Health Policy Commons^™

The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode

Community Health Sciences

Introduction: Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.
Methods: We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of …

Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.

Health

This fact sheet highlights estimated rates of vaccine hesitancy, vaccination rates, the index of social vulnerability, and the level of concern for 17 Nevada counties as of June, 2021. The data are reported in the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) estimates.

Cdc Social Vulnerability Index (Svi): Nevada Counties, Vanessa Booth, Ally M. Beckwith, Kelliann Beavers, William E. Brown Jr.

Demography

This fact sheet highlights how Nevada counties rank on the Social Vulnerability Index (SVI) as defined by the Center for Disease Control (CDC) and the Agency for Toxic Substances and Disease Registry (ASTDR). Socially vulnerable populations are often disproportionately harmed during public health emergencies such as natural disasters and infectious disease outbreaks. The Geospatial Research, Analysis, and Services Program (GRASP) created the CDC/ATSDR Social Vulnerability Index (CDC/ATSDR SCI) to help public health officials and emergency response planners meet community health needs during response and recovery efforts (ATSDR, 2020).

In The Midst Of An Epidemic: How Print Media Shapes Policy Feedback To The Opioid Crisis, Peter S. Federman

Journal of Public Management & Social Policy

As opioid addiction has spread across the country, media discourse around opioid abuse has consistently increased. A content analysis of local newspaper articles from the state of Massachusetts reveals that political and administrative officials conceive of Narcan in distinct ways. Administrators, including police and fire officials, see Narcan as a means to accomplish their organizational mission. Conversely, elected officials are primarily concerned with cost, legal ramifications and the broad impact of the opioid crisis, remaining disconnected from street-level concerns. In delineating these divergent perspectives, this article provides two unique contributions: first, it applies policy feedback theory as a framework to …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Vaccination Options For Medicaid Parents Uncomfortable With Office Visits During Covid Pandemic, Amy Mcqueen, Tess Thompson, Enguday Teshome, Jennifer Staten, Saneel Kulkarni, Thidaporn Tanpattana, Lourdes Balaez, Matthew W. Kreuter

Social Policy Institute Research

Objective: Rates of child vaccinations declined during the COVID pandemic, which increases the risk of outbreaks of preventable diseases among children. Methods: We conducted an online survey of parents of Medicaid beneficiaries age 0-5 years old in Florida USA during January 2021 to assess barriers and strategies to increase adherence to childhood vaccinations.

Results: We surveyed 1,951 parents. Most (91%) respondents reported their child was up-to-date with childhood vaccinations, but fewer (36%) children had received a flu shot. Some (31%) parents had wanted to take their child to see a doctor but decided not to, and 22% were …

Use Of Public Benefits Over The First Year Of Pandemic: Exploring Access, Delays And Outcomes, Sam Bufe, Stephen Roll, Katie Kristensen, Dan Zhao, Mathieu Despard, Michal Grinstein-Weiss

Social Policy Institute Research

In response to the economic crisis caused by the COVID-19 pandemic, the U.S. federal government enacted initiatives designed to help households weather the pandemic’s effects. These initiatives included expansions of existing programs, such as unemployment insurance, as well as new programs like the economic impact payments. In this brief, we investigate the extent to which households relied on an array of public benefit programs over the course of the pandemic, how they used their economic impact payments, and the extent to which the unemployment insurance expansion was effective in insulating recipients from hardship during the pandemic.

We find that, in …

Employment Changes During Covid-19, Mathieu Despard, Sam Bufe, Stephen Roll, Katie Kristensen

Social Policy Institute Research

Early in the COVID-19 pandemic, U.S. unemployment peaked at 14.4%. While some workers have returned to payrolls, others have been left behind. This brief examines the nuances of employment changes over the course of the pandemic and the impact of those changes on household financial well-being. Our study finds that the proportion of employees who were laid off peaked in the spring of 2020 and has only recently returned to pre-pandemic levels.

Meanwhile, self-employment rose during the pandemic by 42% between the springs of 2020 and 2021. In households where someone lost a job during the pandemic, rates of financial …

Impact Of Covid-19 On Households With Children: Family Hardships And Policy Insights, Alejandra Muñoz-Rivera, Jason Jabbari, Stephen Roll, Michal Grinstein-Weiss

Social Policy Institute Research

The COVID-19 pandemic caused major disruptions in employment, child care and education. As a result, both parents and children experienced a variety of hardships in their work and education. While these hardships had reverberating effects throughout households, they were not equally distributed across families with children. In this brief, we explore the effects of COVID-19 on families with children, highlighting unaddressed areas of need, as well as potential points of intervention. In this study we find:

• Almost one-quarter (22%) of families experienced job or income loss as a result of child care disruptions, which was especially prevalent in households with …

Housing Hardships During Covid-19, Sophia Fox-Dichter, Yung Chun, Stephen Roll, Katie Kristensen, Michal Grinstein-Weiss

Social Policy Institute Research

Even prior to the COVID-19 pandemic, U.S. households were burdened by the cost of rental and mortgage payments, burdens which disproportionately fell on Black and Hispanic families. Using a 5-wave survey, we examined whether disparities in housing cost burden continued throughout the pandemic and trends in how households fell behind on rent and mortgage payments. We found that more than a third of households experienced housing cost burdens during the pandemic, with a slightly higher percentage of households of color bearing cost burdens than white households. Renters had greater cost burdens than homeowners.

