Health Policy Commons^™

Expanding Women’S Healthcare Access In The United States: The Patchwork “Universalism” Of The Affordable Care Act, Randy Albelda, Diana Salas Coronado

Center for Social Policy Publications

This paper explores the promise of the Patient Protection and Affordable Care Act, commonly called “Obamacare” (referred to here as the ACA), with attention to the ways gender matter by tracing the development and implementation of key US social protection systems, an examination of the current health system with particular attention to women’s coverage, and the potential impacts of the ACA, including how it conforms to international human rights norms for health care. The ACA promises to vastly improve the key dimensions of health coverage in the US, but it conforms with other US social policy by relying on market-based …

Legal And Ethical Responsibilities Following Brain Death: The Mcmath And Muñoz Cases, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

What are the legal and ethical implications of continuing to treat a brain dead patient? And may a hospital refuse to provide such treatment? These ethical and legal problems are raised in two recent cases. In the first Marlise Muñoz, a pregnant woman declared brain dead, was kept on life support against her family’s wishes due to the treating hospital’s interpretation of a Texas fetal protection law. In the other a hospital refused to treat Jahi McMath, a brain dead girl, despite her family's entreaties. The cases, at first, appear similar because in each case the hospital was refusing to …

“Obesity Is A Disease”: Examining The Self-Regulatory Impact Of This Public-Health Message, Crystal L. Hoyt, Jeni L. Burnette, Lisa Auster-Gussman

Jepson School of Leadership Studies articles, book chapters and other publications

In the current work, we examined the impact of the American Medical Association’s recent classification of obesity as a disease on weight-management processes. Across three experimental studies, we highlighted the potential hidden costs associated with labeling obesity as a disease, showing that this message, presented in an actual New York Times article, undermined beneficial weight-loss self-regulatory processes. A disease-based, relative to an information-based, weight-management message weakened the importance placed on health-focused dieting and reduced concerns about weight among obese individuals—the very people whom such public-health messages are targeting. Further, the decreased concern about weight predicted higher-calorie food choices. In addition, …

Progress In The Articulation Of Undergraduate And Graduate Public Health?, Joel M. Lee, Leonard H. Friedman

Health Policy and Management Faculty Publications

No abstract provided.

Assessing The Potential Impact Of State Policies On Community Health Centers’ Outreach And Enrollment Activities, Peter Shin, Jessica Sharac, Julia Zur, Carmen Alvarez, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Physician Tracking In Sub-Saharan Africa: Current Initiatives And Opportunities, Candice Chen, Sarah Baird, Katumba Ssentongo, Sinit Mehtsun, Emiola Oluwabunmi Olapada-Olaopa, Jim Scott, Nelson Sewankambo, Zohray Talib, Melissa Ward-Peterson, Damien Haile Mariam, Paschalis Rugarabamu

Health Policy and Management Faculty Publications

Background

Physician tracking systems are critical for health workforce planning as well as for activities to ensure quality health care - such as physician regulation, education, and emergency response. However, information on current systems for physician tracking in sub-Saharan Africa is limited. The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices.

Methods

This study included a review of the literature, an online search for physician licensing systems, and a document review of publicly available physician registration forms for sub-Saharan African countries. Primary data …

Later School Start Times In Adolescence: Time For A Change, Paul Kelley, Clark Lee

Homeland Security Publications

This briefing paper summarizes the latest research on the subject of chronic sleep deprivation on education and health in adolescents, explores policy options to address this education and public health issue, and sets forth the recommendation that education start times be adjusted appropriately for U.S adolescents.

Family Policy In China: A Snapshot Of 1950–2010, Yan Ruth Xia, Haiping Wang, Anh Do, Shen Qin

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

The Chinese family policies are shaped by the country’s political, socioeconomic, and cultural contexts and have evolved over the years. China has passed its most significant family policies and laws in marriage; child rearing; child, women, and elderly protection; family planning; and health care in the past 60 years. This chapter will cover the most important laws and policies that affect Chinese families from 1950 to 2010. The discussion focuses on policy development, implementation and analysis, and the challenges China faces in relation to these policy issues.

Representative Robin L. Kelly Letter To Congress Re: Hr 4395, The Action For Dental Health Act Of 2014, American Dental Association

Action for Dental Health

No abstract provided.

