Health Policy Commons^™

Women’S Health Disparities And Midwifery Care: Spotlight On New Hampshire, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

New Hampshire faces significant obstacles to serving the nearly 6% of the population living in medically underserved areas. In addition, many residents of New Hampshire are uninsured, limiting their access to vital medical care. According to 2007-8 data, the racial/ethnic breakdown of New Hampshire residents is: 1% African American/black, 2% Hispanic, 94% non-Hispanic white and 3% Other. In 2005, 5.9% of the total New Hampshire population was foreign born.1 Since 1996, New Hampshire has seen increases in low birth weight births, cesarean births2, and infant mortality with racial/ethnic disparities reflected in most maternal and infant indicators.

Women’S Health Disparities And Midwifery Care: Spotlight On Maine, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

With a large percentage of its population living in rural areas, Maine faces obstacles to providing adequate prenatal and maternity care to many women. The vast majority (96.2%) of Maine residents are non-Hispanic white, 1.2% are African American/black, 1.4% are Hispanic and 1.2% have other racial/ethnic backgrounds.

Women’S Health Disparities And Midwifery Care: Spotlight On Vermont, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

In Vermont, racial and ethnic dispariti es in low birth weight and preterm birth rates exist alongside racial and ethnic disparities in health insurance coverage and use of preventative care. As of 2005, the percentage of racial and ethnic minorities in Vermont was approximately 3.3%, compared to 25% for the nation as a whole. In 2005, 3.4% of the Vermont population was foreign born.

Women’S Health Disparities And Midwifery Care: Spotlight On Rhode Island, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

Rhode Islanders face unique health disparities based on race, ethnicity and location. Just over six percent (6.3%) of the Rhode Island population is living in Primary Care Health Professional Shortage Areas (HPSAs), according to 2008 data. Native American and African American/black communities face particular health disparities, specifically in the areas of reproductive and infant health. In 2008, 79% of the Rhode Island population was non-Hispanic white, while 5% was African-American/black, 11% was Hispanic and 5% had other racial/ethnic backgrounds. In 2005, 12.4% of the total Rhode Island population was foreign born.

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Kinerja Penyuluhan Keluarga Berencana Di Indonesia: Pedoman Pengujian Efektivitas Kinerja Pada Era Desentralisasi, Ukik Kusuma Kurniawan, Hadi Pratomo, Adang Bachtiar

Kesmas

Keberhasilan program KB mengendalikan tingkat kelahiran di Indonesia selama lebih dari tiga dekade tidak terlepas dari peran petugas Penyuluh Keluarga Berencana (PKB). Di Rwanda, keaktifan penyuluhan oleh PKB dapat meningkatkan prevalensi kesertaan akseptor hingga 29%. Sejak tahun 2004, pascakebijakan desentralisasi di Indonesia, jumlah PKB menurun drastis hingga menyisakan dua pertiga dari jumlah awal sekitar 3.500 petugas. Dampak perubahan tersebut tercermin pada angka fertilitas total (TFR) Indonesia berdasarkan data SDKI 2007 yang bertahan sama dengan data SDKI 2002-2003 (2,6 anak per wanita). Hal tersebut dikhawatirkan dapat semakin meningkat apabila kinerja program KB termasuk kinerja petugas PKB tidak mendapat perhatian. Peningkatan TFR …

Pelayanan Rumah Sakit Bagi Masyarakat Miskin (Studi Kasus Di Enam Wilayah Indonesia), Tri Rini Puji Lestari

Kesmas

Pelayanan kepada pasien miskin yang diberikan secara berbeda masih sering terjadi. Penelitian ini bertujuan mendapatkan informasi tentang pelayanan kesehatan yang diberikan oleh rumah sakit kepada masyarakat miskin di enam wilayah Indonesia. Penelitian menggunakan pendekatan kualitatif dengan subjek penelitiannya adalah masyarakat miskin yang sedang dan/atau pernah mendapatkan pelayanan kesehatan di rumah sakit di enam wilayah Indonesia. Hasil penelitian memperlihatkan bahwa pasien miskin di rumah sakit pemerintah maupun rumah sakit swasta, umumnya memiliki tingkat kepuasan yang kurang memadai, di antaranya pada pelayanan administrasi yang dinilai rumit, berbelit, kurang informasi, petugas yang kurang ramah, tidak diberikan resep obat generik, dan pelayanan yang memakan …

Community Health Centers: Opportunities And Challenges Of Health Reform, Sara J. Rosenbaum, Peter Shin, Emily Jones, Jennifer Tolbert

Health Policy and Management Faculty Publications

Community Health Centers: Opportunities and Challenges of Health Reform describes the provisions of the new health reform law that affect community health centers, including increased funding designed to expand the number of health centers, health insurance expansions that will significantly reduce the number of health center patients without insurance, and strategies aimed at increasing the primary care workforce. The brief also discusses some of the opportunities and challenges for the health centers, such as the task of recruiting and retaining qualified health professionals, the need to establish networks and referral arrangements and the renewed focus on prevention and public health …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy & Management: Faculty Publications (2006-2018)

