Health Policy Commons^™

Complex Systems Mapping Of Fiscal Growth Dynamics At Strategic Maritime Chokepoints Using Time-Series Slopes, Rahul Balamurugan, Preethi Nanjundan, Avichal Sharma

Northeast Journal of Complex Systems (NEJCS)

This study examines how maritime and trading states allocate public resources between defence, health, and economic growth around three strategic chokepoints the Strait of Malacca, the Strait of Hormuz, and the Suez Canal. The analysis extends the classic “guns versus butter” framing by treating defence and health spending as co-evolving components of an interconnected fiscal-growth system. Using World Development Indicators data (1999-2024), trend slopes are estimated for military spending (% of GDP), healthcare spending (% of GDP), and GDP growth (annual %). Two derived indicators are computed, a defence-to-health slope ratio (military slope/health slope) and a fiscal-balance proxy (health slope …

Florence S.T.C. Building Starts, Birmingham News

Documents

Student health at Florence State Teachers College to be enhanced with new gymnasium for the school

The Cost Of Affordable Healthcare: How Brazil's Sus And Generic Drug Strtegy Produce Structural Inequality And Challenge Global Pharmaceutical Rules, Elena Kössler

Posters - 2026

Affordable healthcare is often seen as a major social achievement, but maintaining low costs involves important trade-offs. Brazil’s Unified Health System (SUS) provides universal healthcare and relies heavily on generic medicines to expand access. This raises a central question: how can a system reduce the cost of healthcare while simultaneously generating new forms of inequality and tension within global pharmaceutical markets? This paper argues that Brazil’s cost-reduction strategy, particularly its reliance on generic medicines, improves affordability but also produces structural trade-offs between equitable access, quality of care, and incentives for pharmaceutical innovation.

To Work Or Not To Work? Lessons From Older Adults In Maine, Kimberly Snow, Mary Lou Ciolfi, Sarah Currie, Catherine Taylor

All Cutler Institute Publications

Work in later life is currently widely discussed for myriad reasons including that  many older adults want or need to work well past typical retirement age; employers  want and need the expertise, experience, and reliability of older workers; social and  health benefits often accompany later life work; anti-ageism awareness is  heightening the visibility and value of older workers; and economists and  demographers cite the importance of a dependable workforce that includes older  adults. The topic of later life work intersects with several other disciplines in social  science, business, health, technology, communications, and data collection - among  others - presenting opportunities …

Physical And Behavioral Health Diagnoses And Comorbidities Associated With Transition From Military Health System To Veterans Health Care Among Post-­ 9/11 Veterans, Nikki R. Wooten, Megan E. Amaun, Madeline Meyers, Prince Nii Ossah Addo, Jeffery Bowers, Felicia R. Carey, Rudolph P. Rull, Edward J. Boyko, Nathaniel Bell, Ana Defede-Lopéz, Mary Jo V. Pugh

Faculty and Staff Publications

Objective

To identify factors associated with transitioning from Military Health System (MHS) to Veterans Health Administration (VHA) care in post-9/11 veterans.

Study Setting and Design

Retrospective cohort study from the Long-Term Impact of Military-Relevant Brain Injury Consortium Phenotype Study.

Data Sources and Analytic Sample

Population-level data were analyzed from MHS and VHA electronic health data (FY2000-2020). Participants received ≥ 3 years of MHS care and separated from the military before October 1, 2016. The primary outcome was transition from MHS to VHA care after military separation. Covariates included demographic, military, and deployment characteristics at military separation; physical, mental, and substance …

Obesity In The Rio Grande Valley: Applying An Evidence-Based Public Health Approach, Erika Pineda-Horta

Posters - 2026

What structural and social determinants drive elevated adult obesity rates in the Rio Grande Valley, and what evidence-based interventions can reduce adult obesity prevalence in Hidalgo County by 5% by 2030?

Objective: This study applies an EBPH framework to (1) characterize the burden and structural determinants of adult obesity in the RGV, and (2) propose a culturally responsive, evidence-based intervention targeting adults aged 18+ in Hidalgo County.

