Health Policy Commons^™

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 …

Boomers And Fraudsters: A Closer Look At The Financial Elder Abuse Cycle In America, Ryan E. Brown

Marriott Student Review

In 2011, a landmark study was published by the Metlife Mature Market Institute claiming that nearly $3 billion disappears from the wallets and bank accounts of senior citizens annually. More surprising is that a similar study reported that figure could be as high as $36 billion. Because so many seniors let incidents of fraud or financial deceit go unreported, there is a huge discrepancy in annual reporting. This contributes to the overall lack of understanding we have of elder financial abuse, or why seniors continue to lose to fraudsters and scam artists. In a brief overview of financial elder abuse …

La Comunicación Intercultural Entre Pacientes Bolivianos Y Trabajadores De Salud En Buenos Aires, Argentina / Intercultural Communication Between Bolivian Patients And Health-Care Workers In Buenos Aires, Argentina, Lilly Snellman

Independent Study Project (ISP) Collection

Según la Ley de Migraciones 25.871 de 2004, los inmigrantes en Argentina tienen el mismo derecho a la atención médica que los argentinos nativos. El sistema de salud argentina es uno de los más inclusivos en el mundo, pero todavía hay barreras al acceso para comunidades e individuos marginados. Muchas veces los migrantes bolivianos son discriminados en la sociedad argentina por sus rasgos raciales, bajo nivel socioeconómico y diferencias culturales. Tres clases importantes de barreras para el acceso a la atención médica para los migrantes son las económicas, estructurales y comunicativas. En este estudio, decidí enfocarme en las brechas de …

The Hapless State Of Amyotrophic Lateral Sclerosis In India: A Comprehensive Look At Life And Medical Services For Als Patients In Rural Himachal Pradesh, Carson J. Bergström

Independent Study Project (ISP) Collection

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a neurodegenerative disorder that leads to paralysis. The disease requires a high amount of medical intervention and interdisciplinary focus to achieve quality of life for patients. This study looks at ALS patient’s lifestyles, their access to these medical devices, Indian therapeutic approaches and policy that impacts patients in Shimla, Himachal Pradesh. As caretakers have a critical part in the care for this disease, their lives were also considered in the case studies. It was found that ALS patients are not experiencing access to medical devices necessary for life because of physical …

Intersections Between Health And Disability: A Case Study At Disha Centre, Jaipur, Rajasthan, Finnian Brokaw

Independent Study Project (ISP) Collection

This study investigated intersections between health and disability by asking the question: how do community perceptions of disability at Disha: A Resource Centre for the Disabled in Jaipur, India relate to health and quality of life for a person with multiple disabilities? This study utilized a case study methodology. The researcher took qualitative interviews from six respondents in the immediate educational and familial support network of a 27-year-old man with multiple disabilities. An interview based, qualitative methodology was important for investigating the complexity of perceptions of multiple disabilities and health as intersecting identities. The responses were analyzed and reflected upon …

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

Salud Mental Comunitaria: Implementación En Chile Actual, Emma Baker

Independent Study Project (ISP) Collection

This study explores how familiar community mental health organizations in Valparaíso follow an established model of community mental health, derived from a variety of essays, books, and reports on the topic. Additionally, it serves to present the effect of this relationship on the contemporary social revolution in Chile. The present social and political unrest, manifesting itself in massive protests throughout the country, presents a unique moment in which these themes can be examined. Additionally, Chile encounters high rates of psychological disorders among its population, a lack of protection for the mental health of children and adolescents, and a lack of …

La Pertinencia Cultural De Los Proyectos Relacionados A La Planificación Familiar De Las Ongs En El Distrito De Acomayo, Sadie Traylor

Independent Study Project (ISP) Collection

Esta investigación identifica y analiza la pertinencia cultural de los esfuerzos de ayuda ambos de una ONG local (Kallpa) y de una ONG internacional (Plan International), examinando específicamente el proyecto de cada ONG vinculado al aumento del acceso y uso de la planificación familiar en el Distrito de Acomayo en la región de Cusco para evaluar cómo opera (o no opera) cada ONG con una pertinencia cultural. Además, esta investigación explora la forma en que las estrategias de cada ONG mantienen un enfoque intercultural, y también analiza las percepciones de los beneficiarios del proyecto como testimonios de cómo este método …

Reexamining The Impact Of Medicaid Expansion In A Post-Affordable Care Act Environment From A Critical Race Perspective, Ty Price Dooley

