Health Policy Commons^™

Measuring The Impact Of Covid-19 On Older Adults In Massachusetts, Ceara Somerville, Jan Mutchler, Caitlin Coyle

Center for Social and Demographic Research on Aging Publications

The spread of COVID-19 across the United States has affected every facet of life since early 2020. According to the Centers for Disease Control and Prevention (CDC), there are currently over 4 million cases across the nation and over 146,000 deaths from the virus. Massachusetts has been one of the states hit hardest, with over 100,000 confirmed cases and more than 8,000 deaths to date. The Commonwealth currently trails only New York and New Jersey in number of deaths. While cases surge around the country, Massachusetts has seen some leveling out of positive cases since the beginning of July. Though …

Employer-Reported Access To Paid Parental Leave: A Study Of San Francisco’S Paid Parental Leave Ordinance, Julia M. Goodman, Holly Elser, William H. Dow

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: A growing body of research finds that paid leave policies have significant population health benefits for workers and their families, but the lack of a national paid leave policy in the United States leaves most workers without access to any paid leave. In 2017 San Francisco implemented the nation’s first fully paid leave policy, mandating that covered employers provide up to six weeks of leave to care for a new child. The objective of our study is to examine how the San Francisco Paid Parental Leave Ordinance (PPLO) affected paid leave access, including among workers in low-wage industries. Methods: …

What's Left Of The Affordable Care Act?, Helen Levy, Andrew Ying, Nicholas Bagley

Articles

We assess the progress of the Affordable Care Act a decade after it became law. Although most of it remains intact, some parts have been repealed and others have not been implemented as expected. We review how and why the law has aged. Legal challenges have done less damage than is commonly appreciated, with the exception of the Supreme Court case that thwarted full expansion of Medicaid. Most of the important changes have other sources. Some parts were born to fail. Others were dismantled in response to interest-group pressure. Still others have failed to thrive for any number of reasons. …

Mortalidad Por Neumonías En Guatemala (2014-2018): Una Herramienta Del Enfoque Epidemiológico De Riesgo Para La Priorización De Acciones Frente A La Covid-19, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por neumonías en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud publica. El riesgo de morir de neumonía en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas del pueblo mayo, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Aun sin la presencia de COVID-19, deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo …

A Heart Of Gold

DePaul Magazine

An interview with alumnus, retired insurance executive and DePaul Life Trustee Bertram ("Bert") Scott, chairman of the American Heart Association (AHA). He hopes to help focus attention on the social determinants of health, increase research, address vaping illnesses and foster diversity communities to get involved with the AHA.

Using Open Public Meetings And Elections To Promote Inward Transparency And Accountability: Lessons From Zambia, Taryn Vian, Rachel M. Fong, Jeanette L. Kaiser, Viviane Sakanga, Melvin Mwansa, Parker S. Chastain, Thandiwe Ngoma, Nancy Scott

Nursing and Health Professions Faculty Research and Publications

Background
Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members.

Methods
We applied a principally qualitative …

Material Hardship Among Lower-Income Households: The Role Of Liquid Assets And Place, Mathieu Despard, Valerie Taing, Addie Weaver, Stephen Roll, Michal Grinstein-Weiss

Social Policy Institute Research

Lower income households are at risk for material hardship, particularly amidst the economic fallout of COVID-19. Where one lives (e.g. suburb, small town) may affect this risk due to variable access to resources, yet the evidence is mixed concerning the influence of place. We used a pooled, national cross-sectional sample of 66,046 lower-income tax filers to examine differences in material hardship in rural, small town, micropolitan, and urban areas. Controlling only for standard demographic variables, hardship risk appears higher in non-urban areas, yet these differences disappear after controlling for financial characteristics such as liquid assets and home ownership.

The Impact Of Tax Refund Delays On The Experience Of Hardship And Unsecured Debt, Olga Kondratjeva, Stephen Roll, Mathieu Despard, Michal Grinstein-Weiss

Social Policy Institute Research

The Earned Income Tax Credit (EITC) provides substantial financial support to low-income workers, yet around a quarter of EITC payments are estimated to be erroneous or fraudulent. Beginning in 2017, the Protecting Americans from Tax Hikes Act of 2015 requires the Internal Revenue Service to spend additional time processing early EITC claims, delaying the issuance of tax refunds. Leveraging unique data, we investigate how delayed tax refunds affected the experience of hardship and unsecured debt among EITC recipients. We find that early filers experienced increased food insecurity relative to later filers after the implementation of the refund delay.

Employee Financial Wellness Programs: Promising New Benefit For Frontline Workers?, Mathieu Despard, Ellen Frank-Miller, Yingying Zeng, Sophia Fox-Dichter, Geraldine Germain, Michal Grinstein-Weiss, Meredith Covington

Social Policy Institute Research

Interest among employers is growing in Employee financial wellness programs (EFWPs), a new type of benefit to address financial stress among employees. EFWPs benefits include financial counseling, small-dollar loans, and savings programs that address employees' non-retirement financial needs. Little evidence exists concerning the availability and use of and outcomes associated with EFWPs, especially among low- and moderate-income (LMI) workers who may be in greatest need of these benefits. We present findings concerning awareness and use of EFWPs from a national survey of LMI workers (N=16,650). Availability of different EFWP benefits ranged from 11 to 15% and over a third of …

Employee Financial Wellness Programs: Tips For Employers, Sloane Wolter, Jenna Hampton Bsw, Sophia Fox-Dichter, Ellen Frank-Miller

Social Policy Institute Research

There are several types of Employee Financial Wellness Programs (EFWPs), such as workplace financial counseling, workplace credit building, and employer-sponsored small dollar loans. Each program benefits the company and its employees in different ways.