Adult obesity is clinically defined as a Body Mass Index (BMI) ≥30 kg/m² in adults aged 18 and older (CDC, 2022). It is a chronic, multifactorial non-communicable disease shaped by structural, social, and …

Regulation Of Caffeine, Rileigh Gaddini

Gateway Reader- Individual Papers

• The Problem: Public overconsumption of normalized addictive substances like caffeine and sugar results in significant health risks, dependency, and potential cardiac fatalities.

• The Method: An analysis of regulatory policies, product labels, consumer consumption habits, physiological mechanisms, and documented health event case studies.

• Quantitative Finding: The average American daily intake of caffeine is 193 mg, with more than 87% of U.S. adults reporting regular use; the FDA recommended limit for caffeine is 400 mg per day; a 16-ounce Starbucks coffee contains at least 190 mg of caffeine; 70–85% dark chocolate contains 22.7 mg of caffeine per ounce, while …

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Call To Action Against Sex Trafficking Of Black Women And Girls, Stephany Powell, Tracey Sylvester, Brenda Myers-Powell, Audrey Morrissey, Melanie Thompson

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Evaluating The Impact Of Social Determinants Of Health On Outcomes Of Type Ii Diabetes In South Carolina, Alexander G. Downs

Senior Theses

Type II diabetes mellitus (T2DM) represents a significant public health burden in South Carolina, where 13.5% of adults are affected, surpassing the national rate of 12%. This integrative literature review examines the social determinants of health most strongly associated with T2DM morbidity and mortality in South Carolina, including race and ethnicity, socioeconomic status, rural or urban residence, educational attainment, healthcare access, and food insecurity. Evidence drawn from peer-reviewed studies, epidemiological reports, and state health data reveals that African American, rural, and low-income populations bear a disproportionate share of the diabetes burden in the state. These disparities arise through multilevel mechanisms …

Ethical Controversies In Organ Procurement: A National Survey On Public Perceptions Of Thoracoabdominal Normothermic Regional Perfusion, Trevor M Bibler, Jill Oliver Robinson, Adam Omelianchuk, Tariq Nisar, Savitri Fedson, Ariel N Levchenko, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of US adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a neutral description of TA-NRP, participants judged its permissibility, reviewed 5 critic and 5 supporter arguments (in random order), and chose which argument they found most convincing. Multivariable logistic regression examined predictors of agreeing with critics. Before exposure to the arguments, 51.5% stated that …

Quantifying Provider Relief Fund Allocation Trends: A Descriptive Analysis Of Rural And Urban Hospitals, 2014-2023, Wendell C. Mcclurg

MUSC Theses and Dissertations

Rural hospitals operate on thin margins, have limited access to capital, and face a heightened risk of closure. During the COVID-19 pandemic, the Provider Relief Fund (PRF) distributed more than $170 billion to health care providers to offset revenue losses and preserve access to care. Most evaluations of PRF have focused on profitability, which may overstate financial resilience by overlooking liquidity. Using Hospital Cost Reports for hospitals from 2014-2023, we examined trends in Days Cash on Hand (DCOH), operating margin, total margin, and PRF funding intensity by rurality and ownership. Liquidity rose sharply during 2020-2021, coinciding with the peak of …

How Do Minimum Wages Affect Workplace Injuries?, Michael Davies, R. Jisung Park, Anna Stansbury

Upjohn Institute Policy and Research Briefs

No abstract provided.

Minimum Wages And Workplace Injuries, Michael Davies, R. Jisung Park, Anna Stansbury

Upjohn Institute Working Papers

How do minimum wage changes affect workplace amenities? Using the universe of claims from California, the US’ largest workers’ compensation system, over 2000-2019, we exploit geographic variation in state- and city-level minimum wages and local occupation-level variation in exposure to minimum wage changes to estimate whether minimum wage increases affect the rate of workplace injuries. We find a large adverse effect of raising minimum wages on injuries. A 10% increase in the minimum wage increases the injury rate by 7.2% in an occupation-metro area labor market which is fully exposed to the minimum wage increase. Our results imply an elasticity …

Knowledge Of Lifespan And Healthspan And Interest In Healthy Longevity Medicine Among The General Population In Singapore: The Singapore Healthy Longevity (Helo) Survey, Jonas John Posko Amalaraj, Belinda Wang, Anna Szucs, Louis Island, Laureen Yi-Ting Wang, Liz J. Horberg, Paul A. O'Keefe, Sonny Rosenthal, Yap-Seng Chong, Johannes J. Meij, Andrea B. Maier

