bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multidisciplinary Perspective on Person-Environment Fit: Relevance, Measurement, and Future Directions
Authors: Kandler Christian , Kühn Simone , Mönkediek Bastian , Forstner Andreas J. , Bleidorn Wiebke
Published: May 2024

Environments shape people, and at the same time, people are attracted to environments that fit their characteristics because fit facilitates the achievement of people’s desired life outcomes, such as relationship satisfaction, work success, and well-being. In this article, we outline how persons and environments can fit, the relevance of fit and misfit for different life outcomes, and the benefits and pitfalls of different (mis)fit measures. We propose three directions for future research: (a) the use of both subjective and objective (mis)fit measures; (b) the consideration of complex dynamics between person and environment characteristics via pathways through multiple biological, experiential, behavioral, and social layers across the life span; and (c) the integration of insights from different disciplines, including psychology, sociology, neuroscience, and genetics, to move the field forward.
Incomes to Outcomes: A Global Assessment of Disparities in Cleft and Craniofacial Treatment
Authors: Wagner Connor S. , Hitchner Michaela K. , Plana Natalie M. , Morales Carrie Z. , Salinero Lauren K. , Barrero Carlos E. , Pontell Matthew E. , Bartlett Scott P. , Taylor Jesse A. , Swanson Jordan W.
Published: May 2024

Objective

Recent investigations focused on health equity have enumerated widespread disparities in cleft and craniofacial care. This review introduces a structured framework to aggregate findings and direct future research.

Design

Systematic review was performed to identify studies assessing health disparities based on race/ethnicity, payor type, income, geography, and education in cleft and craniofacial surgery in high-income countries (HICs) and low/middle-income countries (LMICs). Case reports and systematic reviews were excluded. Meta-analysis was conducted using fixed-effect models for disparities described in three or more studies.

Setting

N/A

Patients

Patients with cleft lip/palate, craniosynostosis, craniofacial syndromes, and craniofacial trauma.

Interventions

N/A

Results

One hundred forty-seven articles were included (80% cleft, 20% craniofacial; 48% HIC-based). Studies in HICs predominantly described disparities (77%,) and in LMICs focused on reducing disparities (42%). Level II-IV evidence replicated delays in cleft repair, alveolar bone grafting, and cranial vault remodeling for non-White and publicly insured patients in HICs (Grades A-B). Grade B-D evidence from LMICs suggested efficacy of community-based speech therapy and remote patient navigation programs. Meta-analysis demonstrated that Black patients underwent craniosynostosis surgery 2.8 months later than White patients ( P < .001) and were less likely to undergo minimally-invasive surgery (OR 0.36, P = .002).

Conclusions

Delays in cleft and craniofacial surgical treatment are consistently identified with high-level evidence among non-White and publicly-insured families in HICs. Multiple tactics to facilitate patient access and adapt multi-disciplinary case in austere settings are reported from LMICs. Future efforts including those sharing tactics among HICs and LMICs hold promise to help mitigate barriers to care.
Unlocking the Role of Language and National Culture: Effects on Supply Chain Operations in a Global Context
Authors: Hashemi Joo Mohammad , Nishikawa Yuka , Dandapani Krishnan , Jayaraman Vaidyanathan
Published: May 2024

We investigate how language, an essential part of culture, affects manufacturing firms’ supply chain operations management practices, including the cash conversion cycle and its components. Based on the Sapir–Whorf hypothesis, which theorizes that a language's structure may affect how its speakers think, prior studies have established that using the future tense to describe future events increases one's mental distance from the future, reducing a person's concern about it. Building upon this foundation, we hypothesize that firms in weak future-time reference countries are likely to be better prepared for future volatility in demand for their products and therefore carry higher inventory to avoid potential stockouts. We also hypothesize that firms in weak future-time reference countries are more apprehensive about long-term relationships with their customers and hence extend longer credit terms to them. Finally, we hypothesize that firms in weak future-time reference countries have longer operating and cash conversion cycles due to carrying higher levels of inventory and extending longer credit terms to customers. The empirical results using a large global sample of 193,625 firm-year observations from 45 countries support our hypotheses. In terms of economic significance, on average, the cash conversion cycle of firms in weak future-time reference countries is ∼ 11% longer than that of firms in strong future-time reference countries. We also find that the effect of language is dominant over the influence of traditional cultural dimensions. Together, the results suggest that time encoding in the language of a firm is a determining factor in its supply chain operations.
Admission Control in Multi-server Systems Under Binary Reward Structure
Authors: Liu Wei , Kulkarni Vidyadhar G
Published: May 2024

We study a multi-server queueing system where a customer is satisfied (and generates a unit revenue) if their queueing time is at most a given constant. If the queueing time of the admitted customer exceeds this constant, the customer gets served, but is unsatisfied and generates no revenue. Such queueing systems arise in the context of modeling service systems where excessive delays are of concern. A key challenge is how to design an admission control policy to maximize the number of satisfied customers per unit time in the long run, assuming that we can observe the number of customers in the system at any time. We call this the binary reward structure system and show that a threshold-type admission policy is optimal. The optimal threshold policy has to be computed numerically. Hence we propose a square-root admission policy to approximate the optimal admission control policy, and compare the performance of these two policies. We derive an analytical upper bound on the performance of optimal admission control policy by deriving an optimal admission policy assuming we have full information over the queueing time of the admitted customers. This is equivalent to a queueing system where customers abandon the queue (i.e., leave without service) if their queueing time exceeds the given constant. We demonstrate that the optimal policy that includes customer abandonment, or alternatively, the optimal policy under full information, the optimal threshold policy, and the square-root admission policy, all exhibit identical performance in the asymptotic regions of the parameter space. Our numerical results indicate that the worst optimality gap of the square-root admission policy is within 3.9% of the optimal revenue, and implementing the square-root admission policy in the observable queueing system leads to a revenue loss that is at most 5.6% of the maximum possible revenue rate in the full information system. We also compare the binary reward structure with the more common linear reward structure where the system incurs holding cost per unit queueing time per customer. In addition, we also show that the analysis based on queueing time is applicable to the system time as well.
Analyzing Brand Strategy on an International Scale: The Sponsorship Performance Cycle in Formula One Racing
Authors: Jensen Jonathan A. , Cobbs Joe B. , Mazer Alex , Tyler B. David
Published: May 2024

Firms from a variety of industries regularly partner with Formula One racing teams to achieve marketing objectives on an international scale. The sponsored properties offer signals of brand foreignness/localness, country of origin, and the potential for highly visible achievements. Firms enter and exit brand partnerships with some of the world's most famous athletes and iconic teams, yet the partnership decision-making process remains opaque, particularly concerning the impact of geographic origin and team performance among other criteria, including macroeconomic conditions and brand-related factors. This study contributes a quantitative model that analyzes 53 years of data encompassing more than 3,000 sponsorships across six continents. The findings improve understanding of brand partnership continuity/dissolution by explicating a shared nationality effect and a link with sponsored organizational performance that is robust across three distinct eras of Formula One. In doing so, the study contributes to theory by completing the sponsorship performance cycle and distilling partnership limits with regard to brand foreignness. The theory and quantitative analyses are buttressed by interviews with brand decision-makers, excerpts from which also shape the discussion of managerial applications. Implications include efficiencies in partner prospecting that enhance the likelihood of enduring brand relationships in sponsorship-linked international marketing.
Making Room for Citizens at The Public Policy Table
Authors: Reuther Susan , Claire Tam , Coffman Julia
Published: May 2024

Citizen engagement is a critical factor in determining whether devolution, which shifts responsibility for decision-making from the federal to state and local levels, is a success. Devolved policies and decisions will be more effective when the community members they affect are involved in making them. This article presents six lessons from a citizen-focused project conducted in two communities over two years on what it takes to get and keep citizens involved in the policy process. This project showed that, when applied, these lessons will inspire community members to get involved, create the relationships needed to sustain their involvement over time, and build their capacity to understand and problem solve around complex policy issues.
Managing the Quality of Health Care
Authors: Larson James S. , Muller Andreas
Published: May 2024

This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual wort of Avedis Donabedian who defined quality of care as, a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement.
High Performance Public Health: Assessing Agencies’ Strategic Management Capabilities
Authors: Ford Eric W. , Wells Rebecca , Capper Stuart A.
Published: May 2024

Limited knowledge about state health agencies’ strategic management capabilities constrains their capacity to improve public health. The current study addresses this gap through two objectives: 1) To assess agencies’ strategic management capabilities, conceptualized through a learning framework and 2) To portray both those capabilities and where the agencies have progressed along a developmental pathway of strategic management ability. Forty-one state health agencies’ documents from 1995–2000 were content analyzed. Latent Trait Analysis (LTA) was used to depict both the progressive levels of strategic management capabilities and states’ relative mastery along the continuum. Findings indicate that strategic management capabilities have path dependent characteristics and a distinct learning paradigm exists. Therefore, policy-makers wishing to improve agency performance can utilize this framework to assess and target capabilities that need improvement.
The Use of Hospital Care: Do Insurance Status, Prospective Payment, and the Unit of Payments Make a Difference?
Authors: Khaliq Amir A. , Broyles Robert W. , Robertson Madeline
Published: May 2024

Limited to 251,768 discharges during 1999 from short-term hospitals located in Oklahoma, the objective of this study was to examine the influence of insurance status, prospective payment, and the unit of payment on variation in the length of stay. The regression analysis indicated that elderly patients whose care was financed by the Medicare pricing system and the uninsured experienced a significantly shorter episode of hospitalization than their commercially insured counterparts. Conversely, Medicaid recipients, whose care was financed by a fixed per diem and uninsured or self-responsible patients, experienced a significantly shorter hospital stay than the commercially insured. The results also indicate that the type and source of admissions, the discharge destination of the patient, and case complexity significantly influenced the hospital stay. African-Americans and Native Americans also experienced a longer episode of hospital care than their white counterparts. The article concludes with a discussion of policy implications and the need to develop alternate methods of financing hospital care thereby reducing the risks of premature discharge and iatrogenic injury.
Protecting the Public Interests: Issues in Contracting Managed Behavioral Health
Authors: Robinson Julia E. , Clay Thomas
Published: May 2024

In recent years, state governments have begun contracting out behavioral health care to large managed case for-profit organizations. This approach to mental health service delivery has resulted in realignment in roles for both state agencies and the managed care organizations. Overnight state agencies have been transformed into contract managers of multi-million dollar capitated health plans, Management care companies, in turn, moving into the public-sector market must adjust their service delivery to include key concepts of public interest involvement such as consumer input, public comment, and outreach. This article analyzes three public-sector transitions. Common issues in these transformations are used as a springboard for identifying key concerns which states need to monitor when developing managed care contracts.
Creating Partnership Synergy: The Critical Role of Community Stakeholders
Authors: Lasker Roz D. , Weiss Elisa S.
Published: May 2024

While there are compelling reasons for professionals in health and human services administration to collaborate with other stakeholders in the community, the experience with such partnerships thus far has generated more frustration than results. Recent research on partnership synergy—a key indicator of a successful collaboration process— suggests that many of these partnerships are inadvertently compromising their own success by the way they involve community stakeholders. Applying research findings to current practice, this article shows how the ability of a partnership to understand and address complex problems—and sustain interventions over time—is related to who is involved in the partnership, how community stakeholders are involved, and the leadership and management of the partnership. The article addresses key challenges that health and human services administrators face when they seek to optimize the role of community stakeholders in partnership.
Quality Improvement in a Federally Funded Community Breast and Cervical Cancer Screening Program
Authors: Cochran Christopher R. , Moseley Charles B. , Peltier James W.
Published: May 2024

Continuous Quality Improvement (CQI) methods offer healthcare organizations valuable tools for improving services to their patients. These tools are also useful in improving the way an organization delivers its services. In this case study, the authors describe the use of quality improvement activities for improving the enrollment and screening for breast and cervical cancer for the Women's Health Connection (WHC). The WHC is operated by the Nevada Department of Human Resources. Health Division, to provide screening for income eligible women between the ages of 40–64. Funding for the WHC was provided by the Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC) through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). By using Quality Improvement Teams, the WHC was able to restructure the way women were being enrolled in the program in order To increase the number of women screened and to help the program meet CDC performance indicators. This article documents the quality improvement process used in the case study, highlights the areas improved, and demonstrates how quality improvement was useful in improving services provided to women. It also describes staff acceptance of the quality improvement process and its potential future applications.
The Importance of Public Sector Health Care in an Underserved Population
Authors: Greenwald Howard P. , O'Keefe Suzanne , Dicamillo Mark
Published: May 2024

California's employed Latinos are less likely to have private health insurance than most other segments of the US population and face a variety of other barriers to obtaining health care. To better understand the availability and adequacy of health services for these individuals, researchers analyzed data from a telephone survey of 1,000 randomly-selected, employed adults. Among all survey respondents, a significant percentage obtained their health care from sources fully or partially dependent on government financing. Among the uninsured (30.7 percent of the sample), a majority of those who had a regular source of care received services frorn publicly-supported providers. Dissatisfaction with care was infrequent (less than 5 percent of the total sample) and apparently no greater among those receiving care from public sources than among those served by private doctors. These findings underscore the importance of the public sector in providing health care for the underserved, the high quality of the services provided (or partially supported) by the public sector, and the seriousness of the consequences for the disadvantaged should public support for their healthcare diminish.
The State Children's Health Insurance Program: Has it Reduced the Percentage of Uninsured Children?
Authors: Menihild Charles E. , Fletcher Audwin
Published: May 2024

Recent data indicate that the percentage of children in the United States who are uninsured is declining. Although many factors have contributed to that decline, this study assesses the role of public health insurance, specifically the State Children's Health Insurance Program (SCHIP),1 in reducing the percentage of uninsured children without health insurance from 1998–2000 and whether Medicaid and SCHIP crowd out exists. While this research confirms a significant decline in the percentage of uninsured children since SCHIP began enrolling children in 1998, other factors, including the poverty rate, the percentage of children on Medicaid, geographic region and race had a greater impact in explaining that result than SCHIP. Lastly, the data findings are consistent with research suggesting crowd out does exist.2
The Evolution of the Management System of Hospitals in Greece
Authors: Alexiadis Aristidis-Dimitrios
Published: May 2024

The administration system of the health units -hospitals of the country presented different alteration during its course from the formation of the Greek state until now days. To be more specific, we can observe that:

a) During the first period, the management of the few hospitals in the country is practiced by a complicated and multiform systems. Moreover, some hospitals were managed by a fraternity, other by a committee, other by an administrative committee and finally other by a board of directors. In any case, members of these collective sectors are members of the state such as mayors, chief of the community, simply private citizens, or well off citizens who participated in the formation and function of some hospitals as benefactors. But, supreme place to these of organisation and management of the hospitals has the private initiative because of the financial adversity of the state. The turn of the health sector to the well off citizens is obvious, as they dispose great deal of money for health. During this period, the state just supervises the few hospitals, public benevolent and state hospitals.

b) The second period from the reform of the compulsory Law 965/1937 until the year 1983 is characterized by two substantial legislative Acts, which changed radically the border of the organisation and management of health units. Firstly, the compulsory Law 965/1937 establishes officially the boards of the directors as the institution initially covered public hospitals of the country and in the meantime the hospitals of the rest of the categories. It is also established for the first time along with that institution, the institution of the Governmental Trustee. The second legislative Act of that period is the Law Order 2592/1953, through which public health is put into a new basis according to the demands of that period. The Administrative system of public hospitals remains the same without particular changes to it.

c) During the third period from the establishment of the National Health System - Law 1397/1983 until nowadays. This period is characterized by two great facts:

1. The foundation of National Health System [Law 1397/1983]. It is a historical event for health in Greece. The health system has for the first time totally public features and the civilian enjoys the social good of health without any cost. However, the administrative system of health preserves from the establishment of the state until nowadays its centralizing character.

2. The reformation of the N.H.S, Law 2889/2001. It leads to the radical change of the valid administrative system after 175 years of state function. The country is divided into health districts, where in each one the peripheral health system is created (P.H.S.). It is managed by an administrative board, in which substantial authorities are given for the first time in history of Greek health sector. Consequently, we have today a decentralizing management system in health, which is applied by the seventeen (17) peripheral health systems in Greece.
Differences in U.S. Hospital Service Utilization between Traditional Medicare and Medicare HMO Patients
Authors: Revere Lee , Sear Alan
Published: May 2024

This study examines the differences between traditional U. S. Medicare and Medicare HMO Florida inpatient hospital utilization during the years 1992–1998, using nine high volume Diagnosis Related Groups. Utilization was measured by the number of ancillary services consumed, as well as the charges for those services. The analyses controlled for differences in utilization due to patient age, race, hospital size, year and market differences in hospital costs. Patient data were severity-adjusted and the analysis focused on the patients at the highest severity level. The study found that Medicare HMO patients with chronic diseases at the highest severity of illness level consumed significantly more services than traditional Medicare patients with the same chronic diseases. It was concluded that these Medicare HMO patients were either sicker (despite the severity adjustment) than the traditional Medicare patients and/or Medicare HMOs used different production processes than traditional Medicare, perhaps in order to minimize length of stay. Medicare HMO patients with acute illnesses at the highest severity level did not, in general, consume significantly more services than traditional Medicare patients at the same level of severity for the same diagnoses. The results imply that Medicare policy with regard to HMO expansion may not result in cost savings, and may, instead, result in higher costs if the proportion of the Medicare population hospitalized with chronic illnesses increases.
Key Tasks in Healthcare Marketing: Assessing Importance and Current Level of Knowledge
Authors: Kennett Pamela A. , Henson Steve W. , Crow Stephen M. , Hartman Sandra J.
Published: May 2024

When examining the healthcare industry, the need for continuing education in internal functions (i.e., HR management) has been documented. However, equally important to success in the healthcare industry are external functions such as marketing. In an expansion of research on internally focused functions, we report findings from an exploratory study designed to examine the perceptions of executives about managerial skill needs in the externally focused area of marketing. Specifically, we examine eight key tasks in marketing and ask executives to rate the level of knowledge required for each and then to assess current, or actual, levels of knowledge in the field. Findings suggest that pricing strategy, product strategy, and segmentation and targeting were the tasks that require the most knowledge for healthcare marketers, and that they do, in fact, perceive various gaps in all of the areas examined. Implications and suggestions for future research are provided.
Identifying Health Care Quality Attributes
Authors: Ramsaran-Fowdar Roshnee R.
Published: May 2024

Evaluating health care quality is important for consumers, health care providers, and society. Developing a measure of health care service quality is an important precursor to systems and organizations that value health care quality. SERVQUAL has been proposed as a broad-based measure of service quality that may be applicable to health care settings. Results from a study described in this paper verify SERVQUAL dimensions, but demonstrate additional dimensions that are specific to health care settings.
Communication between Public Health Agencies and Their External Stakeholders
Authors: Longest Beaufort B. , Rohrer Wesleym
Published: May 2024

Effective communication between public health agencies and their external stakeholders is vital to the agencies, as well as to those they serve. Agency leaders must obtain information from stakeholders and provide information to them. A process is described whereby agencies can systematically obtain necessary information from external stakeholders, and three of the most important forms of communications are described through which an agency provides information to stakeholders: promotion of the agency, advocacy, and social marketing. Barriers to effective communication of the interpersonal, personality, organizational, operational, skill/knowledge, attitude, and nature-of-information types are described, and guidelines are provided for minimizing the impact of these barriers.
Co-Morbidity in an Elderly Inpatient Population: Are the Risks of Co-Existing Conditions Differentially Distributed?
Authors: Broyles Robert W. , Khaliq Amir A. , Robertson Madeline J.
Published: May 2024

This study examines the distribution of co-morbidity among 167,738 inpatients, aged 65 or more, who experienced an episode of hospitalization during 1999 in short-term institutions that are located in Oklahoma. The analysis was conducted in two phases. In the first, logistic regression analysis was used to examine covariates that separate inpatients who presented at least one secondary diagnosis from those who were not co-morbid. Limited to those whose condition was complicated by at least one secondary diagnosis, Probit analysis was used to assess the covariates of the number of co-existing conditions. The covariates examined were the individual's racial status, demographic attributes, primary diagnosis, source of admission and discharge destination. Results indicate that the oldest of the elderly, African Americans and, to a lesser extent, Native Americans presented more complex cases than other members of the study population. The paper concludes with the policy implications that are associated with the differential distribution of co-morbidity.
A Diagnostic Approach to Understanding Entrepreneurship in Health Care
Authors: McCleary Karl J. , Rivers Patrick A. , Schneller Eugene S.
Published: May 2024

Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.
What's behind the Data: An Examination of the Processes and Policies Underlying the Routine Collection of Clinical Data in Ontario Hospitals
Authors: Blackstein-Hirsch Paula , Croxford Ruth , Flintoft Virginia , Brown Adalsteinn D.
Published: May 2024

This article surveyed the processes and policies underlying the routine collection of clinical data in acute care hospitals in Ontario, Canada. Although there is evidence of a small shortfall in the availability of human resources, most health records departments employ experienced staff with health records certification. However, there is much more important variation in the documented and undocumented processes used to generate routinely collected clinical data. Current guidelines and coding schedules are helpful but insufficient to guide the production of good quality data. The variations in the processes used to produce clinical data have important implications for the management, reimbursement, and planning of healthcare. This is particularly critical at a time when hospitals and other stakeholders, such as governments, are relying more and more on accurate, reliable, and comparable data.
Effects of Institutional Mechanisms on Nursing Home Quality
Authors: Zhang Ning Jackie , Wan Thomas T.H.
Published: May 2024

