Health Policy Commons^™

Buprenorphine Use For Analgesia In Palliative Care, Leanne K Jackson, Ivy O Poon, Mary A Garcia, Syed Imam, Ursula K Braun

Center for Medical Ethics and Health Policy Staff Publications

Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, …

Your Money Or Your Life: A Study Of Medical Debt In The Southeastern United States, Grace Barrett

Honors Theses

A major issue has emerged from the U.S. healthcare system: medical debt. Medical debt is a serious problem in the U.S. that often cripples those who received healthcare services, but are unable to pay the bill. The most common scenario is when an unexpected major medical issue occurs, e.g. a heart attack, an automobile accident, cancer or anything requiring an emergency room visit. These hospital visits often result in very large, very unexpected expenses. These expenses are ultimately owed to the healthcare provider by the patient (or the patient's insurance policy) and increasingly, cause lifelong financial stress to those who …

Covid-19 And Global Institutional Shift From National To Subnational Governments, Jonathan Feld-Jacobson, Armaan Rizvi, Bora Sinan

Working Papers Series

The COVID-19 Pandemic saw dramatic global shifts in legislative powers between central and local governments. With changes in the severity and duration of the pandemic, in the federations of Nigeria, Australia, and Canada, policymaking regarding border and school closures and states of emergency saw an increasing involvement of regional governments. We suggest that looking at the national and regional PPI data for our hypotheses could indicate directly the severity of the pandemic in these nations. Federalisms particularly provide a case of institutional change evidencing that COVID-era decision-making saw a change in the rules and expectations of governance in the nations …

The Impact Of Purchasing Power Parity (Ppp), Infrastructure, And Decentralization On Pandemic Restrictions, Liam Hansen, Veronica Taraskina, Jennifer Weng

Working Papers Series

This research compares a country's mandate to shift to remote work between the federal and regional levels in comparison to PPP. We focus on how economic factors determine a country's ability to move to remote work and at what level of government the decision is made. The findings suggest that while there was variation in which level of government issued work-from-home requirements, there were strong trends for most mandates to come from the federal level. Moreover, an overwhelming majority of countries issued such federal mandates regardless of PPP. We then compare PPP per capita and the stringency of public transportation …

Could It Be That Healthcare Systems Are Putting Profits Before Patients?, Majida Naz

Publications and Research

The escalating costs of healthcare in the United States have led to a significant burden on diverse populations, often resulting in diminished access to quality care. As profit-driven motives increasingly influence healthcare providers and insurers, the affordability and accessibility of healthcare services are adversely affected. This research examines the intricate dynamics between profit motives and healthcare provision, employing a mixed-methods approach to investigate the impact on the diverse groups. By conducting a quantitative and some qualitative examination of healthcare spending data, this study demonstrates a pronounced disparity in the quality of healthcare services provided to populations across different income levels. …

Addressing Or Reinforcing Injustice? Artificial Amnion And Placenta Technology, Loss-Sensitive Care And Racial Inequities In Preterm Birth, Sophie L Schott, Faith Fletcher, Alice Story, April Adams

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

The State Of Mental Health In The Mountain West, 2023, Ayda Atici, Freddy Nie, Jesse M. Fager-Larsen, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines the state of mental health for both youth and adults and availability of mental health care in the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The data are retrieved from Mental Health America’s (MHA) 2023 report, The State of Mental Health in America.

Psychosocial Factors Associated With Substance Use Vulnerability In Black Americans, Aanya Mehta

Honors Scholar Theses

In 2010, the World Health Organization developed the Conceptual Framework for the Social Determinants of Health as a response to epidemiologists’ and public health workers’ need to estimate the impact of social inequality. Within this framework, psychosocial factors are intermediary determinants of health that influence an individual’s interactions with their environment. This paper analyzes data and results from ten articles from the Family and Community Health Study (FACHS), which looks at the impacts of psychosocial, contextual, and family effects on health and developmental outcomes in Black American families. The findings across the ten articles provide strong evidence that there are …

A Qualitative Interview Study To Determine Barriers And Facilitators Of Implementing Automated Decision Support Tools For Genomic Data Access, Vasiliki Rahimzadeh, Jinyoung Baek, Jonathan Lawson, Edward S Dove

