Health Policy Commons^™

Mortalidad Por Neumonías En Guatemala (2014-2018): Una Herramienta Del Enfoque Epidemiológico De Riesgo Para La Priorización De Acciones Frente A La Covid-19, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por neumonías en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud publica. El riesgo de morir de neumonía en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas del pueblo mayo, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Aun sin la presencia de COVID-19, deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo …

What's Left Of The Affordable Care Act?, Helen Levy, Andrew Ying, Nicholas Bagley

Articles

We assess the progress of the Affordable Care Act a decade after it became law. Although most of it remains intact, some parts have been repealed and others have not been implemented as expected. We review how and why the law has aged. Legal challenges have done less damage than is commonly appreciated, with the exception of the Supreme Court case that thwarted full expansion of Medicaid. Most of the important changes have other sources. Some parts were born to fail. Others were dismantled in response to interest-group pressure. Still others have failed to thrive for any number of reasons. …

Using Open Public Meetings And Elections To Promote Inward Transparency And Accountability: Lessons From Zambia, Taryn Vian, Rachel M. Fong, Jeanette L. Kaiser, Viviane Sakanga, Melvin Mwansa, Parker S. Chastain, Thandiwe Ngoma, Nancy Scott

Nursing and Health Professions Faculty Research and Publications

Background
Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members.

Methods
We applied a principally qualitative …

A Heart Of Gold

DePaul Magazine

An interview with alumnus, retired insurance executive and DePaul Life Trustee Bertram ("Bert") Scott, chairman of the American Heart Association (AHA). He hopes to help focus attention on the social determinants of health, increase research, address vaping illnesses and foster diversity communities to get involved with the AHA.

Material Hardship Among Lower-Income Households: The Role Of Liquid Assets And Place, Mathieu Despard, Valerie Taing, Addie Weaver, Stephen Roll, Michal Grinstein-Weiss

Social Policy Institute Research

Lower income households are at risk for material hardship, particularly amidst the economic fallout of COVID-19. Where one lives (e.g. suburb, small town) may affect this risk due to variable access to resources, yet the evidence is mixed concerning the influence of place. We used a pooled, national cross-sectional sample of 66,046 lower-income tax filers to examine differences in material hardship in rural, small town, micropolitan, and urban areas. Controlling only for standard demographic variables, hardship risk appears higher in non-urban areas, yet these differences disappear after controlling for financial characteristics such as liquid assets and home ownership.

Employee Financial Wellness Programs: Tips For Employers, Sloane Wolter, Jenna Hampton Bsw, Sophia Fox-Dichter, Ellen Frank-Miller

Social Policy Institute Research

There are several types of Employee Financial Wellness Programs (EFWPs), such as workplace financial counseling, workplace credit building, and employer-sponsored small dollar loans. Each program benefits the company and its employees in different ways.

The Social Policy Institute at Washington University in St. Louis, with generous support from the W. K. Kellogg Foundation, studied the implementation of EFWPs at several diverse organizations, including a nonprofit in the Midwest and several supply chain locations of a national retailer, to understand the impact. As a result, we’ve identified four ways in which organizations can maximize the benefits of EFWPs and avoid pitfalls …

Tax-Time Saving And The Earned Income Tax Credit: Results From Online Field And Survey Experiments, Mathieu Despard, Michal Grinstein-Weiss, Stephen Roll, Bradley Hardy, Dana Perantie, Jane Oliphant

Social Policy Institute Research

Tax refunds are an opportunity for Earned Income Tax Credit (EITC) recipients to build emergency savings. Randomly assigned behavioral interventions in 2015 and 2016 have statistically significant impacts on refund saving take-up and amounts among EITC recipients who filed their taxes online. From a survey experiment, we also find that EITC recipients have a 49 percent and 59 percent increased likelihood of deferring 20 percent of their refunds for six months when hypothetically offered 25 and 50 percent savings matches (p < .001), respectively. These findings can inform policy development related to encouraging emergency saving at tax time.

