Health Policy
Access to Contraceptives in School-Based Health Centers: Progress and Opportunities
The U.S. has a higher adolescent pregnancy rate than other industrialized countries. School-based health centers can improve access to contraceptives among youth, which can prevent unplanned pregnancies. This cross-sectional study examines the characteristics and predictors of contraceptive provision at school-based health centers in 2016–2017 and changes in and barriers to provision between 2001 and 2017.Video Telehealth Access and Changes in HbA1c Among People With Diabetes
Video telehealth can offer people convenient, real-time access to clinicians without arranging transportation or time off work. Among people with diabetes, this study examines the association between video telehealth access and changes in HbA1c.ICD-10 Z-Code Health-Related Social Needs and Increased Healthcare Utilization
Health-related social needs are known drivers of health and health outcomes, yet work to date to examine health-related social needs using ICD-10 Z-codes remains limited. This study seeks to evaluate the differences in the prevalence of conditions as well as utilization and cost between patients with and without health-related social needs.Medicaid Expansion and Cancer Mortality by Race and Sex in Louisiana
The purpose of this study is to determine the association between Medicaid expansion in Louisiana and cancer mortality by race and sex.Permanent Supportive Housing With Housing First: Findings From a Community Guide Systematic Economic Review
The annual economic burden of chronic homelessness in the U.S. is estimated to be as high as $3.4 billion. The Permanent Supportive Housing with Housing First (Housing First) program, implemented to address the problem, has been shown to be effective. This paper examines the economic cost and benefit of Housing First Programs.Impact of the Affordable Care Act on Colorectal Cancer Incidence and Mortality
The Patient Protection and Affordable Care Act eliminated cost sharing for preventive services, including colorectal cancer screening for individuals aged 50–75 years with private health insurance. This study examines the impact of the Affordable Care Act's removal of cost sharing for colorectal cancer screening on colorectal cancer incidence and mortality.Preventing Leading Causes of Death: Systematic Review of Cost-Utility Literature
Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is to examine the economic value of prevention interventions addressing these 5 conditions.The Impact of a Population-Based System of Care Intervention on Enhanced Prenatal Care and Service Utilization Among Medicaid-Insured Pregnant Women
Enhanced prenatal/postnatal care home visiting programs for Medicaid-insured women have significant positive impacts on care and health outcomes. However, enhanced prenatal care participation rates are typically low, enrolling <30% of eligible women. This study investigates the impacts of a population-based systems approach on timely enhanced prenatal care participation and other healthcare utilization.Governor's Party, Policies, and COVID-19 Outcomes: Further Evidence of an Effect
This study connects the aggregate strength of public health policies taken in response to the COVID-19 pandemic in the U.S. states to the governors’ party affiliations and to state-level outcomes. Understanding the relationship between politics and public health measures can better prepare American communities for what to expect from their governments in a future crisis and encourage advocacy for delegating public health decisions to medical professionals.Impact of Medicaid Expansion on Reported Incidents of Child Neglect and Physical Abuse
The U.S. Affordable Care Act Medicaid expansion, which allowed states to expand Medicaid coverage to low-income adults beginning in 2014, has reduced the risk factors for child neglect and physical abuse, including parental financial insecurity, substance use, and untreated mental illness. This study examines the associations between Medicaid expansion and the rates of overall, first-time, and repeat reports of child neglect and physical abuse incidents per 100,000 children aged 0–5, 6–12, and 13–17 years.A Feasibility Study of Primary Care Liaisons: Linking Older Adults to Community Resources
Programs and services available through the aging services network can help community-dwelling older adults to age in place but are often not discussed in routine primary care. The primary care liaison was developed as a novel integration intervention to address this disconnect.Partisan Control of U.S. State Governments: Politics as a Social Determinant of Infant Health
State policies and programs affect population health; yet, little is known about the connections between health and the political institutions and actors that prescribe and execute those policies and programs.Urban–Rural Variations in Quality of Care Among Patients With Cancer in California
Previous research suggests cancer patients living in rural areas have lower quality of care, but population-based studies have yielded inconsistent results. This study examines the impact of rurality on care quality for 7 cancer types in California.Association Between Dense Breast Legislation and Cancer Stage at Diagnosis