Center for Medical Ethics and Health Policy Staff Publications

Data access committees (DAC) gatekeep access to secured genomic and related health datasets yet are challenged to keep pace with the rising volume and complexity of data generation. Automated decision support (ADS) systems have been shown to support consistency, compliance, and coordination of data access review decisions. However, we lack understanding of how DAC members perceive the value add of ADS, if any, on the quality and effectiveness of their reviews. In this qualitative study, we report findings from 13 semi-structured interviews with DAC members from around the world to identify relevant barriers and facilitators to implementing ADS for genomic …

Trust In Government And Policies Of The Covid-19 Pandemic: The Before And After Comparison In The European Sample, Julia Match

Undergraduate Honors Theses

This research explores the relationship between COVID-19 policies and mortality rates and the level of trust in government in Europe. This study looks at the stringency of measures, as well as their effectiveness as shown through high or low mortality rates, to see if there is a relationship between those factors and increases or decreases in trust in 2020. The Eurobarometer is the dataset for trust in government, with a focus on the data from Summer 2020, the first Eurobarometer after COVID-19 began. The Johns Hopkins Coronavirus Resource Center was used for cumulative mortality, and Shvetsova et al., 2022 provided …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Summer Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

Pros, Cons, And The Barriers To Implementing A Universal Healthcare System In The United States, Arpun Shah

Rowan-Virtua Research Day

Background: The United States has the most expensive healthcare system in the world. Despite that, it also has worse health outcomes than that of several other countries. The United States is also the only wealthy/developed country without universal healthcare. Universal healthcare, also known as a single-payer healthcare system, refers to the concept that the government finances and governs healthcare for most, if not all residents of the country. The United States currently has a multi-payer system, which means that healthcare is financed through various sources such as the public and private sectors. Purpose: The purpose of this is …

Dual-Systems And Fuzzy-Trace Theory Predictions Of Covid-19 Risk Taking In Young Adults, Sarah M. Edelson, Valerie F. Reyna, Bridget B. Hayes, David M. N. Garavito

Articles

Risk-reduction behaviors are the first line of defense in viral epidemics. Choosing to not engage in risk-reduction behaviors produced millions of preventable deaths from COVID-19. Understanding why this happens and how to predict it is important for theory development and public policy. We took four approaches to this problem: experimentally varying theory-driven predictors (social rewards, transmission risk, and mandatory/voluntary regulations) in choice scenarios, further probing choices in specific scenarios predicted to elicit risk taking, conducting hierarchical regressions with demographic and theory-driven predictors for both scenario types, and conducting corresponding regressions for self-reported protective behaviors. The sample consisted of 247 young …

A Problem-Based Approach To Racial And Ethnic Inequities In The German Health System, Thomas C. Lane

German Studies Undergraduate Senior Theses

This work is the first comprehensive book-length survey of racial and ethnic inequities in Germany’s health system. It takes a novel approach to understanding health inequities by focusing on the overarching structures which shape them in the German context, using examples from various areas of the health system to clarify their nuances. The Introduction grounds the need for understanding and combating health inequities in Germany’s unique postwar constitutional commitment to human dignity. Next, Chapter 1 outlines the current methods by which inequities are measured in Germany and why they are problematic. Chapter 2 covers current inequities in the provision of …

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience: Master of Public Health

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …

The Impact Of Policy And Perception On Women’S Health Since 2010, Eryn Busenbark

Theses/Capstones/Creative Projects

This project tackles the complicated relationship between policy and perception of women’s health in the last decade. This was achieved through research on existing literature and semi-structured interviews with five professionals in various areas of women’s health: mental health, public policy, sexual health education, and research. Literature reviews were conducted using University of Nebraska at Omaha Criss Library’s databases, with dozens of articles analyzed. The goal of this research was to gain an understanding of how public opinion and perceptions can sway policy, which has created challenges and consequences for women and their health.

Reaping What You Subsidize: A Comprehensive Review Of Outcomes From Crop Subsidies In The United States, Sawyer J. Knox

Economics Undergraduate Honors Theses

The motivation for researching this topic comes from an interest in public policy and public health. In this paper, we will examine the impact of farm subsidies on the health of citizens, look at who benefits financially and economically from these subsidies, and examine the environmental impact of these programs. The paper will be structured as follows: Section II, the wealth distribution results from farm subsidies; Section III, the disproportionate impacts on health from farm subsidies; Section IV, the impact on global economies from farm subsidies; Section V, the environmental impact from farm subsidies; and Section VI, conclusions and policy …

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Ethical Concerns For Remote Computer Perception In Cardiology: New Stages For Digital Health Technologies, Artificial Intelligence, And Machine Learning, Kristin Kostick-Quenet, Jerry Estep, Jennifer S Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.