Health Policy
Association Between Fatal Occupational Injuries and State Minimum-Wage Laws, 2003–2017
Low wages are associated with an increased risk of occupational injuries. Increasing the minimum wage is one way to increase workers’ wages; however, a previous study found that higher state minimum wage was associated with an increase in nonfatal occupational injuries and illnesses. This study aims to examine the association between state minimum-wage laws and fatal occupational injuries.A Decade of Nutrition and Health Disparities Research at NIH, 2010–2019
Nutrition health disparities include differences in incidence, prevalence, morbidity, and mortality of diet-related diseases and conditions. Often, race, ethnicity, and the social determinants of health are associated with dietary intake and related health disparities. This report describes the nutrition health disparities research supported by NIH over the past decade and offers future research opportunities relevant to NIH's mission as described in the Strategic Plan for NIH Nutrition Research.National Heart, Lung, and Blood Institute: Social Determinants of Health Research, Fiscal Year 2008–2020
Social determinants of health influence the prevention, treatment, and progression of chronic diseases, including heart, lung, blood, and sleep diseases and conditions. Healthy People 2020 classifies Social Determinants of Health into 5 subcategories: (1) Neighborhood and Built Environment, (2) Education, (3) Economic Stability, (4) Social and Community Context, and (5) Health and Health Care. This study's goal is to characterize the National Heart, Lung, and Blood Institute's Fiscal Year 2008–2020 funding in overall Social Determinants of Health research and in the Healthy People 2020 subcategories.Farmers’ Market Incentives for Low-Income Families: Who Uses, How Much, and Why
Focusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers’ market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families.Friendship and Loneliness: A Prototype Roadmap for Health System Action
Loneliness, the subjective perception of social disconnectedness, is emerging as a public health crisis. In 2018, approximately 50 million U.S. adults aged ≥45 years reported feeling lonely, an increase from approximately 43 million in 2010.1 The high rate of loneliness is particularly worrisome because loneliness negatively impacts psychological and physical health and is associated with a 50%, 29%, and 26% increased risk of developing Alzheimer's disease, coronary heart disease, and premature mortality, respectively.Substance Use Disorders Among Medicare Beneficiaries: Prevalence, Mental and Physical Comorbidities, and Treatment Barriers
This study aimed to determine the prevalence of treated and untreated substance use disorders among Medicare beneficiaries, the characteristics of Medicare beneficiaries with substance use disorders, and reasons for their unmet needs.Vaccination Coverage of Privately Insured Children: Comparing U.S. Survey and Administrative Data
National Immunization Survey-Child data are used widely to assess childhood vaccination coverage in the U.S. This study compares National Immunization Survey-Child coverage estimates with estimates using other supplementary data sources.Telemedicine Familiarity and Post-Disaster Utilization of Emergency and Hospital Services for Ambulatory Care Sensitive Conditions
In this study, we examined the association between telemedicine use before a disaster and utilization of emergency or hospital services for ambulatory care sensitive conditions post-disaster.Young Adult Healthcare Exposure and Future Opioid Misuse: A Prospective Cohort Study
Outpatient opioid prescribing is associated with opioid misuse in young adults, but the longitudinal association between general healthcare exposure and opioid misuse has not been explored. The objective of this study is to examine the association between healthcare exposure in young adulthood and future opioid misuse.Community Health Needs Assessment Data and Community Recovery From COVID-19
The COVID-19 pandemic has had a significant impact beyond physical morbidity and mortality. A mid-cycle Community Health Needs Assessment survey was administered in 1 community to generate data to evaluate change in community well-being since the beginning of the pandemic.Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers
Sexual orientation and gender identity data collection is necessary to address health inequities. This study examines sexual orientation and gender identity data reporting among community health centers.Healthcare Utilization and Costs Associated With Perinatal Depression Among Medicaid Enrollees
Differences in healthcare utilization and medical expenditures associated with perinatal depression are estimated.Sustained Impact of the Philadelphia Beverage Tax on Beverage Prices and Sales Over 2 Years
It is unclear whether changes in beverage price and sales after beverage tax implementation can be sustained long term. This study aims to quantify the changes in beverage prices and sales in large retailers 2 years after the implementation of the 1.5 cents per ounce Philadelphia beverage tax.Predictors of Public Support for Social Safety Net Policy During the COVID-19 Pandemic
U.S. residents had varying experiences of the COVID-19 pandemic and social safety net policy in 2020. Past research has suggested that partisanship, ideology, racial attitudes, and personal experience may each influence policy attitudes. In this study, we explore whether variation in support for social safety net policy in 2020 is predicted by negative experiences of the pandemic when controlling for racial attitudes, partisanship, and ideology.State Paid Sick Leave and Paid Sick-Leave Preemption Laws Across 50 U.S. States, 2009–2020
Paid sick leave is associated with lower mortality risks and increased use of health services. Yet, the U.S. lacks a national law, and not all employers offer paid leave, especially to low-wage workers. States have enacted paid sick-leave laws or preemption laws that prohibit local governments from enacting paid sick-leave requirements.Citizenship Status and Mortality Among Young Latino Adults in the U.S., 1998‒2015
Although Latino immigrants, especially noncitizens, endure structural factors that may increase their risk of death at younger ages, little is known about their risk of death in young adulthood. This study evaluates mortality differences across citizenship status among young Latino adults (aged 18–44 years) in the U.S.Screening for Social Risk at Federally Qualified Health Centers: A National Study
Federally Qualified Health Centers serve 29.8 million low-income patients across the U.S., many of whom have unaddressed social risks. In 2019, for the first time, data on social risk screening capabilities were collected from every U.S. Federally Qualified Health Center. The objectives of this study were to describe the national rates of social risk screening capabilities across Federally Qualified Health Centers, identify organizational predictors of screening, and assess between-state heterogeneity.Characteristics of Scientific Evidence Informing Changed U.S. Preventive Services Task Force Insufficient Evidence Statements
The U.S. Preventive Services Task Force (USPSTF) issues “Insufficient Evidence” (I) statements when scientific evidence is inadequate for making recommendations about clinical preventive services. Insufficient Evidence statements may be changed to definitive recommendations if new research closes evidence gaps. This study examines the characteristics of evidence that informed changes from I statements to definitive recommendations, including NIH's role as a funder.Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
Although growing evidence links residential evictions to health, little work has examined connections between eviction and healthcare utilization or access. In this study, eviction records are linked to Medicaid claims to estimate short-term associations between eviction and healthcare utilization, as well as Medicaid disenrollment.The Association of Low-Income Housing Tax Credit Units and Reports of Child Abuse and Neglect
Poverty broadly and financial stress owing to housing insecurity specifically are associated with an increased risk of child maltreatment. Therefore, it is possible that a program designed to increase access to affordable housing such as the Low-Income Housing Tax Credit program could reduce child maltreatment. The purpose of this study is to examine the association of the availability of housing units through the Low-Income Housing Tax Credit Program with the rates of child maltreatment reports, including reports for physical abuse and neglect, at the state and county levels.Social Needs Resource Connections: A Systematic Review of Barriers, Facilitators, and Evaluation
Healthcare organizations increasingly are screening patients for social needs (e.g., food, housing) and referring them to community resources. This systematic mixed studies review assesses how studies evaluate social needs resource connections and identifies patient- and caregiver-reported factors that may inhibit or facilitate resource connections.Enforcing Legal Compliance for Covering of Services Promoting Family Mental Health
The coronavirus disease 2019 (COVID-19) pandemic exacerbated a growing children's mental health crisis in the U.S. Mental health–related emergency department visits rose by 31% during COVID-19 onset compared with the same 7-month time period in 2019.1 This sudden increase built on a pre-existing trend of worsening mental health issues among children, as children experienced a 329% increase in visits for deliberate self-harm between 2007 and 2016.2 Absent intervention, these childhood mental health challenges will have long-term health and economic consequences that propagate disparities.A Cost Effectiveness Model of Long-Acting Reversible Contraceptive Methods in the Brazilian National Health System