During the pandemic, significantly more Black and …

The Socioeconomic Impacts Of Covid-19 Study: Survey Methodology Report, Stephen Roll, Sam Bufe, Yung Chun, Michal Grinstein-Weiss

Social Policy Institute Research

When COVID-19 was declared a pandemic, and economic shutdowns began in March 2020, households across the United States were faced with an unprecedented crisis that would affect their health, financial security and overall well-being for an unforeseeable amount of time. In order to examine and track the wide-ranging impacts of the pandemic on households, as well as the efficacy of different public and private efforts to mitigate these impacts, the Social Policy Institute at Washington University in St. Louis (SPI) launched the Socioeconomic Impacts of COVID-19 Survey (SEICS) in the United States just weeks after the pandemic became a national …

Employment, Financial And Well-Being Effects Of The 2021 Expanded Child Tax Credit: Wave 1 Executive Summary, Leah Hamilton, Stephen Roll, Mathieu Despard, Elaine Maag

Social Policy Institute Research

The 2021 temporary expansion of the Child Tax Credit (CTC) is unprecedented in its reach and is predicted to cut American child poverty by more than half. The expanded CTC provides families with $3,600 for every child in the household under the age of six, and $3,000 for every child between the ages of six and 17. Almost all middle- and low-income families with children are eligible for the CTC. Married parents making less than $150,000 and single parents making less than $112,500 per year will receive the full amount of the credit, which begins to phase out slowly after …

Pandemic Schooling: Lessons In Equity, Advocacy, And Racial Justice, Donna Rivera

Dissertations, Theses, and Capstone Projects

It was my fourth year of teaching at a Brooklyn elementary school when the COVID-19 pandemic forced school buildings, and the entire city, to enter a world of lockdown and quarantine. New York City was an early epicenter of the 2020 coronavirus pandemic, and the virus quickly revealed severe racial and socioeconomic disparities across the city. A disproportionate number of cases, serious illnesses, and death has been experienced by low-income Black and Latinx communities. At the same time, 2020 also ushered in a national racial reckoning following the May murder of George Floyd.

In this thesis, I will provide a …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Homelessness Estimates In The Mountain West, 2020, Saha Salahi, Vanessa Booth, William E. Brown Jr.

Demography

This fact sheet summarizes a recent report titled, “The 2020 Annual Homelessness Assessment Report (AHAR) to Congress,” by the U.S. Department of Housing and Urban Development. By synthesizing homelessness vulnerability categories to the Mountain West states, this report offers data for Arizona, Colorado, Nevada, New Mexico, and Utah.

Accelerating The Provision Of Safe Water Supply In Urban And Rural Areas Of Indonesia, Sumengen Sutomo, Salord Sagala, Bebi Sutomo, Sri Winarti, Gelant Sanjaya

Kesmas

Over the past 100 years, the provision of a safe water supply to drink in Indonesia has been slowly progressed with low coverage. The majority of the population does not have access to safe water. Morbidity and mortality of water-related diseases, including diarrhea, are very high. The provision of safe water is not a technological issue but good water management that comprises content, institutional, and communication layer. This paper provided information for strategic and operational decisions to accelerate the provision of safe water services in urban and rural areas. Benchmarking good water management with the characteristics of the water supply …

Association Between Self-Reported Fatigue And Sarcopenia Measures Among Elderly In Selangor, Malaysia, Maria Justine, Aliff Latir, Nadhirah Noor, Angelbeth Joanny, Izzaty Iskandar, Maisarah Sakinah Amirul Faizi, Dzulhelmi Edinan

Kesmas

The association between fatigue and sarcopenia is not well understood, therefore, this study aimed to compare the sarcopenia measures among elderly with mild and severe fatigue and to determine whether fatigue severity is associated with sarcopenia measures. This was a cross-sectional study conducted on201 elderly (age = 68.45±6.30 years). The elderly was classified into either mild or severe fatigue based on the Fatigue Severity Scale (FSS), meanwhile, sarcopenia measures include SARC-F score, muscle mass (ASM/height2), calf circumference (CC), upper (handgrip) and lower limb muscle strength, as well as physical performance (gait speed). Data were analyzed using independent t-tests and logistic …

Covid-19 Preparedness And The Anxiety Of Thai Citizens, Afifi Lateh, Prasopchai Pasunon, Kiflan Dolah, Panida Kongjam, Saminee Chemae, Phanupong Panomwan, Alawee Lateh

