Health Policy Commons^™

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps

Emergency Medical Services (EMS)

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …

The Paradox Of Child Poverty And Welfare, Tirna Purkait

Department of Nutrition and Health Sciences: Faculty Publications

The United States confronts persistent child welfare issues rooted in poverty. The age-old debate vacillates between advocating personal responsibility and bolstering social safety nets. Current welfare programs, aiming to mitigate child poverty, often fall short given the deep nexus of poverty and child maltreatment. This paper probes the intricate ties between child poverty and welfare, emphasizing state legislative variances, inherent system paradoxes, and potential policy enhancements. Exploring historical contexts, existing societal frameworks, and future reforms, this research emphasizes the urgency for all-encompassing solutions. These should tackle poverty’s core while fortifying child welfare, safeguarding the well-being of forthcoming American generations.

Nursing Abroad: A Comparison Of Healthcare In Italy, Sweden, And The Us, Sadie Stark

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No healthcare system is perfect, nor does one system work for all populations. History and culture have dictated the mindset of people for generations. It is the ever-changing mindset of patients and providers that will continue to expand and improve international healthcare by first changing daily practices. Nursing in Italy, Sweden, and the United States look very similar but also have a number of differences. Each country’s healthcare system works for its population, but efforts for international collaboration could still prove beneficial. Whether it be universal or private, centralized or localized, a patient centered focus is the driving force behind …

The Erasure Of Sex: The Global Capture Of Policies On Sex By Gender Identity Activists And The Effects On The Rights Of Women And Girls, Feminists From Europe, Asia, North America, Latin America, And Africa

Dignity: A Journal of Analysis of Exploitation and Violence

This article reviews the goals, history, and impact of the new gender identity politics. Based on the Yogyakarta Principles, these new ideas and policies will profoundly affect the rights of women and girls worldwide. The Principles are a document from an international meeting about sexual orientation and gender identity in 2006. In 2017, the document was updated to the Yogyakarta Principles Plus 10. The Principles recommend legal changes by states worldwide, resulting in the erasure of sex as a legal and cultural category. These principles have been widely used to lobby for legal changes resulting in profound structural …

Understanding Costa Rica's Response To The Covid-19 Pandemic: Competing Explanations, Lise Charles

The Journal of International Relations, Peace Studies, and Development

As the COVID-19 pandemic continues to have major impacts on the world, careful study of successful health systems is essential. Costa Rica has been identified as a country that has responded well to the pandemic with the proportion of death rates compared to infection rates being the lowest in comparison to other countries in Central America. This paper examines Costa Rica’s relatively successful response to the COVID-19 pandemic as a case study in good public healthcare management. This study also highlights the importance of theory for addressing urgent, practical development challenges to explore what theoretical frameworks can best explain the …

Affordable Housing: A National Crisis Fueled By The Coronavirus • A New Jersey Perspective, Latino Action Network Foundation

Center for Urban Policy Research

The Latino Action Network Foundation [LANF], its sister organization the Latino Action Network [LAN] and longtime ally, the Fair Share Housing Center [FSHC], have collaboratively monitored affordable housing issues in New Jersey for more than a decade. As part of its ongoing work, LANF sponsored a housing roundtable on September 10, 2021, to assess the affordable housing situation in the state and offer policy recommendations. At that time, a coalition of advocates, including the three organizations named above, were fresh from a legislative victory that safeguarded tenants unable to pay their rents during the pandemic and gave them a degree …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Structural Violence & Small Victories: Political Epidemiology Of Hiv Among Msm In Nigeria, 2000-2010, Debbie A. Dada

Harvey M. Applebaum ’59 Award

No abstract provided.

