Health Policy Commons^™

Opioids In Nevada, Peter Grema, Caitlin Saladino, William E. Brown

Health

This Fact Sheet presents data from the Washington Post’s Drug Enforcement Administration (DEA) database on opioid shipments in the United States and provides information pertaining to Nevada and each of its 17 regions (16 counties and one independent city). This Fact Sheet compares the Washington Post’s opioid shipment data with opioid prescription rates relative to Nevada’s population in 2010.

A Health Disparity Action Plan: Achieving Equity Through Clinical Trials, Affordable Care, And Professional Development, Daniel Schafer, Shefa Moten, Ayesha Khan, Mauro Ferrari, Boris Lushniak, Edwin Burkett, Asad Moten

Journal of Health Disparities Research and Practice

Given the threatened nature of affordable care in the United States, it is crucial to underscore its importance. What is more, the reason such care is so important is the presence of an oft-unacknowledged disparity in access to quality care in this country and, indeed, around the world. A world without health disparities can be achieved and will be characterized by prompt and quality care available to all and at all stages of the care continuum. Further insurance reform is needed beyond the Affordable Care Act, while local care must be more accessible in rural, urban, and other underserved areas. …

Factors Associated With Participation In The Oregon Summer Food Program: A Mixed Methods Analysis, Alethea Chiappone, Teresa M. Garvin, Casey Blaser, Hollyanne E. Fricke, Lisa Weissenburger-Moser Boyd, Tom Barnard, Amy L. Yaroch

Journal of Health Disparities Research and Practice

The Summer Food Service Program (SFSP) was established to ensure children eligible for the National School Lunch Program (NSLP) continue to receive meals outside of the school year. However, participation in SFSP is relatively low (2.8 million annually) when compared with NSLP participation (30.4 million annually), suggesting that challenges exist in reaching children. Using a mixed methods approach, this study explored factors associated with SFSP participation. A secondary data analysis of the Oregon SFSP identified factors associated with SFSP participation at the Oregon SFSP-, sponsor-, and site-levels. Semi-structured interviews with SFSP sponsors explored barriers and facilitators to SFSP participation. Results …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

School of Public Health Faculty Research

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

Gambling-Related Harms: Developing Priorities For Harm Reduction Policy Setting, Judith Glynn Msc, Margo Hilbrecht Phd

International Conference on Gambling & Risk Taking

As jurisdictions worldwide have overseen gambling expansion, most have implemented regulatory and public policy regimes to reduce harm. This study was conducted to specify the nature and extent of gambling-related harm that public policy efforts could prevent or mitigate in Ontario, Canada.

Research has historically operationalized harm from gambling as cases of disordered gambling; and policy work has focused on the prevalence and treatment of these cases. Recent work to fully conceptualize and measure gambling-related harm in individual gamblers, their families, and communities (Blaszczynski et al, 2015, Browne et al., 2016, 2017; Langham et al., 2016,) dovetailed with the desire …

Restricted Access And Delays To Hcv Treatment Among Medicaid Patients In Louisiana, Morris M. Kim, Keanan M. Mcgonigle

Journal of Health Disparities Research and Practice

Background: Many people living with chronic Hepatitis C Virus (HCV) have seen delays in accessing treatment or been denied entirely due to Medicaid restrictions requiring patients to meet certain criteria prior to receiving approval for medication pre-authorization.

Methods: This study identified a cohort of Medicaid-insured patients with chronic HCV infection within New Orleans, LA. Patient medical records were reviewed and information regarding HCV care was gathered. This study sought to determine the degree to which HCV care was delayed for this population and describe common reasons for prior-authorization denials for direct-acting antiviral (DAA) medications.

Results: For this population of Medicaid-insured …

Structural Justice: A Critical Feminist Framework Exploring The Intersection Between Justice, Equity And Structural Reconciliation., Camille Burnett, Michael Swanberg, Ashley Hudson, Donna Schminkey

Journal of Health Disparities Research and Practice

Violence against women is a human rights violation (UN, 2006). It affects the health of women globally (UN, 2009) and its elimination is at the heart of many international and national goals. Intimate partner violence (IPV), one of the most common forms of gender-based violence, affects one in three women worldwide (WHO, 2013). The consequences of IPV create negative health outcomes for women that diminish their quality of life and their overall well-being. Abused women access community supports such as shelters to seek safe refuge from the abuse and restore their lives. While shelters play an extensive role in helping …

The Life She Deserves: Medical Marijuana In The United States, John Hudak, George Burroughs, Maritza Bermudez

Brookings Scholar Lecture Series

Brookings Mountain West offered an event titled, "The Life She Deserves: Medical Marijuana in the United States on Monday, November 5, 2018. This event featured a viewing of the film, and was followed by a panel discussion with John Hudak, George Burroughs, and Maritza Bermudez. “The Life She Deserves” is an intimate portrait of Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy. Because her legal pharmaceutical treatments cause severe side effects, Jennifer and her mother move across the country to access medical marijuana. The therapy provides Jennifer and her family with the relief …

Unlv School Of Medicine: Rethinking Governance, Planning, And Economic Impact, The Lincy Institute

Brookings Scholar Lecture Series

The launch of the UNLV School of Medicine presented a unique opportunity for Southern Nevada to address two critical issues: the absence of adequate healthcare services for a region of more than 2.2 million people, and the economic impact of a new medical school resulting in an expanded regional health care economy. A collaborative process that engages local, state, and private sector interests is essential to the development of the UNLV School of Medicine and the expansion of an effective, efficient, and profitable healthcare economy.