Kesmas

The outbreak of COVID-19 has brought sickness and fatality to Thai citizens. In addition, it left a tremendous psychological impact on mental health as they experienced panic and anxiety about controlling situations and preserving their physical and mental well-being. This study aimed to analyze the factors influencing COVID-19 preparedness and anxiety based on groups of Thai citizens. Online questionnaires were employed to collect data from 2,768 respondents selected through convenience sampling and snowball sampling on Facebook, having shared questionnaires with 190 other users. Data were collected from March 29 to April 3, 2020. The acquired data were analyzed using percentage …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Unveiling And Addressing Implementation Barriers To Routine Immunization In The Peri-Urban Slums Of Karachi, Pakistan: A Mixed-Methods Study, Amna Tanweer Yazdani, Ameer Muhammad, Muhammad Imran Nisar, Uzma Khan, Yasir Shafiq

Department of Paediatrics and Child Health

Background: Great disparities in immunization coverage exist in Pakistan between urban and rural areas. However, coverage estimates for large peri-urban slums in Sindh are largely unknown and implementation challenges remain unexplored. This study explores key supply- and demand-side immunization barriers in peri-urban slums, as well as strategies to address them. It also assesses immunization coverage in the target slums.
Methods: Conducted in four peri-urban slums in Karachi, this mixed-methods study consists of a baseline cross-sectional coverage survey of a representative sample of 840 caregivers of children aged 12-23 months, and 155 in-depth interviews (IDIs) through purposive sampling of respondents (caregivers, …

How Did Homelessness Change During The Great Recession And Recovery?, Jenny Schuetz, Matthew Ring

Policy Briefs and Reports

Job losses from the COVID-19 pandemic have exacerbated housing insecurity among low-income renters over the past year. Federal, state, and local policymakers have created temporary measures to help reduce displacement among people who have lost their jobs, but there is considerable uncertainty about what will happen when these temporary measures end. To gain insight into how homelessness changes over macroeconomic cycles, we examine changes in homelessness rates from 2007 to 2020. Our analysis focuses on four metro areas that were particularly hard-hit by the foreclosure crisis: Las Vegas, Los Angeles, Phoenix, and Riverside. Overall homelessness rates declined in all metros …

Conflicts Of Interest: An Invisible Force Shaping Health Systems And Policies, Afifah Rahman-Shepherd, Priya Balasubramaniam, Meenakshi Gautham, Eleanor Hutchinson, Freddy E. Kitutu, Robert Marten, Mishal S. Khan

Community Health Sciences

No abstract provided.

Measuring Routine Childhood Vaccination Coverage In 204 Countries And Territories, 1980–2019: A Systematic Analysis For The Global Burden Of Disease Study 2020, Release 1, Natalie C. Galles, Patrick Y. Liu, Rachel I. Updike, Stephen S. Lim, Jonathan F. Mosser, Asma Tahir Awan, Gbd 2020, Release 1, Vaccine Coverage Collaborators

Environmental & Global Health Faculty Research

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific …

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …

The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson

Patient Experience Journal

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREM^TM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with the healthcare …

“Covid-19 Hospital Isolation Affects More Than Just The Sick”, Lisa M. Tillmann Ph.D.

Faculty Publications

The author faces total hip replacement amid COVID-19 restrictions, politics, and disinformation.

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Health Policy & Community Health: Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Health Policy & Community Health: Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

“Take My Word For It”: Group Texts And Testimonials Enhance State And Federal Student Aid Applications', Jason Jabbari, Stephen Roll, Sam Bufe, Jessica Mckay

Social Policy Institute Research

"As the cost of college continues to rise, it has become increasingly important for students to apply for financial aid. However, many students are unaware of the benefits of FAFSA. We launched a field experiment with a non-profit organization to explore the impact of text message interventions on FAFSA application rates. 2,236 potential students were randomized into three groups: a control group that focused on reminders for upcoming deadlines, a treatment group that focused on benefits-framed messaging, and a second treatment group that added social proofing and norming. Each group received 8 text messages from late September 2020 to early …

Spatio-Temporal Analysis Of The Roadside Transportation Related Air Quality (Startraq) And Neighborhood Characterization, Jaymin Kwon, Yushin Ahn, Steve Chung

Mineta Transportation Institute

To promote active transportation modes (such as bike ride and walking), and to create safer communities for easier access to transit, it is essential to provide consolidated data-driven transportation information to the public. The relevant and timely information from data facilitates the improvement of decision-making processes for the establishment of public policy and urban planning for sustainable growth, and for promoting public health in the region. For the characterization of the spatial variation of transportation-emitted air pollution in the Fresno/Clovis neighborhood in California, various species of particulate matters emitted from traffic sources were measured using real-time monitors and GPS loggers …