Employee Financial Wellness Programs: Promising New Benefit For Frontline Workers?, Mathieu Despard, Ellen Frank-Miller, Yingying Zeng, Sophia Fox-Dichter, Geraldine Germain, Michal Grinstein-Weiss, Meredith Covington

Social Policy Institute Research

Interest among employers is growing in Employee financial wellness programs (EFWPs), a new type of benefit to address financial stress among employees. EFWPs benefits include financial counseling, small-dollar loans, and savings programs that address employees' non-retirement financial needs. Little evidence exists concerning the availability and use of and outcomes associated with EFWPs, especially among low- and moderate-income (LMI) workers who may be in greatest need of these benefits. We present findings concerning awareness and use of EFWPs from a national survey of LMI workers (N=16,650). Availability of different EFWP benefits ranged from 11 to 15% and over a third of …

The Impact Of Tax Refund Delays On The Experience Of Hardship And Unsecured Debt, Olga Kondratjeva, Stephen Roll, Mathieu Despard, Michal Grinstein-Weiss

Social Policy Institute Research

The Earned Income Tax Credit (EITC) provides substantial financial support to low-income workers, yet around a quarter of EITC payments are estimated to be erroneous or fraudulent. Beginning in 2017, the Protecting Americans from Tax Hikes Act of 2015 requires the Internal Revenue Service to spend additional time processing early EITC claims, delaying the issuance of tax refunds. Leveraging unique data, we investigate how delayed tax refunds affected the experience of hardship and unsecured debt among EITC recipients. We find that early filers experienced increased food insecurity relative to later filers after the implementation of the refund delay.

Financial Counseling For Front-Line Workers: A Pilot Study Of Engagement And Outcomes, Mathieu Despard, Yingying Zeng, Sophia Fox-Dichter, Ellen Frank-Miller, Michal Grinstein-Weiss

Social Policy Institute Research

Although financial counseling has been studied in community-based settings, programs offered in the workplace are understudied and yet may aid low- to moderate income employees in improving their financial situations. This study examines workers’ engagement in and associated credit outcomes from an employer-based financial counseling program in the New York City area. Findings suggest that participants engaged equally in services except for older and non-English speaking workers, who had lower levels of digital engagement. In-person engagement in services was minimal. Credit score improvements were modest, but greater for workers who had

scores in the lowest quartile at baseline. These credit …

Promoting Public Retirement Savings Accounts During Tax Filing: Evidence From A Field Experiment, Stephen Roll, Michal Grinstein-Weiss, Olga Kondratjeva, Sam Bufe

Social Policy Institute Research

Many U.S. households—especially those with low- to moderate-incomes (LMI)—struggle to save for retirement. To address this issue, the Department of the Treasury launched myRA, a no-fee retirement account designed primarily to help people who lacked access to employer-sponsored plans build retirement savings. In this paper, we report findings from two myRA-focused field experiments, both of which were administered to well over 100,000 LMI online tax filers before and during the 2016 tax season. The first experiment involved sending one of three different myRA-focused email messages to tax filers immediately prior to tax season, and the second experiment …

Employee Financial Wellness Programs: Tips For Providers, Jenna Hampton Bsw, Sloane Wolter, Sophia Fox-Dichter, Ellen Frank-Miller

Social Policy Institute Research

There are several types of Employee Financial Wellness Programs (EFWPs), such as workplace financial counseling, workplace credit building, and employer-sponsored small dollar loans. Each program benefits the company and its employees in different ways.

The Social Policy Institute at Washington University in St. Louis, with generous support from the W. K. Kellogg Foundation, studied the implementation of EFWPs at several diverse organizations, including a nonprofit in the Midwest and several supply chain locations of a national retailer, to understand the impact. As a result, we’ve identified five ways in which providers can maximize the benefits of EFWPs and avoid pitfalls …

Using Financial Tips To Guide Debt Repayment: Experimental Evidence From Low-And Moderate-Income Tax Filers, Olga Kondratjeva, Stephen Roll, Sam Bufe, Michal Grinstein-Weiss

Social Policy Institute Research

Much of the literature on household finances tends to focus on discrete or relatively objective measures like savings, debt, economic mobility, and there has been a lack of research on holistic measures of financial well-being. This gap is due in part to the absence of a common understanding of how to define and measure financial well-being; a gap that was recently addressed by the Consumer Financial Protection Bureau’s development of a financial well-being scale. However, the research on this scale is still scarce and little is known about how financial well-being evolves over time. To that end, this paper uses …

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Health Policy & Community Health: Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …

The Reproductive Health And Academic Impact Of The New York City School-Based Health Center Reproductive Health Project For Adolescents, Michelle Silverio

