Health Policy Commons^™

Factors Of Anxiety Symptoms Due To Large-Scale Social Restriction Policy During The Covid-19 Pandemic In Indonesia, Indri Hapsari Susilowati, Sudibyo Alimoeso, Susiana Nugraha, Bonardo Prayogo Hasiholan, Magda Sabrina Theofany Simanjuntak, Nur Rachmat Satria

Kesmas

The Indonesian Government took some preventive measures to slow the spread of the COVID-19 virus, including social restrictions and encouraging individuals to stay at home and avoid needless gatherings. This study aimed to identify factors related to anxiety symptoms during large-scale social restrictions. This study employed a cross-sectional design using the snowball technique in an online survey. A total of 788 respondents comprised the target population to detect the smallest effect size (Cohen's dz = .2), with the level of power of 0.8 using G*Power 3.1, specifically targeting adults aged over 18 years. Out of 1,194 people who took part …

The Effect Of Ex-Ante Government Responsibility For Health On Public Health Financing In Post Pandemic Budgets, Denis Granados, Rylee Roman, Hallie Sidman

Working Papers Series

This paper investigates how pre-pandemic levels of government responsibility for public health financing influenced post-pandemic health spending across selected OECD countries. Using a combination of descriptive analysis and regression modeling, the study examines changes in public health expenditure per capita between 2019 and 2022, focusing on key variables such as the government’s share of health financing, the Total Pandemic Policy Intensity (PPI) index, and GDP per capita. Findings suggest that while all countries increased health spending post-COVID-19, the scale of change varied significantly based on economic capacity, institutional readiness, and political will. Notably, countries with higher pre-pandemic public health investment …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

A Narrative Review Of The Covid-19 Infodemic And Censorship In Healthcare, Mitchell Liester, Sohaib Ashraf, Patricia Callisperis, Hector Carvallo, Shankara Chetty, Robert Enzenauer, Carlos Franco-Paredes, Raul Pineda, Panagis Polykretis, Rachel Wilkenson, Peter Mccullough

Secrecy and Society

Ideological and financial motivations have undermined science for decades. In this narrative review, we explore how organizations and governments used misinformation, disinformation, censorship, and secrecy to manage the COVID-19 pandemic. Various rationales for employing censorship and secrecy during the COVID-19 pandemic are examined including how organizations and governments create confusion about the risks associated with their products and blame avoidance to shift responsibility and to avoid accountability for their actions. Methods of censorship employed during the COVID-19 pandemic are reviewed, examples are provided, and the consequences of these actions are reviewed. Information included in this review was obtained from scientific …

Covid Cover-Up: Secrecy, Censorship And Suppression During The Pandemic, Brian Martin

Secrecy and Society

During the height of the COVID-19 pandemic, most health authorities, governments, and mass media organizations presented a single official view concerning lockdowns, masking, distancing, and vaccines. The methods used against contrary views can be classified into four types: flooding, ignoring, censoring, and attacking. The method of information flooding involves presenting dominant views in a unified front, overwhelming contrary views by volume and consistency. The method of ignoring includes the absence of research on alternative approaches, failure to report on research contrary to orthodoxy, and not mentioning challenging views. Censoring involves active measures to prevent the circulation of contrary information and …

Association Of Messenger Rna Coronavirus Disease 2019 (Covid-19) Vaccination And Reductions In Post Covid Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection In A Us Prospective Cohort Of Essential Workers, Josephine Mak, Sana Khan, Amadea Britton, Spencer Rose, Lisa Gwynn, Katherine D Ellingson, Jennifer Meece, Leora R Feldstein, Harmony Tyner, Laura J Edwards, Matthew S Thiese, Allison Naleway, Manjusha Gaglani, Natasha Solle, Jefferey L Burgess, Julie Mayo Lamberte, Meghan Shea, Taryn Hunt-Smith, Alberto Caban-Martinez, Cynthia Porter, Ryan Wiegand, Ramona Rai, Kurt T Hegmann, James Hollister, Ashley Fowlkes, Meredith Wesley, Andrew L Philips, Patrick Rivers, Robin Bloodworth, Gabriella Newes-Adeyi, Lauren E W Olsho, Sarang K Yoon, Sharon Saydah, Karen Lutrick

Center for Medical Ethics and Health Policy Staff Publications

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was …

Exploring Physician Well-Being: A Bibliometric Analysis Of Mental Health, Suriya Kumareswaran, Bala Murali Sundram, Vanitha Thurairasu

