Health Policy Commons^™

Service Learning In Health And Wellness, Leo Spychala

Open Educational Resources

No abstract provided.

The Changing Roles Of Community Health Workers, Mary-Beth Malcarney, Patricia Pittman, Leo Quigley, Naomi Seiler, Katie B. Horton

Health Workforce Research Center Publications

Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts.

This report provides a snapshot of the varied landscape of CHW programs to better understand how CHWs are integrating with the health system both in …

Repealing Federal Health Reform: Economic And Employment Consequences For States, Leighton C. Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Health Policy and Management Issue Briefs

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans.

Goal: To determine the state-by-state effect of repeal on employment and economic activity.

Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal …

Detroit Food Metrics Report 2017, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Reframing Homelessness In Vermont: A Systemic Approach To Homelessness Policy Advocacy In Windham County Vermont, Scott Sharland

Capstone Collection

The Changeworks Committee of the Groundworks Collaborative was created in 2014 to implement advocacy that would build public support for long-term policy changes addressing the root causes of homelessness in Windham County Vermont. This research focused on the work of this committee, and posed the question: How does reframing homelessness as a systemic issue instead of an individual issue impact the public perception of the problem in Windham County, Vermont? I argue that reframing perceptions of homelessness as the result of systemic failure and not as a problem of individual choice is key to building public support for solutions. Additionally, …

Addiction And Substance Abuse In Nevada, Andrea Blin

Social Health of Nevada Reports

Substance abuse is an issue with serious health and societal consequences in Nevada and throughout the nation. In 2016, drug overdoses were responsible for approximately 64,000 deaths in the United States, surpassing motor vehicle deaths by 60 percent (National Institute on Drug Abuse, 2018). Recent attention has been focused on the spike in opioid use and its implications for public health. Nationally, deaths from opioid overdoses increased from 6.1 per 100,000 in 1999 to 19.8 per 100,000 in 2016. Nevada’s experience has mirrored national trends, with the drug overdose death rate in the state increasing from 11.5 per 100,000 in …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh [Hindi], Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Depressive Symptoms Association With Health Outcomes And Treatment In Older Americans With Diabetes, Lashonda Jovon Williams

Theses and Dissertations

Introduction: Diabetes remains the 7th leading cause of death in the United States. Diabetes is a major public health concern of its own, but when you add the comorbidity of depression, diabetes outcomes are amplified. This dissertation examines how depressive symptomatology and treatment for depression are associated with selfreported health (SRH) and diabetes control.

Methods: Chi-square and logistic regression were used to analyze data from the Health and Retirement Study (2012). We assessed the associations between SRH and diabetes control with depressive symptomatology data.

Results: In our sample (n=4374), 19% of respondents reported high depressive symptomatology and …

Feasibility Of Introducing Investor-Owned Hospitals In Korea, Hongseok Seo

Theses and Dissertations

Since 2002, there has been active debate regarding the introduction of for-profit hospitals in South Korea: the advocates highlight the multiplication of economic value after the introduction of for-profit hospitals, whereas the opponents voice their concern about the possible negative consequences for-profit entities can create within the health care system. Various stakeholders including doctors’ associations, hospital associations, and civic groups have been for or against the introduction of for-profit hospitals, according to their interests. The government has tried to develop the national health and medicine system based on the positive and negative impacts of their introduction. In December, 2015, the …

Association Between Job Satisfaction And Pay: The Case Of The Wage Payment System Of Dental Clinics In Korea, Eui Jeong Kim

Theses and Dissertations

The purpose of this study is to investigate empirical type of the wage structures and the sub-items of wage applied at dental clinics and to analyze the determinants of pay satisfaction of dental employees. The questionnaire used in this study consists of personal characteristics, characteristics of workplace, administration of pay, Pay Satisfaction Questionnaire (PSQ), Job Descriptive Index (JDI). PSQ and JDI were translated, and backward translation into Korean was implemented. A pilot test was conducted with 25 dental employees to complete the questionnaire. Survey was conducted from February to July in 2015, receiving 302 valid responses. ANOVA or t-test was …

A Foe More Than A Friend: Law And The Health Of The American Urban Poor, David Ray Papke, Mary Elise Papke

Fordham Urban Law Journal

No abstract provided.