Small-Family Mindset: An Analysis Of The Impact Of China's Family Planning Policies On Family Culture, Sarah Ansley Croft

Honors Theses

This thesis examines the impact of China’s family planning policies on women’s attitudes towards family culture and the implications on China today. The family planning policies began in the 1970s as an emergency measure intended to create a short-term voluntary small-family culture by decreasing fertility rates. My research, comprised primarily of primary and secondary qualitative sources, discusses the development and implementation of the policies, the economic reforms beginning in the 1980s, and their joint effects on fertility rates, sex ratio at birth, women’s liberation, and changes in family culture, particularly in rural areas. This study found that the family planning …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

Reflections On The Effects Of Federalism On Opioid Policy, Matthew B. Lawrence

Dickinson Law Review (2017-Present)

No abstract provided.

Mhpaea & Marble Cake: Parity & The Forgotten Frame Of Federalism, Taleed El-Sabawi

Dickinson Law Review (2017-Present)

No abstract provided.

Consumer-Directed Healthcare And The Physician-Patient Relationship, Chase Floyd

Senior Theses

The physician-patient relationship is the most fundamental unit of medicine itself - and yet currently faces great peril, increasingly encroached upon by a number of different threats. Consumer-directed healthcare, an innovative new form of healthcare financing, empowers indi- viduals to make their own decisions regarding their healthcare, holds providers accountable to their patients, and theoretically establishes a robust working relationship that benefits both par- ties. Could this be what is needed to save and strengthen the physician-patient relationship? This paper studies this question, namely the effect of consumer-directed healthcare on the physi- cian-patient relationship, in-depth through a synthesis of existing …

Prenatal Care For Undocumented Immigrants: Implications For Policy, Practice, And Ethics, Rachel Fabi

Population Health Research Brief Series

Nearly 250,000 babies are born each year to undocumented immigrant parents in the U.S. These babies are U.S. citizens, but undocumented immigrants are ineligible for most public insurance, making it difficult for them to access prenatal care. This research brief describes restrictive policies related to prenatal care for undocumented immigrants and discusses how these policies affect health care providers and the care they are able to offer pregnant immigrant women.

The Incubation Period Of Coronavirus Disease 2019 (Covid-19) From Publicly Reported Confirmed Cases: Estimation And Application, Stephen A. Lauer, Kyra H. Grantz, Qifang Bi, Forest K. Jones, Qulu Zheng, Hannah R. Meredith, Andrew S. Azman, Nicholas G. Reich, Justin Lessler

Biostatistics and Epidemiology Faculty Publications Series

Background:

A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities.

Objective:

To estimate the length of the incubation period of COVID-19 and describe its public health implications.

Design:

Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020.

Setting:

News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. …

Naloxone Availability In Georgia Retail Pharmacies 44 Months After Implementation Of A Statewide Standing Order, Enjoli Willis

Electronic Theses and Dissertations

Opioid overdose deaths have quadrupled since 1999. Georgia is one of 35 states with a significant increase in drug overdose deaths from 2013 – 2017, with deaths increasing by 70% during 2010-2018. Many states, including Georgia, have implemented naloxone standing orders to remove barriers to access to naloxone, an opioid overdose reversal drug that reverses opioid overdose symptoms. However, it is still not readily available in places where it is most needed. This research investigates naloxone availability in Georgia 44 months after the implementation of a statewide standing order. This research also seeks to determine if pharmacy and community-level factors …

Impact Of The Affordable Care Act On The Cooper Women’S Care Center, Amanda Malik, Natali Franzblau

Cooper Rowan Medical Journal

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments.

Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

Structural Justice: A Critical Feminist Framework Exploring The Intersection Between Justice, Equity And Structural Reconciliation., Camille Burnett, Michael Swanberg, Ashley Hudson, Donna Schminkey

Journal of Health Disparities Research and Practice

Violence against women is a human rights violation (UN, 2006). It affects the health of women globally (UN, 2009) and its elimination is at the heart of many international and national goals. Intimate partner violence (IPV), one of the most common forms of gender-based violence, affects one in three women worldwide (WHO, 2013). The consequences of IPV create negative health outcomes for women that diminish their quality of life and their overall well-being. Abused women access community supports such as shelters to seek safe refuge from the abuse and restore their lives. While shelters play an extensive role in helping …

Adults Using Long Term Services And Supports: Population And Service Use Trends In Maine, Sfy 2016, Kimberly I. Snow Mhsa, Ba, Frances Jimenez Ba, Tina Gressani, Louise Olsen

Disability & Aging

All of us have likely either used, will use, or know someone who uses long term services and support (LTSS). They enable us to live with dignity and as much independence as possible and offer us the opportunity to remain involved and productive in our communities. The need for LTSS can arise suddenly after injury or illness or a life-long condition. But how ever the need arises, the impact is the same—services such as personal care, work support, home health care, and residential care provide not just for individual health and comfort, but also for interaction, inclusion, and engagement with …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd

Long Term Services and Supports

The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.

This study used Medicare Current …

Readiness For Assisted Decision-Making: An Exploratory Qualitative Study, Kay Cronin

Theses

Background: Ireland has recently enacted the Assisted Decision-Making (Capacity) Act 2015. The enactment of the legislation has allowed Ireland to ratify the United Nations Convention on the Rights of People with Disabilities (2008). The convention obliges all member states to assist people with disabilities to make their own decisions, with their will and preference taking precedence over what others deem to be in their best interests. Implementation of this legislation requires a change in working practice among health and social care providers to promote autonomy and decision-making among service users. To date, this topic has not been researched in Ireland. …

Discursive Constructions Of Professional Identity In Policy And Regulatory Discourse, Gerard Fealy, Josephine Mary Hegarty, Martin Mcnamara, Mary Casey, Denise O'Leary, Catriona Kennedy, Pauline O’Reilly, Rhona O’Connell, Anne-Marie Brady, Emma Nicholson

Articles

Aim

To examine and describe disciplinary discourses conducted through professional policy and regulatory documents in nursing and midwifery in Ireland.

Background

A key tenet of discourse theory is that group identities are constructed in public discourses and these discursively constructed identities become social realities. Professional identities can be extracted from both the explicit and latent content of discourse. Studies of nursing's disciplinary discourse have drawn attention to a dominant discourse that confers nursing with particular identities, which privilege the relational and affective aspects of nursing and, in the process, marginalize scientific knowledge and the technical and body work of nursing. …

Financial Exploitation Of Maine's Older Adults: An Analysis Of Maine Adult Protective Services And Legal Services For The Elderly Case Records, State Fiscal Years 2010-2016, Eileen Griffin Jd, Catherine Mcguire Bs, Kimberly I. Snow Mhsa, Ba

Disability & Aging

The goal of this study was to capture information about the amount of money Maine’s older adults have lost to financial exploitation, along with information about those exploited, the perpetrators of financial exploitation, the type of loss, and amount of money lost. This report summarizes key findings emerging from this analysis. In particular, we found that, when compared to Maine’s general population of adults age 60 and older, the victims of financial exploitation served by Maine's Adult Protective Services (APS) and Legal Services for the Elderly (LSE) are more likely to be age 80 and older, female; and widowed, single, …

Charting A Pathway Forward: Redesigning And Realigning Supports And Services For Maine's Older Adults, Eileen Griffin Jd, Elizabeth C. Gattine Jd

Disability & Aging

The current growth of the population age 65 and older is one of the most significant demographic trends in the history of this country and is especially significant for Maine, where the number of people age 65 and older is growing even faster than the rest of the nation. By 2025, over a quarter of Maine’s population is expected to be age 65 and older. Because the cost of long term paid support is out of reach for many Mainers, public financing—particularly Medicaid financing—is an essential tool for addressing the long term support needs of older adults. But Medicaid is …

Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika C. Ziller Phd

Health System Reform

Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services under the Affordable Care Act (ACA) or other insurance reform initiatives. To fully benefit from policy efforts to improve health insurance access, rural residents must have the ability to select the plan that best meets their healthcare needs. However, a higher proportion of rural residents possess characteristics that may put them at risk of lower health insurance literacy, including lower incomes and educational attainment, less experience with private insurance, and historically higher uninsured rates. Using Health Reform Monitoring Survey data …

The First Special Issue Of Dignity, Donna M. Hughes

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.