The use of long-acting reversible contraceptives is low among adolescents owing to the high up-front cost. In this study, a 5-year cost-effectiveness model and budget impact analysis were used to compare the use of long-acting reversible contraceptives with the use of combined oral contraceptives among Brazilian adolescents.Trends in the Impact of Medicaid Expansion on the Use of Clinical Preventive Services
This study aims to evaluate the trends in the impact of Medicaid expansion on the use of selected recommended clinical preventive services and examine the differences in use by income level over time.Variations in Healthcare Transition Preparation Among Youth With Chronic Conditions
Youth with special healthcare needs have low rates of healthcare transition services, which can affect lifelong functioning and quality of life. This study examines the variations in receipt of healthcare transition services among youth with special healthcare needs.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.The Impact of Connecticut's Paid Sick Leave Law on the Use of Preventive Services
Paid sick leave laws have received more attention in recent years as a way to improve public health. This study estimates the impact of paid sick leave laws on the use of preventive services using a quasi-experimental design created by the implementation of Connecticut's paid sick leave law in 2012, the first statewide mandate in the U.S.Preventive Care Delivery After the Veterans Choice Program
The Veterans Choice Program expanded Veteran access to community care. The Veterans Choice Program may negatively impact the receipt of preventive care services owing to care fragmentation. This study assesses 10 measures of preventive care in Veterans with the Department of Veterans Affairs coverage before and after the Veterans Choice Program.Paid Sick Leave and Healthcare Utilization in Adults: A Systematic Review and Meta-analysis
The U.S. is the only industrialized country in the world with no national policy mandating paid sick leave for workers. This study systematically reviews and quantifies the impact of paid sick leave on the use of healthcare services among employed adults.New NIH Primary and Secondary Prevention Research During 2012–2019
This manuscript characterizes primary and secondary prevention research in humans and related methods research funded by NIH in 2012‒2019.Without Thoughtful, Hard-Earned Design, Public Option Plans Unlikely to Relieve the Rising Uninsured Rate
Although not new,1 public option insurance plans are gaining momentum and popularity as a means to decrease healthcare spending, expand coverage, and preserve consumer choice.2 Public option plans are traditionally defined by government-set payment rates and government administration of the plan (either at the state level or at the federal level).3 More recently, the administration of public option plans has been expanded to include the choice of contracting with private insurance companies, analogous to existing Medicare and Medicaid programs.Who Is (and Is Not) Receiving Telemedicine Care During the COVID-19 Pandemic
The COVID-19 pandemic has forced telehealth to be the primary means through which patients interact with their providers. There is a concern that the pandemic will exacerbate the existing disparities in overall healthcare utilization and telehealth utilization. Few national studies have examined the changes in telehealth use during the COVID-19 pandemic.Adolescents’ Patterns of Well-Care Use Over Time: Who Stays Connected
Well-care use can positively impact adolescents’ current and future health. Understanding adolescents’ longitudinal well-care use is critical to determine to whom and when to target engagement strategies to improve healthcare access. This study describes prospective well-care use patterns from childhood through adolescence stratified by sex.Addressing COVID-19 Using a Public Health Approach: Perspectives From the Cancer Prevention and Control Research Network
The U.S. response to the coronavirus disease 2019 (COVID-19) pandemic has entailed challenges related to testing, case management, and community-level mitigation.1 Community spread of the infection continues, and U.S. COVID-19 mortality leads in the world, exceeding 500,000 deaths as of late winter 2021. Sustained prevention and control efforts are urgently needed.Access Denied: The Proliferation of American Medical Abortion Laws, 2000–2018
Medical abortion is a safe, effective, and often preferred method of terminating an unintended pregnancy, but access can be made difficult by the laws of a state. Despite modern efforts to prevent unintended pregnancies in the U.S., they comprise almost half of pregnancies and 95% of abortions, signifying that abortion is a necessary and desired healthcare service. This study's purpose is to describe the proliferation of American medical abortion access laws between 2000 and 2018.Out-of-Pocket Spending for Influenza Hospitalizations in Medicare Advantage
Although many Medicare Advantage plans have waived cost sharing for COVID-19 hospitalizations, these waivers are voluntary and may be temporary. To estimate the magnitude of potential patient cost sharing if waivers are not implemented or are allowed to expire, this study assesses the level and predictors of out-of-pocket spending for influenza hospitalizations in 2018 among elderly Medicare Advantage patients.Effect of Medicaid Expansions on HIV Diagnoses and Pre-Exposure Prophylaxis Use
Increased insurance coverage and access to health care can increase identification of undiagnosed HIV infection and use of HIV prevention services such as pre-exposure prophylaxis. This study investigates whether the Medicaid expansions facilitated by the Affordable Care Act had these effects.Purchasing Drugs Abroad Among U.S. Cancer Survivors: Analysis of the National Health Interview Survey, 2011–2018
According to the American Cancer Society, >1.8 million Americans will be diagnosed with cancer in 2020.1 Many patients with cancer face financial toxicity, which can lead to negative outcomes during the course of cancer treatment.2 Unfortunately, patients with cancer in the U.S. report increasing difficulties with affording their prescription medications.3 Cancer drugs routinely exceed $100,000 per year of treatment.2,3 Patients and their families are forced to make coping decisions to manage this financial burden.Continued Counseling for the Relationship Between State-Level Medicine and Public Health
Public health and organized medicine have operated somewhat independently of each other since the early 1900s. In the wake of the COVID-19 pandemic, the necessity of healing any divide between organized medicine and state and local health officials seems self-evident. Using the recommendations abstracted from a 2005 article by Dr. Ronald Davis, “Marriage Counseling for Medicine and Public Health,” this cross-sectional study explores the formal relationships that existed between state-level public health and medical practice across the U.S.Receipt of Social Needs Assistance and Health Center Patient Experience of Care
Community health centers often screen for and address patients’ unmet social needs. This study examines the degree to which community health center patients report receiving social needs assistance and compares measures of access and quality between patients who received assistance versus similar patients who did not.State Medical Board Policy and Opioid Prescribing: A Controlled Interrupted Time Series
In March 2016, the Centers for Disease Control and Prevention issued opioid prescribing guidelines for chronic noncancer pain. In response, in April 2016, the North Carolina Medical Board launched the Safe Opioid Prescribing Initiative, an investigative program intended to limit the overprescribing of opioids. This study focuses on the association of the Safe Opioid Prescribing Initiative with immediate and sustained changes in opioid prescribing among all patients who received opioid and opioid discontinuation and tapering among patients who received high-dose (>90 milligrams of morphine equivalents), long-term (>90 days) opioid therapy.Changing Urban–Rural Disparities in the Utilization of Direct-Acting Antiviral Agents for Hepatitis C in U.S. Medicare Patients, 2014–2017
The advent of direct-acting antiviral agents for treating hepatitis C virus infection has made hepatitis C virus elimination possible. Rural patients with hepatitis C virus infection may be less likely to access direct-acting antiviral agents, but the real-world evidence is scarce on urban–rural disparities in direct-acting antiviral agent utilization.Primary Care Use Among Commercially Insured Adolescents: Evidence From the 2018 Healthcare Effectiveness Data and Information Set
Improving the utilization of preventive care among adolescents is important for achieving individual-level and population-level health goals. The Healthcare Effectiveness Data and Information Set reports data submitted by managed care health plans, capturing a large number of individuals in the U.S.Using Mistrust, Distrust, and Low Trust Precisely in Medical Care and Medical Research Advances Health Equity
Trust, mistrust, and distrust influence people's ability to utilize critical resources and make decisions that are best for their health and well-being. Trust is necessary for optimizing health research, eliminating healthcare disparities, and achieving health equity, but efforts to build trust to increase healthcare utilization and research participation may have little effect on attitudes or behaviors that are rooted in distrust or mistrust. Thus, it is critical to be clear whether policies and initiatives are designed to improve trust or decrease mistrust and distrust.Asynchrony Between Individual and Government Actions Accounts for Disproportionate Impact of COVID-19 on Vulnerable Communities