Local Health Department Adoption Of Health Information Technology And Its Impact On Population Health, Tina Yeung

Electronic Theses and Dissertations

Since the enactment of the HITECH Act in 2009, the US has invested billions in building a robust health information technology (HIT) infrastructure that is secure, capable of the electronic transfer of data and allows for real-time access of patient medical data, among others. This empirical study explored the driving forces (coercive, mimetic, and normative) in the adoption of HIT (i.e. EHRs and HIEs) by local health departments (LHDs) and how it has impacted the population health of counties in the US. The researcher conducted a cross-sectional, quantitative study using secondary data sources. The study included data on 505 local …

Determinants Of Hospital Efficiency And Patient Safety In The United States, Madhu Shettian

Electronic Theses and Dissertations

Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling …

Addressing Antibiotic Resistance From Farm-Raised Fish Imported To The United States, Nicholas Ali

Bard Center for Environmental Policy

Misuse of medically important antibiotics in animal production threatens the effectiveness of drugs that are vital in combating disease and infections. Recently, the FDA implemented regulations to limit the use of and access to veterinary drugs. However, these regulations only affect domestic production operations. Because over 90% of seafood consumed in the U.S. is imported from countries with different regulatory standards and because the U.S. has an import inspection rate of less than 1%, antibiotic resistance stemming from imported aquaculture is still a risk that is not sufficiently accounted for. This research investigates how the U.S. has reacted to the …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Jail Mental Health Innovations: Factors Influencing Mental Health Services Innovations For Jails, Orville Clayton

Electronic Theses and Dissertations

The U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding of the factors that influence the adoption of such services may help guide jails to implement beneficial services, and ensure that such services reflect, reflect quality standards. This study used a mixed …

Differentiating Sexual Offender Type On Measures Of Impulsivity And Compulsivity, Tara J. Ryan, Matthew T. Huss, Mario Scalora

Department of Psychology: Faculty Publications

It is suspected that rapists, child molesters, and offenders with both child and adult victims (mixed offenders) may have different motivations and offending patterns—that they are heterogeneous. A central difference between these groups of offenders may be their propensity toward sexually impulsive behaviors and compulsive behavior. Analyses were conducted to assess the mean differences between the various offender types across four measures related to sensation seeking and compulsivity as well as several other proxy behavioral measures. Results suggest that there are differences in sexual impulsive and compulsive behavior among the different types of offenders. Treatment implications are discussed.

Assessment Of The Current Reporting Requirements Of The Kentucky Immunization Registry, Lindsey Lewis

MPA/MPP/MPFM Capstone Projects

Immunizations are essential to societal health and wellbeing. Throughout one’s lifespan, immunizations are to be administered incrementally to decrease the prevalence of preventable diseases. Despite this, there are disparities in the rates of vaccinations across the country. Numerous guidelines and regulations have been published regarding the administration and scheduling of vaccines. Certain vaccinations are mandatory in order to be able to attend school or hold certain occupational positions and normally proof of administration is required.

Immunization registries were created to monitor and record patient-specific data about administered vaccines. These confidential reporting systems were developed to improve population health by allowing …

Comparative Storage And Utilization Analysis Of Insulin Across Inpatient Hospital Settings, Tristan A. Moorman

MPA/MPP/MPFM Capstone Projects

Insulin is the primary medication used by health systems across the nation to provide glucose control to those patients who need it. As this medication is generally available in a multi-dose vial, proper administration techniques should be used to minimize waste and optimize the cost effectiveness of the drug. Even though dosing guidelines for hospital use of insulin exist each institution has the opportunity to choose their administration technique. In this paper I will to identify administration characteristics utilized by four different hospitals in the central Kentucky area, compare and contrast those techniques through data collection, and analyze the findings …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Compte Rendu De La Réunion Régionale Des Comités De Plaidoyer Pour Avortement Médicalisé, Fatou Mbow

Reproductive Health

En partenariat avec le Ministère de la Santé et de l'Action Sociale, particulièrement la Direction de la santé de la reproduction et de la survie de l’enfant et le comité national de plaidoyer pour l’accès à l’avortement médicalisé (Taskforce), le bureau du Population Council du Sénégal a organisé une réunion régionale des comités/associations de plaidoyer pour avortement médicalisé de l’Afrique de l’ouest francophone. La réunion a eu lieu le 24 octobre 2017 à Dakar, Sénégal. Elle avait pour but de discuter des avancées notées dans l’accès à l’avortement médicalisé et mettre en exergue les efforts des pays de la région …