The Social Policy Institute at Washington University in St. Louis, with generous support from the W. K. Kellogg Foundation, studied the implementation of EFWPs at several diverse organizations, including a nonprofit in the Midwest and several supply chain locations of a national retailer, to understand the impact. As a result, we’ve identified four ways in which organizations can maximize the benefits of EFWPs and avoid pitfalls …

Employee Financial Wellness Programs: Tips For Providers, Jenna Hampton Bsw, Sloane Wolter, Sophia Fox-Dichter, Ellen Frank-Miller

Social Policy Institute Research

There are several types of Employee Financial Wellness Programs (EFWPs), such as workplace financial counseling, workplace credit building, and employer-sponsored small dollar loans. Each program benefits the company and its employees in different ways.

The Social Policy Institute at Washington University in St. Louis, with generous support from the W. K. Kellogg Foundation, studied the implementation of EFWPs at several diverse organizations, including a nonprofit in the Midwest and several supply chain locations of a national retailer, to understand the impact. As a result, we’ve identified five ways in which providers can maximize the benefits of EFWPs and avoid pitfalls …

Financial Counseling For Front-Line Workers: A Pilot Study Of Engagement And Outcomes, Mathieu Despard, Yingying Zeng, Sophia Fox-Dichter, Ellen Frank-Miller, Michal Grinstein-Weiss

Social Policy Institute Research

Although financial counseling has been studied in community-based settings, programs offered in the workplace are understudied and yet may aid low- to moderate income employees in improving their financial situations. This study examines workers’ engagement in and associated credit outcomes from an employer-based financial counseling program in the New York City area. Findings suggest that participants engaged equally in services except for older and non-English speaking workers, who had lower levels of digital engagement. In-person engagement in services was minimal. Credit score improvements were modest, but greater for workers who had

scores in the lowest quartile at baseline. These credit …

Promoting Public Retirement Savings Accounts During Tax Filing: Evidence From A Field Experiment, Stephen Roll, Michal Grinstein-Weiss, Olga Kondratjeva, Sam Bufe

Social Policy Institute Research

Many U.S. households—especially those with low- to moderate-incomes (LMI)—struggle to save for retirement. To address this issue, the Department of the Treasury launched myRA, a no-fee retirement account designed primarily to help people who lacked access to employer-sponsored plans build retirement savings. In this paper, we report findings from two myRA-focused field experiments, both of which were administered to well over 100,000 LMI online tax filers before and during the 2016 tax season. The first experiment involved sending one of three different myRA-focused email messages to tax filers immediately prior to tax season, and the second experiment …

Tax-Time Saving And The Earned Income Tax Credit: Results From Online Field And Survey Experiments, Mathieu Despard, Michal Grinstein-Weiss, Stephen Roll, Bradley Hardy, Dana Perantie, Jane Oliphant

Social Policy Institute Research

Tax refunds are an opportunity for Earned Income Tax Credit (EITC) recipients to build emergency savings. Randomly assigned behavioral interventions in 2015 and 2016 have statistically significant impacts on refund saving take-up and amounts among EITC recipients who filed their taxes online. From a survey experiment, we also find that EITC recipients have a 49 percent and 59 percent increased likelihood of deferring 20 percent of their refunds for six months when hypothetically offered 25 and 50 percent savings matches (p < .001), respectively. These findings can inform policy development related to encouraging emergency saving at tax time.

Using Financial Tips To Guide Debt Repayment: Experimental Evidence From Low-And Moderate-Income Tax Filers, Olga Kondratjeva, Stephen Roll, Sam Bufe, Michal Grinstein-Weiss

Social Policy Institute Research

Much of the literature on household finances tends to focus on discrete or relatively objective measures like savings, debt, economic mobility, and there has been a lack of research on holistic measures of financial well-being. This gap is due in part to the absence of a common understanding of how to define and measure financial well-being; a gap that was recently addressed by the Consumer Financial Protection Bureau’s development of a financial well-being scale. However, the research on this scale is still scarce and little is known about how financial well-being evolves over time. To that end, this paper uses …

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Health Policy & Community Health: Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

Covid-19 And Latinos In Massachusetts, Lorna Rivera, Phillip Granberry, Lorena Estrada-Martínez, Miren Uriarte, Eduardo Siqueira, Ana Rosa Linde-Arias, Gonzalo Bacigalupe

Gastón Institute Publications

This report focuses on the Latino population of Massachusetts and uses 2014–2018 American Community Survey (ACS) demographic data to explore both Latinos’ vulnerability to COVID-19 infection and the key predictive factors. We explore what is known about the social determinants of health previously identified as critical to understanding the spread and differential infection rates of COVID-19 across populations—for example, opportunities for infection due to employment and housing conditions—and how these apply to the Latino population in Massachusetts. We also briefly explore those factors that lead to COVID-19 severe illness and possibly death from the disease, including the age of the …

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …