Health Policy Commons^™

Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review, Icha Khaerunnisa, Megah Andriany, Luky Dwiantoro

Kesmas

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping …

General Practitioners' Perspectives On Identifying Early Symptoms For Breast Cancer Detection In The Primary Care Facilities: A Case Study, Bob Andinata

Kesmas

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion …

Editorial: Migration And Health: A Human Rights Perspective - Conference Insights And Beyond, Noemi Rodriguez, Mira Goral, Justine Mcgovern, Allison Squires, María Isabel Roldos

Publications and Research

No abstract provided.

Wired Differently, Working Brilliantly: Understanding And Supporting Adhd & Audhd Employees, April Miller, Katherine Loving

Faculty Articles & Research

This paper explores the unique experiences, strengths, and challenges faced by neurodivergent individuals—particularly those diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), as well as the overlapping condition often referred to as AuDHD—in both clinical and workplace settings. It begins by examining diagnostic criteria, comorbidities, and the evolving understanding of ADHD and ASD as intersecting neurodevelopmental conditions. The paper then highlights common cognitive, emotional, and sensory challenges, including time blindness, neurodivergent paralysis, masking, overstimulation, executive dysfunction, rejection-sensitive dysphoria (RSD), and auditory processing disorder (APD).

Despite these challenges, many neurodivergent individuals possess exceptional strengths such as creativity, adaptability, rapid …

Investigating The Relationship Between Noun Classes And Plant Folk Taxonomy In Chasu Language Of Kilimanjaro Region In Tanzania, Peter Rabson Mziray

Journal of Humanities and Social Sciences

The current study investigates the relationship between noun classes and plant folk taxonomy in Chasu (G 22). The study focuses on two objectives: the first objective is to describe the plant folk taxonomy in Chasu and the second objective is to determine the relationship between noun classes and plant folk taxonomy in Chasu. Data were collected from rural villages in Same and Mwanga districts by using free listing, field interviews (jungle-walk-and-identify), and written texts containing Chasu plant names. The findings reveal that Chasu folk taxonomy reflects different ethnobotanical categories; including a unique beginner which is mmea/mimea ‘plant(s)’, and three life …

Advancing Children's Mental Health In Nevada, Kelliann Beavers, Christopher Kearney

Lincy Institute Events

Nevada ranks 51st nationally in youth mental health access and services, underscoring persistent shortages and disparities across the state. Nearly one in four youths aged 12–17 (23.5%) experienced a major depressive episode in the past year, and 73% did not receive treatment. Approximately 34,000 Nevada youths have reported suicidal thoughts—an urgent call for prevention and coordinated support.

During the 2024–2025 school year, 31.3% of Clark County School District students were chronically absent (missing 10% or more of school days), a challenge closely linked to mental health struggles and socioeconomic barriers.

This community forum provided an opportunity to generate dialogue and …

Refugee Stigma And Its Toll On Mental Health: Development And Validation Of The Refugee Stigma Scale (Rss), Hamed Abdollahpour Ranjbar, Khaled Elazab, Ibrahim Yigit, Fatema Almeamari, Ceren Acartürk, Gülşah Kurt, Janet Turan, Andrea Norcini Pala, Bulent Turan

Student Publications [Scholarly]

Background Unprecedented, forced displacement, especially from conflict and war areas, requires addressing resultant mental health issues. Aim Refugees experience mental and physical health problems due to post-displacement stressors, and the pervasive stigma associated with refugee status can exacerbate these difficulties, highlighting the need for a comprehensive assessment tool to understand various facets of refugee stigma. Method We developed the refugee stigma scale (RSS), consisting of 43 items informed by the literature, qualitative and quantitative data. The scale includes four theoretical dimensions of stigma: perceived community stigma, experienced stigma, anticipated stigma and internalised stigma. To examine convergent validity, validated self-report measures …

A Historical Cohort Comparison After Inpatient Admission For Adolescents With Anorexia Nervosa: Feasibility Of Virtual Group Therapy, Elizabeth V Franklin, Margaret Mathias, Rachel Wolfe, Duc T Nguyen, Drusilla M Rosales, Sofia Pedroza, Albert C Hergenroeder, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Objective: Access to follow-up care after a medical admission for adolescents with anorexia nervosa (AN) is important; yet access can be delayed or unavailable. This study assessed the feasibility and acceptability of a supplemental virtual 8-week outpatient group therapy program following inpatient care. A secondary aim explored the outpatient program's impact on self-reported anxiety, disordered eating, and depression symptoms, and readmission rates.