Partnering With The Private Sector To Strengthen Provision Of Contraception, Karen Hardee, David Wofford, Nandita Thatte

Reproductive Health

Family planning is most successful when clients have a variety of methods to choose from and a variety of service delivery sites from which to obtain them. The private sector plays a critical role in family planning and can contribute to a total market approach to providing contraceptives. Among private sector service options, social marketing, social franchising, and pharmacies and drug shops most readily contribute to sustainable markets for contraceptive services. Corporate sector workplace programs also show promise for reaching millions of women. This evidence brief outlines a number of policy and program considerations for countries as they move toward …

Assessment Of The Use Of Overdose Education And Naloxone Distribution By Maine Buprenorphine/Naloxone Prescribers, Stephen Kirsch

Muskie School Capstones and Dissertations

Background: Overdose deaths, specifically related to opioids, have been identified as a public health problem both nationally and in the state of Maine. Overdose Education and Naloxone Distribution (OEND) is an innovative model of patient education that has been shown to be effective in increasing knowledge of overdose risk and has the potential to help reduce opiate related overdose deaths.

Methods: A 28-item web-based survey examining clinician attitudes, OEND practices and characteristics was distributed to 196 Maine based physicians with a Drug Enforcement Agency waiver to prescribe burprenorphine/naloxone. Facilitators and barriers to the provision of OEND were also assessed. Surveys …

Cairing4carlisle: A Community Health Needs Assessment, Caitlin Coyle

Center for Social and Demographic Research on Aging Publications

Caring4Carlisle (C4C) is a community initiative aimed at addressing the social, emotional, spiritual and physical health of Carlisle residents. Community Health Network Areas (CHNAs) were created by the Massachusetts Department of Public Health in 1992. There are 27 CHNAs in the Commonwealth, and Carlisle belongs to CHNA 15. In July of 2016, Carlisle was awarded a planning grant ($20,000) from CHNA 15 to engage in a community needs assessment process with the intention of identifying priority community health needs to be addressed in Carlisle.

The Carlisle Board of Health served as the lead Town Department with the Gleason Public Library, …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

The International Scientific Association For Probiotics And Prebiotics (Isapp) Consensus Statement On The Definition And Scope Of Prebiotics, Glenn R. Gibson, Robert W. Hutkins, Mary Ellen Sanders, Susan L. Prescott, Raylene A. Reimer, Seppo J. Salminen, Karen Scott, Catherine Stanton, Kelly S. Swanson, Patrice D. Cani, Kristin Verbeke, Gregor Reid

Department of Food Science and Technology: Faculty Publications

In December 2016, a panel of experts in microbiology, nutrition and clinical research was convened by the International Scientific Association for Probiotics and Prebiotics to review the definition and scope of prebiotics. Consistent with the original embodiment of prebiotics, but aware of the latest scientific and clinical developments, the panel updated the definition of a prebiotic: a substrate that is selectively utilized by host microorganisms conferring a health benefit. This definition expands the concept of prebiotics to possibly include non-carbohydrate substances, applications to body sites other than the gastrointestinal tract, and diverse categories other than food. The requirement for selective …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Association Of Provider Communication And Inpatient Hospital Readmissions, Jeremy Dean Faulkenburg

Theses and Dissertations

Introduction: Inpatient hospital readmission rates represent an important clinical and economic problem. Clinical interventions have shown significant decreases in preventable readmissions, but are costly to implement. Another approach is to better equip patients with the knowledge and resources to manage their care after discharge. Patients receive instruction from both nurses and physicians, as well as information pertaining to post-discharge care and instructions for care while at home. This study examines the association between provider communication and inpatient hospital readmissions.

Methods: This study used survey data from the 2013 and 2014 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The …

The Socio-Political And Economic Causes Of Natural Disasters, Nicole Southard

CMC Senior Theses

To effectively prevent and mitigate the outbreak of natural disasters is a more pressing issue in the twenty-first century than ever before. The frequency and cost of natural disasters is rising globally, most especially in developing countries where the most severe effects of climate change are felt. However, while climate change is indeed a strong force impacting the severity of contemporary catastrophes, it is not directly responsible for the exorbitant cost of the damage and suffering incurred from natural disasters -- both financially and in terms of human life. Rather, the true root causes of natural disasters lie within the …