Journal of Public Management & Social Policy

The passage of the Patient Protection and Affordable Care Act (ACA) in 2010 drastically transformed the health care system in the United States. This paper examines the factors influencing state decisions relative to Medicaid expansion in a post-ACA environment through the lens of Critical Race Theory. This study incorporates economic, geographic and health variables into a model of post-ACA-Medicaid decision-making by using logistic regression to examine State Medicaid expansion from 2010 to 2014. The size of the minority population in state, tobacco use and southern distinctiveness are significant predictors of decision making relative to Medicaid expansion. Findings support that racialized …

“Greening” Worcester: Municipal Best Practices For Sustainability, Erin Mckeon, Charline Kirongozi, Jared Duval, Antannia Greene, Qianshu Sun, Zewei Yao

School of Professional Studies

In response to the urgent threat posed by climate change, more and more cities, including Worcester, are attempting to become more environmentally responsible and sustainable. Worcester is attempting to develop ways to become more sustainable; both to strengthen their communities and to protect the planet. The Green Worcester Working Group (GWWG) tasked the Clark Capstone Team with researching best practices for municipal sustainability. The GWWG has set the following priorities: climate change mitigation, resilience, open spaces, sustainable resource management, education and awareness. Taking these into account, the Clark Capstone Team researched the sustainability practices of cities in New England, across …

Worcester Chamber Of Commerce: Recruiting Minority Business Owners, Ryan Dimaria, Alexander Hull, Xikun Lu, Haopeng Wang, Jiacheng Hou, Danning Zhao

School of Professional Studies

Our capstone project was to help the Worcester Regional Chamber of Commerce identify how to re-frame their marketing so it would be appealing to immigrant and minority owned businesses. Based on interviews and external research, our group was able to create a tangible and resourceful data set that provided justified recommendations and ideas on how the Chamber could make adjustments to their marketing plan to attract more businesses of this particular demographic in the city of Worcester. By implementing these recommendations, we believe the Chamber has the opportunity to create a more diverse group of Chamber members, add value to …

Service Now: Cmdb Research, Monika Patel, Smita Patil, Katerina Tzanavara, Manish Chauhan, Yuhao Wang, Houmin Xie, Lei Shi

School of Professional Studies

The MAPFRE Capstone team has been tasked with reviewing and recommending roadmap on the existing CMDB configuration. Paper discusses the team’s overall research on ServiceNow CMDB, Client’s deliverables and introduction to the latest technological innovations. Based on given objectives and team’s analysis we have recommended key solutions for the client to better understand the IT environment areas of business service impact, asset management, compliance, and configuration management. In addition, our research has covered all the majority of the technical and functional areas to provide greater visibility and insight into existing CMDB and IT environment.

For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li

School of Professional Studies

The entirety of this project was completed on the foundation of the three focus areas, which were identified by our client as areas of high need. The client wanted to prioritize these three areas as they believed that these three areas were the most integral to the successful achievement of their mission, as well as to the overall health and longevity of the organization.

Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva

School of Professional Studies

There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.

Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak

School of Professional Studies

One of Worcester Interfaith’s goals is to eradicate the stigma of affordable housing in Worcester. Currently, the perception of affordable housing is of an image of unkept and old residences filled with destitute citizens who cannot afford basic needs to live in a city, let alone housing. This image is perpetuated by media, stigma, and a lack of education of the true reality of affordable housing and who its recipients are. Affordable housing-qualified citizens represent a range of educations, professions, age, race, and income levels. Affordable housing units, too, represent a variety of homes, many of which are extremely well-kept …

Sweeping Exposures: Lead Poisonings And Black Working Poor Populations In The United States, Shirley Reid

Dissertations, Theses, and Capstone Projects

The focus of my thesis is to explore some of the realities that the impoverished urban black poor populations face in America today. The goal of my thesis is to illustrate how poverty is reproduced within impoverished neighborhoods through the idea and mechanism of lead exposure, by recognizing how specific exposure to the element lead and its by-products is both a symbol and a material cause of black urban poor illness and disability. There is no mistake that people living in the U.S. are aware of the social injustices against black populations in the form of racial injustice. However, …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

From The American People: An Autoethnographic Exploration Of South African Ngos' Perceptions Of Pepfar, Antonia Asher

Independent Study Project (ISP) Collection

The aim of this research was to understand what the ideal partnership would be between United States (US) governmental aid agencies and South African non-governmental organizations (NGOs), specifically concerning HIV/AIDS programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), from the perspective of NGOs. PEPFAR is the largest relief fund for a single disease; thus, I additionally sought to deeply reflect upon myself as a US citizen in South Africa, a country that has received trillions of dollars from taxpayers such as myself.

