Health Policy Commons^™

Towards A Framework Convention On Global Health, Lawrence O. Gostin, Eric A. Friedman, Kent Buse, Attiya Waris, Moses Mulumba, Mayowa Joel, Lola Dare, Ames Dhai, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

A global health treaty, a Framework Convention on Global Health (FCGH)–grounded in the right to health, with the central goal of reducing immense domestic and global health inequities–could serve as a robust global governance instrument to underpin the United Nations post-2015 Millennium Development Goals (MDGs). It would ensure for all people the three essential conditions for a healthy life–public health, health care, and the positive social determinants of health–while advancing good governance, responding to drivers of health disadvantages for marginalized populations, elevating health in other legal regimes, and enhancing people's ability to claim their rights.

The legally binding nature of …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton C. Ku

Health Policy and Management Faculty Publications

Six years ago, Massachusetts implemented a broad expansion of health coverage to the uninsured population in the state. Understanding that outreach and enrollment assistance would be essential to the success of the expansion, state policymakers provided for public education campaigns, but also for person-to-person, hands-on assistance, especially in communities with large numbers of uninsured people. Community health centers play a central role in this effort. As states and communities gear up to provide outreach and enrollment assistance under the ACA, the experience of the Massachusetts health centers offers lessons that can help inform current efforts to reach and enroll millions …

Racial Disparity In Duration Of Patient Visits To The Emergency Department: Teaching Versus Non-Teaching Hospital, Zeynal Karaca, Herbert S. Wong

Health Policy and Management Faculty Publications

Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs) have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.

Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) were used in the analyses. The data include 4.3 million routine ED …

Overcoming Shortage Of Pharmacists To Provide Pharmaceutical Services In Public Health Centers In Indonesia, Yuyun Yuniar, Max Joseph Herman

Kesmas

Indonesia masih menghadapi keterbatasan jumlah apoteker di puskesmas, sehingga pihak pemerintah daerah dan puskesmas harus berupaya mengatasi permasalahan tersebut. Penelitian ini bertujuan untuk menggambarkan ketersediaan dan distribusi tenaga pelayanan kefarmasian di puskesmas serta permasalahan dan alternatif pemecahannya. Data diambil dari hasil Riset Fasilitas Kesehatan (Rifaskes) tahun 2011I. Data kuantitatif tentang tenaga pelayanan kefarmasian di puskesmas dianalisis secara deskriptif berdasarkan regional. Data kualitatif sebagai pendukung diperoleh melalui wawancara mendalam dengan bagian kepegawaian dinas kesehatan dan apoteker empat puskesmas di Kota Bogor dan Bekasi, 3 kemudian dianalisis dengan metode analisis tema. Hasil analisis menunjukkan bahwa Sulawesi memiliki persentase puskesmas dengan tenaga apoteker …

Friends In The Desert Foundation, Inc. Program Evaluation, Gina Brooksbank, Jessica Wilde, Holly Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

This report presents an evaluation of the Friends in the Desert, Foundation Incorporated (FID), a sit-down feeding program in downtown Henderson, Nevada. The evaluation identified both strengths of the program and opportunities for growth. Major components of this report are presented in the following order: scope of work, research design, findings, recommendations, conclusions and limitations. The report recommendations provide the agency’s members and principal stakeholder groups with proposals designed to improve the program’s financial position and long-term viability. These recommendations focus on opportunities for restructure, growth, and uninterrupted success.

FID is a sit-down feeding program located at St. Timothy’s Episcopal …

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Community Health Assessment By Local Health Departments: Presence Of Epidemiologist, Governance, And Federal And State Funds Are Critical, Gulzar H. Shah, Barbara Laymon, Julia Joh Elligers, Carolyn Leep, Christine B. Bhutta

Frontiers in Public Health Services and Systems Research

Using the data from the National Association of County and City Health Officials’ (NACCHO) 2010 Profile of Local Health Departments (LHDs) our study investigates whether or not infrastructural characteristics of LHDs were associated with completion of community health assessment (CHA). Our results show that local and shared LHD governance, greater share of revenue from federal and state sources, smaller population size in LHD jurisdiction, and having an epidemiologist significantly increased the odds of CHA completion in the past, after controlling for community characteristics and other independent variables. These findings have important implications for LHDs, PHAB and its partners.

Jefferson Hosts American Public Health Association Student Assembly's Strategic Planning Meeting, Alex Bryan

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Reform Upate: The Road To Implementing State-Run, Partnered, And Federally Facilitated Exchanges, Anne Mainardi Md, Shira Yun Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Bipartisan Senate Immigration Bill: Implications For Health Coverage And Health Access, Leighton C. Ku

Health Policy and Management Issue Briefs

No abstract provided.

