Health Policy Commons^™

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Change

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …

Land Use Policy Impact On Health Equity In Rural America Counties, Shayla Holmes

West Chester University Doctoral Projects

This dissertation investigates the relationship between land use policies and health equity in rural American counties. Utilizing a qualitative case study approach, the research scrutinizes eight counties across four states, examining publicly available data such as census details, land use policy documents, community health reports, and planning documents. The study is guided by two main research questions: 1) Are there land use policies in rural America that align with the creation of health equitable communities? and 2) Do health equitable communities within rural America feature equity in housing stock? The results from the thematic coding and content analysis of ninety-six …

Historical Trauma: Literary And Testimonial Responses To Hiroshima, Mariam Ghonim

Theses and Dissertations

The concept of trauma is controversial in literature. While one may be able to come up with ways to describe trauma in fiction, representing historical trauma is a hard task for writers. Some argue that trauma can not be described through those who did not experience it, while others claim that, provided some elements are added, one can represent trauma to the reader. This thesis focuses on twentieth-century historical traumas related to a nuclear catastrophe and explores the different literary and testimonial responses to the catastrophic man-made event of Hiroshima (1945). In this thesis, Kathleen Burkinshaw’s historical fiction The Last …

Developing The Food Navigator Role At Everyone's Harvest, Chase Rodriguez

Capstone Projects and Master's Theses

Everyone’s Harvest (EH) is a 501(c)(3) non-profit that operates farmers’ markets. In order to reduce hunger in Monterey County, Everyone's Harvest offers several food assistance programs for low-income people including the Market Match (MM) incentive program which matches CalFresh money, modern day food stamps, dollar for dollar. The problem is that in Monterey County 1 in 4 adults and 1 in 3 children are food insecure. The purpose of the Food Navigator (FN) at EH is to engage with the local community and connect low-income people with food assistance resources, primarily the MM program. This project was a role development …

Fighting For The Public’S Health: Challenges And Opportunities To Reinvigorate Public Health Advocacy, Madeleine S. Frey

Georgia Public Health Association Annual Meeting and Conference

Background

Covid-19 shed a painful light on racial health disparities. As health officials asserted their public health authority to stop the pandemic and promote health equity, elected officials moved to limit their ability to do so. Without strong advocacy infrastructure, public health has struggled to defend its legal public health authority, support the workforce, and ensure equitable health outcomes for everyone.

Methods

Fighting for Public Health, a 2022 Feasibility Study from the Network for Public Health Law, assessed what’s happening in public health advocacy, and what’s needed to strengthen it on state and national levels. With funding from Healthcare …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Motivations And Conflicts In Prison Medical Contracting, Meagan D. Sok

Theses and Dissertations

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical

State correctional departments are responsible for all medical care incarcerated individuals require. Many systems outsource their medical program. Literature indicates that many of these contracts experience significant issues that negatively impact state resources, including both personnel and money.

This dissertation explores the relationship between prison administrators' motivations and the structure, outcomes, efficiencies, and partner conflicts that arise in the contractual process. Using a framework developed from Incomplete Contract Theory, Contracts as Reference Points Theory and the concept of “essential tension,” this dissertation hypothesizes …

Governing The Pandemic: A Comprehensive Policy Analysis Of The $4.1t Strategy, Sean D. Jasso

Education Division Scholarship

From January 2020 to March 2021, the U.S. Government implemented five laws to marshal the federal response to the December 2019 outbreak of the Coronavirus. For context, past federal emergency policies include the New Deal $1T, World War II $4T, Hurricane Katrina $120B, AIDS $100B, $2.4T Iraq War, $90B Ukraine War, $44B Climate Change, Covid Vaccines $30B and, the largest emergency spending allocation in U.S. history, Covid-19 $4.1T. An evaluation of the government’s strategy to confront the pandemic is framed into two segments: legislative function – how the Congress mobilizes emergency legislation; and, executive function – how the administration manages …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

Affordable Housing: A National Crisis Fueled By The Coronavirus • A New Jersey Perspective, Latino Action Network Foundation

Center for Urban Policy Research

The Latino Action Network Foundation [LANF], its sister organization the Latino Action Network [LAN] and longtime ally, the Fair Share Housing Center [FSHC], have collaboratively monitored affordable housing issues in New Jersey for more than a decade. As part of its ongoing work, LANF sponsored a housing roundtable on September 10, 2021, to assess the affordable housing situation in the state and offer policy recommendations. At that time, a coalition of advocates, including the three organizations named above, were fresh from a legislative victory that safeguarded tenants unable to pay their rents during the pandemic and gave them a degree …

If A Tree Falls In The Forest: Presidential Press Conferences And Early Media Narratives About The Covid-19 Crisis, Masha Krupenkin, Kai Zhu, Dylan Walker, David Rothschild

