Health Policy Commons^™

Rural Hiv Prevalence And Service Availability In The United States: A Chartbook, Katherine Ahrens Phd, Amanda Burgess Mppm, Louisa Munk, Erika Ziller Phd

Population Health

This chartbook examines 2016 HIV prevalence and the availability of HIV prevention, testing, and treatment services across the rural-urban continuum and by US Census region. Publicly available county-level HIV prevalence data from the CDC and state-produced HIV surveillance reports were used to estimate HIV prevalence across the rural-urban continuum. HIV prevalence data include all diagnoses of HIV infection, with or without a stage 3 (AIDS) diagnosis. Geocoded data on organizations that provide prevention, testing, and treatment services related to HIV were obtained from the National Prevention Information Network.

HIV prevalence is higher in urban counties than rural counties (399 per …

Opioid-Related Visits To Rural Emergency Departments, Erika C. Ziller Phd, Jean A. Talbot Phd, Deborah Thayer Mba, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient …

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …

Understanding The Impacts Of Emerging Infectious Disease (Eid) Media Exposure: The Case Of U.S. Ebola Virus Disease (Evd), Alicia Mason, Kevin Wright, Laura Lambert

Faculty Submissions

Introduction: Using the Extended Parallel Processing Model (EPPM) as a theoretical framework this study examines the impact of Ebola virus disease (EVD) media exposure on U.S. audience perceptions of the threat severity, personal susceptibility, and behavioral intentions to respond to the 2014 Ebola virus disease (EVD) threat.

Methods: Respondents included (n = 255) residents from the Midwest and Southern regions of U.S. Participants completed an online survey between 28 October and 3 December 2014 during the height of Ebola-related media coverage.

Results: Findings reveal that increased exposure to EVD media content was associated with increased threat severity and personal susceptibility. …

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 …

Healthcare Protection Policies During The Covid-19 Pandemic: Lessons Towards The Implementation Of The New Egyptian Universal Health Insurance Law, Alaa Ghannam, Ayman Sebae

Faculty Journal Articles

On March 11th 2020, the World Health Organization (WHO) declared the coronavirus a global pandemic. The spread of the virus in many countries has exceeded the capabilities of the traditional healthcare systems and has challenged government plans to contain it.

The COVID-19 pandemic arrived in Egypt at a time when the first steps in the implementation of the newly ratified law on social health insurance were taking place. Law number 2 for the year 2018 saw the first steps of its implementation in Port Said governorate. As the realisation of the law is proceeding in other governorates, the pandemic and …

Executive Summary- Social Protection In Egypt: Mitigating The Socio-Economic Effects Of The Covid-19 Pandemic On Vulnerable Employment, Dina Makram-Ebeid, Amr Adly, Nadine Sika, Hania M Sholkamy, Samer Atallah

Faculty Journal Articles

This is the executive summary of an interdisciplinary project between the fields of development economics, political economy, labor sociology, development anthropology and public health. It reviews the social protection available to vulnerable employees and their households in Egypt and suggests ways to adapt them in light of the COVID 19 pandemic. The research focuses on four areas a) employment security b) social assistance c) health insurance d) gendered mitigations. The project will map the impact of the crisis on vulnerable employees and their households and propose policy interventions to alleviate the socio-economic effects of the pandemic through the publication of …

Covid-19: Event Size Risk By Nevada County, January 2021, Olivia K. Cheche, Madison Frazee-Bench, Katie M. Gilbertson, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data on Nevada counties, drawing from the Georgia Institute of Technology’s “COVID-19 Event Risk Assessment Planning Tool,” as of January 14th, 2021. Various risk scenarios are displayed based on event size for the rate of COVID-19 transmission in Nevada’s 17 counties.

Covid-19: Hospital Bed Capacity In Nevada Counties, January 2021, Marie A. Falcone, Madison Frazee-Bench, Caitlin J. Saladino, William E. Brown Jr.

Health

This Fact Sheet presents data on hospital bed use during the COVID-19 pandemic in Nevada for the week of January 4 - 11, 2021. The data indicate the percentage of adult inpatient and intensive care unit (ICU) beds used in each hospital and clarify what percentage of those bed occupancies are COVID-19 patients. Information is available on 45 hospitals throughout Nevada located in the following counties: Clark, Nye, Douglas, Washoe, Churchill, Humboldt, Elko, and Carson. Other Nevada counties did not report relevant statistics, or the sample size was fewer than four.