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Holly Mead

Health Policy and Management Faculty Publications

Objective

To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources

Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design

The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …

Triglyceride/Hdl Ratio As A Screening Tool For Predicting Success At Reducing Anti-Diabetic Medications Following Weight Loss., Ghanshyam P. S. Shantha, Anita A. Kumar, Scott Kahan, Pavan K. Irukulla, Lawrence J. Cheskin

Health Policy and Management Faculty Publications

Background and Objectives

Intentional weight loss, by reducing insulin resistance, results in both better glycemic control and decreased need for anti-diabetic medications. However, not everyone who is successful with weight loss is able to reduce anti-diabetic medication use. In this retrospective cohort study, we assessed the predictive accuracy of baseline triglyceride (TGL)/HDL ratio, a marker of insulin resistance, to screen patients for success in reducing anti-diabetic medication use with weight loss.

Methods

Case records of 121 overweight and obese attendees at two outpatient weight management centers were analyzed. The weight loss intervention consisted of a calorie-restricted diet (~1000Kcal/day deficit), a …

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Katherine H. Mead

Health Policy and Management Faculty Publications

Objective: To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources: Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design: The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …

The Stigmatization Of Disabilities In Africa And The Developmental Effects, Kelsey Koszela

Independent Study Project (ISP) Collection

Stigmatization still exists in large scale and leads to exclusion and continued poverty and poor standard of life for persons with disabilities, especially for those living in Africa. The main cause of stigmatization in Africa is a lack of education about disabilities and the needs of persons with disabilities. The unknown creates fear in society and exclusion for persons with disabilities, prohibiting them from obtaining decent education, proper health care and having access to jobs and financial support. Since the Convention for the Rights of Disabled Persons (CRPD) in 2006 societal education has been supplemented by implementation of development programs …

Model Pengambilan Keputusan Meningkatkan Akseptor Keluarga Berencana Metode Kontrasepsi Jangka Panjang, Suryani Manurung

Kesmas

Pada periode 2002-2012, tren angka fertilitas total mengalami stagnasi sekitar 2,6. Milenium Development Goals (MDGs) menunjukkan kemajuan yang baik, tetapi masih memerlukan kerja keras untuk mencapai target tahun 2015. Khususnya upaya untuk mencapai target 102 per 100.000 kelahiran hidup. Metode keluarga berencana (KB) yang banyak digunakan pasien pascapersalinan saat ini adalah metode kontrasepsi jangka pendek seperti pil dan suntik. Sedang metode kontrasepsi jangka panjang seperti intra uterine device dan implant cenderung turun satu poin dari tahun 2002 hingga 2007. Upaya mengatasi masalah yang sedang dialami masyarakat Indonesia saat ini meningkatkan akseptor KB metode kontrasepsi jangka panjang (MKJP). Model pengambilan keputusan …

Local Public Health In Financial Crises: Common Decision Drivers For Changes In Services Due To Economic Downturn, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

We measured the impact of the 2008-2010 economic recession on local health departments (LHDs) across the United States. Between 2008 and 2010, we conducted 3 Web-based, cross-sectional surveys of a nationally representative sample of LHDs to assess cuts to budgets, workforce, and programs. By early 2010, more than half of the LHDs (53%) were experiencing cuts to their core funding. In excess of 23 000 LHDs jobs were lost in 2008-2009. All programmatic areas were affected by cuts, and more than half of protecting the health of the public, such as monitoring health status to identify and solve community health …

Community Health Assessment Activity By Lhds: The Influence Of Local Health Agency And Community Characteristics, Gulzar H. Shah, Barbara Laymon, Carolyn Leep, Julia Elligers

Health Policy & Management: Faculty Presentations (2008-2022)

Research Objective: This study investigates organizational and community characteristics associated with the likelihood of local health departments to conduct community health assessments (CHAs).

Study Design: For this observational study, we used data from the 2010 National Profile of Local Health Departments Study (Profile). Using the FIPS codes for the county and place, additional data were merged with Profile data to capture community characteristics. To compute estimates of community characteristics for LHDs involving multiple cities/counties, we computed population weighted averages. In order to estimate unbiased population parameters, we used appropriate statistical weights in all analyses, to account for disproportionate non-responses …

The Resilient Local Health Department: Surviving The 2008 Economic Crisis, Paul C. Erwin, Gulzar H. Shah, Glen P. Mays

Health Policy & Management: Faculty Presentations (2008-2022)

Research Objective: The purpose of this study was to identify potential modifiable factors that can protect local health departments from job losses and budget cuts during periods of economic stress.

Study Design: This was a retrospective cohort study which used data from census surveys of local health departments (LHDs) which were conducted in 2005 and 2010 by the National Association of County and City Health Officials. The 2005 survey data served as the source of independent variables, which were grouped around domains of organization, revenue, and services. The outcome of interest - resiliency of the LHD - represented financial resiliency …

Comprehensive Immigration Reform And Health Care: Cbo's Analysis Of S. 744, Leighton C. Ku

Health Policy and Management Issue Briefs

No abstract provided.

