Medicine and Health Commons^™

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Pain Limits Family Caregivers’ Daily Activities, Shelbie G. Turner, Karl A. Pillemer, Jamie Robinson, M. Cary Reid

Population Health Research Brief Series

Family caregivers are the main providers of home care to older adults, especially as the prevalence of Alzheimer’s disease and related dementia rises. Caregiving can take a toll on caregivers’ physical and mental health, which impacts both their own well-being and their care recipients’ health outcomes. This brief summarizes findings from a study that used data from the 2017 National Study on Caregiving (NSOC) to estimate the prevalence of arthritis and activity-limiting pain among 1,930 family caregivers to older adults. Over half of all caregivers reported bothersome pain in the previous month, 24% of whom had pain that limited their …

Aca Medicaid Expansions Did Not Significantly Improve Maternal Morbidity, Pinka Chatterji, Hanna Glenn, Sara Markowitz, Jennifer Karas Montez

Population Health Research Brief Series

Rising rates of severe maternal morbidity in the U.S. highlight the unmet need for continuous and comprehensive health care for women before, during, and after pregnancy. This data slice summarizes findings from a study that tested whether ACA Medicaid expansions helped reduce severe maternal morbidity, including transfusion, ruptured uterus, unplanned hysterectomy, eclampsia, and the need for intensive care. Results show little evidence that the ACA expansions improved maternal morbidity, other than reducing the need for blood transfusions.

How Did Healthcare Affordability Change For U.S. Adults With Intellectual Disability After The Implementation Of The Affordable Care Act?, Nastassia Vaitsiakhovich

Center for Policy Research

Individuals with intellectual disabilities are marginalized in the United States and have worse health outcomes than their peers without disabilities. Lower socioeconomic status and a reliance on social welfare benefits and public health insurance programs often create barriers to access to care. In 2010, the Affordable Care Act (ACA) aimed to make healthcare services more accessible. This brief summarizes the findings from a recent study that examined patterns in healthcare affordability under the ACA or noninstitutionalized adults ages 18-64 with intellectual disabilities. The findings suggest that the ACA increased the likelihood that adults with intellectual disabilities would access medical, specialty, …

How Did Healthcare Affordability Change For U.S. Adults With Intellectual Disability After The Implementation Of The Affordable Care Act?, Nastassia Vaitsiakhovich

Population Health Research Brief Series

Individuals with intellectual disabilities are marginalized in the United States and have worse health outcomes than their peers without disabilities. Lower socioeconomic status and a reliance on social welfare benefits and public health insurance programs often create barriers to access to care. In 2010, the Affordable Care Act (ACA) aimed to make healthcare services more accessible. This brief summarizes the findings from a recent study that examined patterns in healthcare affordability under the ACA or noninstitutionalized adults ages 18-64 with intellectual disabilities. The findings suggest that the ACA increased the likelihood that adults with intellectual disabilities would access medical, specialty, …

Unhealthy Workplace Conditions Contribute To Physician Suicide, Mariah Brennan Nanni, Alexandra Punch

Population Health Research Brief Series

Physicians have the highest suicide rate of all professions. High-stress working environments, long hours, burnout, substance use, and financial stress all contribute to high physician suicide rates. Adding fuel to the fire, COVID-19 has intensified this long-term problem. This issue brief describes the unhealthy workplace conditions that contribute to poor mental health among physicians and calls for policies that encourage physicians to seek help and rest without the fear of punishment.

Health Is Political: Public Health Practitioners And Researchers Should Be Trained Accordingly, Claire Pendergrast

Population Health Research Brief Series

Policy has long been considered a core element of public health practice. The COVID-19 pandemic has made clear that public health practice and research exist within a political context that cannot be ignored.

Prenatal Care For Undocumented Immigrants: Implications For Policy, Practice, And Ethics, Rachel Fabi

Population Health Research Brief Series

Nearly 250,000 babies are born each year to undocumented immigrant parents in the U.S. These babies are U.S. citizens, but undocumented immigrants are ineligible for most public insurance, making it difficult for them to access prenatal care. This research brief describes restrictive policies related to prenatal care for undocumented immigrants and discusses how these policies affect health care providers and the care they are able to offer pregnant immigrant women.

Research Brief: "Physical Activity, Suicide Risk Factors, And Suicidal Ideation In A Veteran Sample", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of physical activity on level of suicidal risk and ideation in veterans. In policy and practice, veterans should continue to exercise, either individually or in groups, and physicians should assist veterans with disabilities in finding adaptive exercises and sports; the DoD and VA should create health transition plans to help service members transition back into civilian life. Suggestions for future research include collecting data through interviews and including more veterans with disabilities in the study.

Research Brief: "Age, Race, And Cardiovascular Outcomes In African American Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study builds on previous research that shows increased risk of cardiovascular disorders among African Americans, and applies that research to African American veterans who receive care at the VHA. For policy and practice, this study suggests various ways that African American veterans can lower their risk of cardiovascular disorders, as well as ways that the VHA can improve the health of veterans. Suggestions for future research include having a larger sample of female veterans, analysis of the factors that contribute to African Americans' higher risk of cardiovascular disorders, and differences in access to health care among African American veterans.

The Health Care Expenditure And Income: A Global Perspective, Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti

Center for Policy Research

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and cross-section dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, …

A Framework For Measurement Error In Self-Reported Health Conditions, Ling Li, Perry Singleton

Center for Policy Research

This study develops and estimates a model of measurement error in self-reported health conditions. The model allows self-reports of a health condition to differ from a contemporaneous medical examination, prior medical records, or both. The model is estimated using a two-sample strategy, which combines survey data linked medical examination results and survey data linked to prior medical records. The study finds substantial inconsistencies between self-reported health, the medical record, and prior medical records. The study proposes alternative estimators for the prevalence of diagnosed and undiagnosed conditions and estimates the bias that arises when using self-reported health conditions as explanatory variables.

So Many Hospitals, So Little Information: How Hospital Value Based Purchasing Is A Game Of Chance, Andrew I. Friedson, William C. Horrace, Allison F. Marier

Center for Policy Research

As part of the Patient Protection and Affordable Care Act, participating Medicare hospitals have part of their Medicare reimbursements withheld and then redistributed based on quality performance. The Hospital Value Based Purchasing reimbursement plan relies partly on ordinal rankings of hospitals to determine how money is distributed. We analyze the quality metric distributions used for payment and show that there is not enough information to reliably differentiate hospitals from one another near the payment cutoffs; and conclude that a large part of the payment formula is driven by sampling variability rather than true quality information. Alternative reimbursement plans are developed.

Research Brief: "Aging Well Among Women Veterans Compared With Non-Veterans In The Women’S Health Initiative", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study analyzes a veteran status' effects on aging among women 80 years and older. For policy and practice, this research clearly states that mental health and healthy behaviors are important for aging women, and that the VA should continue research on health needs of aging female veterans. Suggestions for future research include studies to better understand special health risks among older female veterans, how self-resiliency among female veterans affects their health as they age, and how educational attainment relates to older female veterans' health.

Welfare Reform And Children’S Health, Badi H. Baltagi, Yin -Fang Yen

Center for Policy Research

This study investigates the effect of the Temporary Aid to Needy Families (TANF) program on children’s health outcomes using data from the Survey of Income and Program Participation (SIPP) over the period 1994 to 2005. The TANF policies have been credited with increased employment for single mothers and a dramatic drop in welfare caseload. Our results show that these policies also had a significant effect on various measures of children’s medical utilization among low-income families. These health measures include a rating of the child’s health status reported by the parents; the number of times that parents consulted a doctor; and …

Research Brief: "Melanoma Incidence Rates Among Whites In The U.S. Military", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about a comparison of melanoma incidence rates between white active-duty military members and the general population in the U.S. In policy and practice, health practitioners should promote skin cancer screenings for active duty service members, older personnel, and veterans; the DoD should look to prevent exposure to melanoma risk factors, such as retiring equipment containing harmful PCBs and providing protective clothing and sunscreen for military personnel who are at risk for developing melanoma. Suggestions for future research include analyzing the increase in melanoma incidence rates among younger male military personnel, analyzing the varying risk factors among the …

Research Brief: "Cognitive Behavioral Treatment For Post-Traumatic Nightmares: An Investigation Of Predictors Of Dropout And Outcome", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the cognitive behavior treatment outcomes and drop outs of Vietnam veterans with PTSD who experience nightmares. In policy and practice, various socialization strategies should be implemented by clinics based on veterans' levels of traumatic history, and veterans' families should work to create a positive view of therapy; policymakers should provide support for these therapies and the training of clinicians to provide them. Suggestions for future research include having a more generalizable population in the study, examining the impact of the study's exclusion criteria, and the impact of psychotropic medicines on treatment outcome.

Weighing In On Heavy Issues: Exploring Race, Nativity, And Pre-Pregnancy Body Mass Index In Relationship To Preterm Birth And Low Birth Weight, Karyn Alayna Stewart

Sociology - Dissertations

Black women in the United States occupy a unique position of disadvantage in our social strata. This dissertation explores the health consequences associated with race, nativity, and pre-pregnancy body mass index among Black and White women giving birth in the Central New York region using data from the 2004 through 2010 New York Statewide Perinatal Data System. It examines the likelihood of the occurrence of a preterm birth or low birth weight birth. This study also examines racial disparities in birth outcomes between Black women and White women overall in addition to nativity disparities in birth outcomes among Black women. …

Research Brief: "Health And Health Behavior Differences: U.S. Military, Veteran, And Civilian Men", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the health differences between veteran men, active duty men, National Guard/Reserve men, and civilian men. In policy and practice, organizations besides the VA should expand their preventative health services and health education for veterans, and policymakers should push health and healthcare access initiatives for veterans and service members. Suggestions for future research include collecting data over time, accounting for deployment and combat experience, and adding more thorough measures of health conditions within both veterans and civilians.

Research Brief: "Access To Care For Women Veterans: Delayed Healthcare And Unmet Need", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study builds on previous research that shows there are female veteran-specific access barriers to health care, and explores reasons for those barriers. For policy and practice, the study shows that potential barriers to healthcare for female veterans include not being able to afford healthcare or time to seek treatment, and that healthcare reform policies could eliminate some of these barriers. Future research includes analyzing the health consequences of delayed care, various caregiver responsibilities that serve as barriers to seeking treatment, and non-VA users' access to healthcare.

Research Brief: "Caregiver Objective Burden And Assessments Of Patient-Centered, Family-Focused Care For Frail Elderly Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about quality care for elderly veterans and how mental health of the patient can impact caregiver burden. For practice and policy, healthcare providers should include family caregivers in decisions about best course of care for elderly veterans, caregivers should communicate with physicians on the things that increase caregiver burden, and veterans' health organizations should create programs for caregivers to address caregiver burden. Suggestions for future research include using data from different points in time and looking at elderly veterans' health experiences outside of the VA system.

Research Brief: "Military Training And Personality Trait Development: Does The Military Make The Man, Or Does The Man Make The Military?", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about whether students who join the military in Germany have a difference in personality compared to those who do not, and whether military service changes service members' personalities. In practice and policy, policymakers should consider how military experience affects service members' long-term health and well-being. Suggestions for future research include also studying female service members and expanding the sample to other countries to see whether the same effects occur in other countries' military personnel.

Research Brief: "Bmi Trajectory Groups In Veterans Of The Iraq And Afghanistan Wars", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about obesity rates among OEF/OIF veterans and how race, education level, gender, and use of the VA play a role in obesity rates. For practice and policy, a fitness education program should be implemented by the VA to help lower obesity rates since obesity can cause more serious health problems. Suggestions for future research include expanding the study to involve veterans from other military eras and expanding the study to look at more risks associated with obesity.

Research Brief: "Military Service And (Dis) Continuity In The Life Course: Evidence On Dis- Advantage And Mortality From The Health And Retirement Study And The Study Of Assets And Health Dynamics Among The Oldest-Old", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about influence of military service on later-life mortality among veterans. In policy and practice, programs should provide more services for African American veterans whose fathers had a lower education, and policies should focus on employment status, income, health conditions, smoking habits, and obesity when addressing veteran mortality likelihood. Suggestions for future research include broadening the study's sample, incorporating length of service and historical context of service into the study, and expanding the number of variables studied.

Research Brief: "Military Service And Men’S Health Trajectories In Later Life", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the health and age-related changes of wartime male veterans during later years in life as compared to non-veterans and non-wartime veterans. In policy and practice, veterans reaching retirement age, with help from their families, should pay attention to their health in case any conditions arise, and health policies should look at early-life health in addition to later-life health. Suggestions for future research include performing studies over time on younger veterans as they age and clearing up biases within the sampling processes.

Physician Sovereignty: The Dangerous Persistence Of An Obsolete Idea, David M. Lawrence

Center for Policy Research

The heart of the model is this: to quote Pogo, "We have met the enemy and it is us." We doctors are the problem, not because we are venal or self-serving or insulated from reality. Far from it. Most of us are hard-working, dedicated professionals. We are the problem, though, because of the way our profession developed in the 20th century. This model is no longer appropriate for what lies ahead. The notion of the sovereign physician comes from Paul Starr's 1982 work, "The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a …

The Experience Of A Lifestyle, Brian Lonsway

School of Architecture - All Scholarship

This essay traces the evolution of themed environment design from theme parks to a series of new architectural types – Urban Entertainment Destinations, Lifestyle Enhancement Centers, and Lifestyle Villages – as a chronicle of spatial mediation from urban décor to urban design technique. Culled partly through semiotic deconstruction and partly through ethnographic investigation, this history examines the environmental design techniques employed in these spaces in order to better understand the relationship of design practice to the cultural practices of work and leisure.

From spatialized branding strategies to the neo-urbanist configurations of location-based entertainment, leisure/entertainment ventures use these narratively motivated techniques …

Careers, Organization Size, And Succession, Louis Kriesberg

Program for the Advancement of Research on Conflict and Collaboration

The analysis is based upon data from a national study of heads of public health and mental health programs at the state and local levels. Consistent with Grusky's findings, heads of large public health and of large mental health departments at the state level tend to have shorter tenure periods than heads of small departments. Although the positions are filled by political appointment, the professional requirements are sufficiently important that the mechanisms discussed by Grusky can operate. furthermore, the kind of career line, itinerant or home guard, also is relevant; this helps the findings that at the local level length …