Health Policy Commons^™

The Effect Of The Affordable Care Act Medicaid Expansion On The Risk Of Hospital Closure And Adolescent Hpv Immunization In Rural Counties, Juliette Des Rosiers

Scripps Senior Theses

From 2005 to 2025, over 200 rural hospitals shut their doors, often citing increased operational costs, staffing shortages, low patient volume, regulatory barriers, financial challenges exacerbated by the COVID-19 pandemic, and uncompensated care as common contributors to the closures. Rural patients are often referred by their primary care physician to a hospital for regular immunizations, since smaller clinics have less capacity to provide immunizations due to a shortage of pediatricians and limited vaccine stock. A crucial vaccine that is not required by schools and underutilized in rural areas is that against human papillomavirus (HPV), a virus that infects cutaneous and …

Improving Maternal Health: Investigating The Early Impacts Of Medicaid Coverage Of Doulas In Oregon, Miriam Akhmetshin

Scripps Senior Theses

While the U.S. spends more per-capita than any country on healthcare, we experience the worst maternal health outcomes of high-income nations. In addition to hefty healthcare bills, an overwhelming majority of mothers experience pregnancy-related health issues that decrease productivity and utility. Thus, it is critical to research cost-effective solutions that can improve maternal health and promote equitable outcomes. Doulas are trained non-medical professionals who support mothers and families before, during and after birth. As a growing body of medical literature points to the role of doulas in decreasing costly medical interventions, insurance companies have begun covering their services. In 2014, …

Food Stamp Participation And Health Outcomes In Ca Immigrants, Esther Kang

Scripps Senior Theses

The U.S. social welfare system includes programs aiming to increase access to nutritious food to reduce nutrition insecurity. However, studies suggest that immigrants continue to face disproportionate risks of nutrition insecurity and may face barriers to enrollment due to legal status. This study, using secondary data from the 2023 California Health Interview Survey, examines the associations between food stamp participation, food insecurity, and clinical diagnosis of diabetes among adult U.S.-born, naturalized, and non-citizen adults in California. The findings suggest that those enrolled in food stamps are more likely to report food insecurity than those who are not enrolled, and that …

Understanding The Flow: Deconstructing The Link Between Immigrants And Fentanyl, Madeline F. Nesbitt

CMC Senior Theses

This thesis explains how a false link between undocumented immigration and fentanyl becomes widely accepted in the United States. Empirical data show that most fentanyl enters through legal ports of entry and that U.S. citizens account for the majority of those caught transporting it. Why, then, do 41% of Americans attribute overdose deaths to migrants trafficking fentanyl? This project examines how this myth is built, repeated, and sustained, and what policy consequences follow from it.

When complex social problems lack clear culprits, political actors often manufacture them through scapegoating. Current literature documents how political actors link immigrants to drug crimes, …

Faltered States: The Rise, Fall, And Containment Of Psychedelic Science In The United States, Baxter Brew

CMC Senior Theses

This thesis traces the history of psychedelic science in the United States and its implications for policymaking. In the postwar period, psychedelic researchers were enabled by a unique convergence of optimism in medical science and structural flexibility. But their hope blinded them to the deeper tensions of their field. As institutions grew increasingly rigid and risk-averse, the space for psychedelics began to close. Some scientists responded by fortifying the walls around them, developing socially and professionally acceptable research methods. Others tried to escape these walls entirely. But neither approach could prevent psychedelics from being squeezed out of formal inquiry. Yet …

Fitting A Covid-19 Model Incorporating Senses Of Safety And Caution To Local Data From Spartanburg County, South Carolina, D. Chloe Griffin, Amanda Mangum

CODEE Journal

Common mechanistic models include Susceptible-Infected-Removed (SIR) and Susceptible-Exposed-Infected-Removed (SEIR) models. These models in their basic forms have generally failed to capture the nature of the COVID-19 pandemic's multiple waves and do not take into account public policies such as social distancing, mask mandates, and the ``Stay-at-Home'' orders implemented in early 2020. While the Susceptible-Vaccinated-Infected-Recovered-Deceased (SVIRD) model only adds two more compartments to the SIR model, the inclusion of time-dependent parameters allows for the model to better capture the first two waves of the COVID-19 pandemic when surveillance testing was common practice for a large portion of the population. We find …

Emerging From Behind The Curtain: A Comparative Analysis Of Polish And Czech Reforms Based On Quality Of Life Improvements, Summer Ellis

CMC Senior Theses

This thesis examines the economic reforms undertaken by Poland and the Czech Republic during the 1990s transition period. It seeks to ultimately differentiate reform quality between the Czech Republic and Poland in terms of well-being. The basis of reform success is determined using a quality of life scale that spans economic, health, and environmental indicators. Reform quality is then assessed based on improvements in well-being, instead of high-level economic metrics that often evaluate in a manner that fails to capture individual citizen sentiment. From this point, it is possible to determine which transitioning country underwent the most optimal reform process …

