Health Policy Commons^™

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.

Health

This fact sheet highlights estimated rates of vaccine hesitancy, vaccination rates, the index of social vulnerability, and the level of concern for 17 Nevada counties as of June, 2021. The data are reported in the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) estimates.

Cdc Social Vulnerability Index (Svi): Nevada Counties, Vanessa Booth, Ally M. Beckwith, Kelliann Beavers, William E. Brown Jr.

Demography

This fact sheet highlights how Nevada counties rank on the Social Vulnerability Index (SVI) as defined by the Center for Disease Control (CDC) and the Agency for Toxic Substances and Disease Registry (ASTDR). Socially vulnerable populations are often disproportionately harmed during public health emergencies such as natural disasters and infectious disease outbreaks. The Geospatial Research, Analysis, and Services Program (GRASP) created the CDC/ATSDR Social Vulnerability Index (CDC/ATSDR SCI) to help public health officials and emergency response planners meet community health needs during response and recovery efforts (ATSDR, 2020).

In The Midst Of An Epidemic: How Print Media Shapes Policy Feedback To The Opioid Crisis, Peter S. Federman

Journal of Public Management & Social Policy

As opioid addiction has spread across the country, media discourse around opioid abuse has consistently increased. A content analysis of local newspaper articles from the state of Massachusetts reveals that political and administrative officials conceive of Narcan in distinct ways. Administrators, including police and fire officials, see Narcan as a means to accomplish their organizational mission. Conversely, elected officials are primarily concerned with cost, legal ramifications and the broad impact of the opioid crisis, remaining disconnected from street-level concerns. In delineating these divergent perspectives, this article provides two unique contributions: first, it applies policy feedback theory as a framework to …

The Socioeconomic Impacts Of Covid-19 Study: Survey Methodology Report, Stephen Roll, Sam Bufe, Yung Chun, Michal Grinstein-Weiss

Social Policy Institute Research

When COVID-19 was declared a pandemic, and economic shutdowns began in March 2020, households across the United States were faced with an unprecedented crisis that would affect their health, financial security and overall well-being for an unforeseeable amount of time. In order to examine and track the wide-ranging impacts of the pandemic on households, as well as the efficacy of different public and private efforts to mitigate these impacts, the Social Policy Institute at Washington University in St. Louis (SPI) launched the Socioeconomic Impacts of COVID-19 Survey (SEICS) in the United States just weeks after the pandemic became a national …

Vaccination Options For Medicaid Parents Uncomfortable With Office Visits During Covid Pandemic, Amy Mcqueen, Tess Thompson, Enguday Teshome, Jennifer Staten, Saneel Kulkarni, Thidaporn Tanpattana, Lourdes Balaez, Matthew W. Kreuter

Social Policy Institute Research

Objective: Rates of child vaccinations declined during the COVID pandemic, which increases the risk of outbreaks of preventable diseases among children. Methods: We conducted an online survey of parents of Medicaid beneficiaries age 0-5 years old in Florida USA during January 2021 to assess barriers and strategies to increase adherence to childhood vaccinations.

Results: We surveyed 1,951 parents. Most (91%) respondents reported their child was up-to-date with childhood vaccinations, but fewer (36%) children had received a flu shot. Some (31%) parents had wanted to take their child to see a doctor but decided not to, and 22% were …

Use Of Public Benefits Over The First Year Of Pandemic: Exploring Access, Delays And Outcomes, Sam Bufe, Stephen Roll, Katie Kristensen, Dan Zhao, Mathieu Despard, Michal Grinstein-Weiss

Social Policy Institute Research

In response to the economic crisis caused by the COVID-19 pandemic, the U.S. federal government enacted initiatives designed to help households weather the pandemic’s effects. These initiatives included expansions of existing programs, such as unemployment insurance, as well as new programs like the economic impact payments. In this brief, we investigate the extent to which households relied on an array of public benefit programs over the course of the pandemic, how they used their economic impact payments, and the extent to which the unemployment insurance expansion was effective in insulating recipients from hardship during the pandemic.

We find that, in …

Housing Hardships During Covid-19, Sophia Fox-Dichter, Yung Chun, Stephen Roll, Katie Kristensen, Michal Grinstein-Weiss

Social Policy Institute Research

Even prior to the COVID-19 pandemic, U.S. households were burdened by the cost of rental and mortgage payments, burdens which disproportionately fell on Black and Hispanic families. Using a 5-wave survey, we examined whether disparities in housing cost burden continued throughout the pandemic and trends in how households fell behind on rent and mortgage payments. We found that more than a third of households experienced housing cost burdens during the pandemic, with a slightly higher percentage of households of color bearing cost burdens than white households. Renters had greater cost burdens than homeowners.

During the pandemic, significantly more Black and …

Employment Changes During Covid-19, Mathieu Despard, Sam Bufe, Stephen Roll, Katie Kristensen

Social Policy Institute Research

Early in the COVID-19 pandemic, U.S. unemployment peaked at 14.4%. While some workers have returned to payrolls, others have been left behind. This brief examines the nuances of employment changes over the course of the pandemic and the impact of those changes on household financial well-being. Our study finds that the proportion of employees who were laid off peaked in the spring of 2020 and has only recently returned to pre-pandemic levels.