This study explores institutional mechanisms explaining the variation in nursing home quality. A two-level panel design with the national data is conducted. Structural equation modeling is employed to examine the main and interaction effects of institutional factors on nursing home quality at both facility and state levels. The findings indicate that the quality of nursing homes is more responsive to regulatory and payment constraints than to normative and mimetic mechanisms. The potential demand for care, Medicaid reimbursement rate, and occupancy rate are positively associated with nursing home quality. An interaction effect between the regulatory mechanism and nurse staffing is statistically significant. The findings lend support to the importance of multi-level analysis of nursing home quality.
Public Health Coalitions: Patterns and Perceptions in State Immunization Programs
Authors: Morrow Helen , Collins Brian K. , Smith David R.
Published: May 2024

The central question of this research is whether state public health programs collaborate with other public and private institutions to promote public health goals. Public health administration is highly bureaucratized and dependent upon government support, but administrators can establish coalitions as adjunct to more traditional means of providing public health services. We explain how public health coalitions are beneficial to providing public health services and then assess whether administrators in state immunization programs collaborate with both the public and private sectors. The results of a 50-state survey of state immunization program officials suggest that coalitions between state immunization programs and institutions of the public and private sectors are common. Moreover, most state program officials think that the more extensive use of immunization coalitions is important for improving state immunization coverage. Our findings also indicate that some states have not yet maximized the potential involvement of the private sector to collaborate in public health efforts.
The Road to Empowerment: A Historical Perspective on the Medicalization of Disability
Authors: Hayes Jeanne , Hannold Elizabeth “Lisa” M.
Published: May 2024

The aims of this paper are to analyze the role of medical and health professions in creating and establishing the disability category. We also explore how the diagnosis, measurement, and treatment of disability have contributed to stigmatization and promoted social, political and economic inequality. Theories from a variety of disciplines are used to examine the ways that medicine and the health-related professions have contributed to the oppression of people with disabilities, including the maintenance of a ‘medical/knowledge power differential,’ reinforcement of the ‘sick role,’ and objectification of people with disabilities. We also explore opportunities for empowerment versus ‘sick role’ status. The medical and health professions are uniquely positioned to promote the empowerment of people with disabilities as active partners in their own health care. Replacing the biomedical model of disability with a socio-political model that prioritizes disease/health care management, wellness and prevention of further disability as opposed to treatments aimed at curing disability could facilitate the empowerment process.
Evaluating Heart Disease Presciptions-Filled as A Proxy for Heart Disease Prevalence Rates
Authors: Cossman Ronald E. , Cossman Jeralynn S. , James Wesley L. , Blanchard Troy , Thomas Richard K. , Pol Louis G. , Cosby Arthur G. , Mirvis David M.
Published: May 2024

Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective health care interventions. We use heart disease drug prescriptions-filled as a proxy measure for prevalence of heart disease. We test the correlation to the Behavioral Risk Factor Surveillance System (BRFSS) and find positive, statistically significant correlations. Next we illustrate the geographic patterns revealed using the county-level prevalence estimate maps. This information can be used to provide a better understanding of sub-state variations in disease patterns and subsequently target the delivery of health resources to small areas in need.
Advance Directives for Health Care among Older Community Residents
Authors: Mcauley William J. , Mccutcheon Megan E. , Travis Shirley S.
Published: May 2024

Advance directives (ADs) for healthcare are useful planning tools for older people. In addition, the utilization of ADs is important for health and human services planners, administrators, and policy makers to understand because whether or not people have an AD, and what types of ADs they have can dramatically influence the treatment trajectories and the well-being of older people who can longer make decisions for themselves. Using telephone survey data with a random sample of Oklahoma residents age 60 and older, we examined the prevalence of four measures of AD use. Prior to the implementation of this survey in 2002, the Oklahoma Aging Services Division was very active in promoting two types of AD—the living will and the durable power of attorney for healthcare. More than half of those interviewed had a living will, two-fifths had a durable power of attorney for healthcare, and one-third had both ADs. Older age and higher levels of education were consistently associated with having ADs.
Terrorism and Emergent Challenges in Public Health
Authors: O'Boyle Irene , Johnson James A. , Simms Michelle , Metzroth Robert
Published: May 2024

The authors explore the complexity of challenges facing the public health community in an era increasingly defined by terrorism. The public health and associated political structure in this country has much to do to better coordinate its’ efforts in an effective way. Solutions will ultimately come from partnerships between government agencies, community organizations, the business community, and international interests.
Weight Counseling for Elderly Patients in Primary Care: How often and how Much Time
Authors: Tai-Seale Thomas , Tai-Seale Ming , Zhang Weimin
Published: May 2024

Some 20 million Americans over the age of 60 will soon be obese. As a result, they will likely suffer lower life-expectancy, higher disability, and higher health care costs. How much time do physicians spend with elders, especially obese elders, in helping them plan weight loss? This study, which analyzed 352 videotaped visits with elderly patients and their provider, has found that only a third of the visibly obese patients were counseled, and that the average time spent discussing the subject – if discussed – was 103 seconds. This is probably less than a fifth of the time needed to adequately counsel patients about weight loss. In addition, the study has found that both provider and patient characteristics determine if and how long discussion lasts.
The Population Health and Income Nexus in the Mississippi River Delta Region and Beyond
Authors: Bloom David E. , Bowser Diana M.
Published: May 2024

The association between health and income has been well established using cross-country panel data. This paper explores this association further using data for corresponding cross sections of counties in the United States in 1970 and 2000. Special attention is paid to the stability of the associations over time and to differences between counties in the Mississippi River Delta Region and those in the rest of the United States. Regression results show that income is positively correlated with improvements in life expectancy over the period 1970 to 2000. This relationship strengthens from 1970 to 2000 for the U.S. and the non-Delta region and weakens slightly for the Delta region. Decomposition analysis shows that income explains more of the improvements in life expectancy from 1970 to 2000 for the Delta region (49%) than for the U.S. (35%) or the non-Delta region (32%). Factors other than income are less important in the Delta region during this time period. In 1970, income (64%) explains more of the difference in health between the Delta and non-Delta counties than non-income factors (36%). By the year 2000, non-income factors (77%) explain more of the disparities in health between the Delta and non-Delta countries than income factors (23%). For the year 2000, if the Delta region were to count on increased income to improve life expectancy to the average of the non-Delta region, it would need to increase its income level by 135%. The analysis indicates that population health in the Mississippi River Delta Region lags behind the rest of the United States not only because of lower income levels, but more importantly because of lower contributions to health of non-income factors.
Commentary: Reflections on the Culture of the Lower Mississippi Delta: Challenges and Opportunities
Authors: Hyland Stanley
Published: May 2024

This symposium addresses the interrelationship between two issues critical to the Mississippi Delta–poor health and limited economic development. I will address this linkage from three perspectives, the historical context of the Delta culture, the role of culture in the evolution as well as in the correction of these issues, and the potential role of higher education institutions in improving the conditions in the Delta region.
Why Public Health Needs Relationship Management
Authors: Wise Kurt
Published: May 2024

Relationship management can be applied in a variety of fields, but there is perhaps no other field that could benefit more from the application of relationship management than public health. The achievements of public health in the United States over the last century are many, but its challenges are daunting. This paper begins with a review of the mission of public health and the status of public health in this nation, including an examination of the most significant public health challenges. I then describe the complex nature of the public health system and summarize the latest positive development in public health planning. Finally, I outline how relationship management can be implemented in order to help improve public health outcomes.
Enhancing Long-Term Care for Older Adults: An Exploration of Interagency Collaboration within Geriatric Education Centers
Authors: Ford Channing R. , Henderson Jennifer , Handley Donna Milam
Published: May 2024

This article examines how the study of geriatric education provides a collaborative environment in which nonprofits can work together and with government in order to effectively manage the challenges in caring for older adults in the coming decades. The U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) provides federal funding to implement and maintain Geriatric Education Centers (GECs) in health care facilities across the country. These GECs have recently been directed to focus on strengthening the availability and quality of comprehensive interdisciplinary training for health care professionals that work with older adults. The funding has come at a time when the nation is faced with both a shortage of health care professionals and a dramatic increase in the older adult population in future years. Due to the critical relevance of GEC offerings for health care and the baby boomer generation, this study provides an exploratory evaluation of programs offered by GECs and the degree of both interdisciplinary and interagency collaboration between GECs, community nonprofits, and government partners in the provision of geriatric health care training. Findings suggest the interdisciplinary and interagency partnerships do exist but are vulnerable to conflicts especially between GECs.
Cultural Competence: Its Promise for Reducing Healthcare Disparities
Authors: Harris G.L.A.
Published: May 2024