Va Medical-Legal Partnerships: Implementation Guidance And Suggested Measures, Jennifer Trott, Kimberly Lattimore, Joel Teitelbaum, Marsha Regenstein

Health Policy and Management Faculty Publications

No abstract provided.

Determining Frailty In People With Intellectual Disabilities In The Covid-19 Pandemic, Dederieke A.M. Festen, Josje D. Schoufour, Thessa I.M. Hilgenkamp, Alyt Oppewal

Physical Therapy Faculty Research

© 2021 The Authors. Journal of Policy and Practice in Intellectual Disabilities published by International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals LLC Background: Across the world, frailty is part of the guidelines that are being developed in the COVID-19 pandemic for triaging in crisis situations. The Clinical Frailty Scale (CFS) evaluates the ability to perform daily tasks to identify frail individuals, potentially excluding those from intensive care (IC) treatment. Individuals with intellectual disabilities (ID) experience varying degrees of dependence, distinct from age-related physical deterioration. Using the CFS for triage in crisis situations could …

Drug Treatment Providers In Nevada, Vanessa Booth, Peter Grema, Caitlin J. Saladino, William E. Brown

Health

This fact sheet reports data from Behavioral Health Nevada’s drug treatment provider database for May 2020. The data focuses on the number of drug treatment providers in Nevada counties and municipalities, how the facilities are funded, and if the facilities accept Medicaid. A breakdown of the number of clinics, the facilities that provide adult services, and the clinics that attain above standard ratings in Clark County are also provided.

Sullivan County Covid-19 Needs Assessment, Melissa Mccollister

2020 Fall Reports (Sullivan)

Sullivan responded and continues to respond to the COVID-19 pandemic. A community needs assessment was performed through the SOWK 382 course in partnership with United Way of the Wabash Valley. The needs assessment revealed how the community has responded in relation to mental health and addiction, food, schooling, and stability. The assessment reveals how Sullivan should respond to further help the community members during this pandemic.

Hiv Clinical Stage Progression Of Patients At 241 Outpatient Clinics In Democratic Republic Of Congo: Disparities By Gender, Tb Status And Rurality, Gina D. Etheredge, Raimi Ewetola, Gulzar H. Shah, L. Maluantesa, Kristie C. Waterfield, A. Mulenga, A. Kilundu

Health Policy & Community Health: Faculty Publications

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO's four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services.

Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and …

Tb/Hiv Coinfection And Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Congo, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, L. Maluantesa, Kristie C. Waterfield, L.-K. Lukusa

Health Policy & Community Health: Faculty Publications

Background: To provide efficient, equitable, patient-centered, and evidence-based services to people living with HIV/AIDS (PLWH), it is critical for the intervention programs to understand the nature of barriers to effective treatment and additional risks faced by PLWH with tuberculosis (TB) coinfection. This study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes such as death, loss to follow up, and higher viral load among PLWH with TB coinfection compared to those without such coinfection.

Methods and materials: This quantitative study used …

Retention And Predictors Of Attrition Among Children Living With Hiv On Antiretroviral Therapy (Art) In Côte D’Ivoire Between 2012 And 2016, F. Traore-Toure, Gina D. Etheredge, Gulzar H. Shah, C. Brennan

Health Policy & Community Health: Faculty Publications

Background: In Côte d’Ivoire a retrospective national-level cohort study conducted in 2009 indicated that 77%, 72% and 75% of children living with HIV (CLHIV) remained in care at 12, 36, and 48 months after starting ART, respectively. The CDC-sponsored Improving HIV Surveillance and Program Evaluation in Côte d’Ivoire project assessed retention progress since that study.

Methods and materials: A retrospective review of medical records was conducted using 2-stage cluster sampling. HIV care and treatment centers (CTC) were sampled based on patient caseload, then records of patients under 15 years of age who initiated ART between 2012–2016 were randomly …

All Over The Map: A Systematic Literature Review And State Policy Scan Of Medicaid Buy-In Programs For Working Individuals With Disabilities, Dan Ferris, Mpa, Yueh-Ya Hsu, Mph, William Liem, Msw, Meredith Raymond, Msw, Mary Acri, Phd

Social Policy Institute Research

While supports for people with disabilities have increased, significant healthcare and financial barriers persist. State-administered Medicaid Buy-In programs for working people with disabilities, distinct from broader buy-in discussions that have emerged as some states consider expanding access to health insurance, are intended to incentivize employment and protect against a loss of Long-Term Services and Supports. Loss of these services would be detrimental to a person’s ability to access daily living and workforce participation supporting services. This paper explores identified drivers of and barriers to participation, outcomes, and the current state of programs that are currently in place. Authors conducted a …