Protocol For Culturally Responsive Organizations, Ann Curry-Stevens, Marie-Elena Reyes, Coalition Of Communities Of Color

Center to Advance Racial Equity Publications and Reports

Communities of color have long been marginalized in mainstream service delivery – invisible in terms of their access to resources and services, the adequacy of such services, and in the types of interventions available to members of the community. When available, organizations have been ripe with inequitable outcomes. Today, greater attention to racial equity exists, with local leaders of color having been able to leverage influence to ensure that stronger accountability exists among mainstream organizations in terms of how well communities of color are served, with heightened emphasis on the cultural responsiveness of the entire organization. At the request of …

Protocol For Culturally Responsive Organizations: Literature Review And Standards For Performance, Marie-Elena Reyes, Ann Curry-Stevens

Center to Advance Racial Equity Publications and Reports

At the request of the Coalition of Communities of Color, the Center to Advance Racial Equity (CARE) was asked to assist in the development of a Protocol for Culturally Responsive Organizations (also called the Protocol) that it would use to improve the quality of services available to communities of color in mainstream health and human services. To achieve this, we have researched the literature available that provides evidence of the effectiveness of various interventions. Priority has been given to the literatures on culturally-responsive service delivery (which has been thin) and culturally-competent services (which while abundantly written about, relatively little exists …

Action For Dental Health Year One Report To Congress, American Dental Association

Action for Dental Health

No abstract provided.

Action For Dental Health Year One Report To Congress Executive Summary, American Dental Association

Action for Dental Health

No abstract provided.

The Impact Of Patient Centered Medical Home On The Patient’S Experience, Courtne Flynn

Master in Public Administration Theses

No abstract provided.

Medicaid Reimbursement For Naloxone: A Toolkit For Advocates, Naomi Seiler, Katie B. Horton, Mary-Beth Malcarney

Health Policy and Management Faculty Publications

Naloxone is an opioid antagonist drug used to counter the effects of an opiate overdose. It can be administered in medical settings, such as an emergency room, or prescribed as a take‑home medication to be used in case of an emergency. Currently, most types of insurance will cover and reimburse for naloxone administered directly in a medical setting. However, coverage of prescription take‑home naloxone is limited. The Medicaid program provides health insurance for a large and growing number of Americans. Therefore, securing coverage for take‑home naloxone—including costs of counseling/training and for the medicine itself—within Medicaid should be a critical priority …

Progress And Implementation Of Team-Based Care In The United States, Debora Goetz Goldberg, Anton J. Kuzel

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Complexity In National Policy Implementation: A Top-Down Look At The Failure Of Healthcare.Gov, Samuel Fandrich

Master in Public Administration Theses

No abstract provided.

Happiness In Public Policy, Laura Musikanski

Journal of Sustainable Social Impact

The happiness movement represents a new paradigm where social, economic, and environmental systems are structured to encourage human well-being in a sustainable environment. Bhutan has adopted Gross National Happiness (GNH) as a way of determining its society’s success in contrast to purely economic goals and the singular use of the gross domestic product indicator. Bhutanese policy promulgation includes use of a GNH screening tool. In the United Kingdom, happiness indicators are being used to collect data and the government is starting to explore their application to policy. The Bhutanese GNH policy screening tool has been adapted for the grassroots activists, …

Trafficking In Child Labor In Ghana And Senegal, Steven Brandt

Annual Interdisciplinary Conference on Human Trafficking: 6th (2014)

The goal of this paper is to determine the efficacy of anti-trafficking governance in Senegal and Ghana and what social, political, legal and economic factors work for or against those policies such as: - social policies for and against the growth of the NGO community - enforcement of anti-trafficking laws - economic policies for impoverished urban and rural communities - government rehabilitation policies for minors - federal, state and local corruption - border security/immigration - religious and political freedom This research comprises a comprehensive literature analysis as to the current state of trafficking of minors in Ghana and Senegal. First …

Strategies For Health Care Cost Containment (1980s-Present), Rick Mayes

Political Science Faculty Publications

The U.S. health care system during the past three decades has been over two interrelated questions: first, who will control the manner in which medical care is paid for, and, second, how much will it cost? Many health care experts believe that Medicare's efforts at cost control, primarily in the form of the program's seminal transition to and continual modification of prospective payment of health care providers, has both triggered and repeatedly intensified the economic restructuring of the U.S. health care system. Medicare is an almost $600 billion public health insurance program for individuals sixty-five years of age and older; …