To accomplish this, I interviewed NGO staff about the nature of current partnerships, outcomes …

Characterizing Systems Of Reporting And Mitigating Anthrax Outbreaks Near Mto Wa Mbu, Monduli District, Tanzania, Megan Levy

Independent Study Project (ISP) Collection

Northern Tanzania has experienced several anthrax outbreaks in the recent past. In Monduli district, an outbreak in 2016 prompted an organization of district officials to create an updated outbreak response action plan. The pastoralist community is often affected by these outbreaks due to their frequent direct contact with cattle and herds’ proximity to wild species potentially affected by the disease. This characterization of the existing systems of reporting and mitigating anthrax outbreaks was accomplished through structured interviews with ward and village officers, local veterinarians, and members of the pastoralist community in Monduli district near Mto wa Mbu. The purpose of …

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Nationalizing Services For The Trans-National: How Sub-Saharan Migrants Navigate Healthcare Access In Tunisia, Batoul Hasan

Independent Study Project (ISP) Collection

The right to human health and the resources that empower this state is an entitlement recognized under international law. With the circumstances surrounding their journeys, migrants face increased risks and vulnerabilities that necessitate social protections. Nations of reception, due to exclusionary policies or lack of capacity, may fail to guarantee these protections. This study investigates how this phenomenon unfolds in Tunisia, a middle-income nation undergoing a host of political and economic changes, but one that’s nonetheless become an alluring destination for migrants, specifically those from sub-Saharan African nations. The analysis proceeds from an assessment of the public health situation in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

El Rol De Los Agentes Sanitarios Para Mejorar El Acceso A La Salud Sexual Y Reproductiva Para Mujeres En San Carlos, Mendoza. / The Role Of Agentes Sanitarios In Improving Access To Sexual And Reproductive Health For Women In San Carlos, Mendoza., Laura Hult

Independent Study Project (ISP) Collection

Introducción: Es evidente que Argentina tiene un enfoque que atiende a la salud sexual y reproductiva, dado que tiene cobertura universal y la ley de Programa Nacional de Salud Sexual y Procreación Responsable que establece un estándar de cuidado para toda la población. Sin embargo, cobertura universal no implica acceso universal, el cual que está determinado por el transporte, el idioma y la cantidad de recursos de la región. En lugares como San Carlos, Mendoza, donde no hay transporte regular y hay pocos recursos, existe inequidad en la salud, lo que puede aumentar las tasas de embarazos no intencionales y …

Los Microcosmos De La Interculturalidad? Una Mirada Al Cómo Los Trabajadores De La Salud Biomédica De Orígen Indígena Relacionan Con Los Modelos De Salud Tradicional Y Occidental, Taylor Lord

Independent Study Project (ISP) Collection

Research Question: How does a biomedical health professional with indigenous roots in Chile relate the biomedical model of healthcare with the alternative indigenous model in their practice?

Objectives: The primary objective of this study was to understand how and if a biomedical health professional with indigenous roots relates and integrates two models of healthcare in their daily practice. A Secondary objective was analyzing if integration affects philosophy of care in relation to patients in critical conditions. In sum, it looked to study biomedical health professionals with indigenous roots as potential microcosms of interculturality that can demonstrate the benefits of a …

Is Technology The Key To Prevention Of Falls Among The Elderly In Rapidly Aging Societies? A Case Study Of Kunming, China, Phoebe Kiburi

Independent Study Project (ISP) Collection

As the aging society rapidly becomes more dominant in the world, there is a pressing need for different stakeholders to tend to the needs of the aging sufficiently. This is crucial in ensuring the robustness of the healthcare system as a whole; given that it can only be as strong as its weakest link. This study focuses on one of the areas of need of the ageing society: fall prevention.

Numerous studies have been done on interventions by the government, private entities, elderly people and their caregivers to prevent occurrence and recurrence of falls. However, most of these have been …

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

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 …

We Should Promote Harm Reduction To Combat The Opioid Overdose Crisis, Alexandra Punch

Population Health Research Brief Series

Over 70,000 people in the U.S. died from drug overdoses last year, and the U.S. continues to struggle with how to address this crisis. This issue brief explains the concept of harm reduction, describes various types of programs that fall under the harm reduction model, and discusses the promises these approaches hold for helping to combat the current opioid crisis.

A Roadmap To Competitive Integrated Employment: Strategies For Provider Transformation, Esther Kamau, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Competitive integrated employment is defined within the Workforce Innovation and Opportunity Act (WIOA, 2014) as full-time or part-time work at minimum wage or higher, with wages and benefits similar to those without disabilities performing the same work, and fully integrated with coworkers without disabilities. The Act requires that states ensure employment is offered as a priority outcome for people with intellectual and developmental disabilities (IDD). As a result, providers who offer employment support to people with IDD have been working to phase out sheltered workshops and transform to offer competitive integrated employment.