Method: A retrospective chart review study compared 68 adolescents (aged 11-18) with AN enrolled in an 8-week group therapy program (Recovery and Prevention Program [RAPP]) to 64 adolescents who were not enrolled in RAPP (historical cohort). "RAPP completers" …

Uthealth Mcgovern Medical School 2025 Quality Symposium Abstracts

Teaching in Clinics

UTHealth McGovern Medical School 2025 Quality Symposium Abstracts

About Ama’S Reimagining Residency Project

Teaching in Clinics

About AMA’s Reimagining Residency Project

Diaper Insecurity In Nevada And The Mountain West, 2024, Mia Tschan, Olivia K. Cheche, William E. Brown Jr.

Health

This fact sheet presents data on diaper insecurity in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. It also presents data on the diaper gaps faced by fifteen Nevada counties: Carson City, Churchill, Clark, Douglas, Elko, Humboldt, Lander, Lincoln, Lyon, Mineral, Nye, Pershing, Storey, Washoe, and White Pine. Esmeralda County and Eureka County are not included due to a lack of data. The 2025 Urban Institute report, “Mapping Diaper Insecurity in the US,” highlights 2024 data on diaper insecurity across all 50 U.S. states and the District of Columbia.

Nevada's Healthcare And Education Workforce Pipelines, David Damore, Caitlin J. Saladino, William E. Brown Jr.

Policy Briefs and Reports

With ongoing workforce shortages in K-12 education, healthcare, and mental and behavioral health—occupations central to the HEAL (health, education, administration, and literacy) economy—this brief utilizes the Nevada P-20 to Workforce Research Data System (NPWR) and data from the U.S. Bureau of Labor Statistics to explore the current and projected landscape for these workforces in Nevada. Examining the demographic characteristics of those participating in focused career and technical education training and those earning relevant postsecondary credentials illuminates gender disparities in Nevada’s healthcare and education workforce pipelines. After reviewing the current state of these workforces and assessing the available NPWR data, we …

Cost Of Living For Older Adults (65+) In Mountain West Metropolitan Statistical Areas, 2024, Anirudh Polagani, Annie Vong, Mohit Pande, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Demography

This fact sheet explores 2024 cost of living data for adults over the age of 65 in the largest metropolitan statistical areas (MSAs) across five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. The data are sourced from the “Elder Index,” a dashboard that focuses on housing, healthcare, food, transportation, and miscellaneous expenses that collectively reflect the monthly expenses for those over the age of 65. This fact sheet focuses on five MSAs in the Mountain West: Phoenix-Mesa-Chandler, AZ; Denver-Aurora-Centennial, CO; Las Vegas-Henderson- North Las Vegas, NV; Albuquerque, NM; and Salt Lake City-Murray, UT.

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

Venezuelan Migrants In Prostitution: A Personal Decision?, Yazmin Maria Lucila Cadena Camargo, Izara Maite Mondragon Moreno, Isabela Osorio Jaramillo, Paula Angélica Suárez Álvarez, Andrés Duarte Osorio, Carlos Gómez-Restrepo

Dignity: A Journal of Analysis of Exploitation and Violence

This paper explores the multifaceted experiences of Venezuelan migrant women engaged in prostitution, framed through three critical moments: the “decision to enter in prostitution,” the unique abuses faced, and the resultant consequences on mental, physical, and social health. The study highlights how socioeconomic vulnerabilities—exacerbated by migration and poverty—significantly influence the likelihood of entering prostitution. It also shows how traumatic experiences, particularly in childhood and adolescence, coupled with a lack of support networks, contribute to a heightened risk of exploitation. Eleven life stories were collected through a phenomenological approach, revealing a common narrative of abuse, poverty, and the search for survival …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Adapting To Inflationary Pressures: Household Coping Strategies In Urban Egypt (2016– 2025), Mohamed Mohamed Ashraf Kamal

Theses and Dissertations

Over the past decade, Egypt has faced persistent economic challenges including repeated currency devaluations, high inflation rates, subsidy reforms such as the gradual reduction of food and energy subsidies, and the ripple effects of global crises that have significantly impacted household well-being, especially in urban areas. These pressures have eroded purchasing power and heightened food insecurity, especially among low- and middle-income families. Although substantial attention has been paid to macroeconomic indicators, there remains a critical gap in understanding how households adapt on a daily basis to manage financial stress and sustain their livelihoods. This inquiry is especially timely, as household …

Real-World Use Of Classic And Non-Classic Psychedelics In Hispanic/Latino Adults With Obsessive-Compulsive Disorder: International Findings From The Latino Study, David S Mathai, Jill O Robinson, Kevin Wagner, Logan Neitzke-Spruill, Dayan Berrones, Jacey L Anderberg, Renee M Frederick, Vanessa Zavala Cruz, Josselyn S Muñoz, Latin American Trans-Ancestry Initiative For Ocd Genomics, Brazilian Obsessive-Compulsive Spectrum Disorder Working Group;, Carolyn I Rodriguez, Lynnette A Averill, James J Crowley, Eric A Storch, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Objective: Despite growing research on the potential mental health benefits of psychedelics, there has been limited study of these drugs in populations with obsessive-compulsive disorder (OCD) and with Hispanic and Latin American (H/L) ancestry.