Business Faculty Articles and Research

Throughout the COVID-19 crisis, as we confronted questions about social distancing, masking wearing, and vaccines, public safety experts warned that the consequences of a misinformed population would be particularly dire due to the serious nature of the threat and necessity of severe collective action to keep the population safe. Thus, the media and the political elites (e.g., President of the United States) who possess the power to set the information agenda around COVID-19 bear a huge responsibility for the general welfare. Through automated text analysis of complete transcripts of national cable, network, and local news, we explore their narratives surrounding …

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …

Redesigning Price Setting Under The Universal Health Insurance In Egypt / إعادة تصميم التسعير في ظل التأمين الصحي الشامل في مصر, Ahmed El Agamy, Hebatalla Ahmed Ismail, Hend Hassan, Reem Gouda, Samah El Sayed

Papers, Posters, and Presentations

Since the Sustainable Development Goals were adopted by the United Nations Development Programme, Universal Health coverage became the main target for many nations. One of the main challenges facing the governments to achieve universal health coverage is maintaining adequate policies to set fair pricing for the healthcare services. Each country has different strategies to apply fair pricing and this paper is discussing the current pricing methods in Egypt and suggesting three policies to tackle its challenges.

Improving Egypt’S Access To Vaccines And Medicines: Communication During Covid-19 / تحسين إتاحة الوصول إلى اللقاحات والأدوية في مصر: سياسة توعية الجمهور خلال أزمة فيروس كورونا, Alaa Abdel-Rahman, Sarah Attef, Helen Gabrah, Reem El-Sayed, Sarah El-Lithy

Papers, Posters, and Presentations

Since the start of the COVID-19 pandemic, the Egyptian government has been following protocol as best as possible when it comes to responding to the needs of the health and economic sectors amid difficult times. From lockdown measures to the WHO’s recommended practices in terms of isolation of cases and treatments, Egypt has been lauded as one of the fastest and most effective countries in terms of COVID-19 emergency response. Authorities have implemented several awareness campaigns directed at citizens to inform them about the pandemic, how to prevent infection, what to do if infected and how to act accordingly. Authorities …

The Lived Experience: Collective Realities Of Black Maternal Healthcare, Rhonda Parham

West Chester University Doctoral Projects

Maternal health has become an increasingly important public health issue in the United States due to the country elevated levels of maternal mortality rates. As the patient experience which entails a wide variety of interactions between patients and the healthcare system becomes more associated with patient outcomes, it is important to explore how the patient experience is affecting maternal health outcomes. This study consists of in-depth interviews to investigate their experience receiving maternal healthcare in Southeastern Pennsylvania. The study aims to figure out what are black women experiences while receiving maternal healthcare in southeastern Pennsylvania and are those experiences negative. …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Covid-19 And The “Space” Problem Of U.S. Hospitals: A Pragmatic Domestic Policy Solution For The Future, Timothy P. O'Brien

Liberty University Journal of Statesmanship & Public Policy

The healthcare system in the United States operates daily somewhere in excess of 75 percent of capacity with limited ability to absorb a sudden and large surge that may come about from an unexpected event, such as a large-scale terrorist attack, natural disaster, or pandemic. In order to manage a large-scale health crisis, also known as Public Health Emergencies (PHEs), governments at all levels must be prepared and have “space, staff, and stuff” in place. This article offers a solution that utilizes and re-purposes existing structures that could easily be “stood-up” and put into service in the times of emergency. …

Healthcare Of Indigenous Amazonian Peoples In Response To Covid-19: Marginality, Discrimination And Revaluation Of Ancestral Knowledge In Ucayali, Peru, Doreen Montag, Marco Barboza, Lizardo Cauper, Ivan Brehaut, Isaac Alva, Aoife Bennett, José Sanchez-Choy, Juan Pablo Sarmiento Barletti, Pilar Valenzuela, José Manuyama, Italo García Murayari, Miguel Guimaraes Vásquez, Celso Aguirre Panduro, Angela Giattino, Edwin Julio Palomino Cadenas, Rodrigo Lazo, Carlos A. Delgado, Alfonso Nino, Elaine C. Flores, Maria Amalia Pesantes, Juan Pablo Murillo, Luisa Elvira Belaunde, Sergio Recuenco, Robert Chuquimbalqui, Carol Zavaleta-Cortijo

World Languages and Cultures Faculty Articles and Research

"Systematic and persistent discrimination against Indigenous Peoples translates into differential health outcomes when analysed through ethnicity and/or mother tongue.1 In Peru, morbidity and mortality rates among Indigenous Peoples for COVID-19 appear to confirm this.2 The COVID-19 pandemic has highlighted the historical structural violence against Indigenous Peoples that currently takes a disproportionate toll in the Peruvian Amazon. This equally applies to Indigenous Andean Peoples and Afro Peruvians. Indigenous Peoples in voluntary isolation and those in initial contact are at highest health risk in this pandemic as they have no previous immunity against common infectious diseases, and lack access to public healthcare …

Reimagining China’S Transportation Funding Investments In Africa In The Context Of Covid-1, Clovia Hamilton, Sira Maliphol