Many states have mandated breast density notification and insurance coverage for additional screening; yet, the association between such legislation and stage of diagnosis for breast cancer is unclear. This study investigates this association and examines the differential impacts among different age and race/ethnicity subgroups.Association of State Gestational Age Limit Abortion Laws With Infant Mortality
A growing number of state legislatures have passed laws that restrict access to abortion care after a specified gestational age (gestational age limit laws). The impact of these laws on maternal and child population health outcomes and inequities is unknown. The objective of this study is to determine whether states that implement gestational age limit laws experience subsequent changes in rates of infant mortality.Prevalence and Determinants of Difficulty in Accessing Medical Care in U.S. Adults
Ensuring adequate access to health care is essential for timely delivery of preventive services. It is important to evaluate the prevalence and determinants of difficulty in accessing medical care in the overall U.S. population and among those with high-risk chronic conditions.Helpline Calls Associated With Preventable Emergency Department Utilization
Unmet social needs are linked with greater healthcare utilization, but most studies lack timely and granular data on these needs. The 2-1-1 helpline is a telephone helpline focused on social needs. The objective of the study is to determine whether the number of 2-1-1 requests per 1,000 people is associated with preventable emergency department visits and compare the strength of the association with another commonly used predictor, Area Deprivation Index.Paid Family Leave and Mental Health in the U.S.: A Quasi-Experimental Study of State Policies
Several U.S. states have implemented paid family leave policies for new parents. Few studies have evaluated the impacts of U.S. paid family leave policies on families’ health. This study tests the hypothesis that paid family leave policies in California and New Jersey improved parent and child mental health.A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce
Peer providers with lived experiences of mental health and substance use are a growing component of the workforce responsible for the prevention and treatment of behavioral health disorders. This systematic literature review aims to better define the roles of peers and their unique contributions to behavioral health care.Health Insurance Disruptions and Care Access and Affordability in the U.S.
Health insurance is associated with better care in the U.S., but little is known about the associations of coverage disruptions (i.e., periods without insurance) with care access, receipt, and affordability.Impact of Neighborhood Social and Environmental Resources on Medicaid Spending
In an era of COVID-19, Black Lives Matter, and unsustainable healthcare spending, efforts to address the root causes of health are urgently needed. Research linking medical spending to variation in neighborhood resources is critical to building the case for increased funding for social conditions. However, few studies link neighborhood factors to medical spending. This study assesses the relationship between neighborhood social and environmental resources and medical spending across the spending distribution.Trends in the Utilization of Recommended Clinical Preventive Services, 2011–2019
The Patient Protection and Affordable Care Act requires many health insurance plans to cover certain clinical preventive services in network with no cost sharing. This study describes the utilization trends of 8 clinical preventive services by insurance status and analyzes utilization disparities.Health Savings Plans and Disparities in Access to Care by Race and Ethnicity
High-deductible health plans are often touted to motivate patients to become informed healthcare purchasers; however, racial/ethnic minorities report that high deductibles prevent them from seeking the needed care. One proposed way to mitigate the financial burden of high-deductible health plans is the use of health savings plans. This cross-sectional study investigates whether chronically ill Blacks and Hispanics enrolled in high-deductible health plans experience greater access to care difficulties than non-Hispanic Whites and whether racial/ethnic disparities are mitigated by the use of health savings plans.Trends in Mail-Order Pharmacy Use in the U.S. From 1996 to 2018: An Analysis of the Medical Expenditure Panel Survey
The use of mail-order pharmacies is generally associated with lower healthcare costs and improved medication adherence. To promote the use of mail-order pharmacies, it is important to understand the time trends in their use and whether these trends vary by population subgroups.Understanding the Value of the Wellness Visit: A Descriptive Study
Clinical preventive services can reduce mortality and morbidity, but Americans receive only half of the recommended care. Although wellness visits protect time for clinicians to review needs and discuss care with patients, studies have not shown that having a wellness visit improves health outcomes. This study seeks to understand the types of discussions and volume of care delivered during wellness visits.