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Buying Health Care, The Individual Mandate, And The Constitution, Sara J. Rosenbaum, Jonathan Gruber

Health Policy and Management Faculty Publications

Three separate cases raising constitutional challenges to the Affordable Care Act (ACA) are now under way, and together they present issues of great legal complexity. Yet although difficult legal questions must be resolved, a pivotal issue is whose version of events will serve as the judicial analytic filter. For reasons related to the very basis of Congress's constitutional power to enact health care reform, the fight is over whether the individual mandate to purchase health insurance (or pay a tax) is about regulating individuals' economic conduct or regulating their noneconomic status. Depending on which characterization of the facts prevails, the …

Coverage Of Obesity Treatment: A State-By-State Analysis Of Medicaid And State Insurance Laws, Jennifer S. Lee, Jennifer L.O. Sheer, Nancy Lopez, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Objectives. We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers.

Methods. We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations.

Results. Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly …

Socioeconomic Indicators That Matter For Population Health, Paula M. Lantz, Andrew Pritchard

Health Policy and Management Faculty Publications

Increasing research and policy attention is being given to how the socioeconomic environment influences health. This article discusses potential indicators or metrics regarding the socioeconomic environment that could play a role in an incentive-based system for population health. Given the state of the research regarding the influence of socioeconomic contextual variables on health outcomes, the state of data and metrics for these variables at the local level, and the potential for program and policy intervention, we recommend a set of metrics related to the socioeconomic composition of a community (including poverty, unemployment, and public assistance rates); educational attainment and achievement; …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …

Mengenal Rancang Bangun Program Keluarga Harapan Kesehatan, Budi Hidayat

Kesmas

Pemerintah Indonesia sedang melakukan uji coba program bantuan tunai bersyarat (BTB), yakni Program Keluarga Harapan (PKH). Program ini memberikan bantuan tunai kepada rumah tangga miskin dengan mensyaratkan mereka melakukan investasi sumber daya manusia. Pelaksanaan BTB di berbagai negara selalu diikuti upaya sistematis untuk mengukur efektivitas dan memahami dampak yang lebih luas dari program pada perilaku rumah tangga. Artikel ini menyajikan bukti nyata bahwa BTB telah meningkatkan kehidupan penduduk miskin. BTB dipuji sebagai cara untuk mengurangi kesenjangan terutama di sejumlah negara Amerika Latin; membantu rumah tangga keluar dari lingkaran setan kemiskinan yang ditularkan dari satu generasi ke generasi berikutnya; meningkatkan status …

The Social Mission Of Medical Education: Ranking The Schools, Fitzhugh Mullan, Candice Chen, Stephen Petterson, Gretchen Kolsky, Michael Spagnola

Health Policy and Management Faculty Publications

The study proposes a new method of ranking medical schools through the creation of a "social mission" score, reflecting that many believe that medical schools should be accountable to society and have a social mission to train physicians to care for the population as a whole, taking into account such issues as whether schools produce physicians who practice primary care, work in underserved areas, and represent the diversity of the population.

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Early Childhood Care And Education For All In 2015: Is This A Mirage In Nigeria?, Esther A. Oduolowu

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This paper examines the possibility of the provision of Early Childhood Care and Education (ECCE) for all children from birth to age five in Nigeria by 2015. In the paper are the history of preschool education in Nigeria) situation of ECCE worldwide in the 1980s) and the, global trends in basic education in the 1990s. The paper also examines the limitations of the attempt and offers probable solutions.

Forced Migration And The Survival Needs Of The Nigerian Child, Ngozi Diwunma Obidike

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This article identifies the survival needs of the forced migrant Nigerian child as well as the extent to which the identified needs are satisfied. The population consisted of 600 forced migrant children and 10 emergency workers who were chosen based on their experiences being forced migrants. A questionnaire was used for the study. The result showed) among other things, that although the need for food, clean water, education, peace, and shelter were identified as the five most essential needs, other needs were also identified as necessary for the children's survival. Based on the results, recommendations were made.

A Case Study On Contracted Seasonal Workers And Farm Labor Contractors In The Stockton Area, Cristal Verduzco

Agribusiness

This study was conducted to define the current situation between contracted seasonal workers and farm labor contractors in the Stockton area. Specifically, this study focuses on the perception workers have of farm labor contracted employment. It also addresses the perception farm labor contractors have on the contracting business.

To gather the information needed to compare perceptions, interviews with twelve contracted seasonal workers and two farm labor contractors were conducted in Stockton. The analysis process consists of a detailed account of the problems workers and farm labor contractors encounter in the farm labor contracting business.