Technology & Society Faculty Publications

Africa has not invested enough in its healthcare system, and China has been investing in and financing much of Africa’s transportation system. Many African countries’ fragile health and transportation systems have been further weakened by the COVID-19 pandemic. This literature review confirms the interdependence of the key functional areas of comprehensive development planning and the importance of building and maintaining a sound transportation infrastructure. With respect to partnerships with China, African nations need to strengthen government functional areas more comprehensively, considering all of the areas of development planning including trade as well as transportation and aid issues. It is all …

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Preventing Obesity: A Social Ecological Exploration Of Centers For Disease Control Prevention Strategies And Guidance Toward Healthy Eating, Physical Activity, And Communities, Ryan Kelly

Theses and Dissertations

Abstract

Obesity has reached nearly 40% of the adult public in the United States, costing the citizen taxpayer over $200 billion annually in healthcare costs. Those suffering from obesity deal with multiple physical and mental repercussions. Through a content analysis of four Centers for Disease Control (CDC) documents and guided by the conceptual framework of the social ecological model, this research explores the federal approach to preventing obesity. The analysis finds that CDC solutions to obesity involve connecting people to each other and healthier choices, an orientation toward local public administration, and an emphasis on environmental and infrastructure improvements. The …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Essays On Rehospitalization Under The Hospital Readmission Reduction Program, Yangyuna Yang

Theses & Dissertations

The Hospital Readmission Reduction Program (HRRP), a part of the Affordable Care Act (ACA), requires the Centers for Medicare and Medicaid Services (CMS) to penalize hospitals with excess readmissions. The following conditions/procedures with high 30-day readmission rates were included in the program: Acute Myocardial Infarction, heart failure, pneumonia, chronic obstructive pulmonary disease, total hip arthroplasty and/or total knee arthroplasty, and coronary artery bypass graft (CABG). More research needs to be done regarding the national impact of the program. In addition, the risk factors of newly targeted CABG needs to be investigated robustly. Lastly, besides evaluating the risk of readmissions before …

Planned Policy Action, Nicole T. Cesanek

Student Publications

Gettysburg College was built on the foundation of “doing great work,” not just for the betterment of ourselves and our education but also for others in the college and surrounding community. This project seeks to do precisely this, encourage everyone, including students, tourists, and community members, to do great work in benefiting others around them. It primarily consists of a comprehensive summary of the plans and actions required to create a community-wide tab collection bin to benefit the Ronald McDonald House Charities (RMHC). The project seeks to achieve two main goals: encourage people to collect and donate their aluminum can …

Human Trafficking And Gender Inequality In Remote Communities Of Central Vietnam, Bich Ngoc Nguyen, Mark Gordon

Journal of Sustainable Social Change

Human trafficking crime is rising globally at an alarming rate. Vietnam has one of the highest prevalence of trafficking female victims for forced sex and marriages and of girls abandoning school for unskilled work. In this study, we explored human trafficking awareness in remote communities of central Vietnam and the factors for young girls leaving school for work at an early age. The study also investigated a link between gender inequality and child labor. Gender inequality and vulnerability theories provided theoretical constructs and context for face-to-face interviews with 19 villagers, mothers of the child labor victims, teachers, human services workers, …

Peer Verbal Sexual Harassment In Early Adolescence: A Feminist And Sexual Scripts Theoretical Approach., Shawn M. Rolfe

Electronic Theses and Dissertations

Until recently, sexual harassment research has focused primarily on adults and college and high school students with little attention given to younger students. While recent research has noted sexual harassment occurs among younger students, the literature addressing sexual harassment among middle school students is still sparse. Additionally, most studies of sexual harassment have focused on sexual harassment generally, with no distinction made between verbal and sexual harassment. In fact, only limited research has been exclusively conducted on verbal sexual harassment. Using self-report data, the current study adds to the literature by examining the nature of verbal sexual harassment as well …

Who Pays For Gun Violence? You Do., Edda S. Fransdottir, Jeffrey A. Butts

Publications and Research

The total economic impact of gun violence is unknown. Studies focus on the direct and short-term expenses immediately following a shooting but often exclude the long-term and far-reaching effects of gun violence on the victim, their family, and their community. Available data vastly underestimate the full economic impact of firearm injuries in the United States, including the fact that taxpayers often get the bill.

Non-Traditional Church Involvement As A Life-Course Turning Point: Qualitative Interviews With Religious Offenders, William Hunter Holt

Dissertations

This research project conducted and then analyzed qualitative interviews from former and current addicts and criminal offenders who are voluntarily participating in the Christian faith at the same non-traditional, Protestant church. An abridged case study of this church is also provided for background and context. Life-course theory and grounded theory are utilized.

Both the offenders and this church were chosen in an attempt to better understand how the offenders’ involvement at this house of worship, along with their faith in general, have impacted them. Obtaining the perspectives of the offender is essential for three reasons. First, qualitative research conducted in …