Public Policy Commons^™

Combatting Rising Healthcare Costs For Healthier Adults, Alejandra Muñoz-Rivera

Social Policy Institute Research

In 2020, healthcare expenditures averaged $12,530 per person, up 9.7% from 2019. In 2018, 19% of U.S. households had medical debt with $2,000 being the median amount owed. Over half of adults between 18 to 64 years of age are estimated to experience some form of medical financial hardship including medical bills or debt, stress about medical bills, and delaying or forgoing treatment specifically due to cost. In a 2022 survey of 140 Medicaid and Marketplace members by researchers from the Social Policy Institute (SPI) and the Centene Center of Health Transformation, one-third of respondents reported having unpaid medical bills. …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Weathering The Storm: Navigating Urban Ecologies Of Communication In Times Of Crisis, Austin Hestdalen

Electronic Theses and Dissertations

This project explores cities as urban ecologies of communication in which crises emerge and are given significance within the dialogic relations cultivated among public actors attempting to make a living, together, within the shared historical-cultural contexts of everyday life. To describe cities as urban ecologies of communication is to describe them in terms of urban communication and its interdisciplinary foundations in the study of rhetoric, philosophy, planning, policy, architecture, sociology, geography, and media. The first chapter introduces the challenges of urban risk and crisis management within the complex ecologies of communication constituted by cities and reviews how ‘risk’ and ‘crisis’ …

Affordable Housing: A National Crisis Fueled By The Coronavirus • A New Jersey Perspective, Latino Action Network Foundation

Center for Urban Policy Research

The Latino Action Network Foundation [LANF], its sister organization the Latino Action Network [LAN] and longtime ally, the Fair Share Housing Center [FSHC], have collaboratively monitored affordable housing issues in New Jersey for more than a decade. As part of its ongoing work, LANF sponsored a housing roundtable on September 10, 2021, to assess the affordable housing situation in the state and offer policy recommendations. At that time, a coalition of advocates, including the three organizations named above, were fresh from a legislative victory that safeguarded tenants unable to pay their rents during the pandemic and gave them a degree …

A Commentary On The Healthy Community Stores Case Study Project: Implications For Retailers, Policy, And Future Research, Samantha M. Sundermeir, Megan R. Winkler, Sara John, Uriyoán Colón-Ramos, Ravneet Kuar, Ashley Hickson, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Julia Deangelo, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as …

Balancing Mission And Margins: What Makes Healthy Community Food Stores Successful, Sara John, Megan R. Winkler, Ravneet Kuar, Julia Deangelo, Alex B. Hill, Samantha M. Sundermeir, Uriyoán Colón-Ramos, Lucia A. Leone, Rachael D. Dombrowski, Emma C. Lewis, Joel Gittelsohn

Urban Studies and Planning Faculty Research Publications

Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores’ success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store successful and identified strategies for success in seven community stores in urban areas across the United States. We used Stake’s multiple case study analysis approach to identify the following key aims that contributed to community store success across all cases: (1) making healthy food available, (2) offering healthy foods …

Examining Disparities In The Early Adoption Of Covid-19 Personal Mitigation Across Family Structures, Casey Harris, Kevin Fitzpatrick, Michael Nino, Priya Thelapurath, Grant Drawve

Sociology and Criminology Faculty Publications and Presentations

The United States' response to the COVID-19 pandemic has relied heavily on personal mitigation behaviors versus centralized governmental prevention strategies, especially early in the virus's outbreak. This study examines how family structure shapes mitigation, focusing on the intersectional effects of gender, marital status, and the presence of children while accounting for differences in worry about infection from the virus. Using data from a national survey of 10,368 United States adults early in the pandemic (March 2020), survey-weighted logistic regression models show important differences in the likelihood of personal mitigation adoption across family structures. Unmarried women with children were most likely …

Characterization And Assessment Of Barriers And Facilitators To The Decision-Making Process For Blood And Blood Donor Safety In The United States: A Collective Case Study, Lauren A. Crowder