The results of these interviews concluded …

The Effect Of Increased Coverage On U.S. Medical Expenditures, Ayaz S. Alam

Honors College Theses

The purpose of this research paper is to examine the effect of the health reform bill, known as the Patient Protection and Affordable Care Act (PPACA), on total medical expenditures in the United States. Since the PPACA will provide health insurance to an additional 32 million Americans, medical expenditures can be expected to increase since the government will have to insure individuals who presently have no health insurance. This paper will outline the present healthcare system in the United States and explain why there was a growing call for healthcare reform in the country. A regression analysis was performed using …

System Dynamics Of Diabetes In The Presence Of Social Determinants, Victoria Akins

Masters Theses, 2010-2019

Diabetes is a chronic and persistent disease that is on the rise in the U.S. in spite of medical advances and current public health efforts to address it. There is a relationship between socioeconomic factors such as poverty and education and the risk of developing diabetes and the progression of the disease. A systems approach is employed to develop a dynamic hypothesis with a stock and flow model will uncover and analyze these relationships to gain a better understanding of the socioeconomic dynamics of diabetes. Social factors have a significant impact on health outcomes and their consideration is essential to …

Medical-Legal Partnerships: Addressing The Unmet Legal Needs Of Health Center Patients, Peter Shin, Fraser Rothenberg Byrne, Emily Jones, Joel B. Teitelbaum, Lee Repasch, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Medical-legal partnerships (MLPs), now available at over 180 hospitals and health centers across 38 states, are an important option for addressing the legal needs affecting low-income and vulnerable patients, and thereby improving their overall health. We estimate that each year, anywhere between 50 and 85 percent of health centers users - or between ten and 17 million people - experience unmet legal needs, many of which negatively impact their health. In a medical-legal partnership, health care staff at hospitals, clinics, and other sites are trained to screen for health-related legal issues, refer the patient to an affiliated lawyer or legal …

Finite Mixture Models With Applications, Partha Deb

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Job Loss: Eat, Drink And Try To Be Merry, Partha Deb, William T. Gallo, Padmaja Ayyagari, Jason M. Fletcher, Jody L. Sindelar

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

District Health Information System On Maternal, Newborn And Child Health How Good Is It? A Case Of Deli Serdang And Sumedang Districts, Anhari Achadi

Kesmas

Data dan informasi yang valid sangat penting untuk program kesehatan, terutama untuk perencanaan, pemantauan, dan evaluasi. Sistem Informasi Kesehatan Kabupaten dibuat untuk menghasilkan data rutin tentang indikator proses dan output program kesehatan di tingkat kabupaten. Studi ini, yang dilakukan di kabupaten Deli Serdang dan Sumedang, bertujuan untuk mengetahui proses bekerjanya SIK Kabupaten, serta ketersediaan, kualitas dan penggunaan data yang dihasilkan. Pengumpulan data dilakukan dengan menggunakan beberapa cara, yaitu wawancara mendalam dengan para pemangku kepentingan di desa, fasilitas kesehatan, dan kabupaten, pemeriksaan formulir-formulir yang digunakan di semua tingkatan, dokumen lainnya, serta laporan. Temuan studi menunjukkan adanya kelemahan-kelemahan SIK dalam semua tingkatan. …

Understanding Systems That Affect Families: A Look At How 40+ Programs Might Touch One Los Angeles Family, Margaret C. Dunkle

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

International Health Regulations, Andrew Weber, Nicole Lurie, Scott Dowell, Julie E. Fischer, Jennifer Kates, Stephen Morrison

Health Policy and Management Faculty Posters and Presentations

On Tuesday, April 6, 2010, the George Washington University School of Public Health and Health Services (GW SPHHS) hosted the annual Southby Distinguished Lectureship in Comparative Health Policy on the "International Health Regulations." This lectureship gave an overview of the U.S. Government's approach to addressing the challenges, policies, and opportunities related to both domestic and international implementation of the IHR (2005).

Introductory remarks were given by GW School of Public Health faculty, including Josef Reum, Interim Dean; Professor Sara Rosenbaum, Chair of the Department of Health Policy & Hirsh Professor of Health Law and Policy; Richard Southby, Executive Dean Emeritus; …

How To Help Your Community Recover From Disaster: A Manual For Planning And Action, Judah J. Viola,, Society For Community Research & Action Task Force For Disaster, Community Readiness, And Recovery

Faculty Publications

No abstract provided.

Standardized Performance Measurement And Reporting In Emergency Departments (Eds), Gw Urgent Matters Learning Network Ii

Health Workforce Research Center Publications

The drive to maximize emergency department (ED) efficiency while also ensuring the quality of care they deliver has been the focus of experts in the United States for decades. Access to patient-centered and equitable emergency care is critical to a community, and EDs are the safety net that must provide that care whenever it is needed, to whomever needs it. A wellmanaged ED increases the quality and safety of patient care and strengthens the health care infrastructure.

Public Health And Health Reform: A Chance For Transformation, Jeffrey Levi

Health Policy and Management Faculty Posters and Presentations

What's in the new health reform law with a special focus on public health provisions; How public health became a part of health reform; Challenges associated with implementation: can public health meet the expectation of transformation?