Health Policy Commons^™

The Growing Needs For Young Adults’ Behavioral Health Services In Oregon And Pathways For Sustainable Service Deliveries, Anis Zaman

Hatfield Graduate Journal of Public Affairs

Recent OHA data indicate a significant surge in behavioral health cases among young adults ages 17-26 across Oregon. Every year in Oregon, the total number of young adults receiving medical treatment includes a significant number of them who have behavioral health challenges. This large group of young adults with mental health conditions is vulnerable to suicidal ideation and substance overdose. Despite sincere efforts by the Oregon Health Authority (OHA), the young adult mental health state of Oregon remains a concern. Therefore, there is a need for a comprehensive action plan for the sustainable delivery of mental health services to young …

Activity Levels Among Older Adults In A Life Plan Community, Emily D. Winters

OHSU-PSU School of Public Health Annual Conference

This study aimed to analyze resident's knowledge of the health and wellness programs available to them in their facility. It explored activity levels, preferred activity methods, and health and wellness program utilization among older adults residing in a life-plan community. A total of 166 survey respondents, aged 65 and older, were included in the analysis. Data were collected using a self-administered questionnaire designed to assess physical activity patterns, preferences for activity types, and engagement with the facility’s health and wellness offerings. Open-ended questions were assessed qualitatively through thematic analysis to find common themes within data. Results indicated that the most …

Comparing Cpr Ventilation Strategies Within Tualatin Valley Fire And Rescue Using A Retrospective Observational Cohort Study, Jack T. Hindley

OHSU-PSU School of Public Health Annual Conference

Study Objective: This was a registry based retrospective observational cohort study of roughly 1,150 cardiac arrest cases transported by the Tualatin Valley Fire and Rescue emergency medical service (EMS) agency to hospitals in the Portland area from 2018-2019 and from 2022-2023 to compare cardiopulmonary resuscitation (CPR) ventilation policy changes between these two years from continuous chest compressions (CCC) to a compression ventilation ratio of 30:2. Hospital outcomes were linked to EMS records through trauma registries, state discharge and emergency department data. The primary outcome was survival to discharge, and the secondary outcome was positive neurological outcome (Cerebral performance category score …

Academyhealth - 2024 Data Visualization Winners, Chelsea Keating, Emily Boniface, Mina Colon

OHSU-PSU School of Public Health Annual Conference

Social determinants of health, such as income, employment, social contexts, and the built environment, influence the risk of food insecurity. Food insecurity can be defined as uncertain access to food and can lead to negative health outcomes like increased risk for obesity, chronic disease, and adverse effects on a child's development and mental health. Drivers like limited physical access to food, limited transportation options, and the quality and access to food assistance programs within local systems perpetuate health disparities—particularly in those communities with populations who have been systematically marginalized. This descriptive study uses 2022 data from the National Health Interview …

Exploring Health Equity With Culturally Specific Providers Of Permanent Supportive Housing, Judith R. Solomon

OHSU-PSU School of Public Health Annual Conference

Chronic homelessness is an important public health issue. Permanent Supportive Housing (PSH) is a promising opportunity for transitioning people experiencing homelessness into housing, however there remain unaddressed racial inequities in service provision and outcomes. The aim of this study is to better understand the role of culturally specific (CS) providers of PSH in improving health equity. I analyzed interviews with CS PSH providers for themes related to health and healthcare. Providers spoke about the importance of connecting clients to healthcare. Providers stressed the importance of honesty and lived experience, highlighting the strong sense of responsibility to the community. Providers also …

Comparing Acuity Of Patient Care At Student Run Free Medical Clinic Locations, Hana Warmflash, Olivia Krol, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Intro:

Student run free medical clinics (SRFC) are present at roughly 75% of Association of American Medical Colleges member institutions1,2 providing care for underserved populations, such as those experiencing houselessness. 3 Persons experiencing houselessness have a higher burden of illness than housed persons but experience a greater barrier to obtaining care4. Delays in care result in more complex and longer hospitals stays4,5.

Our SRFC, Bridges Collaborative Care Clinic (BCCC), functions to address emergent complaints and monitor chronic health conditions. We aim to demonstrate how relocating from River District Navigation Center (RDNC) to a more accessible location, Resource Center (RC), enabled …

How To Kill A Human: Creating An Immersive Learning Game, Théo Caldwell, Nathan Bonnell

OHSU-PSU School of Public Health Annual Conference

How to Kill a Human is an experiment in teaching through gameplay. The environmental crisis facing the planet, though denied by many, is a collection of well-documented historical environmental catastrophes. The purpose of this project was to design a method of relating the impacts of environmental systems on human health, highlighting the dangers of ill planned human tampering, by presenting hypothetical environmental catastrophes and then relating them to documented historical disasters. In pursuit of this goal, we designed a semi-collaborative game for three to six players with a suggested age rating of 10+, ideal for teaching individuals of middle school …