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Over 16 million blood components are transfused to patients in need every year in the United States (Jones et al., 2021). Because of the reliance on human blood donors, the donation and transfusion of blood will always be associated with some level of risk for both donors and recipients; the tolerability of these risks may vary from stakeholder to stakeholder. While the U.S. Food and Drug Administration (FDA) concedes that attaining a blood supply with zero risk for transmission of infectious diseases may be unattainable (U.S. Food and Drug Administration, 2019), they continue to strive for the lowest …

Forms Of Community Engagement In Neighborhood Food Retail: Healthy Community Stores Case Study Project, Ravneet Kuar, Megan R. Winkler, Sara John, Julia Deangelo, Rachael D. Dombrowski, Ashley Hickson, Samantha M. Sundermeir, Christina Kasprzak, Bree Bode, Alex B. Hill, Emma C. Lewis, Uriyoán Colón-Ramos, Jake Munch, Lillian L. Witting, Angela Odoms-Young, Joel Gittelsohn, Lucia A. Leone

Urban Studies and Planning Faculty Research Publications

Community engagement is well established as a key to improving public health. Prior food environment research has largely studied community engagement as an intervention component, leaving much unknown about how food retailers may already engage in this work. The purpose of this study was to explore the community engagement activities employed by neighborhood food retailers located in lower-income communities with explicit health missions to understand the ways stores involve and work with their communities. A multiple case study methodology was utilized among seven retailers in urban U.S. settings, which collected multiple sources of data at each retailer, including in-depth interviews, …

Oregon's Senate Joint Resolution 12: Understanding The Implications Of A Constitutional Right To Healthcare, Anna Starr, Mpp

Hatfield Graduate Journal of Public Affairs

Problems persist throughout the U.S. healthcare system including exorbitant costs, poor health scores, high rates of uninsured, and lack of access to services among marginalized groups. Among many proposed solutions is a constitutional provision to healthcare. Largely based in ethics, healthcare as a right is also expected by many to improve health outcomes. However, while constitutional provisions for healthcare are found in countries around the world, empirical research results are limited and mixed at best. In the wake of social justice movements and resurgence of vibrant conversations about human rights, and with international pressure mounting for the U.S. to follow …

Bringing People Back Into Public Health Data: Community Feedback On A Set Of Visualization Tools - Summary Report, Alejandro Cerón, Mia Glover, Quisi Rodriguez-Oregel, Dani Thompson, Tom Adams, Naomi Asakura, Kaela Belknap, Anna Block, Nicole Boehler, Hannah Boeve, Sarah Bomers, Sasha Borovok, Grace Bryan, Kate Buffington, Majesty Cain, Beth Carideo, Haley Chesno, Grace Connell, Jake Corbett, Camille Cruz, Chloe Dawkins, Anna Denniston, Lydia Dickens, Sophie Duplock, Samuel Dwinell, Avery Ess, Sam Ferman, Ellis Geis, Ethan Graupmann, Xander Hedrick, Angel Hernandez-Miramontes, Grant Huyghe, Sara Ibrahiem, Anna Jamieson, Ian Kang, Allie Kris, Erin Lawrence, Maddie Leake, Ryan Leary, Taylor Loh, Charlotte Monroe, Alexander Nguyen-Lopez, Henry O’Daffer, Cat Parish, Jaylee Recountre, Grace Rizzo, Noah Roseth, Grace Rothstein, Katie Sage, Marie Saltzmann, Stephen Shlain, Riley Shores, Mackenna Simson, Mark Teneza, Jack Weinmeister, Justin Weinzweig, Alison Wenman, Patch Whelan, Lea Zimmerman

Anthropology: Undergraduate Student Scholarship

This course-based study is a product of the University of Denver’s Spring 2022 The Social Determination of Health (ANTH 2424) class. The study aimed to understand how well a set of public health visualization tools tells the data stories about people in Colorado, and about important public health problems. For this, a team of almost sixty undergraduate students taking the class, coordinated by three graduate teaching assistants, and directed by the course instructor interviewed a total of fifty-six people from Colorado, qualitatively analyzed those interviews, and wrote reports that draw conclusions and recommendations.