Previously estimated effects of social distancing do not account for changes in individual behavior before the implementation of stay-at-home policies or model this behavior in relation to the burden of disease. This study aims to assess the asynchrony between individual behavior and government stay-at-home orders, quantify the true impact of social distancing using mobility data, and explore the sociodemographic variables linked to variation in social distancing practices.Low Rates of Preventive Healthcare Service Utilization Among Adolescents and Adults With Down Syndrome
People with Down syndrome have health risks that require specific lifelong preventive health care. With increasing life expectancy, people with Down syndrome also face health conditions typical of their unaffected peers and thus need coordinated health care. The purpose of this study is to describe rates of age/sex- and Down syndrome–specific preventive healthcare activities among adolescents and adults with Down syndrome.Impact of Expanded Medicaid Eligibility on the Diabetes Continuum of Care Among Low-Income Adults: A Difference-in-Differences Analysis
The impact of Medicaid expansion on linkage to care, self-maintenance, and treatment among low-income adults with diabetes was examined.High Cotinine and Healthcare Utilization Disparities Among Low-Income Children
This study assesses the associations of child salivary cotinine, parent-reported smoking, and child tobacco smoke exposure with the number of child healthcare visits and hospital admissions over a 6-month period. This study also assesses the relationships between participant characteristics and child cotinine.Women's Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status
Reproductive rights policies can potentially support or inhibit individuals’ abilities to attain the highest standard of reproductive and sexual health; however, research is limited on how broader social policies may differentially impact women of color and immigrants in the U.S. This study examines the associations among state-level reproductive rights policies, race, and nativity status with preterm birth and low birth weight in the U.S.Uptake of Preventive Services Among Patients With and Without Multimorbidity
Patients with multiple chronic conditions (multimorbidity) are seen commonly in primary care practices and often have suboptimal uptake of preventive care owing to competing treatment demands. The complexity of multimorbidity patterns and their impact on receiving preventive services is not fully understood. This study identifies multimorbidity combinations associated with low receipt of preventive services.Effect of Elementary School-Based Health Centers in Georgia on the Use of Preventive Services
This study measures effects on the receipt of preventive care among children enrolled in Georgia's Medicaid or Children's Health Insurance Program associated with the implementation of new elementary school-based health centers. The study sites differed by geographic environment and predominant race/ethnicity (rural white, non-Hispanic; black, small city; and suburban Hispanic).The Impact of Public Health Organization and Political Figure Message Sources on Reactions to Coronavirus Prevention Messages
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a global health emergency. Currently, there are no effective vaccines, and there are limited biomedical treatment options. Multiple countries, including the U.S., have not implemented effective testing, tracing, or isolation and quarantine efforts. Consequently, behaviors such as using face coverings are crucial to averting substantial morbidity and mortality. Government officials, the Centers for Disease Control and Prevention (CDC), and health departments across the U.S.Deficient Response to COVID-19 Makes the Case for Evolving the Public Health System
Coronavirus disease 2019 (COVID-19) has affected more than 14 million individuals and caused more than 600,000 deaths as of July 20, 2020, rapidly spreading across large cities as well as many rural areas. In parallel with rising cases and deaths globally, the situation in local communities fluctuates daily while knowledge about the disease and transmission evolves.Postpartum Health Care Among Women With Intellectual and Developmental Disabilities
Postpartum health care among women with intellectual and developmental disabilities has not been well studied. This study uses administrative claims to compare postpartum outpatient visits among women with and without intellectual and developmental disabilities.Financial Risk for COVID-19–like Respiratory Hospitalizations in Consumer-Directed Health Plans
This study aims to quantify out-of-pocket spending associated with respiratory hospitalizations for conditions similar to those caused by coronavirus disease 2019 and to compare out-of-pocket spending differences among those enrolled in consumer-directed health plans and in traditional, low-deductible plans.State Legislative Strategies to Pass, Enhance, and Obscure Preemption of Local Public Health Policy-Making
Local governments are often innovators of public health policy-making, yet states are increasingly preempting or prohibiting local control over public health issues. Previous research identified examples of strategies used by state legislatures to pass preemption in ways that may obscure public discussion about preemption or the topics preempted or enhance the strength of a previously passed preemptive law.Health and Budgetary Impact of Achieving 10-Year U.S. Sodium Reduction Targets
This study estimates the health, economic, and budgetary impact resulting from graduated sodium reductions in the commercially produced food supply of the U.S., which are consistent with draft U.S. Food and Drug Administration voluntary guidance and correspond to Healthy People 2020 objectives and the 2015–2020 Dietary Guidelines for Americans.Assessing Rural Health Coalitions Using the Public Health Logic Model: A Systematic Review
Rural communities face unique challenges including fewer healthcare providers and restricted access to nutritious foods, likely leading to poor health outcomes. Community health coalitions are groups of local organizations partnering to address local health needs. Employing such coalitions is one strategy for implementing policy–system–environment changes for improving rural health. However, their success is variable without standardized evaluation. In this review, rural community health coalitions were retrospectively assessed using the W.K.Impact of Medicaid Expansion on Healthcare Access Among Individuals Living With Chronic Diseases
The Affordable Care Act's Medicaid expansion has been found to increase healthcare access among low-income individuals in the general population. Fewer studies have explored the impact of Medicaid expansion on healthcare access among those living with chronic diseases. It is also unclear whether the impact of Medicaid expansion varies across levels of educational attainment or poverty among this subgroup. This study investigates the impact of Medicaid expansion on healthcare access among adults aged 18–64 years living with chronic diseases, as well as its variations across educational attainment and federal poverty levels.State Policies and Healthcare Use Among Transgender People in the U.S.
The introduction and passing of restrictive and protective transgender-specific state policies have increased during the past decade. These policies are critical for the health of transgender and other gender diverse people; however, little is known about the relationship between these policies and healthcare use, and the role that race/ethnicity plays in this relationship.Accountable Care Organizations and Preventable Hospitalizations Among Patients With Depression
Accountable care organizations have been successful in improving quality of care, but little is known about who is benefiting from accountable care organizations and through what mechanism. This study examined variation of potentially preventable hospitalizations for chronic conditions with coexisting depression in adults by hospital accountable care organization affiliation and care coordination strategies by race/ethnicity.Social Risks Among Primary Care Patients in a Large Urban Health System
Health systems are increasingly interested in addressing the social determinants of health via social risk screening. The objective of this study is to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system.Analyses of Employer Medical Claims Data to Assess Receipt of High-Priority Preventive Health Services
The Affordable Care Act mandated that health plans cover preventive health services without patient cost sharing. A process, based on the analyses of medical claims data, is presented that allows companies to assess whether their healthcare plans are providing employees and dependents with age- and sex-appropriate high-priority preventive healthcare services.Effect of an Intervention for Obesity and Depression on Patient-Centered Outcomes: An RCT
An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms.Older Adults’ Physical Activity and Healthcare Costs, 2003–2014
Research has documented the health benefits of physical activity among older adults, but the relationship between physical activity and healthcare costs remains unexplored at the population level. Using data from 50 U.S. states and the District of Columbia, this study investigates the extent to which physical activity prevalence is associated with healthcare costs among older adults.Change and Stability in the Characteristics of the Population Without Health Insurance
The uninsured population faces greater health risks than the insured population. Although prior research has examined how the uninsured rate has changed for various sociodemographic groups, less is known about how the characteristics of the uninsured population have changed in recent years.Reducing Both Food Insecurity and Excess Body Weight in Costa Rican Women: A Cluster Randomized Trial
The coexistence of food insecurity and excess body weight has been well documented in women. Both food insecurity and excess body weight have multiple consequences for physical and mental health. Concerns have been raised about interventions aimed to reduce food insecurity because these interventions might contribute to excess body weight, particularly in adult women. The purpose of this study was to develop, implement, and evaluate an intervention to simultaneously reduce food insecurity and body weight through alleviating discouragement—which women described as feeling sad, depressed, hopeless, and lacking drive to do important activities, such as finding a job or studying more—by increasing women's empowerment.The Affordable Care Act and Ethnic Disparities in Colorectal Cancer Screening
Cost sharing can deter the use of health services and act as a potential contributor to racial/ethnic disparities in cancer. The Affordable Care Act required most health plans to cover, without cost sharing, preventive services, including colorectal cancer screening. Population-based data were used to estimate the impact of the Affordable Care Act's cost-sharing provision (together with other Affordable Care Act provisions targeting preventive care) on ethnic disparities in colorectal cancer screening, comparing Hispanics with non-Hispanics.Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review
The Patient Protection and Affordable Care Act increases healthcare access and includes provisions that directly impact access to and cost of evidence-based colorectal cancer screening. The Affordable Care Act's removal of cost sharing for colorectal cancer screening as well as Medicaid expansion have been hypothesized to increase screening and improve other health outcomes. However, since its passage in 2010, there is little consensus on the Affordable Care Act's impact.Availability of Safety-net Sexually Transmitted Disease Clinical Services in the U.S., 2018
Safety-net sexually transmitted disease services can prevent transmission of sexually transmitted disease. This study assesses the availability of safety-net sexually transmitted disease clinical services across the U.S.Intersecting Experiences of Healthcare Denials Among Transgender and Nonbinary Patients
Transgender and nonbinary individuals experience high levels of health disparities and are more likely to experience denials of health care than their cisgender (nontransgender) counterparts. There is a lack of evidence on how healthcare denials vary by gender identity and other intersecting identity characteristics in the transgender and nonbinary populations.Association Between E-Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017
The association between e-cigarette use and chronic bronchitis, emphysema, and chronic obstructive pulmonary disease has not been studied thoroughly, particularly in populations defined by concomitant combustible smoking status.Association Between Social and Economic Needs With Future Healthcare Utilization
Unmet social and economic needs are associated with poor health outcomes, but little is known about how these needs are predictive of future healthcare utilization. This study examined the association of social and economic needs identified during medical visits with future hospitalizations and emergency department visits.Prescription Benzodiazepine Use in Privately Insured U.S. Children and Adolescents
Benzodiazepines are commonly prescribed in the U.S. but entail safety concerns, including dependency. In pediatrics, many indications lack trial data. Authors aimed to describe youth initiating prescription benzodiazepine treatment, identify potential indications and prescribing concerns, estimate the duration of treatment by potential indication, and identify factors that predict long-term use.Impacts of Medicaid Expansion on Health Among Women of Reproductive Age
Preconception and interconception health care are critical means of identifying, managing, and treating risk factors originating before pregnancy that can harm fetal development and maternal health. However, many women in the U.S. lack health insurance, limiting their ability to access such care. State-level variation in Medicaid eligibility, particularly before and after the 2014 Medicaid expansions, offers a unique opportunity to test the hypothesis that increasing healthcare coverage for low-income women can improve preconception and interconception healthcare access and utilization, chronic disease management, overall health, and health behaviors.County Smoke-Free Laws and Cigarette Smoking Among U.S. Adults, 1995–2015
Tobacco use remains the leading cause of preventable death worldwide. Though research on smoke-free policies in the U.S. exists at the state or national level, there is limited evidence on such policies at the county level. This study examined the association between changes in county-level comprehensive smoke-free laws and smoking behavior among U.S. adults.
