Health Policy Commons^™

Gender In The Time Of Covid-19: Evaluating National Leadership And Covid-19 Fatalities, Leah C. Windsor, Gina Yannitell Reinhardt, Alistair J. Windsor, Robert Ostergard, Susan Allen, Courtney Burns, Jarod Giger, Reed Wood

Social Work Faculty Publications

In this paper we explore whether countries led by women have fared better during the COVID-19 pandemic than those led by men. Media and public health officials have lauded the perceived gender-related influence on policies and strategies for reducing the deleterious effects of the pandemic. We examine this proposition by analyzing COVID-19-related deaths globally across countries led by men and women. While we find some limited support for lower reported fatality rates in countries led by women, they are not statistically significant. Country cultural values offer more substantive explanation for COVID-19 outcomes. We offer several potential explanations for the pervasive …

Protocol For A Trial Assessing The Impacts Of School-Based Wash Interventions On Children’S Health Literacy, Handwashing, And Nutrition Status In Low- And Middle-Income Countries, Stephanie O. Sangalang, Shelley Anne J. Medina, Zheina J. Ottong, Allen Lemuel G. Lemence, Donrey Totanes, John Cedrick Valencia, Patricia Andrea A. Singson, Mikaela Olaguera, Nelissa O. Prado, Roezel Mari Z. Ocaña, Rovin James F. Canja, Alfem John T. Benolirao, Shyrill Mae F. Mariano, Jergil Gyle Gavieres, Clarisse P. Aquino, Edison C. Latag, Maria Vianca Jasmin C. Anglo, Christian Borgemeister, Thoomas Kistemann

Development Studies Faculty Publications

Diarrhea, soil-transmitted helminth infection and malnutrition are leading causes of child mortality in low- and middle-income countries (LMICs). To reduce the prevalence of these diseases, effective interventions for adequate water, sanitation, and hygiene (WaSH) should be implemented. This paper describes the design of a cluster-randomized controlled trial that will compare the efficacy of four school-based WaSH interventions for improving children’s health literacy, handwashing, and nutrition. Interventions consisted of (1) WaSH policy reinforcement; (2) low-, medium-, or high-volume health education; (3) hygiene supplies; and (4) WaSH facilities (e.g., toilets, urinals, handwashing basins) improvements. We randomly allocated school clusters from the intervention …

Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.
Methods: We used a Bayesian geostatistical model and …

Global Burden Of Cardiovascular Diseases And Risk Factors, 1990-2019: Update From The Gbd 2019 Study, Gregory A. Roth, Veincent Christian F. Pepito, Gbd-Nhlbi-Jacc Global Burden Of Cardiovascular Diseases Writing Group, 608 Co-Authors

Ateneo School of Medicine and Public Health Publications

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.

Prevalent cases …

Health Care And Education Access Of Transnational Children In Mexico, Catalina Amuedo-Dorantes, Laura Juarez

Mission Foods Texas-Mexico Center Research

Between 2001 and 2018, more than 5.5 million Mexican migrants were removed from the United States or returned to Mexico with their families as immigration enforcement escalated. Learning how this transition affected the access to health and education services of their children –also referred to as “the invisibles”– is a policy-relevant topic for both the United States and Mexico. Using representative data on 7.6 million Mexican and U.S.-born children from the 2015 Mexican Intercensal Survey, we provide evidence on the education and health care access gaps between these two groups and on the factors potentially responsible for the barriers encountered …

Covid-19 Educational Inequities: Shining A Light On Disparities In A Graduate School Of Social Work, Jason Jabbari, Dan Ferris, Tyler Frank, Michal Grinstein-Weiss

Social Policy Institute Research

In the wake of COVID-19, universities and schools of social work face unprecedented challenges and uncertainty in aligning their academic models with public heath protocols and best practices, while prioritizing the safety and well-being of their students. In order to best respond to these challenges and uncertainty, more research is needed to advance a greater understanding of (1) what challenges students face, (2) who is most at risk and impacted by these challenges, and (3) how universities can best support students. Through a survey administered during the spring 2020 semester at a large research university in the Midwest, we explored …

Racial And Ethnic Disparities In Housing Instability During The Covid-19 Pandemic, Yung Chun, Stephen Roll, Selina Miller, Hedwig Lee, Savannah Larimore, Michal Grinstein-Weiss

Social Policy Institute Research

Stable and adequate housing is critical in the midst of a pandemic; without housing, individuals and families cannot shelter in place to prevent the spread of disease. Understanding and combating housing hardships in vulnerable populations is therefore essential to a sound public health response. This study aims to explore the pandemic’s disproportionate impacts on housing-related hardships across racial/ethnic groups in the United States as well as the extent to which these disparities are mediated by households’ broader economic circumstances; namely, their pre-pandemic liquid asset levels and the experience of COVID-19-related job and income losses. Using a national survey of over …

Aging Strong For All: Examining Aging Equity In The City Of Boston, Jan Mutchler, Caitlin Coyle, Nidya Velasco Roldán, Paul Watanabe, Cedric Woods, Lorna Rivera, Quito Swan, Elena Stone, Laurie Nsiah-Jefferson

Center for Social and Demographic Research on Aging Publications

The experience of being and becoming older differs substantially based on one’s race, ethnicity, and gender. In the City of Boston, it has never been more critical to strategically pursue greater equity in the aging experience of residents. According to data from the US Census Bureau, the number of Boston residents aged 60 or older increased by more than a third just since 2010 and persons of color now make up half of Boston’s older adults. As well, stakeholders share a growing recognition of the powerful ways in which inequity, racism and discrimination shape health outcomes and the aging experience, …

Downeast Maine Mat Expansion Project: Year 2 Data Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Tyler Egeland Ba

Substance Use Research & Evaluation

This report summarizes the Year 2 activities of the Healthy Acadia Downeast Maine MAT Expansion Project. Through a collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network and Downeast Substance Use Response Coalition, the project utilized multiple evidence-based strategies to combat opioid use disorder (OUD) in Downeast Maine.

FMI: M. Lindsey Smith, PhD, m.lindsey.smith@maine.edu

Cost, Coverage, And The Underuse Of Medications Among People With Cf, Semret Seyoum, Marsha Regenstein, Lea Nolan

Health Policy and Management Issue Briefs

No abstract provided.

Health Is Political: Public Health Practitioners And Researchers Should Be Trained Accordingly, Claire Pendergrast

Population Health Research Brief Series

Policy has long been considered a core element of public health practice. The COVID-19 pandemic has made clear that public health practice and research exist within a political context that cannot be ignored.

Status And Factors Associated With Healthcare Choices Among Older Adults And Children In An Urbanized County: A Cross-Sectional Study In Kunshan, China, Yuxi Zhao, Linqi Mao, Jun Lu, Qi Zhang, Gang Chen, Mei Sun, Fengshui Chang, Xiaohong Li

Community & Environmental Health Faculty Publications

As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service resources and to provide support for resource allocation. A cross-sectional study was conducted in Kunshan, a highly urbanized county in China, in 2016, among older adults aged 60 or over and children aged 0–6. Multinomial logistics models were used to identify the factors associated with healthcare choices. In this study, we found that income, distance of the …

Learning Before And During The Covid-19 Outbreak: A Comparative Analysis Of Crisis Learning In South Korea And The Us, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

Learning is imperative in government responses to crises like the COVID-19 pandemic. This study examines the South Korean and United States governments’ responses to COVID-19 from a comparative perspective. The analysis focuses on crisis learning conducted before and during the COVID-19 outbreak, using the conceptual categories of intercrisis/intracrisis learning and single-/double-loop learning. The findings suggest that double-loop, intercrisis learning allows for more effective crisis management by (re)developing a common operating framework. The efficacy of learning is enhanced when double-loop learning is followed by single-loop learning that embeds new structures and operational procedures. The findings also suggest that intercrisis learning facilitates …

Who Relocates, Where Do They Move, And Why?, Yung Chun, Jason Jabbari, Pranav Nandan, Andrew Foell, Michal Grinstein-Weiss

Social Policy Institute Research

The lack of socioeconomic mobility among marginalized populations leads to the concentration of poverty, a long-standing issue in American cities. Empirical studies on neighborhood effects have found that poverty concentration adversely affects the socioeconomic mobility of residents—associated with their economic well-being, employment, education, health, and safety—in lower-income neighborhoods. Through a variety of neighborhood revitalization projects, federal, state, and local governments have put enormous efforts into cutting the vicious cycle of poverty while increasing the socioeconomic mobility of lower-income households. One of these projects, the Choice Neighborhood Initiative, is a recent Federal effort to revitalize distressed public housing sites in American …

Covid-19 Reduced Outpatient Visits By Up To 70% In The Us, Pinka Chatterji, Yue Li

Population Health Research Brief Series

The COVID-19 pandemic has created new challenges for healthcare providers. Outpatient visits dropped by up to 70% relative to the same weeks in prior years.

Child Food Insecurity In Nevada Counties, 2018, Ally Beckwith, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on the child hunger discrepancies in Nevada counties from the Feeding America 2018 Map the Meal Gap Study. The information focuses on food insecurity experienced by children, and the food budget shortfall in Nevada.

Migration And Inequalities In The Face Of Covid-19: Vulnerable Populations And Support Networks In Mexico And The United States, Claudia Masferrer

Mission Foods Texas-Mexico Center Research

Our world changed drastically on February 11th 2020 when the World Health Organization announced the name of the new coronavirus disease as COVID-19, and the pandemic was later considered the greatest challenge we have faced since World War II. Although we have started to experience social life in various new ways, the impacts that it will bring are still unknown. In recent years, migration had already undergone different transformations globally, and more changes are expected. How will populations on the move and migrant populations live in the following years post-COVID, and how different actors will respond to these changes, is …

Migration And Inequalities In The Face Of Covid-19: Economic, Political And Social Context In Mexico And The United States, Claudia Masferrer

Mission Foods Texas-Mexico Center Research

Our world changed drastically on February 11th 2020 when the World Health Organization announced the name of the new coronavirus disease as COVID-19, and the pandemic was later considered the greatest challenge we have faced since World War II. Although we have started to experience social life in various new ways, the impacts that it will bring are still unknown. In recent years, migration had already undergone different transformations globally, and more changes are expected. How will populations on the move and migrant populations live in the following years post-COVID, and how different actors will respond to these changes, is …

Substance Use Among Rural And Urban Youth And Young Adults, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

Rural youth and young adults have historically had higher use rates of alcohol and other substances than their urban counterparts. Recent research suggests that rates of youth and young adult alcohol and other substance use have declined over the past two decades, but we have limited knowledge of whether and how current rural and urban substance use patterns may differ. As national substance use rates decline, it is important to re-assess differences in use among rural versus urban youth and young adults. This study uses data from the National Survey of Drug Use and Health (NSDUH) to examine rural-urban differences …

It Shouldn’T Take A Pandemic To Increase School Meal Access For Low-Income Students: A Two-Step Floating Catchment Area Analysis Of School Meal Access During Covid-19, Jason Jabbari, Yung Chun, Pranav Nandan, Laura Mcdermott, Tyler Frank, Dan Ferris, Sarah Moreland-Russell, Stephen Roll

Social Policy Institute Research

COVID-19 created an additional barrier for students who benefit from free school meals. While some schools attempted to provide alternative meal access points, many students lack adequate transportation. Thus, physical proximity to meal access points is particularly important during the pandemic. Taking into account both the “supply” and the “demand” for free meals, we employed a two-step floating catchment area analysis to analyze meal accessibility in St. Louis, MO. Overall, while meal access during the spring 2020 semester was substantially lower than the spring 2019 semester, meal access during the 2020 summer was substantially higher than the 2019 summer. Moreover, …

Availability And Affordability Of Medicines And Cardiovascular Outcomes In 21 High-Income, Middle-Income And Low-Income Countries, Clara Kayei Chow, Tu Ngoc Nguyen, Simone Marschner, Rafael Diaz, Omar Rahman, Alvaro Avezum, Scott A. Lear, Koon Teo, Karen E. Yeates, Khawar Kazmi

Section of Cardiology

Objectives: We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study.
Methods: We defined high CVD risk as the presence of any of the following: hypertension, coronary artery disease, stroke, smoker, diabetes or age >55 years. Availability and affordability of blood pressure lowering drugs, antiplatelets and statins were obtained from pharmacies. Participants were categorised: group 1-all three drug types …

The Role Of The Opioid Crisis In Elder Abuse, Kimberly I. Snow Mhsa, Jennifer Pratt, Stuart Bratesman Mpp

Disability & Aging

As the opioid crisis has deepened over the past twenty years, its effect on individuals and families, including older adults, has grown. To find out how the opioid crisis might be impacting elder abuse, neglect, and exploitation in Maine, we conducted a mixed methods analysis of 2015-2018 Maine Adult Protective Services (APS) investigations to determine: 1) Did opioid-related investigations increase over time? 2) Do investigations involving opioid misuse or abuse differ from investigations that don’t involve opioids? 3) What themes or features of cases involving opioid misuse or abuse by clients and/or perpetrators emerge from the data?

Key Findings: The …

Evaluating The Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana, Kamil Fuseini, Augustine Ankomah

Reproductive Health

Contraceptive use in Ghana has remained low despite annual increases since 2012. Having a high unmet need for family planning (FP) suggests that there may be barriers to access and uptake. Over time, several policies, including Ghana’s Costed Implementation Plan from 2015–20, have suggested FP initiatives to improve contraceptive use yet they have not been entirely implemented. Further, although FP was included in the health insurance act passed in 2003, amended in 2008, and revised in 2012, which indicated that health-care benefits include FP, people continue to pay out of pocket for services at National Health Insurance Authority facilities because …

Income Loss And Financial Distress During Covid-19: The Protective Role Of Liquid Assets, Stephen Roll, Mathieu Despard

Social Policy Institute Research

Nearly a quarter of U.S. households have experienced job or income losses related to the COVID-19 pandemic. Liquid assets mitigate financial distress in the face of financial shocks such as job loss, yet this relationship in the midst of the COVID-19 pandemic is unknown. Using a nationally representative sample of U.S. households (N = 4,383) who completed a survey in the early days of the pandemic, we examined pre-pandemic liquid assets as a moderator of the relationship between job and income loss and difficulty meeting financial obligations and use of high-cost financial resources. Estimates from propensity score-weighted linear probability models …

Pennsylvania’S Covid-19 Response Through The Homeland Security Frameworks And Research Lens – Lessons Learned, Alexander Siedschlag

Publications

• Although typically framed as a pandemic owned by the public health sector, the COVID-19 response falls directly within the homeland security mission space, whose core missions include “Ensuring Resilience to Disasters” (QHSR 2014).
• In some aspects PA’s COVID-19 response is in line with security research.
• In other dimensions, it is neither in line with what research would recommend nor with what the National Preparedness System would foresee.
• The Keystone State has yet to fully make the step from disaster to catastrophe as the characteristic challenge to U.S. emergency management in our century.

Global Burden Of 87 Risk Factors In 204 Countries And Territories, 1990–2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Christopher J L Murray, Veincent Christian F. Pepito, Gbd 2019 Risk Factors Collaborators, 938 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease.

Methods

GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of …

Global Age-Sex-Specific Fertility, Mortality, Healthy Life Expectancy (Hale), And Population Estimates In 204 Countries And Territories, 1950–2019: A Comprehensive Demographic Analysis For The Global Burden Of Disease Study 2019, Kaja M. Abbas, Haidong Wang, Veincent Christian F. Pepito, Gbd 2019 Demographics Collaborators, 725 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019.

Methods

8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used …

Public Policy Origins Of U.S. Data, Bert Chapman

Libraries Faculty and Staff Presentations

Provides detailed introduction and overview of public policy origins of U.S. data. Shows how congressional legislation and Office of Management and Budget documents influence compilation and dissemination of U.S. Government data. Stresses how Indiana General Assembly requirements influence compilation of Indiana state agency data and Indiana local government agency data. Places emphasis on roles played in data compilation and dissemination by public policy research institutions/think tanks. Concludes by stressing limitations of data collection by governmental and non-governmental entities.

Improving Health Care In Nevada, Ember Smith, Kaylie Pattni

Policy Briefs and Reports

Across the United States, improvements in health outcomes lag while health care costs rapidly rise. Medical personnel and resource shortages combined with high underinsured and uninsured rates further complicate access to quality, affordable health care. In order to better understand state-level solutions, we explore factors that contribute to health care deficiencies and emphasize Nevada’s unique obstacles.

Months Into The Covid-19 Pandemic, Community Health Centers Report Signs Of Improvement, But Face Financial Uncertainty, Jessica Sharac, James Hernandez, Feygele Jacobs, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Executive Summary:

This policy brief reports on the COVID-19 experience of the nation’s community health centers over a six-month period, utilizing data from the Health Resources and Services Administration’s (HRSA’s) weekly Health Center COVID-19 Survey from April 3rd, 2020 to October 2nd, 2020. The data demonstrate that community health centers were immediately responsive to the public health crisis, initiating diagnostic testing for the COVID-19 virus, and adapting care such as telehealth to address patient needs. However, with visits down overall and limited financial relief, the pandemic has taken an enormous financial toll on health centers. Cumulative patient revenue losses over …