Methods: Demographic and clinical assessments were conducted as part of the Latin American Trans-ancestry Initiative for OCD genomics (LATINO) Study in H/L participants with OCD living throughout the Americas. Self-reported data on the prevalence of naturalistic psychedelic use and associated outcomes on OCD symptoms were collected in a subsample of 2,639 adults. Descriptive statistics and regression analyses were used to assess psychedelic use, predictors of use, …

A Qualitative Exploration Of Child, Caregiver, And Clinician Perspectives On Mental Health In Children With Osteogenesis Imperfecta, Justin H Qian, Andrew D Wiese, Clarissa Gonzalez, Whitney S Shepherd, Hannah Cho, Gianna M Colombo, Julia M Morales, Selena Guo, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Kara Ayers, Members Of The Bbdc, Marie-Eve Robinson, Chaya N Murali, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Osteogenesis imperfecta (OI) is a heritable connective disorder with clinical manifestations including bone fragility and short stature. Previous research identified psychosocial themes related to mental health among children with OI and their caregivers, such as independence, social isolation, depression, and anxiety. Several studies have also examined clinicians of individuals with OI for their perspectives on mental health among their patients. However, no known studies have compared psychosocial themes among all three participant groups concurrently. This qualitative study examined mood and anxiety, along with risk and protective factors, from perspectives of youths, parents, and clinicians. Semi-structured interviews were conducted, which were …

The Cost Of Malnutrition In Older Adults In The Mountain West, 2020, Taylor Volk, Anirudh Polagani, Olivia K. Cheche, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents 2020 data on the annual costs of disease-associated malnutrition for adults aged 65 years and older across the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The data are sourced from “Advancing Policies for Quality Malnutrition Care in Older Adults: A Toolkit for State Legislators,” a report published by Defeat Malnutrition Today and Women in Government.

How Is Food Insecurity Measured In The United States And What Share Of Older Adults Are Food Insecure?, Colleen M. Heflin, Madonna Harrington Meyer

Population Health Research Brief Series

The U.S. Department of Agriculture measures food insecurity based on whether households had problems affording food during the last twelve months. Based on the current definition, in 2023 9.2% of households with adults ages 60 and older were food insecure. But there are many problems with the existing definition for accurately capturing food insecurity among older adults.

Based on the book, Food for Thought: Understanding Older Adults Food Insecurity, this brief summarizes those limitations, noting that existing measures do not account for barriers that are common among older adults, such as mobility, physical distance, and transportation barriers.

African Swine Fever In Indonesia: Insights From Southeast Asia’S Policy Response Through The One Health Approach, Niken Salindri, Wachyu Sulistiadi

Journal of Indonesian Health Policy and Administration

African Swine Fever (ASF) seriously threatens pig production systems, food security, and rural livelihoods across Southeast Asia. This study employs an analysis of secondary national data from Indonesia using a quantitative descriptive analysis approach, complemented by regional policy responses to ASF from 2019 to 2024. To contextualize regional findings, this study also integrates official statistics from Statistics Indonesia (BPS) covering provincial pork production trends (2021–2023), the number of ASF-affected pigs per province (2020–2024), and per capita pork consumption by district. Quantitative data show that ASF outbreaks have been disproportionately concentrated in specific provinces such as East Nusa Tenggara and North …

The Effects Of Input And Characteristic Factors On Contact Rate Achievement Among Puskesmas In Indonesia, Iqbal Andri Makarim, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The contact rate is the lowest-performing indicator in the Performance-Based Capitation Payment system initiated by BPJS Kesehatan. Analysis of the 2019 National Health Facility Research (Rifaskes) data showed that less than half of Puskesmas in Indonesia achieved the target. This cross-sectional study analyzed 5,384 Puskesmas from the 2019 Rifaskes to examine the effect of input and characteristic factors on achieving the contact rate. Independent variables included health worker ratios (doctors, nurses, midwives per 5,000 participants), completeness of essential medical equipment, communication facilities, P-Care application use, and Puskesmas characteristics. Multivariate logistic regression identified four significant factors: doctor ratio (OR=1.06; p<0.0001), midwife ratio (OR=1.01; p=0.033), completeness of essential medical equipment (OR=1.16; p=0.029), and BLUD-based financial management (OR=1.13; p=0.029). These factors explained only 2.6% of the variance (Nagelkerke R²=0.026), suggesting other unmeasured influences. Policy implications include equitable distribution of health personnel, targeted procurement of essential equipment, strengthening financial autonomy through BLUD, and optimizing P-Care data utilization to improve service accessibility and performance.