Differences Between Stem Students And Faculty On Seeing Value In A Classroom Belonging Exercise, Kaisa S. Holt

OHSU-PSU School of Public Health Annual Conference

Efforts to enhance belonging in undergraduate STEM classrooms are believed pivotal for student success. However, we must not only promote belonging interventions but also understand STEM students and faculty perceptions of their value and utility. We gathered perspectives of faculty and undergraduates regarding the implementation and efficacy of a belonging exercise (Our Lives Lived, OLL) used in multiple STEM classes at one university over two years. We hypothesized that students would see more value in the exercise than faculty. We sent a survey instrument with an OLL summary and a series of open-ended responses to faculty. We recruited for focus …

Primary Health Care: Strengthening Health Systems In Low- And Middle-Income Countries, Erin Young

OHSU-PSU School of Public Health Annual Conference

In recent decades, global health priorities have shifted away from promoting selective, donor-led interventions and towards the goal of strengthening primary health care systems in low- and middle-income countries. This project seeks to identify recommendations for and best practices of primary health care system development from the existing literature. A critical literature review was conducted using the Ovid-MEDLINE database to identify articles that focused on primary health care, included recommendations for health systems strengthening, and addressed low- and middle-income countries. Ultimately, 27 articles published between 2004 and 2019 were included in this review. Results suggest that important priorities for building …

Universal Health Care, Oregon, Jennifer S. Arnold, Bethany Clouse, Alec Martin

OHSU-PSU School of Public Health Annual Conference

Historically, the US has chosen not to fund universal health care at every opportunity, leaving our nation as the only industrialized country without some system of health coverage for our citizens and with the worst health care outcomes of any high-income nation in the world. Health care in Oregon is no exception. Our current health care system is financially unsustainable, harmfully complex, and socially unjust, as well as inequitably delivered. Too many Oregonians, because of their race, age, income, geography, or insurance, endure vastly different health care access, varied health care quality, and wide-ranging health outcomes. In 2019, the Oregon …

Behind The Walls: The Implications Of Assisted Living Building Codes On Resident Safety, Adam Pennavaria, Lindsey Smith, Paula Carder, Cassandra Hua, Eric Jutkowitz, Kali Thomas

OHSU-PSU School of Public Health Annual Conference

As the US population collectively ages, issues related to assisted living (AL) resident safety have become an increasingly pressing issue for the general public, reflected by major media reporting in the last year. The building codes that govern ALs play an important role in mitigating the risks associated with falls, wandering, and other hazards, especially for residents living with Alzheimer’s disease and related dementias. We sought to understand how states vary in their approaches to building code regulations that might impact resident safety. We used search term-based text retrieval to identify areas of text relevant to locks, alarms, and egress …

Expanded Patient Reach At New Student Run Free Medical Clinic Location, Olivia Krol, Hana Warmflash, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Background: Critical to modern medical education, student run free medical clinics (SRFCs) are present at more than 75% of AAMC member institutions. SRFCs educate students while providing low-barrier, free healthcare to underserved populations. SRFCs provide unique leadership and health systems management opportunities not traditionally emphasized in training, including leading logistical and operational changes.

In this project, we highlight the impact of a student-led operational initiative that transitioned our clinic from the River District Navigation Center (RDNC) to the Resource Center (RC), improving accessibility.

Methods:

Deidentified patient data from medical clinics from January 2024 to February 2025 were analyzed using RStudio …

Assisted Living, Residential Care, And Memory Care Staffing Level Dynamics: Oregon, 2017–2023, Sarah Dys, Ozcan Tunalilar

Institute on Aging Publications

Objectives

To examine changes in staffing levels over time in Oregon assisted living and residential care (AL/RC) communities between 2017 and 2023.

Design

Longitudinal study of licensed AL/RC communities.

Setting and Participants

A total of 1720 setting-year observations from 535 individual AL/RC communities in Oregon between 2017 and 2023.

Methods

Primary data were collected through the Oregon Community-Based Care (CBC) study. Staffing levels were estimated as care staff hours per resident per day and reported overall and by staff type, including registered nurses, licensed practical nurses, certified nursing assistants, certified medication aides, unlicensed care staff, life enrichment staff, and social …

Promoting Cultural Humility, Belonging, And Inclusion To Improve Well-Being Among Direct Care Staff In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Jacklyn Kohon, Dani Himes, Laura Rodriguez, Sarah Dys, Paula Carder, Diana Jacoby, Madeline Fox