Aging In Falmouth: Assessing Current And Future Needs Of Our Aging Population, Jan E. Mutchler, Bernard A. Steinman, Hayley Gleason, Caitlin E. Coyle

Gerontology Faculty Publication Series

This report describes the collaborative efforts undertaken by the Town of Falmouth Council on Aging Senior Center and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston. Beginning in Spring 2013, these organizations joined to conduct a needs assessment to investigate the needs, interests, preferences and opinions of the Town’s older resident population, with respect to aging in Falmouth. The focus of this report is on two cohorts of Falmouth residents—those aged 45 to 59 (referred to as “Boomers”), and the cohort of individuals who are currently aged 60 …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Research Gaps In Scale Up Of Family Planning And Reproductive Health Programming, The Evidence Project, E2a, Hpp, Measure Evaluation

Reproductive Health

The Evidence Project, in collaboration with the Evidence to Action Project, the Health Policy Project, and MEASURE Evaluation convened a meeting to discuss research gaps related to scale-up. The meeting was held at the request of USAID’s Office of Population and Reproductive Health (OPRH) to help guide their research strategy. The meeting had four objectives: discuss scale-up experiences and the role of research and monitoring for strengthening program performance at scale; identify research gaps related to scale-up; prioritize the scale-up research gaps for OPRH; identify next steps for addressing these priority research gaps. This meeting generated a rich discussion about …

Increasing Access To Family Planning In Ghana Through Policy Change: Task-Sharing To Enable Auxiliary Nurses To Provide Contraceptive Implant Services, Population Council

Reproductive Health

Ghana has made significant progress toward reducing the maternal mortality ratio but the rate is still unacceptably high. Up to 26 percent of married Ghanaian women have unmet need for family planning and one in four currently married women is using a modern contraceptive method. Satisfying unmet need for family planning could cut the number of maternal deaths by almost a third. One factor contributing to low usage of modern methods is shortage of trained staff, particularly those skilled in providing long-acting reversible and permanent methods. Until recently, implant services were provided primarily by Ghana Health Service (GHS) trained midwives, …

Libertarian Patriarchalism: Nudges, Procedural Roadblocks, And Reproductive Choice, Govind Persad

Georgetown Law Faculty Publications and Other Works

Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves.

This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to discourage women from exercising their right to choose an abortion, or from becoming or remaining pregnant. I then argue that …

Future Oversight Of Recombinant Dna Research: Recommendations Of An Institute Of Medicine Committee, Lawrence O. Gostin, Bruce M. Altevogt, Andrew M. Pope

Georgetown Law Faculty Publications and Other Works

The National Institutes of Health (NIH) established the Recombinant DNA Advisory Committee (RAC) in 1974 in response to public concerns about the safety of manipulating genetic material through recombinant DNA. The accumulation of 40 years of experience with gene transfer research has led to a better understanding of the risks. Yet, as gene transfer research has matured, the complexity of the overall regulatory environment has remained. Gene transfer research continues to be subjected to multiple layers of review: the Food and Drug Administration (FDA), institutional review boards, institutional biosafety committees, and the RAC. It is within the context of overlapping …

Governing For Health As The World Grows Older: Healthy Lifespans In Aging Societies, Lawrence O. Gostin, Anna Garsia

Georgetown Law Faculty Publications and Other Works

So much of global health governance focuses intensely on a brief moment in the human lifespan—from a safe birth to infant and child survival. Yet, with all the attention to this early window of life (infancy to age five), the opposite end of the life spectrum is comparatively neglected. The Millennium Development Goals (MDGs) do not mention a healthy lifespan or a healthy old age. This inadequate attention to the older years of the life appears to be a glaring omission given the universal challenges posed by aging societies. Aging is a demographic fact in almost all countries, but it …

Public Health Emergencies: What Counts?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccines and drugs to prevent and treat Ebola Virus Disease that have never been tested in humans, and in scarce supply raise profound ethical challenges. What if good evidence emerged demonstrating safety and efficacy of drugs? What would be an ethical method of allocating scarce beneficial resources? The apparent preference given to foreign aid workers over West Africans provoked a firestorm. In addition to discussing the ethical allocation of scarce drugs, this article also asks a more fundamental question: Why did it take nearly 40 years after the first Ebola outbreak in 1976 to launch clinical trials?

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …