Health Policy Commons^™

Données Démographiques Pour Développement Ii—De La Recherche À L'Intervention: Améliorer L'Accès Et L'Utilsation Des Données Par Les Médias, Population Council

Poverty, Gender, and Youth

This policy brief describes the Population Council’s project to improve access and use of demographic, health, and other public sector data that are essential evidence for development policy planning and evaluation. In many countries, access to data is limited and, when data are available, the format is rarely user-friendly for nonprofessionals, limiting their potential applications. In recent years, the Population Council has examined access to and sharing of data through case studies in Ethiopia, Ghana, Senegal, and Uganda. In phase II of the project, the Council will strive to promote domestic demand for data by working with key intermediaries—the media.

Oil And Water: Mixing Individual Mandates, Fragmented Markets, And Health Reform, Allison K. Hoffman

All Faculty Scholarship

With momentum toward national health reform, there is wide support for legislation to include an individual mandate that would require all Americans to carry health insurance. Discussion of the individual mandate has relied largely on whether the mandate will generate universal coverage as a gauge for success. This article challenges the notion that an individual mandate is successful if it leads to universal coverage, revealing a critical problem the individual mandate will face even if all Americans were to have health insurance. To uncover this problem, this article sets out a novel framework that disentangles the three different policy objectives …

Fragmentation In Mental Health Benefits And Services: A Preliminary Examination Into Consumption And Outcomes, Barak D. Richman, Daniel Grossman, Frank Sloan

Faculty Scholarship

In this chapter, we examine consumption patterns and health outcomes within a health insurance system in which mental health benefits are administered under a carved-out insurance plan. Using a comprehensive dataset of health claims, including insurance claims for both mental and physical health services, we examine both heterogeneity of consumption and variation in outcomes. Consumption variation addresses the regularly overlooked question of how equal insurance and access does not translate into equitable consumption. Outcomes variation yields insights into the potential harms of disparate consumption and of uncoordinated care. We find that even when insurance and access are held constant, consumption …

Curtis Fogel On Dying Inside: The Hiv/Aids Ward At Limestone Prison. By Benjamin Fleury-Steiner & Carla Crowder. Ann Arbor, Mi: University Of Michigan Press, 2008. 238pp., Curtis Fogel

Human Rights & Human Welfare

A review of:

Dying Inside: The HIV/AIDS Ward at Limestone Prison. By Benjamin Fleury-Steiner & Carla Crowder. Ann Arbor, MI: University of Michigan Press, 2008. 238pp.

Avoiding Tough Policy Choices In An Influenza Pandemic: The Role Of Kettl's Rocket Science Model In Public Health, Danny Lambert

Electronic Theses and Dissertations

The security and social inequality approaches to public health present distinct answers to policy objectives relative to a pandemic. However, each approach leaves us with tough choices between the most valued objectives. I demonstrate how the networked approach, which Kettl's Rocket Science Model (RSM) exemplifies, does not leave us with such choices. Furthermore, I connect the epidemiological concepts public health practitioners apply toward communicable disease pandemics to RSM concepts. Finally, drawing on the disease parameters of a worst-case scenario influenza pandemic, I demonstrate how the networked approach helps public health practitioners expand capacity such that tough choices are unnecessary.

Understanding School Travel: How Residential Location Choice And The Built Environment Affect Trips To School, Yizhao Yang, Marc Schlossberg, Robert Parker, Bethany Johnson

TREC Final Reports

This project investigates issues related to parents’ decisions about children’s school transportation. This has become an important area of research due to the growing concerns that increased reliance on private automobile in school travel has led to adverse health impacts on children and negative impacts on environment. This study examines school transportation in the context of where families live and how families make decisions about school travel in the process of choosing their residence.

Using a middle-sized school district in Oregon State, we conducted a 5500-household survey and a number of interviews and focus groups. The study shows that parents …

Contingent Valuation Studies And Health Policy, Matthew D. Adler

All Faculty Scholarship

This short comment argues that both cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA) should be seen as imperfect tools for evaluating health policy. This is true, not only for extra-welfarists, but even for welfarists, since both CBA and CEA can deviate from the use of social welfare functions (SWF). A simple model is provided to illustrate the divergence between CBA, CEA, and the SWF approach. With this insight in mind, the comment considers the appropriate role of contingent-valuation studies. For full text, please see: http://www.law.upenn.edu/cf/faculty/madler/workingpapers/578A59B6d01.pdf.

Governing The Infections Bacteria Commons: Preventing Antibiotic Resistance, Christopher R. M. Pilch

Global Honors Theses

In recent decades, concerns have arisen over the misuse of antibiotics and the resultant increase in ever-more resilient strains of pathogenic bacteria. The author examines this issue through the lens of common pool resource theory, which frames a case study comparison between the United States and the Netherlands and their respective antibiotic distribution practices. The results of the case study offer insights into how the United States can better manage its antibiotic and public health policies.

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

All Faculty Scholarship

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Snapshot 2010: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Scaling Up, Lourdes Hernández-Cordero, Susan P. Sturm, Kathleen Klink, Allan J. Formicola

Faculty Scholarship

Moments of crisis require big, bold ideas. In this chapter we will zoom out of our close examination of the Northern Manhattan Community Voices Collaborative experience to propose ways to scale up the things that worked for us in order to make them applicable at a national level. With this chapter we honor the intent of the W. K. Kellogg Foundation in its support of learning laboratories across the nation. Our goal is to contribute to the collective dialogue on how to improve the health care system. Specifically, we propose that making a healthier nation and reducing health care costs …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Workers On The Margin: Who Drops Health Coverage When Prices Rise?, Edward Okeke, Richard Hirth, Kyle Grazier

Edward Okeke

We revisit the question of price elasticity of employer-sponsored insurance (ESI) take-up by directly examining changes in the take-up of ESI at a large firm in response to exogenous changes in employee premium contributions. We find that, on average, a 10% increase in the employee’s out-of-pocket premium increases the probability of dropping coverage by approximately 1%. More importantly, we find heterogeneous impacts: married workers are much more price-sensitive than single employees, and lower-paid workers are disproportionately more likely to drop coverage than higher-paid workers. Elasticity estimates for employees below the 25th percentile of salary distribution in our sample are nearly …

Public Values, Health Inequality, And Alternative Notions Of A “Fair” Response, Elizabeth Rigby, Erika Blacksher, Claire Espey

Elizabeth Rigby

The fact that disadvantaged people generally die younger and suffer more disease than those with more resources is gaining ground as a major policy concern in the United States. Yet, we know little about how public values inform public opinion regarding policy interventions to address these disparities. This paper presents findings from an exploratory study of the public’s values and priorities as they relate to social inequalities in health. Forty-three subjects were presented with a scenario depicting health inequalities by social class and were given the opportunity to alter the distribution of health outcomes. Participants’ responses fell into one of …

Gay And Lesbian Elders: History, Law, And Identity Politics In The United States, Nancy J. Knauer

Nancy J. Knauer

The approximately two million gay and lesbian elders in the United States are an underserved and understudied population. At a time when gay men and lesbians enjoy an unprecedented degree of social acceptance and legal protection, many elders face the daily challenges of aging isolated from family, detached from the larger gay and lesbian community, and ignored by mainstream aging initiatives. Drawing on materials from law, history, and social theory, this book integrates practical proposals for reform with larger issues of sexuality and identity. Beginning with a summary of existing demographic data and offering a historical overview of pre-Stonewall views …

Medicare’S Bundled Reimbursement Policy For Patients With End-Stage Renal Disease, Lisa M. Lines

Lisa M. Lines

No abstract provided.

Impact Of The Australia-Us Free Trade Agreement On Australian Medicines Regulation And Prices, Thomas A. Faunce, James Bai, Duy Nguyen

Thomas A Faunce

The Australia – United States Free Trade Agreement (AUSFTA) came into force on 1 January 2005. Before and subsequently to the AUSFTA being concluded, controversy surrounded the debate over its impact on Australia ’ s health policy, specifically on regulation of pharmaceutical patents and Australia ’ s cost-effectiveness system relating to prescription medicine prices known as the Pharmaceutical Benefits Scheme (PBS). This article examines the expectations of both parties in the pharmaceutical sector with regard to the AUSFTA, as well as how successfully they were achieved. It seeks to analyse important relevant outcomes for regulators, the public and pharmaceutical industry, …

Nanotechnology And The International Law Of Weaponry: Towards International Regulation Of Nano-Weapons., Thomas A. Faunce, Hitoshi Nasu

Thomas A Faunce

The development of nanotechnology for military application is an emerging area of research and development, the pace and extent of which has not been fully anticipated by international legal regulation. Nano-weapons are referred to here as objects and devices using nanotechnology or causing effects in nano-scale that are designed or used for harming humans. Such weapons, despite their controversial human and environmental toxicity, are not comprehensively covered by specific, targeted regulation under international law. This article critically examines current international humanitarian law and arms control law regimes to determine whether significant gaps exist in the regulation of nanotechnology focused on …