Not Just The Flu: The Impacts Of Asiaflucap Influenza Policy Recommendations On Southeast Asia During The Sars-Cov-2 Pandemic, Rebekah Huber

Honors Projects

During 2008 to 2011, a multi-year influenza pandemic study (ASIAFLUCAP) took place in six Southeast Asian countries: Thailand, Indonesia, Vietnam, Taiwan, Cambodia, and Laos, to analyze their healthcare system capacities and determine appropriate policy recommendations in order that they might be better equipped for future influenza pandemics. This research expands upon that project to see if the countries that implemented higher numbers of ASIAFLUCAP policy recommendations prior to or in the SARS-CoV-2 pandemic fared better than those countries which did implemented fewer recommendations. It finds that results are mixed across the sample, with no clear association between a country’s adoption …

Devil’S Lettuce Or Heaven Sent? How The Legalization Of Recreational Cannabis Impacts Rates Of Schizophrenia In Washington State., Elizabeth C. Lucas

Honors Projects

Washington State legalized the manufacturing, processing, and distribution of recreational cannabis with the passing of Initiative 502 in November of 2012. As of 2021, there are over 500 retail stores with active licenses to sell (Cannabis License Applicants, 2021). Since then, public opinion polls and state-wide surveys have found a steady increase in the percentage of the population using cannabis, including children under the age of 18. Schizophrenia is a complex disease thought to be influenced by several genetic and environmental factors. The association between cannabis use and the development of schizophrenia has been well documented (Marconi et al., 2016 …

Assessing The Influence Of Food Insecurity And Retail Environments As A Proxy For Structural Racism On The Covid-19 Pandemic In An Urban Setting, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathrybn A. G Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn, Winona Bynum

Urban Studies and Planning Faculty Research Publications

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was …

Sexually Transmitted Diseases (Stds) In The Mountain West, 2015 - 2019, Kristian Thymianos, Saha Salahi, Zachary Walusek, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines data on sexually transmitted diseases (STDs) in the Mountain West as originally reported in the “STD Surveillance Report 2019” published by the Center for Disease Control (CDC). This includes data for Mountain West states and metropolitan statistical areas (MSAs) on the following STDs: chlamydia, gonorrhea, and primary and secondary syphilis.

Covid-19 Behind Bars In The Mountain West, Dielle T. Telada, Caitlin J. Saladino, William E. Brown Jr.

Criminal Justice

Due to overcrowding, inadequate healthcare, systemic neglect, and violence in U.S. carceral (i.e. jails or prisons) and immigration detention centers, these facilities are a hot spot for the spread of COVID-19. In March 2020, the UCLA Law “Covid Behind Bars Data Project” began tracking official agency websites for self-reported data of COVID-19 across prisons, jails, and other detention facilities in the U.S. The number of COVID-19 cases, deaths, and tests performed from 50 state correctional agencies, the District of Columbia’s Department of Corrections, the Federal Bureau of Prisons (BOP), U.S. Immigration and Customs Enforcement (ICE), and several county jail systems …

Civil Commitment: An Assessment Of The Alcohol And Drug Statute In Mississippi, Elizabeth Foley

Honors Theses

This thesis assesses the alcohol and drug commitment statute in Mississippi. Substance use disorder has impacted millions of people around the world, including within the U.S. Civil commitment is one of the many policies aimed at helping those with substance use disorder; however, it is highly debated and under researched. This thesis looks specifically at the alcohol and drug commitment statute in Mississippi, interviewing legal and medical professionals who are responsible for implementation of this statute. The findings of this thesis include a lack of uniformity in the implementation of the statute and several areas where procedures can and ought …

Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins

Research Days

Watch recording of live presentation.

Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children.

Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below …

A Geographically Targeted Approach For A Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (Hpsas), Julia Mattingly, Sarah Belcher, Samuel C. Kessler

Commonwealth Policy Papers

Years before the COVID-19 pandemic brought on a health care shortage in Kentucky, its rural areas were already struggling to obtain and attract primary care medical practitioners. Even though the number of medical school graduates in the U.S. has steadily increased throughout the years, there is a general disinterest in rural or small-town practice, and legislators throughout the country have pondered ways to address this issue plaguing communities. Versions of Preceptor Tax Incentive legislation in Kentucky have been proposed in the General Assembly to address care shortages in the state, however, all have been unsuccessful at truly targeting rural areas …

Promoting Health Equity Among Racial And Ethnic Minorities During And After The Covid-19 Pandemic, Alexandra Viramontes, Deserry Salgado

Electronic Theses, Projects, and Dissertations

Racial and ethnic minorities experience disproportionate health outcomes during a pandemic, yet preparedness plans have failed to address the social determinants of health that produce the most severe impact. By examining social workers’ perspectives on the health disparities faced by racial and ethnic minorities during the COVID-19 pandemic, this study provides insight into the ways in which services can be improved in a future health crisis. In this exploratory study, a qualitative approach was utilized where social workers were asked to participate in interviews consisting of open-ended questions. The qualitative data was obtained in the form of interview transcripts, which …

The Effect Of Rhetoric On Progressive Health Care Reform Policies’ Public Perception, Megan Geher

Honors Theses

Health care is one of the most contentious issues in United States politics today, and there are a variety of reform plans on the table. In order for these reform plans to be politically feasible, it is fundamental that the rhetorical framing strategies utilized are done so with caution. In this paper, I seek to understand to what extent rhetorical framing plays a role in how Americans perceive progressive health care reform plans. While there are many factors that go into public support of policies, rhetoric is one factor that cannot be ignored, as it has shown to have significant …

Vermont: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika C. Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

The Value Of Education: School Policy Decisions During The Covid-19 Pandemic, Elika W. Somani

Individually Designed Interdepartmental Major Honors Project

During the COVID-19 pandemic, lacking national U.S. policies, wide variation and conflict over chosen public school policy decisions emerged. What factors and guidelines informed the decision-making process in K-12 public schools during the COVID-19 pandemic and who were the key stakeholders? This study examines three school district types – a large city, medium city, and small-town – across Minnesota as case studies to unpack how policy decisions were made during the pandemic. Stakeholder interviews uncovered that the school decision-making process was a) connected to a district's political opinions, b) made by the superintendent and school board, c) primarily influenced by …

New Hampshire: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika C. Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the …

Maine: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Yvonne Jonk Phd, Louisa Munk Mph, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the …

The Northern Border Region: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

New York: A Health-Focused Landscape Analysis, Katherine Ahrens Phd, Amanda Burgess Mppm, Mph, Carly Milkowski Mph, Louisa Munk Mph, Yvonne Jonk Phd, Erika Ziller Phd

Population Health

The Northern Border Regional Commission State and Region Chartbooks compile county- and state-level data related to health and health care access for the Northern Border Region and the individual states of Maine, New Hampshire, New York, and Vermont. Topics covered in the chartbooks include demographic and socioeconomic characteristics, access to care, health outcomes, mortality rates, Health Professional Shortage Areas, and the location of Rural Health Clinics, Federally Qualified Health Centers, hospitals, and substance use treatment facilities. When data allow, we highlight the counties with the worse performance on a measure, compared with the rest of the counties in the Northern …

American Rescue Plan Act (Arpa): City And County Budget Allocations In The Mountain West, Katie M. Gilbertson, Caitlin J. Saladino, William E. Brown Jr.

Economic Development & Workforce

This fact sheet details how city and county governments within the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah allocated funds from the State and Local Fiscal Recovery Fund (SLFRF) portion of the American Rescue Plan Act (ARPA). Brookings Metro in partnership with the National League of Cities and the National Association of Counties created the “Local Government ARPA Investment Tracker” to display how communities across the country allocate this financial resource. This interactive site allows budget information from cities and counties to be added as such decisions are made.

Youth Mental Health In The Mountain West, Kristian Thymianos, Olivia K. Cheche, Kelliann Beavers, Katie M. Gilbertson, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet explores youth mental health metrics of Mountain West states from the Hopeful Futures Campaign’s 2022 report, America’s School Mental Health Report Card. This study provides state snapshots on school mental health policies and workforce availability for all 50 states and the District of Columbia. The Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah are considered here.