Institute on Aging Publications

The voices and experiences of those working and living in assisted living, residential care, and memory care (AL/RC) settings in Oregon are highlighted in this study to understand cultural humility, belonging, inclusion, and intersectional experiences related to sustaining the workforce and promoting quality care. This qualitative study collected data through individual and focus group interviews with a total of 68 people, including 25 direct care staff, voice memos or interviews with 9 former direct care staff, interviews with 9 administrators, interviews with 7 management representatives (owner/operators, human resources specialists, directors of operations, among other titles), and interviews with 18 current …

Climate And Extreme Weather Event Impacts On Administrators, Direct Care Staff, And Residents In Oregon Assisted Living, Residential Care, And Memory Care Communities, 2024, Dani Himes, Jacklyn Kohon, Madeline Fox, Laura Rodriguez, Sarah Dys, Diana Jacoby, Paula Carder

Institute on Aging Publications

This brief report on AL/RC staff and resident experiences with climate events highlights the voices of AL/RC direct care staff, former direct care staff, residents, administrators, and management representatives to promote well-being in these care settings. This study can inform Oregon’s efforts to support long-term care workforce readiness for future climate emergencies and inform future quantitative data collection on AL/RC and other long-term care workers, including those employed in home health agencies, nursing facilities, and adult foster homes.

Impacts Of Sex Work Criminalization On Sex Workers In Oregon: A Pilot Study, Stephanie Wahab, Katie Shammel

School of Social Work Faculty Publications and Presentations

Executive Summary

Context for the Study
In July, 2023, Oregon legislators voted to fund research exploring the impacts of the criminalization of sex work in Oregon. Unfortunately, the Governor vetoed the budget item, stating that the private sector should fund this type of public health research and noting the need for additional public discussion about the issue. To date, there have been no attempts to study the impacts of prostitution laws on the people most impacted by them in Oregon. The research presented in this report seeks to address this gap.

This qualitative pilot study was designed to better understand …

2024 Adult Foster Home: Resident And Community Characteristics Report On Adult Foster Homes, Ozcan Tunalilar, Sarah Dys, Diana Jacoby, Wafi Albalawi, Minju Kim, Yuliana Levchenko, Paula C. Carder

Institute on Aging Publications

This year marks the 10th anniversary of the Resident and Community Characteristics Report on Adult Foster Homes as part of the Oregon Community Based Care project. The first of these reports was published in 2014 and looking back, one gets a sense of both stability and change. In this year’s report, we describe the results based on data we collected from AFHs licensed and monitored by the Aging and People with Disabilities program of the Oregon Department of Human Services (ODHS/APD). These are small residential settings that provide personal and health-related services for up to five residents. They are primarily …

Economic Analysis Of Population-Based Next Generation Sequencing For Breast Cancer, Sapphire Curelaru

University Honors Theses

Breast cancer develops due to accumulated DNA replication insults which causes cancer to uncontrollably proliferate. An individual's predisposition to developing cancer, as well as the composition of a tumor, can be sequenced using genetic tests. Myriad's BRACAnalysis CDx^® seems to be the most utilized genetic test. However, Next Generation Sequencing (NGS) seems to be a better genetic test for breast cancer when compared to Myriad's BRACAnalysisCDx^® in terms of return-time, accuracy, efficiency, and healthcare cost. By using Next Generation Sequencing tests, stakeholders can save money on genetic testing which can be invested in more genetic tests. Payers can …

Women’S Leadership And Covid-19 Pandemic: Navigating Crises Through The Application Of Connective Leadership, Chris Taylor Cartwright, Maura Harrington, Sarah Smith Orr, Tessa Sutton

International & Global Studies Faculty Publications and Presentations

International and national crises often highlight behavioral patterns in the labor market that illustrate women’s courage and adaptability in challenging times. The COVID-19 pandemic and resulting changes in the workplace due to social distancing, remote work, and tele-communications protocols showcased women’s power of authenticity and accessibility (interpersonal and personalized experiences) to engage with their constituents effectively. The catalyzed this research was our desire to underscore the importance of studying the impact of COVID-19 on women leaders. The COVID-19 pandemic brought to light specific challenges and disparities women faced in the workplace. It has been asserted that women leaders substantially benefit …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

(Un)Weighted Assumptions: Anti-Fatness & Health, Kieran Chase, Nell Carpenter, Madysen Schreiber

OHSU-PSU School of Public Health Annual Conference

This lecture/discussion session aims to expand and add nuance to public health students’, professors’, and practitioners’ understanding of the interplay between body size and health. We will begin by naming and challenging common assumptions about the relationship between bodyweight and health outcomes. We will then argue for the consideration of weight-related stigma as a Fundamental Cause of Disease as defined by Phelan and Link, and for institutionally embedded anti-fat bias at the policy level (e.g., insurance policy, medical equipment) as a cause of population health inequity as defined in Whitehead’s Health Equity Framework. We offer these frameworks in contrast to, …