Covid-19 And The “Space” Problem Of U.S. Hospitals: A Pragmatic Domestic Policy Solution For The Future, Timothy P. O'Brien

Liberty University Journal of Statesmanship & Public Policy

The healthcare system in the United States operates daily somewhere in excess of 75 percent of capacity with limited ability to absorb a sudden and large surge that may come about from an unexpected event, such as a large-scale terrorist attack, natural disaster, or pandemic. In order to manage a large-scale health crisis, also known as Public Health Emergencies (PHEs), governments at all levels must be prepared and have “space, staff, and stuff” in place. This article offers a solution that utilizes and re-purposes existing structures that could easily be “stood-up” and put into service in the times of emergency. …

Healthcare Of Indigenous Amazonian Peoples In Response To Covid-19: Marginality, Discrimination And Revaluation Of Ancestral Knowledge In Ucayali, Peru, Doreen Montag, Marco Barboza, Lizardo Cauper, Ivan Brehaut, Isaac Alva, Aoife Bennett, José Sanchez-Choy, Juan Pablo Sarmiento Barletti, Pilar Valenzuela, José Manuyama, Italo García Murayari, Miguel Guimaraes Vásquez, Celso Aguirre Panduro, Angela Giattino, Edwin Julio Palomino Cadenas, Rodrigo Lazo, Carlos A. Delgado, Alfonso Nino, Elaine C. Flores, Maria Amalia Pesantes, Juan Pablo Murillo, Luisa Elvira Belaunde, Sergio Recuenco, Robert Chuquimbalqui, Carol Zavaleta-Cortijo

World Languages and Cultures Faculty Articles and Research

"Systematic and persistent discrimination against Indigenous Peoples translates into differential health outcomes when analysed through ethnicity and/or mother tongue.1 In Peru, morbidity and mortality rates among Indigenous Peoples for COVID-19 appear to confirm this.2 The COVID-19 pandemic has highlighted the historical structural violence against Indigenous Peoples that currently takes a disproportionate toll in the Peruvian Amazon. This equally applies to Indigenous Andean Peoples and Afro Peruvians. Indigenous Peoples in voluntary isolation and those in initial contact are at highest health risk in this pandemic as they have no previous immunity against common infectious diseases, and lack access to public healthcare …

Adios 2020 And Welcome 2021, Srinivasan Ragothaman

Creative Work

This is a short ballad about current health policy and practice regarding the Coronavirus. As vaccines are being administered, this poem points out that light is at the end of the tunnel. At the same time it urges caution, vigilance, masking and common sense. It praises science and scientists. It also calls for unity, cooperation and healing!

Increasing The Retention Of The Health Workforce In Egypt: Improving Work Environments/ الاحتفاظ بعاملي الرعاية الصحية في مصر: تحسين بيئة العمل, Ebaa El-Kalamawie, Eman Gamal, Hoda Hassan, Nagui Salama

Papers, Posters, and Presentations

Egypt faces an urgent public health crisis which is a shortage in its health workforce capacity. The main reason for the lack of health workforce retention is the working environment. The Ministry of Health has multiple options to improve the quality of the working environment for health workers. Three interrelated policy options are proposed in this brief: 1) Enhancing organizational trust, 2) providing financial and non-financial incentives, 3) Developing a digital human resource system providing multiple services.

Acknowledging the economic constraints, the suggested options are tailored to be cost-effective. Policymakers can start immediately with their trust repair and trust-building initiatives …

Missouri’S Public Health Response To Covid-19: Key Findings And Recommendations For State Action And Investment, Alexis Acosta, Marie-Anais Benoit, Ciara Conway, Dora Hughes, Jeffrey Levi, Anne Markus, Marsha Regenstein, Semret Seyoum, Jennifer Trott, Hope Van Bronkhorst

Health Policy and Management Issue Briefs

This report from the study, Strengthening Missouri’s Capacity to Respond to Public Health Crises, summarizes key findings that are relevant to strengthening the state’s and local public health agencies’ (LPHAs) capacity to respond to future public health crises. With funding from Missouri Foundation for Health, a George Washington University study team conducted 138 stakeholder interviews within public health and other sectors involved in the COVID-19 response, revealing several key opportunities for the Missouri Department of Health and Senior Services (DHSS). Missouri, like many other states, faced great challenges in responding to the COVID-19 pandemic. Missouri now has a singular opportunity …

Splenic Artery Pseudo-Aneurysm Secondary To Necrotizing Pancreatitis – A Rare Lethal Complication., Vinay Raj Dr, Divya Vishwanatha Kini Dr

Radiology Teaching Files

CLINICAL HISTORY:

A 35-year-old male patient presented with history of massive hemoptysis associated with pain abdomen and breathlessness since the past 3 days. Patient had no prior co-morbidities; however was a chronic alcoholic and smoker since the past 15 years. No hospital admissions in the past

Advancing And Promoting Community Health: Opportunities For Accountable Communities For Health And Community Health Centers, Helen Mittmann, Jeffrey Levi, Janet Heinrich, Feygele Jacobs, Rebecca Morris, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Executive Summary:

Accountable Communities for Health (ACHs) are multi -sector, community-based partnerships that aim to address community health and social needs, and Community Health Centers (CHCs) provide important community-based healthcare services for underserved and medically vulnerable populations. Given the critical role that both ACHs and CHCs play in addressing health-related social needs and social determinants of health, a survey of ACHs on CHC engagement was conducted to better understand opportunities and challenges for CHC participation in ACHs. This survey, along with follow-up conversations with ACH and CHC representatives, confirmed that ACHs and CHCs are natural partners in the effort to …

Oligodendroglioma, Bala Seshank Akshit Reddy Mettu Dr, Rudresh Hiremath Dr, Vinay Raj Dr

Radiology Teaching Files

CLINICAL HISTORY:

A 39 year old male patient presented to our institute with one episode of GTCS and post-ictal headache. No other relevant history was present, no similar complaints were present in the past and no comorbidities. On examination, neurological examination was within normal limits. Blood-work up was also within normal limits.

Post Primary Pulmonary Tuberculosis: A Case Report, Abhigna S. Moudgalya Dr, Vikram Patil Dr

Radiology Teaching Files

No abstract provided.

Splenic Artery Pseudoaneurysm Secondary To Necrotizing Pancreatitis – A Rare Lethal Complication, Vinay Raj Dr, Divya Vishwanatha Kini Dr

Radiology Teaching Files

CLINICAL HISTORY:

A 35-year-old male patient presented with history of massive hemoptysis associated with pain abdomen and breathlessness since the past 3 days. Patient had no prior co-morbidities; however was a chronic alcoholic and smoker since the past 15 years. No hospital admissions in the past.

Voices From The Field: A Qualitative Study Of The Challenges And Promising Practices Of Rural Public Health In Addressing Hiv And Hepatitis C, Martha Elbaum Williamson Mpa, Karen B. Pearson Mlis, Ms, Amanda R. Burgess Mppm, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd

Population Health

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. Researchers at the University of Southern Maine’s Rural Health Research Center examined the capacity of rural public health systems to prepare for, identify, control, and respond to an HIV or HCV outbreak. Through semi-structured interviews with 36 state and local public health professionals from six rural states, we sought to understand the challenges related to HIV, HCV, and serving rural persons who inject drugs and to identify strategies to address those challenges. Challenges limiting the public health capacity …

Downeast Maine Mat Expansion Project: Year 3 Final Data Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katharine Knight Mph, Tyler Egeland Ba

Substance Use Research & Evaluation

This report summarizes the collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network, and Downeast Substance Use Response Coalition, to combat opioid use disorder (OUD) in Downeast Maine through multiple evidence-based strategies.

Project goals included the reduction of barriers to accessing medication-assisted treatment (MAT) and the enhancement of MAT services by improving provider capacity through training and implementation of best practice treatment.

For more information, please contact M. Lindsey Smith, PhD, [email protected]

Evaluating Racial And Ethnic Disparities In Access To Primary Care Among Gay And Bisexual Men In The Us, A Population At High-Risk Of Hiv Infection, Jessica S. Kiernan, April D. Kimmel

Graduate Research Posters

BACKGROUND: 69% of new HIV diagnoses in the US are among gay and bisexual men, with disparities by race and ethnicity. Primary care providers increasingly provide HIV prevention. Racial and ethnic disparities in primary care access are well-documented, but their persistence among gay and bisexual men is unknown. We examined racial and ethnic disparities in access to primary care among this population.

METHODS: We used nationally representative person-level sociodemographic, health status and utilization data, and data on organizational- and socially determinant barriers to care, from the National Health Interview Survey, 2013-2018. Outcomes were: 1) general physician visit

RESULTS: The sample …