Kesmas

This bibliometric study examined the evolving research landscape on physician mental health from 2010 to 2023, analyzing key themes, publication trends, and global contributions. A total of 3,360 articles, including 3,137 original research and 223 reviews, were sourced from Web of Science and Scopus. Findings revealed a significant increase in research output, particularly during the COVID-19 pandemic, with burnout, depression, and anxiety emerging as dominant themes. The US accounted for most publications, while research from low- and middle-income countries remains limited, indicating a substantial global disparity. Thematic analysis highlighted variations in burnout assessment methodologies, underscoring the need for standardized evaluation …

Analysis Of Covid-19 Prevention And Control Policy Implementation In Islamic Boarding Schools In Dki Jakarta, Dickha Adi Wibowo, Fajar Ariyanti

Journal of Indonesian Health Policy and Administration

Indonesia, as one of the countries affected by COVID-19, has implemented various efforts to prevent the transmission of COVID-19. One effort that can be implemented is the implementation of COVID-19 prevention protocols. Apart from that, according to the COVID-19 Handling Task Force, Islamic boarding schools are locations with high mobility. This research aims to determine the implementation of policies related to the prevention and control of COVID-19 in Islamic boarding schools in the DKI Jakarta Province. This research used descriptive research with a qualitative approach, with the number of respondents being three Islamic boarding school leaders and students. The results …

Lessons For Public Policy From The Covid-19 Pandemic, Olga Shvetsova

Political Science Faculty Scholarship

In the early 2020s, as the COVID-19 pandemic unfolded, governments, bureaucracies, and health practitioners around the globe faced unforeseen tasks and responsibilities. The novelty and intensity of the crisis spurred innovation and experimentation in public policy, health policy, and crisis management. However, the pandemic also revealed bottlenecks and adverse incentives within policy framework and healthcare systems. From this experience, critical lessons emerged: the paramount importance of swift and well-informed policy responses and the ability to optimize ongoing policy response as the crisis unfolds.

Pandemics And Partisanship: The Impact Of Political Identity On Public Health Responses, Andy Tuholski

Midwest Social Sciences Journal

This literature review examines the intersection of political partisanship and public health responses during pandemics, with a focus on the COVID-19 pandemic in the United States. Historically, pandemics such as the Venetian plague (1575-1577) and the Great Plague of London (1665-1666) have elicited responses driven by socioeconomic and health factors. In contrast, the COVID-19 pandemic in the U.S. was distinctly shaped by pre-existing political affiliations, particularly between conservative and liberal factions. Applying Social Identity Theory (SIT), this review explores how group identity and partisanship influenced pandemic-related behaviors and attitudes. Empirical evidence indicates that Republican-leaning states experienced higher COVID-19 mortality rates, …

Parallel Electrophysiological Abnormalities Due To Covid-19 Infection And To Alzheimer’S Disease And Related Dementia, Yang Jiang, Jennifer Neal, Pradoldej Sompol, Görsev Yener, Xianghong Arakaki, Christopher M. Norris, Francesca R. Farina, Agustin Ibanez, Susanna Lopez, Abdulhakim Al-Ezzi, Voyko Kavcic, Bahar Güntekin, Claudio Babiloni, Mihály Hajós

Neurology Faculty Publications

Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting-state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID-19 and to Alzheimer’s disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID-19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in …

What Is The Economic Benefit Of Annual Covid-19 Vaccination From The Adult Individual Perspective?, Sarah M Bartsch, Kelly J O'Shea, Colleen Weatherwax, Ulrich Strych, Kavya Velmurugan, Danielle C John, Maria Elena Bottazzi, Mustafa Hussein, Marie F Martinez, Kevin L Chin, Allan Ciciriello, Jessie Heneghan, Alexis Dibbs, Sheryl A Scannell, Peter J Hotez, Bruce Y Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.

Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine.

Results: For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe …

Expanding A Behavioral View On Digital Health Access: Drivers And Strategies To Promote Equity, Maura M Kepper, Lauren A Fowler, Isabelle S Kusters, Jean W Davis, Manal Baqer, Sara Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C Yi, Bryan Gibson, Kristin E Heron, Nicole M Alberts, Marissa Burgermaster, Veronica Ps Njie-Carr, Lisa M Klesges

Center for Medical Ethics and Health Policy Staff Publications

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for …

The Correlation Of Age With Thrombocytes And D-Dimer Values In Covid-19 Patients At Hospital X In Jakarta, Indonesia, Nanik Prasetyoningsih, Ascobat Gani