Challenges Of Nutrition In Malaysia: Poverty, Land Appropriation, And Indigeneity, Jeanie Kim

CMC Senior Theses

Malnutrition, especially in the form of wasting, stunting, and obesity, is disproportionately harming the Indigenous communities in Malaysia. Under the current legal system, Indigenous people receive little to no recognition and protection. Their land is often appropriated by the oil palm and dam industries, resulting in higher incidences of malnutrition and poverty. In order to improve the nutritional status of Malaysia as a whole, potential policies and programs include food fortification, crop diversification, and social safety nets. For the most marginalized communities, indigeneity and land restitution are analyzed as avenues to improve their livelihood.

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …

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 …

Politics Of The Obesity Epidemic, Jacob Lyle

CMC Senior Theses

American society has long been obsessed with the issue of obesity. The turn of the 20th century broadly marked the beginning of America's current collective understanding of obesity. Throughout the century, the salience of the issue waxed and waned due to various factors. Around 2000, obesity became a major political issue. Media coverage of the issue exploded, and it became a hot topic for political debate. This paper looks to conduct a complete reckoning of the obesity epidemic that includes contextualizing the economic, cultural, and political factors that have shaped the issue throughout the 20th and 21st centuries.

An Analysis And Critique Of Mental Health Treatment In American State Prisons And Proposal For Improved Care, Shelby Hayne

Scripps Senior Theses

Mental health treatment in state prisons is revealed to be highly variable, under-funded, and systematically inadequate. Existing literature exposes this injustice but fails to provide a comprehensive proposal for reform. This paper attempts to fill that gap, outlining a cost-effective, evidence-based treatment proposal, directly addressing the deficits in care revealed through analysis of our current system. In addition, this paper provides historical overviews of the prison system and mental health treatment, utilizing theoretical perspectives to contextualize this proposal in the present state of affairs. Lastly, the evidence is provided to emphasize the potential economic and social benefits of improving mental …

Campaigning On An Environmental Justice Platform: Irmalinda Osuna For Upland City Council, District 3, Jenny Bekenstein

Pitzer Senior Theses

After successfully organizing around preserving Cabrillo Park in Upland and feeling a lack of local political representation, Irmalinda Osuna ran for Upland City Council in the 2018 midterm elections. As one of the many female candidates in the 2018 elections, Irmalinda led a grassroots, community-led political campaign in which she advocated for environmental justice and the preservation of parks, a more inclusive community, increased civic participation, a more efficient use of technology in politics, and support for small businesses.

Put Your Money Where Your Mouth Is: Reforming Organized Dentistry To Address Persistent Oral Health Disparities In The U.S., Aparna Chintapalli

Pomona Senior Theses

The importance of oral health has been largely neglected from the conventional standards of healthcare in terms of public understanding & prioritization, the industrial infrastructure, and the scope of prevention & early-intervention services. Its adjunctive locus to the field of medicine has lead to the bifurcation of the oral cavity from the rest of the human body. As a result of this divide, there have been multiple factors that have allowed socially stratified oral health outcomes to manifest. This thesis examines the determinants of oral health disparities through a multidisciplinary lens (i.e. biology, public policy, infrastructure), and offers evidence of …

Individual Bodies, Informed Consent, And Self-Determination: A Rhetorical Analysis Of The Vaccine Refusal Movement, Gretta Richardson

Scripps Senior Theses

This project sought to explore the narratives and rhetorical themes that permeate the anti-vaccination movement. Mass media has portrayed vaccine refusal groups as stupid, as conspiracy theorists, and as radically selfish. However, the data I analyzed from vaccine refusal nonprofits and advocacy groups supports that although these themes may appear to be radical, in reality, each is congruent with already present societal frameworks, particularly neoliberal social discourse and a preoccupation with the individualistic and self-determined health care rather than utilitarian or collective action.

Paid Parental Leave In The United States: Reconciling Competing Demands, Sydney Joseph

CMC Senior Theses

The United States is the only developed nation that fails to provide its citizens with paid parental leave. The lack of parental benefit provision operates to the detriment of individuals and society as a whole by contributing to inequity across gender, race, socioeconomic status, and sexual orientation. As the demographics of the American workforce have changed, public policy has not kept pace. Paid parental leave is associated a number of health, economic, and social benefits. However, the greatest barrier to legislating paid parental leave is the philosophical underpinnings of American politics, specifically the strong current of liberal individualism and absence …

The Socio-Political And Economic Causes Of Natural Disasters, Nicole Southard

CMC Senior Theses

To effectively prevent and mitigate the outbreak of natural disasters is a more pressing issue in the twenty-first century than ever before. The frequency and cost of natural disasters is rising globally, most especially in developing countries where the most severe effects of climate change are felt. However, while climate change is indeed a strong force impacting the severity of contemporary catastrophes, it is not directly responsible for the exorbitant cost of the damage and suffering incurred from natural disasters -- both financially and in terms of human life. Rather, the true root causes of natural disasters lie within the …

Multi-Year Optimization Of Malaria Intervention: A Mathematical Model, Harry J. Dudley, Abhishek Goenka '15, Cesar J. Orellana '17, Susan E. Martonosi

All HMC Faculty Publications and Research

Malaria is a mosquito-borne, lethal disease that affects millions and kills hundreds of thousands of people each year, mostly children. There is an increasing need for models of malaria control. In this paper, a model is developed for allocating malaria interventions across geographic regions and time, subject to budget constraints, with the aim of minimizing the number of person-days of malaria infection.

What's In A Name? Effects Of The "Mentally Ill" Label On Autonomy, Miriam E. Cruz

CMC Senior Theses

Over the past years, mental health has attracted increased attention throughout the world, in the form of initiatives, programs, support groups, etc. all with goals to increase awareness and support of mental health. The stark discrepancy between the vision driving this mental health movement and our reality comes from a basic misunderstanding. While there are both legislative and cultural efforts in place to reform our mental health system, the two must work hand in hand in order to affect substantial change. Rather than producing a collaborative effort, our legislators and society tend to ignore each other, resulting in isolated attempts …

Earth, Air, Water, Oil: Regulating Fracking In The Monterey Shale With Health And Environment In Mind, Gideon J. Salzman-Gubbay

Pomona Senior Theses

“Earth, Air, Water, Oil: Regulating Fracking in the Monterey Shale with Health and Environment in Mind,” explores how hydraulic fracturing regulation in California’s oil-rich Monterey Shale will impact regional public health, including groundwater and air quality. This is achieved through a combination of case study and policy analysis on both the state and national level.

Linkage Politics And The Persistence Of National Policy Autonomy In Emerging Powers: Patents, Profits, And Patients In The Context Of Trips Compliance, Aseema Sinha, Tricia Olsen

CMC Faculty Publications and Research

The Trade Related Intellectual Property Agreement (TRIPS) has had a profound effect on industrialization and innovation, as well as access to medicines in cases of public health crisis such as HIV/AIDS. However, compliance with TRIPS has varied in developing countries, despite heightened international pressure. For instance, Brazil has pursued a coherent approach to its HIV/AIDS health crisis, while India has failed to take care of its HIV patients despite late compliance with the TRIPS agreement and the presence of business firms that produce the generic medicines for HIV/AIDS. This article suggests that divergence in TRIPS compliance is the result of …

Deinstitutionalization And Its Discontents: American Mental Health Policy Reform, Olga Loraine Kofman

CMC Senior Theses

In 1963, President John F. Kennedy signed the Mental Retardation and Community Mental Health Centers Construction Act, establishing the beginnings of deinstitutionalization in the United States. By some counts, this Act was a stupendous policy success—by others, a dismal failure. 50 years later, no cohesive national mental health care policy has emerged to deal with increased rates of mental illness among the homeless and the incarcerated. However, California has made enormous strides to create a state policy which provides adequate services to the mildly, moderately, and severely mentally ill as well as adequate funding for those services through Proposition 63, …

Sector-Switching In Transition Economies: A Case Study Of Kazakhstan's Health Care Sector, Dariga Chukmaitova

CGU Theses & Dissertations

The dissertation examines the economic and behavioral factors influencing 'sector-switching' in Kazakhstan's health care industry. Sector-switching involves doctors moving from the national to the private system, which is not well established, thereby raising questions about why the switch occurs. It addresses the question: why health care professionals in Kazakhstan switch from the public sector to similar jobs in the private or nonprofit sectors? This study addresses a key issue in public management (sector switching) and also offers insights into the dynamics of the transition from a centralized economy to a market economy. As such, its findings have `real-world' applications beyond …

When Curiosity Kills More Than The Cat: The Perils Of Unchecked Scientific Inquiry, Jamie Shannon

Pomona Senior Theses

This work analyzes the ecological, physical, emotional and health impacts of the US nuclear testing done in the Marshall Islands in the mid-20th century.

The Intersection Of Public Policy And Health Behavior Theory In The Physical Activity Arena, Genevieve Dunton, Michael Cousineau, Kim D. Reynolds

CGU Faculty Publications and Research

Background:

Policy strategies aimed at modifying aspects of the social, physical, economic, and educational environments have been proposed as potential solutions to the growing problem of physical inactivity. To develop effective physical activity policies in these and other areas, greater understanding of how and why policies successfully impact behavior change is needed.

Methods:

The current paper proposes a conceptual framework explaining how policy strategies map onto health behavior theoretical variables and processes thought to lead to physical activity change. This framework is used to make hypotheses about the potential effectiveness of different policy strategies.

Results:

Health behavior theories suggest that …