Dissertations and Theses

Background: Gaining an understanding of how school reproductive health policies impact adolescent sexual health and academic outcomes is a public health priority in the United States (U.S.) since it has the highest rates of adolescent pregnancy and sexually transmitted infections among developed nations. Adolescence is a critical developmental period and influences in this period affect reproductive health and social well-being over a person’s entire lifespan. Almost all adolescents spend the majority of their time in school settings; therefore local school reproductive health policies may have substantial lifetime impacts. Policies such as providing comprehensive sexual health education and contraceptive access in …

Covid-19 And Latinos In Massachusetts, Lorna Rivera, Phillip Granberry, Lorena Estrada-Martínez, Miren Uriarte, Eduardo Siqueira, Ana Rosa Linde-Arias, Gonzalo Bacigalupe

Gastón Institute Publications

This report focuses on the Latino population of Massachusetts and uses 2014–2018 American Community Survey (ACS) demographic data to explore both Latinos’ vulnerability to COVID-19 infection and the key predictive factors. We explore what is known about the social determinants of health previously identified as critical to understanding the spread and differential infection rates of COVID-19 across populations—for example, opportunities for infection due to employment and housing conditions—and how these apply to the Latino population in Massachusetts. We also briefly explore those factors that lead to COVID-19 severe illness and possibly death from the disease, including the age of the …

Creating Comprehensive Wrap-Around Services For The Homeless Community: Exploring Network Activity Among Shelters And Service Organizations Within The South-Side Of Chicago, Gloria West

Dissertations

We may not all agree that the homeless community is increasing and that their essential needs to survive such as food, healthcare and housing are quality of life rights for everyone. We must adopt the compassion of the medical industry and understand the importance of how community programs and services impact their survival. The sense of urgency to address the issues of homelessness does not appear to be moving as fast as other government agendas hindering families and individual’s ability to achieve self-sufficiency. It is expected that the priorities within this population are addressed immediately, it should be understood that …

Strategic Alliances As Treatment For Covid-19 And Beyond, Theodor Florian Cojoianu, Aoife Brophy Haney, Alet Meiring

Research Collection College of Integrative Studies

Novel strategic alliances have been emerging quickly in response to the Covid-19 crisis. We know much at alliance and firm-level about the benefits and challenges associated with different types of alliance configurations, however there are still gaps in our knowledge about the connection between alliances and impacts on society and the environment. In this paper, we use a novel dataset of 217 strategic alliances that have emerged between January and April 2020 in response to the Covid-19 crisis. We analyze which alliances have emerged and how these alliances are tackling different needs related to the crisis. We find that alliances …

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

Identifying The Weak Foundation Of Public Health Resilience Fornational Disaster Policy In Indonesia’S Mid-Term Developmentagenda 2015–2019: A Policy Content Analysis, Gita Miranda Warsito, Meiwita Budiharsana, Sharyn Burns

Kesmas

Indonesia is one of the most susceptible nations toward natural disasters in the world. Since 1992, approximately 37 tsunami incidents have occurred inIndonesia, with at least 1,244 cases of natural disasters during 2018. Despite the overwhelming impact of disasters on Indonesia, Public Health Resilience,as an approach to disaster countermeasures, has been poorly elaborated in Indonesia’s development agenda (National Mid-term Development Plan (NMDP),or Rencana Pembangunan Jangka Menengah Nasional (RPJMN), 2015 - 2019). By utilizing the method of policy content analysis, this study aimed to analyzethe policy background of Public Health Resilience against disasters in the NMDP 2015 - 2019 and National …

Benson's Relaxation Therapy And Sleep Quality Among Elderlyat A Social Institution In Inakaka, Indonesia, Nur Baharia Marasabessy, Lucky Herawati, Irhamdi Achmad

Kesmas

Serious sleep disturbances among elderlies include attention or memory disorders, depression and often fall. A quasi experimental study design with pre-posttest with control group was performed to determine effect of Benson’s relaxation therapy on sleep quality among the elderly, and influences of sex, age anddisease suffered differences. Of a total of 46 elderlies from a Social Institute in Ambon, 29 were taken for the treatment group and 19 for the control group.The treatment group was interfered with Benson’s breathing relaxation for 14 days. Sleep quality was measured using Pittsburg sleep quality index form. Datawere analyzed using independent t-test and multivariate …

Effects Of Climbing Choice, Demographic, And Climate On Walking Behavior, Febriani Fajar Ekawati, Frank Francis Eves

Kesmas

Walking is a public health recommendation to increase physical activity. Although walking for transport is associated with health benefits, it is frequently avoided when a mechanized alternative is available and when the weather or individuals’ available resources are unfavorable. The present quasi-experimental study used chosen walking speed to estimate the use of resources by pedestrians and investigated 730 pedestrians’ behavior when approaching a choice point between a short stair and a ramp at an exit from a university campus toward the local train station on six separate days. Results revealed that individuals who climbed the stairs walked faster than those …

Myths About Menstrual Personal Hygiene Among Female Adolescents, Tyas Diah Palupi, Terry Y.R. Pristya, Randy Novirsa

Kesmas

Poor personal hygiene during menstruation among adolescents can lead to urinary tract infection, reproductive tract infection, and skin irritation. This studyaimed to determine the relationship between belief in myths and personal hygiene during menstruation. Cross-sectional quantitative study was conductedusing a sample of 119 10th grade female students from Tangerang 13 State Senior High School selected through purposive sampling. Logistic regressionanalysis was used in this study to determine the relationship between myths and personal hygiene after age of menarche, attitude, socioeconomic status,information, and maternal education were controlled. In the bivariate selection, modeling was completed by entering confounding and interaction variablesthen reducing …

Adaptation And Validation Of The Tamil (Sri Lanka) Version Ofthe Montreal Cognitive Assessment, Pethirupillai Amal Dinesh Coonghe, Pushpa Fonseka, Sampasivamoorthy Sivayogan, Ajantha Keshavaraj, Rahul Malhotra, Truls Ostbye

Kesmas

The study aimed to develop the Tamil (Sri Lanka) version of the Montreal Cognitive Assessment (MoCA) and investigate its reliability and validity as a briefscreening tool for mild cognitive impairment (MCI). Tamil-speaking Sri Lankan elderly with normal cognition and MCI were recruited from a neurology clinic.Adaptation of the English MoCA to the Tamil (Sri Lanka) involved context-specific content modification and translation. The content validity, reliability, sensitivity,and specificity of the tool were evaluated. Study participants were 184 older adults, comprising 85 with normal cognition and 99 neurologist-diagnosed MCI.The tool had high internal consistency (Cronbach's alpha = 0.83). Receiver operating characteristic curve …

Adverse Effect Of Aerosol Pesticide On Lung Dysfunction Amongpaddy Farmers In Purworejo, Central Java, Indonesia, Fajaria Nurcandra, Renti Mahkota, Tri Yunis Miko Wahyono

Kesmas

The World Health Organization estimated that chronic obstructive pulmonary disease (COPD) will be the highest non-communicable disease worldwide by2030, and pesticide exposure is one of major risk factors. This study aimed to determine effect of pesticide exposure on lung dysfunction among paddyfarmers. A case-control study was performed on April - May 2016 in Purworejo. The case group comprised 66 farmers suffering from lung dysfunction during2015 based on medical records, while the control group comprised 59 neighboring farmers showing normal lung function. Both case and control groups weretested using a spirometer and COPD assessment test (CAT) questionnaire. Logistic regression analysis of …

Correlation Of Knowledge And Beliefs To Adherence With Antibiotic Use In Adult Patients At A Private Hospital In Sidoarjo, Muhammad Hasan Wattiheluw, Fauna Herawati, Setiasih Setiasih, Rika Yulia

Kesmas

Infectious diseases are one of the top ten causes of death in the world. Antibiotic therapy is administered for infectious diseases, but if bacteria are exposed to antibiotics continuously, then the bacteria are able to adapt to the medication, thereby resulting in antibiotic resistance. This condition results in an increase in mortality, long hospitalization period, and increased cost of antibiotic therapy and health services. Adherence to using antibiotics may be influenced by knowledge and beliefs about them. This study aimed to understand correlation between knowledge and belief with adherence to antibiotic use at a private hospital in Sidoarjo. This cross-sectional …

Religious Leader’S Support Toward Individual At Risk Ofhiv/Aids To Attend Voluntary Counselling And Testing Service, Imelda Februati Ester Manurung, Chatarina Umbul Wahyuni, Ari Probandari

Kesmas

Religious leader is a figure who is believed to have the gift of healing. A person with illness will follow any advice the religious leader gives for his/her recovery.Based on the phenomenon, religious leader is a potential local figure to give support for individuals at risk of human immunodeficiency virus (HIV) andacquired immune deficiency syndrome (AIDS). This study aimed to determine factors related to religious leader’s support toward individuals at risk of HIV andAIDS to attend voluntary counselling and testing (VCT) service. This study was an observational analytical with cross-sectional design. The population of thisstudy was religious leader in Kupang …