Overview Of A Hospital Management Information System Using The Hot-Fit Method In Medan Hospitals In 2025, Grace Putri Laia, Hotmarina Lumban Gaol, Jev Boris

Journal of Indonesian Health Policy and Administration

Hospital Management Information System (SIMRS/HMIS) is crucial in ensuring efficiency and quality in hospital services by integrating clinical and administrative functions. This study aims to evaluate the implementation of HMIS at Medan Adventist Hospital in 2025 using the Human-Organization-Technology Fit (HOT-Fit) framework. A descriptive design with total sampling was employed, involving 70 respondents comprising medical records staff, inpatient and outpatient registration staff, and ward officers. Data were collected through a structured questionnaire adapted from a validated instrument (validity 0.690–0.900; reliability 0.841–0.911) and analyzed using descriptive statistics. The results showed a high level of implementation in all HOT-Fit domains: system use …

The Ethics Of Clinical Ethics, Matthew Shea

Center for Medical Ethics and Health Policy Staff Publications

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …

Eugenics And Polygenic Embryo Screening: Public, Clinician, And Patient Perceptions Of Conditions Versus Traits, Dorit Barlevy, Rémy A Furrer, Asha Kalapatapu, Abigail Martinez, Todd Lencz, Shai Carmi, Gabriel Lázaro-Muñoz, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) estimates an embryo's genetic chances of developing complex conditions (eg, cancer) and traits (eg, height). Stakeholders have raised concerns that PES promotes eugenic practices and ideology.

Methods: We surveyed a nationally representative sample of the US public on approval of screening embryos for 12 conditions and 12 traits and examined the association between disapproval and concern about eugenics. We also conducted semistructured interviews with US-based reproductive endocrinology and infertility specialists and patients undergoing in vitro fertilization on their perspectives toward PES.

Results: Among the US public (n = 1423), disapproval of screening embryos for traits …

Towards A New Health Politics In Kenya: Labor Organizing And Strikes By Health Workers In The Public Health Sector, Michael Scanlon

Graduate Doctoral Dissertations

There has been insufficient attention by global health scholars to labor organizing by health workers, including when and why organizing occurs, what forms and strategies it takes and its implications for governance and policy. These questions are critical but largely absent in research on what has been called the “global health workforce crisis.” Kenya represents an important case study. A new constitution in 2010 expanded institutional spaces for labor organizing and decentralized governance of the health system. Both reforms had significant implications for the health workforce and strikes by health workers have been pervasive. In 2017, nationwide strikes by public …

Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned From Indonesia: A Systematic Review, Masyitoh Basabih, Indriaswari Widhakuswara

Kesmas

This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service …

Experiences Of Elderly Living With Noncommunicable Diseases In Utilizing Health Services In Myanmar During The Covid-19 Pandemic, Nway Eint Chei, Kwanjai Amnatsatsue, Natkamol Chansatitporn, Ariya Bunngamchairat

Kesmas

The COVID-19 pandemic and armed conflicts in Myanmar have intensified the challenges in accessing and utilizing health services, particularly for noncommunicable diseases (NCDs) among older adults. This qualitative study explored the experiences of the elderly with NCDs regarding health service accessibility and utilization in secure areas with fully operational health facilities by conducting in-depth interviews with 20 eligible older adults in Myanmar; data were analyzed using content analysis. Four key themes emerged: NCD service utilization patterns; unmet needs; preferences and hesitancy toward NCD services; and disparities, barriers, and opportunities. The findings revealed widespread underutilization of NCD services due to several …

Government Health Spending And Life Expectancy: Evidence From Cities And Districts In Indonesia, Kurnia Sari, Budi Hidayat, Amal Chalik Sjaaf, Mardiati Nadjib

Kesmas

Life expectancy is widely recognized as a fundamental indicator of population health, and its improvement is often linked to government health spending, particularly in decentralized health systems. This study aimed to investigate the relationship between local government health expenditures and life expectancy in decentralized Indonesia. Data from 492 cities and districts, spanning from 2015 to 2019, were analyzed using a two-way fixed effects regression model to control for time-invariant district characteristics and common temporal shocks. The findings indicated that a 10% increase per capita in government health expenditure was associated with a 0.01% increase in life expectancy. This association was …