In this colloquium The Lincy Institute released new health policy publications prepared with the support …

Evaluation Of Innovative Medical School Facilities And Consultant Recommendations, Tripp Umbach

Lincy Institute Reports and Briefs

In August 2018, The Lincy Institute1 retained Tripp Umbach2 to provide consultation to evaluate and identify best practices for medical school facilities and development models as the University of Nevada Las Vegas (UNLV) and the community embarks on the development of a home for the UNLV School of Medicine. To complete this assignment, Tripp Umbach completed a comprehensive process involving secondary data analysis and actively sought and received input from stakeholders including leadership at The Lincy Institute, UNLV School of Medicine, previous Tripp Umbach clients, leading design professionals with experience developing medical schools, and potential donors to the proposed project. …

Extracorporeal Membrane Oxygenation (Ecmo) Access In The 30 Largest U.S. Metros, Kaylie Pattni, Caitlin J. Saladino, William E. Brown

Lincy Institute Reports and Briefs

This Fact Sheet highlights the locations and availability of ECMO (extracorporeal membrane oxygenation) medical capacity in the 30 largest U.S. metropolitan statistical areas (MSAs). Using the ELSO (Extracorporeal Life Support Organization) registry,1 the Table that follows shows all registered ELSO hospitals in the top 30 MSAs, and their respective type(s) of ECMO access.

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

The Fight For Birth, Jessica E. Brown

Research Briefs

No abstract provided.

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the …

Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole

Journal of Health Disparities Research and Practice

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the health …

Addiction And Substance Abuse In Nevada, Andrea Blin

Social Health of Nevada Reports

Substance abuse is an issue with serious health and societal consequences in Nevada and throughout the nation. In 2016, drug overdoses were responsible for approximately 64,000 deaths in the United States, surpassing motor vehicle deaths by 60 percent (National Institute on Drug Abuse, 2018). Recent attention has been focused on the spike in opioid use and its implications for public health. Nationally, deaths from opioid overdoses increased from 6.1 per 100,000 in 1999 to 19.8 per 100,000 in 2016. Nevada’s experience has mirrored national trends, with the drug overdose death rate in the state increasing from 11.5 per 100,000 in …

Best Practices For Self-Exclusion Reinstatement And Renewal, Alex Price

International Conference on Gambling & Risk Taking

While many studies have examined self-exclusion few have focused on the processes through which gamblers return at the end of their agreements. In 2014, the RGC Centre for the Advancement of Best Practices examined voluntary self-exclusion reinstatement and renewal in an effort to develop evidence-informed best-practices for both land-based and online gambling operations. The presentation outlines the findings of the study and the recommended best practices for reintegration and ban renewal.

The study examined a range of practices around the world. In the end the study recommended an active reinstatement process in which all participants are required to apply to …

Developing Capacity, Skills, And Tobacco Control Networks To Address Tobacco-Related Disparities: Leadership And Advocacy Institute To Advance Minnesota’S Parity For Priority Populations (Laampp), Linda M. Bosma, Raffaele Vacca, Raymond G. Boyle, Jaime L. Martinez, Rod Lew

Journal of Health Disparities Research and Practice

Priority populations disproportionately experience tobacco-related disparities, despite population level declines in tobacco use. The Leadership and Advocacy Institute to Advance Minnesota’s Parity for Priority Populations (LAAMPP) recruits and trains African immigrants/African Americans, Asian Americans/Pacific Islanders, American Indians, Chicano/Latinos, and LGBTQ community members to develop leaders to address tobacco harms in their communities. This paper describes and evaluates the LAAMPP Institute, and discusses lessons learned through the Institute and future directions for community-based tobacco-control efforts.

The mixed-methods evaluation included qualitative key informant interviews with LAAMPP Fellows and community and project contacts, a Skills Assessment Tool, project case studies, and a social …

Balancing Coordinated Care With Tribal Sovereignty: Lesson’S From Oregon’S Medicaid Reform, Lydia E. Riley, R. Turner Goins, Stephanie Bernell

Journal of Health Disparities Research and Practice

The purpose of this case study is to examine the efforts made by the legislature and the Oregon Health Authority (OHA) to involve Oregon’s nine federally recognized tribes in the implementation of the revised Oregon Health Plan. We identified eight key informants, consisting of four tribal representatives and four state representatives, for interviews. Additionally, we identified the contact person from each newly-established Medicaid delivery network to determine if they had included the tribe(s) or planned to include the tribe(s) in their network. The OHA made some steps to ensure the inclusion of tribes in the planning and implementation process, but …

Health Care Limitations Available To Transgender Teenagers: A Systematic Review Of The Literature, Yessenia Madrigal, Michael Curtis

McNair Poster Presentations

This systematic review of literature explores the current academic literature that is available in regards to transgender teenagers, their healthcare options and the services that are available to these teenagers and any obstacles they face when seeking and obtaining healthcare services. This review specifically focuses on transgender teenagers and their family’s experiences and the lack of support given to them at different levels in different healthcare facilities. For this review a total of 29 articles were included in the final literature review and were categorized into different areas: the detrimental effects of non-accepting parents are explained healthcare options available, the …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Unlv School Of Medicine Return On Investment To The State General Fund, Tripp Umbach, Lincy Institute

Lincy Institute Reports and Briefs

Economic activity in the State of Nevada’s economy from the spending of the UNLV School of Medicine will remain inside the state as well as fresh dollars that will flow inside the state because the medical school will generate general fund revenue through a wide variety of taxes. Tripp Umbach estimates that every fresh dollar in economic impact from the UNLV School of Medicine will generate 4.9% in state general fund revenue. As the UNLV School of Medicine matures, the Return on Investment (ROI) to the State of Nevada’s economy will grow.

Nevada Should Opt-In To Organ Policy Changes, Alex Velto

Brookings Mountain West Publications

Organ donation shortages are a problem in Nevada. A shift in policy towards an opt-out system could more than double the number of registered organ donors in Nevada. A Libertarian Paternalistic strategy would allow potential donors to express their preference for organ donations more accurately. Currently Nevada abides by an opt-in policy where people are only organ donors if they explicitly request to become donors. Under an opt-out policy, people would be presumed organ donors unless they requested not to be donors. Policy changes during the 2015 Legislative session were a good start but failed to fully utilize behavioral economics …

Health Information Exchange: Growth And Patient Privacy, Niam Yaraghi

Brookings Scholar Lecture Series

Health Information Exchanges (HIE) provide the electronic movement of health-related information among organizations according to nationally recognized standards. The goal of health information exchange is to facilitate access to and retrieval of clinical data to provide safer, timelier, efficient, effective, equitable, patient-centered care. HIEs are becoming integral parts of the national healthcare reform efforts, chiefly owing to their potential impact on cost reduction and quality enhancement in healthcare services. However, the potential of a HIE platform can only be realized when its multiple constituent users actively participate in using its variety of services. In this research, Yaraghi models HIE systems …

Competing For Federal Grant Dollars In Nevada, Cyndy Ortiz Gustafson, Jennifer Ouellette

Lincy Institute Reports and Briefs

Federal grant funding in Nevada accounts for 19 percent of statewide federal funding, or roughly $3.7 billion a year. Federal grant funding consists of (1) formula based aid and, (2) competitive discretionary grant dollars. In the latter category Nevada is encouraged to substantially improve its performance and secure more federal resources for its citizens.

Sentiments Of Community Stakeholders Living In Southern Nevada Neighborhoods, Erin Sheehy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Community stakeholders provided insight to their local neighborhoods and shared their thoughts about the potential redevelopment of their neighborhoods. This study utilized data from the Southern Nevada Strong ethnographic research project. Ethnographic research was conducted over ten weeks in Summer 2013. Neighborhood observations and interviews with community stakeholders were conducted to understand how neighborhoods are utilized, how residents feel about potential redevelopment, and what areas of the neighborhoods residents would like to see improved in the future. Photographs were also collected to further examine the characteristics, aesthetics, and spatial landscape of the neighborhoods. The purpose of this qualitative research project …

Behavioral And Mental Health In Nevada, David Caloiaro, Luana Ritch

Social Health of Nevada Reports

Until recently, the Nevada Division of Mental Health and Developmental Services (MHDS) was the public provider of mental health, substance abuse and developmental services. On July 1, 2013, the delivery of the mental health, substance abuse and developmental services in Nevada was restructured on several levels. With this reorganization, Developmental Services for persons with intellectual disabilities was transitioned into the Aging and Disability Services Division (ADSD), while mental health and substance abuse services were integrated to become Behavioral Health. Behavioral Health was then merged with the public health from the State Health Division to form the new Division of Public …

An Analysis Of Capacity Issues Within The Division Of Mental And Behavioral Health For The State Of Nevada, Jeffrey Buchwald, Tara Cooley, Enrique Mazon Jr., Jessica Sifuentes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

Nevada’s competitiveness in receiving federal funding has been a serious and contentious topic that has steered recent efforts to ascertain ways the state can increase and utilize federal dollars efficiently. Nevada is positioned 53rd out of 53 U.S. states and territories in bringing federal dollars to the state, missing out on $1.5 billion annually (Gustafson, 2012). Nevada spends far less on Medicaid (per capita) than any other state. Medicaid is a key factor in improving Nevada’s position; however, there are additional non-formula funding opportunities that are missed every year.

Purpose

The purpose of this evaluation project is to identify …