Kesmas

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, spread globally, with research indicating that prognosis severity can be assessed by thrombocyte and D-dimer levels; while, patient age serves as a mortality predictor. This study aimed to analyze the relationship between age with thrombocytes and D-dimer in COVID-19 patients. This cross-sectional study used laboratory testing samples from 667 COVID-19 patients at Hospital X in Jakarta, Indonesia, collected from August 2020 until May 2021. The data was collected using cluster random sampling and analyzed using descriptive statistics and the Chi square test (95% CI). The results showed that age and thrombocytes positively …

Supporting Ontario Public Health Units To Address Adverse Childhood Experiences In Pandemic Recovery Planning: A Priority-Setting Exercise, Kimberly B Harding, Erica Di Ruggiero, Erick Gonzalez, Amanda Hicks, Daniel W Harrington, Sarah Carsley

Faculty, Staff and Student Publications

BACKGROUND: Adverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units' work towards ACEs-informed pandemic recovery plans.

METHODS: The Child Health and Nutrition Research Initiative method …

Dual-Systems And Fuzzy-Trace Theory Predictions Of Covid-19 Risk Taking In Young Adults, Sarah M. Edelson, Valerie F. Reyna, Bridget B. Hayes, David M. N. Garavito

Articles

Risk-reduction behaviors are the first line of defense in viral epidemics. Choosing to not engage in risk-reduction behaviors produced millions of preventable deaths from COVID-19. Understanding why this happens and how to predict it is important for theory development and public policy. We took four approaches to this problem: experimentally varying theory-driven predictors (social rewards, transmission risk, and mandatory/voluntary regulations) in choice scenarios, further probing choices in specific scenarios predicted to elicit risk taking, conducting hierarchical regressions with demographic and theory-driven predictors for both scenario types, and conducting corresponding regressions for self-reported protective behaviors. The sample consisted of 247 young …

Waiving Snap Interviews During The Covid-19 Pandemic Increased Snap Caseloads, Colleen Heflin, William Fannin, Leonard M. Lopoo, Siobhan O'Keefe

Population Health Research Brief Series

Food insecurity in the United States reached historically high rates during the COVID-19 pandemic, thus substantially increasing demand for the Supplemental Nutrition Assistance Program (SNAP). To facilitate access to SNAP during the pandemic, the federal government granted state SNAP offices the option to waive the interview requirement – an administrative burden associated with the SNAP certification process. This brief summarizes findings from a recent study that used data from SNAP offices across 10 states to examine the impact of SNAP interview waivers on SNAP caseloads from January 5th to April 30th of 2021. Findings reveal that counties that implemented the …

Implementation Of Digital Health In Addressing Global Threats: Lessons From The Use Of Technology During Covid-19 Pandemic In Indonesia, Naili Shifa, Anisa Tiasari, Kemal N. Siregar

Kesmas

This research conducted a systematic literature review to explore the implementation of digital health in Indonesia, focusing on the digital health policies, usage during the COVID-19 pandemic, benefits, and lessons learned. The study identified 10 relevant journals through database searches and analyzed the trends in publication, productive journals, and top institutions involved in digital health research. The findings revealed an increasing interest in digital health, with a growing number of published articles from 2021 to 2023. ScienceDirect emerged as the most productive journal, followed by PubMed and MDPI. The University of Indonesia and the University of Gajah Mada were the …

Waiving Snap Interviews During The Covid-19 Pandemic Increased Snap Caseloads, Colleen Heflin, William Clay Fannin, Leonard M. Lopoo, Siobhan O'Keefe

Center for Policy Research

Food insecurity in the United States reached historically high rates during the COVID-19 pandemic, thus substantially increasing demand for the Supplemental Nutrition Assistance Program (SNAP). To facilitate access to SNAP during the pandemic, the federal government granted state SNAP offices the option to waive the interview requirement – an administrative burden associated with the SNAP certification process. This brief summarizes findings from a recent study that used data from SNAP offices across 10 states to examine the impact of SNAP interview waivers on SNAP caseloads from January 5th to April 30th of 2021. Findings reveal that counties that implemented the …

Fitting A Covid-19 Model Incorporating Senses Of Safety And Caution To Local Data From Spartanburg County, South Carolina, D. Chloe Griffin, Amanda Mangum

CODEE Journal

Common mechanistic models include Susceptible-Infected-Removed (SIR) and Susceptible-Exposed-Infected-Removed (SEIR) models. These models in their basic forms have generally failed to capture the nature of the COVID-19 pandemic's multiple waves and do not take into account public policies such as social distancing, mask mandates, and the ``Stay-at-Home'' orders implemented in early 2020. While the Susceptible-Vaccinated-Infected-Recovered-Deceased (SVIRD) model only adds two more compartments to the SIR model, the inclusion of time-dependent parameters allows for the model to better capture the first two waves of the COVID-19 pandemic when surveillance testing was common practice for a large portion of the population. We find …

The Impact Of Censorship On Covid-19 Policy Formation In The United States, Victor Wallis

Faculty Works

No abstract provided.

Commonalities And Differences In Governments’ Covid-19 Public Health Responses Around The World, Olga Shvetsova, Andrei Zhirnov

Political Science Faculty Scholarship

As the world enters the era of increased frequency of global health crises and natural disasters, with climate change looming as an ever-present threat, how we govern ourselves matters for the ways in which we will live through these difficult times. The authors in this volume provide observations backed by mixed methods of analysis on the many ways in which government organization and political realities affect crisis response and crisis management. In this chapter, we further strengthen the validity of their findings with large N global sample analyses where the timing and stringency of the adoption of public health policies …

Spanish-Language Communication Of Covid-19 Information Across Us Local Health Department Websites, Isabelle S Kusters, Amanda M Gutierrez, Julianna M Dean, Mark Sommer, Anna Klyueva

Center for Medical Ethics and Health Policy Staff Publications

The COVID-19 pandemic has brought new urgency to a longstanding problem: the US health system is not well-equipped to accommodate the country's large limited English proficient (LEP) population in times of national emergency. We examined the landscape of Spanish-language COVID-19 website information compared to information in English provided by health departments of the top 10 cities by population in the USA. For each city, coders evaluated three score measures (amount of information, presentation quality, and ease of navigation) for six content types (general information, symptoms, testing, prevention, vaccines, and live statistics) across six delivery modes (print resources, website text, videos, …

Covid-19 Mortality Rates Were Higher In States That Limited Governments From Enacting Public Health Emergency Orders, Xue Zhang, Mildred E. Warner, Gen Meredith

Population Health Research Brief Series

State and local governments enacted various public health emergency policies during the COVID-19 pandemic, resulting in lower infection and death rates than would have occurred without these policies. However, some states limited the emergency public health authority of state executives, state governors, and other state and local officials during the pandemic. This brief summarizes the results of a study that used data from the Center for Public Health Law Research and Oxford COVID-19 Government Response Tracker to explore which states passed laws that limited emergency public health authority during the COVID-19 pandemic and the effects of those limits on COVID-19 …

Emotional Distress During Covid-19 By Mental Health Conditions And Economic Vulnerability: Retrospective Analysis Of Survey-Linked Twitter Data With A Semisupervised Machine Learning Algorithm, Michiko Ueda-Ballmer, Kohei Watanabe, Hajime Sueki

Center for Policy Design and Governance

The brief summarizes "Emotional Distress During COVID-19 by Mental Health Conditions and Economic Vulnerability: Retrospective Analysis of Survey-Linked Twitter Data With a Semisupervised Machine Learning Algorithm," co-authored by Michiko Ueda-Ballmer, Kohei Watanabe, and Hajime Sueki in the Journal of Medical Internet Research.

Toward An Equity-Driven Conceptual Model Of Covid-19 Vaccine Decision-Making For People With Idd, Lydia Ocasio-Stoutenburg, Reese Triana, Shelly Baer, Jairo Arana, Ana C. Sale, Douglene Jackson, Michelle Schladant, Nastasia Boulos, Grace Dima, Jeffrey Brosco

Developmental Disabilities Network Journal

COVID-19 presented a public health emergency in the U.S., resulting in severe illness, hospitalizations, high mortality rates, and long-term adverse health care conditions. Several studies examined the disparities in transmission rates, barriers to care, and negative health outcomes for persons with disabilities, particularly people with intellectual and developmental disabilities (I/DD). While data revealed similar trends among Black, Hispanic or Latino/a/x/e, Native, Indigenous, and Asian people, outcomes are compounded for people of color with I/DD. Several historical, pervasive, systemic, structural, and attitudinal barriers have constrained healthcare access and adequate treatment, instigating feelings of distrust among those in systems of care. Although …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

Breaking Down Barriers: Investigating Structural And Systemic Factors That Contribute To Covid-19 Disparities In African American Communities In New Jersey, Fazal Choudhary, Suraj Pothineni

Rowan-Virtua Research Day

Background: The COVID-19 pandemic has affected the lives of millions of Americans; however, minority communities have been hit the hardest as infection rates continue to sky rocket and new variants arise. As of October 5, 2021, the CDC reports that African Americans make up a similar share of cases relative to the overall population, at about 12%, but have a significantly higher rate of deaths compared to the population, at approximately14%. African American communities are being disproportionately affected because of higher incidence of chronic diseases, inadequate access to health care, and poorer living and working conditions, which increases their vulnerability …