics, Her Majesty's Treasury, the British Parliament including parliamentary committees and research agencies, the website of Member of Parliament (MP) Jacob Rees-Mogg (Conservative-North East Somerset), a webcast of House …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Does Medicaid Increase Emergency Room Use: Evidence From Oregon Health Program?, Md Fourkan

Electronic Theses and Dissertations

This thesis paper strives to identify the relationship between Medicaid expansion and Emergency Department use. I use a Monte Carlo simulation for demonstrating the endogeneity problem and a copula model using the Oregon Health Program (OHP) data to show the previous literature has exaggerated the causal relation between Medicaid expansion and Emergency Department use. This paper can be divided into two parts. First, it tries to focus on the under-identification of multiple endogenous variables problem in typical econometrics papers, where researchers correct for a single endogenous variable but intentionally or unintentionally ignore the endogeneity of one or more other independent …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Rethinking Consumer Protection: Escaping Death By Regulation, Thomas L. Tacker

Publications

This book is designed to appeal to anyone who is at all interested in topics related to making life better and safer—for all us consumers. Our current approach to consumer protection is extremely flawed; sometimes costing lives rather than saving them. There are better ways to protect ourselves and the people we love.

Which Side Are You On?, Gina Mamone

Exhibit Panels

Which Side Are You On? is a new work by Gina Mamone, co-founder of the West Virginia-based art collective Queer Appalachia. Which Side Are You On? invokes the spirit of Zoe Leonard’s 1992 poem I Want a President, but speaks with the voice of 2018 rural America.

"I want a survivor for Governor. I want a Governor whose home has been raided by ICE. I want the child of a public school teacher for Governor, and I want someone who knows what days to hit what food pantries. I want a Governor who has had experience heating a home …

Gettysburg Social Sciences Review Fall 2018

Gettysburg Social Sciences Review

No abstract provided.

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …

Kisumu County Hospital Patient Demographic Analysis: Looking Toward Universal Health Coverage, Lauren Scheffey

Independent Study Project (ISP) Collection

Universal health coverage is priority sought after by developed and developing nations alike, and Kenya sits on the list of countries seeking to achieve this goal in the coming years. The definition of “coverage” can vary by country, but three criteria are commonly found in the discussion of UHC globally: access, affordability, and quality. Affordability is determined by the state’s healthcare financing system; quality refers to the services provided by health facilities; and access, at least in part, concerns the geographic placement of health services providers in relation to the population they intend to serve. This geographic element is the …

The Fight For Birth, Jessica E. Brown

Research Briefs

No abstract provided.

Healthcare Coverage In The United States And New York Metropolitan Area, 2009 - 2015, Andrew S. Alger

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines trends regarding health insurance coverage in the United States along lines of sex, race/ethnicity, place of birth, and poverty status between 2009 and 2015.

Methods: This study uses the American Community Survey PUMS (Public User Microdata Series) for the years 2009, 2011, 2013, and 2015. These datasets were downloaded from the IPUMS USA website hosted by the University of Minnesota. The variables used in the study describe these populations in terms of sex, the four major race/ethnic groups (non-Hispanic white, non-Hispanic black, Latino, and Asian), being born either within the United States or abroad, and being …

Overweight And Obesity: Correlates And Temporal Trends In Global Context, Rajesh Gautam, Amir H. Golnabi, D K. Adak, P Bharati

Department of Mathematics Faculty Scholarship and Creative Works

This work attempts to highlight the global magnitude of the obesity and examining the evolutionary perspective with focus on the correlates and temporal trend. It is based on a wide literature survey following PRISMA. The data on country wise prevalence was obtained after systematic review of over 500 articles and websites on the prevalence of obesity. A total of 301 entries/data points were found for 84 countries. Regression analysis was computed for 177 countries based on prediction made by WHO to identify the correlates. To find out the regional variation, data on height and weight of two different national surveys …

Three Essays On Public Finance And Public Policy: Financial Disclosure And Policy Reinvention In U.S. State And Local Governments, Jinhai Yu

Theses and Dissertations--Public Policy and Administration

This dissertation consists of three essays. The first essay, or Chapter 2, advances the literature by examining the conditional effects of lobbying on the relationship between policy learning and policy reinvention. Scholars have consistently shown that learning of successful policies in other states leads to higher likelihood of policy adoption. This essay extends this finding two ways. First, policy learning can also lead to more comprehensive adoption of successful policies. Second, the effect of policy learning on policy comprehensiveness is conditional on lobbying by interest groups, an alternative source of information about policy success. To test these hypotheses, I conduct …

Of Rats And Men, Thomas S. Walsh

Capstones

This capstone is a data-driven investigation into New York City's rat problem. By using publicly available government data to map rat activity in NYC, I identified several socio-economic variables that correlate with rat populations at the community district, borough, and city-scale. I used these findings (mainly that rat problems are linked to lower incomes) as the basis of an investigation, which includes interviews with residents, experts, and city officials. Prof. Bobby Corrigan, urban rodentologist and formerly with the NYC Department of Health criticizes the city's efforts for the first time on the record.

https://thomasseiyawalsh.wixsite.com/ratstone

The Efficacy Of Public Health Interventions Aimed At Curbing Gun Violence: An Integrative Review, Brian Cook

Grace Peterson Nursing Research Colloquium

Abstract

Background: Gun violence is a pressing public health issue in the United States. Homicide is the second-leading cause of death for 15 to 24 year-old Americans, and the third-leading cause of death for 25 to 34 year-old Americans, and 80% of these homicides are committed via firearm. In recent years, the field of criminology has studied the efficacy of a variety of policing, public health, and public policy interventions that aim to reduce the incidence of gun violence, but many of their findings have yet to be incorporated into the body of nursing literature.

Objective: This project’s objective was …