Meanwhile, self-employment rose during the pandemic by 42% between the springs of 2020 and 2021. In households where someone lost a job during the pandemic, rates of financial …

Employment, Financial And Well-Being Effects Of The 2021 Expanded Child Tax Credit: Wave 1 Executive Summary, Leah Hamilton, Stephen Roll, Mathieu Despard, Elaine Maag

Social Policy Institute Research

The 2021 temporary expansion of the Child Tax Credit (CTC) is unprecedented in its reach and is predicted to cut American child poverty by more than half. The expanded CTC provides families with $3,600 for every child in the household under the age of six, and $3,000 for every child between the ages of six and 17. Almost all middle- and low-income families with children are eligible for the CTC. Married parents making less than $150,000 and single parents making less than $112,500 per year will receive the full amount of the credit, which begins to phase out slowly after …

Impact Of Covid-19 On Households With Children: Family Hardships And Policy Insights, Alejandra Muñoz-Rivera, Jason Jabbari, Stephen Roll, Michal Grinstein-Weiss

Social Policy Institute Research

The COVID-19 pandemic caused major disruptions in employment, child care and education. As a result, both parents and children experienced a variety of hardships in their work and education. While these hardships had reverberating effects throughout households, they were not equally distributed across families with children. In this brief, we explore the effects of COVID-19 on families with children, highlighting unaddressed areas of need, as well as potential points of intervention. In this study we find:

• Almost one-quarter (22%) of families experienced job or income loss as a result of child care disruptions, which was especially prevalent in households with …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Pandemic Schooling: Lessons In Equity, Advocacy, And Racial Justice, Donna Rivera

Dissertations, Theses, and Capstone Projects

It was my fourth year of teaching at a Brooklyn elementary school when the COVID-19 pandemic forced school buildings, and the entire city, to enter a world of lockdown and quarantine. New York City was an early epicenter of the 2020 coronavirus pandemic, and the virus quickly revealed severe racial and socioeconomic disparities across the city. A disproportionate number of cases, serious illnesses, and death has been experienced by low-income Black and Latinx communities. At the same time, 2020 also ushered in a national racial reckoning following the May murder of George Floyd.

In this thesis, I will provide a …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Homelessness Estimates In The Mountain West, 2020, Saha Salahi, Vanessa Booth, William E. Brown Jr.

Demography

This fact sheet summarizes a recent report titled, “The 2020 Annual Homelessness Assessment Report (AHAR) to Congress,” by the U.S. Department of Housing and Urban Development. By synthesizing homelessness vulnerability categories to the Mountain West states, this report offers data for Arizona, Colorado, Nevada, New Mexico, and Utah.

Accelerating The Provision Of Safe Water Supply In Urban And Rural Areas Of Indonesia, Sumengen Sutomo, Salord Sagala, Bebi Sutomo, Sri Winarti, Gelant Sanjaya

Kesmas

Over the past 100 years, the provision of a safe water supply to drink in Indonesia has been slowly progressed with low coverage. The majority of the population does not have access to safe water. Morbidity and mortality of water-related diseases, including diarrhea, are very high. The provision of safe water is not a technological issue but good water management that comprises content, institutional, and communication layer. This paper provided information for strategic and operational decisions to accelerate the provision of safe water services in urban and rural areas. Benchmarking good water management with the characteristics of the water supply …

Covid-19 Preparedness And The Anxiety Of Thai Citizens, Afifi Lateh, Prasopchai Pasunon, Kiflan Dolah, Panida Kongjam, Saminee Chemae, Phanupong Panomwan, Alawee Lateh

Kesmas

The outbreak of COVID-19 has brought sickness and fatality to Thai citizens. In addition, it left a tremendous psychological impact on mental health as they experienced panic and anxiety about controlling situations and preserving their physical and mental well-being. This study aimed to analyze the factors influencing COVID-19 preparedness and anxiety based on groups of Thai citizens. Online questionnaires were employed to collect data from 2,768 respondents selected through convenience sampling and snowball sampling on Facebook, having shared questionnaires with 190 other users. Data were collected from March 29 to April 3, 2020. The acquired data were analyzed using percentage …

Association Between Self-Reported Fatigue And Sarcopenia Measures Among Elderly In Selangor, Malaysia, Maria Justine, Aliff Latir, Nadhirah Noor, Angelbeth Joanny, Izzaty Iskandar, Maisarah Sakinah Amirul Faizi, Dzulhelmi Edinan

Kesmas

The association between fatigue and sarcopenia is not well understood, therefore, this study aimed to compare the sarcopenia measures among elderly with mild and severe fatigue and to determine whether fatigue severity is associated with sarcopenia measures. This was a cross-sectional study conducted on201 elderly (age = 68.45±6.30 years). The elderly was classified into either mild or severe fatigue based on the Fatigue Severity Scale (FSS), meanwhile, sarcopenia measures include SARC-F score, muscle mass (ASM/height2), calf circumference (CC), upper (handgrip) and lower limb muscle strength, as well as physical performance (gait speed). Data were analyzed using independent t-tests and logistic …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Unveiling And Addressing Implementation Barriers To Routine Immunization In The Peri-Urban Slums Of Karachi, Pakistan: A Mixed-Methods Study, Amna Tanweer Yazdani, Ameer Muhammad, Muhammad Imran Nisar, Uzma Khan, Yasir Shafiq

Department of Paediatrics and Child Health

Background: Great disparities in immunization coverage exist in Pakistan between urban and rural areas. However, coverage estimates for large peri-urban slums in Sindh are largely unknown and implementation challenges remain unexplored. This study explores key supply- and demand-side immunization barriers in peri-urban slums, as well as strategies to address them. It also assesses immunization coverage in the target slums.
Methods: Conducted in four peri-urban slums in Karachi, this mixed-methods study consists of a baseline cross-sectional coverage survey of a representative sample of 840 caregivers of children aged 12-23 months, and 155 in-depth interviews (IDIs) through purposive sampling of respondents (caregivers, …