Rural Children Experience Different Rates Of Mental Health Diagnosis And Treatment, David Hartley Phd, Mph, Jennifer D. Lenardson Mhs, Nathaniel J. Anderson Ms, Mph, Samantha J. Neuwirth Md

Mental Health / Substance Use Disorders

Research indicates that privately insured, rural adults have lower use of office-based mental health services, but higher use of prescription medicines than their urban counterparts. Patterns for rural children may be different from urban children because of the limited supply of pediatric mental health providers in rural areas, which may lead to reduced access and lower use of mental health services in rural areas versus urban. Using data on children ages 5-17 from the 2002-2008 of the Medical Expenditure Panel Survey, researchers from the Maine Rural Health Research Center find that rural children are significantly less likely to be diagnosed …

From The Frontier: Translating Research To Practice…Qi As The Hinge Point, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

This article is number three in the series From the Frontier: Translating Research to Practice. The narrative describes the work of a practice-academic network in Minnesota which explored the degree to which having a culture of quality at the local health department level influenced the capacity to implement a new statewide initiative. The network conducted a mixed-methods study of grantees funded to develop and implement local policy, systems, and environmental change strategies to promote nutrition, increase activity, and reduce tobacco use and exposure. The results of their study indicated that grantees with higher performance levels in Quality Improvement (QI) …

Addressing Health Inequalities In The United States: Key Data Trends And Policy Action, Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell, Thomas A. Laveist

Frontiers in Public Health Services and Systems Research

Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting in the form of national objectives or goals to address health inequalities. More research and better methods are needed to precisely measure relationships between stated …

Quality Of Care In Community Health Centers And Factors Associated With Performance, Julia Paradise, Peter Shin, Jessica Sharac, Sara J. Rosenbaum, Kaiser Commission On Medicaid And The Uninsured

Health Policy and Management Issue Briefs

This study examines quality performance among community health centers (CHC) on three key measures of primary and preventive care — diabetes and blood pressure control and timely Pap tests — using quality in Medicaid managed care organizations (MCO) as a benchmark. The study also identifies factors that differ significantly between high- and lower-performing health centers. Most health centers perform better than 75% of all Medicaid MCOs on the two chronic care measures, and more than 1 in 10 exceed this benchmark on all three quality measures. Few health centers lag behind average Medicaid MCO performance on all three measures. Lower-performing …

The Role Of Health Care In A Democratic Capitalist Society, Barbi Appelquist

Pepperdine Policy Review

What is the government’s role in health care? On March 23, 2010, President Barack Obama signed into law The Patient Protection and Affordable Care Act, commonly known as “Obamacare.” Did the government’s hand reach too far into the health care economy of our nation? This paper focuses on the Affordable Care Act’s general application to the capitalist tradition as framed by Adam Smith and Milton Friedman, with a limited analysis of the federal mandate to purchase individual health insurance. First, I will provide an overview of our nation’s health care system and the Affordable Care Act. Then, I will analyze …

Regulation Of Hydraulic Fracturing Of Shale Gas Formations In The United States, Fatemeh Bagheri

Pepperdine Policy Review

The practice of hydraulic fracturing has become increasingly common over the years since it has been looked at to replace energy derived from coal. Though hydraulic fracturing may be one of the better forms of obtaining energy, it comes with its own set of problems ranging from environmental problems to health problems if the appropriate safeguards are not implemented when completing the process. Regulations at the local, state, and federal level are assessed to determine which entity should regulate the practice and many technologies are reviewed in order to offer suggestions which allow the process to be completed without significant …

Mobile Health Technology In Developing Countries: The Case Of Tanzania, Shruti Modi

Pepperdine Policy Review

Mobile technology is one of the fastest growing industries. In rural parts of the world, mobile phones are more accessible than sanitation facilities and electricity. Mobile phones can be used to transmit health information, promote health awareness, track the spread of diseases, and ultimately decrease the prevalence of diseases. In particular, this study focuses on how mobile health technology, m-health, can reduce the spread of HIV/AIDS and malaria in Tanzania.

Can Clean Drinking Water And Sanitation Reduce Child Mortality In Senegal?, Catherine Bampoky

Pepperdine Policy Review

The purpose of this paper is to measure the impact of clean drinking water, modern sanitation facilities and hygiene on child mortality rates in Senegal. Diarrhea-related morbidity is still fairly common among young children and this disease is mainly due to poor hygiene and environmental factors. Although extensive research has been done on the determinants of child mortality in Senegal, they were mainly descriptive studies that did not focus on a policy-related variable on which public policies could have a direct intervention. Using dummy dependent variable models, I find that drinking water source and sanitation facility are not individually statistically …

Quality Of Care In Community Health Centers And Factors Associated With Performance, Peter Shin, Jessica Sharac, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federally funded community health centers are a key source of comprehensive primary care for medically underserved communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA) expanded the health center program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of keen interest. Most research shows high performance by health centers relative to various standards, but some gaps have also been found, and suitable benchmarks for …