Healthcare disparities have reached such disproportionate levels of disease burden for certain groups that the issue has become a national priority. This article examines the most recent iteration of the healthcare disparities movement, the aggressive legislative steps by the federal government to disrupt its destructive path and the promise that cultural competence holds for healthcare providers and the healthcare industry as a whole in placing the patient back at the center of healthcare treatment. Such efforts, it is argued, will be instrumental in helping to reduce healthcare disparities and make the healthcare delivery experience a more positive outcome for all patients.
Federalism, Intergovernmental Relations, and the Challenge of the Medically Uninsurable: A Retrospective on High Risk Pools in the States
Authors: Plein L. Christopher
Published: May 2024

While relatively overlooked in health policy research and analysis, state high risk insurance pools play a notable role in contemporary health policy arrangements. Also know as State Comprehensive Health Insurance Plans, high-risk pools emerged in the late 1970s as states began to grapple with the challenges of the medically uninsured. Today, thirty-five states operate these programs. To further our understanding of health and human services administration, it is important to examine these plans, especially in context of intergovernmental health policy in the United States. This analysis provides an overview of high risk pool evolution and gives attention to forces that have shaped their development, such as model legislation, funding arrangements, and increasing federal-level interest in their use as platforms to advance national policy initiatives.
Racial Disparities in Stroke Awareness: African Americans and Caucasians
Authors: Alkadry Mohamad G. , Ruchi Bhandari , Wilson Christina S. , Blessett Brandi
Published: May 2024

Considerable evidence supports the existence of racial disparities in incidence, mortality, and morbidity related to stroke. Awareness of risk factors could substantially lower the probability of stroke incidence. Awareness of stroke warning signs and treatment options could significantly alter the outcome of a stroke if patients immediately seek emergency help. This article examines the disparities in awareness of stroke risk factors, stroke signs, and action to be taken when stroke occurs. Survey results from 422 Caucasian Americans and 368 African Americans in West Virginia were analyzed. Significant disparities in recognition of cholesterol, smoking, prior stroke, and race as stroke risk factors were observed. The study also found a significant and substantial difference in awareness of stroke signs. There was also a significant difference in the way African Americans and Caucasians would respond to a stroke. The study found no evidence of disparities in recognition of stroke risk factors, such as hypertension, diabetes, heart disease, obesity, alcoholism, and family history.
Asthma Education Information Source Preferences and Their Relationship to Asthma Knowledge
Authors: Zahradnik Anne
Published: May 2024

This study recounts the findings from a year-long survey of Brooklyn residents. Survey respondents were questioned about their knowledge of asthma signs, triggers, symptoms and their attitudes and beliefs about asthma. If they had asthma or were responsible for a child or adult who had asthma they were asked questions to determine how well that asthma was controlled. They were also questioned about their preferred sources of asthma information. Descriptive and inferential statistics indicate that the survey respondents (mostly African American, middle aged, females) were generally knowledgeable about asthma, although they shared some misconceptions about asthma treatments and triggers. They showed a marked preference for obtaining their asthma information from traditional Western medicine providers rather than friends, family members, alternative or complimentary medicine providers or spiritual leaders. This information is useful in guiding investments of time and resources for asthma education programs addressing such audiences. It is also useful for planning health care education programs for a variety of disorders, including high blood pressure and diabetes.
Evaluation of Cross-Disciplinary Training on the Co-Occurrence of Domestic Violence and Child Victimization: Overcoming Barriers to Collaboration
Authors: Haas Stephen M. , Bauer-Leffler Simon , Turley Erica
Published: May 2024

The co-occurrence of child abuse and domestic violence has gained increasing attention over the last several years. As a result, there have been a number of efforts around the country to cross-train domestic violence and child welfare workers. Many of these initiatives are based on recommendations derived from prior research which emphasizes the importance of cross training child welfare workers, domestic violence advocates, and others in order to enhance inter-agency collaborations and ultimately improve the handling of cooccurrence cases. Using a survey design and two samples of child protective service (CPS) workers were drawn, this paper evaluates the effectiveness of a statewide initiative to improve inter-agency collaboration through a series of cross-disciplinary trainings. Special attention is also given to the identification of barriers and their potential role in shaping collaboration. While this study did not find significant changes in CPS workers’ knowledge, attitudes, or self-reported levels of collaboration overall as a result of the training, collaboration was found to be related to increased knowledge and positive attitudes toward collaboration post training. the findings further demonstrate that efforts to cross-train staff can change the way CPS workers view the presence of some barriers to collaboration. Implications for future research and strategies for enhancing inter-agency collaboration in cooccurrence cases are discussed.