Oregon's Senate Joint Resolution 12: Understanding The Implications Of A Constitutional Right To Healthcare, Anna Starr, Mpp

Hatfield Graduate Journal of Public Affairs

Problems persist throughout the U.S. healthcare system including exorbitant costs, poor health scores, high rates of uninsured, and lack of access to services among marginalized groups. Among many proposed solutions is a constitutional provision to healthcare. Largely based in ethics, healthcare as a right is also expected by many to improve health outcomes. However, while constitutional provisions for healthcare are found in countries around the world, empirical research results are limited and mixed at best. In the wake of social justice movements and resurgence of vibrant conversations about human rights, and with international pressure mounting for the U.S. to follow …

Travelling For Abortion Services In Mexico 2016–2019: Community-Level Contexts Of Mexico City Public Abortion Clients, Laura E. Jacobson Mph, Biani Saavedra-Avendano, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To describe the community context of women who travel to access Mexico City’s public sector abortion programme and identify factors associated with travelling from highly marginalised settings.

Methods: We used data from the Interrupción Legal de Embarazo (ILE) programme (2016–2019) and identified all abortion clients who travelled from outside Mexico City. We merged in contextual information at the municipality level and used descriptive statistics to describe ILE clients’ individual characteristics and municipalities on several measures of vulnerability. We also compared municipalities that ILE clients travelled from with those where no one travelled from. We used logistic regression to identify …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Aligning Food Environments With Institutional Values: A Mixed Methods Study Of Oregon Health Care Organizations, Elizaveta Walker

Dissertations and Theses

A major driver of the obesity epidemic is obesogenic food environments, characterized by nutrient-poor and energy-dense foods that saturate the collective physical, economic and sociocultural conditions that influence nutritional status. Food environments in organizations such as hospitals and public health agencies warrant special consideration given their health-focused mission. Improving food environments within health care settings has been highlighted by the Centers for Disease Control and Prevention (CDC) as one of seven key strategies to prevent obesity. However, most of the refereed literature examining healthy food environment policies (HFEPs) within hospitals focuses on the inpatient dietary environment, leaving a paucity of …

Employer-Reported Access To Paid Parental Leave: A Study Of San Francisco’S Paid Parental Leave Ordinance, Julia M. Goodman, Holly Elser, William H. Dow

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: A growing body of research finds that paid leave policies have significant population health benefits for workers and their families, but the lack of a national paid leave policy in the United States leaves most workers without access to any paid leave. In 2017 San Francisco implemented the nation’s first fully paid leave policy, mandating that covered employers provide up to six weeks of leave to care for a new child. The objective of our study is to examine how the San Francisco Paid Parental Leave Ordinance (PPLO) affected paid leave access, including among workers in low-wage industries. Methods: …

A Public Health Recommendation Countering The Online Anti-Vaccination Movement, Grace M. Neumann

University Honors Theses

The anti-vaccination movement had posed a threat to the health of communities, since the inception of the smallpox inoculation practice. As the anti-vaxx movement continues to grow in strength and reach, public health officials must be prepared to combat the flow of misinformation, with sound scientific data in a way that connects with individuals from all communities. Online platforms such as blogs and social media, allow newfound access to vaccine opinions and information, posing an even greater risk of vaccine misinformation being spread to the public. Different communities hold different reasons for vaccine hesitancy and avoidance. An effective public health …

Organizational Risk In Multi-Sector Health Partnerships: A Case Study Of Oregon's Accountable Health Communities, Shauna Jean Nicole Petchel

Dissertations and Theses

The literature on collective action has documented that the perception of organizational risk -- both the uncertainty of potential outcomes and the meaning attached to them -- is an important factor in whether and how organizations engage in cross-sector collaborations. Yet there are few examples to date that document how health and social service leaders perceive organizational risks in cross-sector health partnerships focused on social determinants of health, or how their perceptions influence organizational commitment and willingness to engage in these partnerships over time.

This research aimed to fill this gap through a mixed methods case study of health and …

Healthcare Spending Mandate Modeling Report, Northwest Economic Research Center, Peter Hulseman, Adam Rovang, Devin Bales, Nicholas Chun

Northwest Economic Research Center Publications and Reports

Governor Brown’s health care financing package, which was released with the 2019-21 recommended budget included several revenue components which provide broad-based, sustainable revenue for health care coverage in Oregon for the next six years. One component of that package is the Subsidized Employer Participation Program, which would be similar to the San Francisco Health Care Security Ordinance (HCSO). The new requirement would compel employers of a certain size who otherwise do not qualify for any exemption to contribute to their employees’ health care costs. An employer’s contribution could be in one of three ways: (1) in the form of directly …

Making The Business Case For An Addiction Medicine Consult Service: A Qualitative Analysis, Kelsey C. Priest, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.

Methods

Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with …