Research Collection College of Integrative Studies

Given the growing global interest in Healthy Longevity Medicine (HLM), the field lacks understanding about public knowledge and interest, which are crucial for any public health intervention relying on HLM. This study presents findings from the Healthy Longevity (HELO) survey conducted in Singapore, assessing public knowledge regarding lifespan (number of years a person is alive), healthspan (number of years a person spends in good health), and interest in HLM. This nationwide cross-sectional survey, conducted between June and August 2024, involved 3034 participants. Main domains including questions on demographics, living arrangements, medical information, health behaviours, income and financial status were tested …

Post-Dobbs Realities: Ethical Imperatives For Data Transparency And Trust In Maternal Health Care, Faith E Fletcher, Sophie L Schott, Kelley Akhiemokhali, Kari White

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Patterns Of Tobacco Marketing And User Engagement On Social Media In Indonesia: Challenges For Digital Public Health, Resti Yulianti Sutrisno, Nopryan Ekadinata, Sutantri Sutantri, Dinasti Pudang Binoriang, Enrico Aditjondro, Rachfiansyah Rachfiansyah, Yosef Rabindanata, Silvia Dini, Rebecca Perl, Riska Rachmawati, Bertha Tesma Wulandari, Dianita Sugiyo

Kesmas

Large-scale tobacco marketing on social media has resulted in widespread population-level exposure, particularly in Indonesia, which faces growing challenges in digital public health. This study aimed to assess the associations between platform type and marketing tactics and identify correlations of user engagement. An analytical cross-sectional study was conducted using secondary data from the Tobacco Enforcement and Reporting Movement (TERM), collected from January 2022 to August 2023. A total of 21,255 tobacco marketing posts from social media were analyzed. Platform–tactic associations were examined using Chi-square tests, and multivariable Poisson regression was used to identify factors associated with user engagement. The findings …

Low-Dose Prophylaxis Versus On-Demand Treatment For Children With Severe Hemophilia A In Indonesia: A Conceptual Model, Levina Chandra Khoe, Nur Atika, Dhia Ticha Pertiwi, Septiara Putri

Kesmas

Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to …

The Role Of Gynecologic Oncologists In Improving Survival Outcomes Of Epithelial Ovarian Cancer: A Retrospective Cohort Study, Widyorini Lh Hanafy, Bambang Dwipoyono, Asri C. Adisasmita, Yosephine E. Regina, Airine S. Lians, Oktaviani P. Rahayu, Jane G. Auwelia

Kesmas

Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three …

The Disproportionate Impact Of Hiv On Young Women In Durban: Exploring Gendered Vulnerabilities And Socioeconomic Barriers, Adrian A. Nolasco

Capstone Collection

South Africa has a high rate of HIV, with young women in Durban especially affected due to social, economic, and cultural challenges. This study looks at the experiences of young women living with HIV and the views of healthcare professionals caring for them in KwaZulu-Natal. Using a qualitative, phenomenological approach, semi-structured interviews were conducted with five women and three medical professionals to explore how HIV affects their lives, the challenges they face, and how they cope.

The findings show that both structural and personal barriers make it hard for young women to stick to treatment. Long waits at clinics, limited …

Self-Medication And Pharmaceutical Dispensing In Egypt: Practices, Policies, And Regulatory Challenges, Lobna Fawzy Ali Shaheen

Theses and Dissertations

Access to safe and appropriate medications is a critical component of public health, particularly in low- and middle-income countries. In Egypt, self-medication and informal pharmaceutical dispensing have become deeply embedded practices shaped by systemic, economic, and cultural factors. This research explores the complex interplay between self-medication behaviors, pharmaceutical regulation, and healthcare access in Egypt. Through qualitative interviews with policymakers, pharmacists, physicians, industry professionals, and citizens, the research uncovers widespread informal dispensing of prescription-only medicines, driven by high out-of-pocket costs, limited insurance coverage, and high public reliance on pharmacists as primary care providers. Despite the presence of regulatory frameworks, weak enforcement, …