Matching Items (18)
Description
Growing hotspots of unvaccinated children corroborate with states that have highly permissive vaccination policies. State-based nonmedical exemption (NME) policies such as religious or philosophical exemptions make it easy for parents to opt out of vaccinating their children thus lowering herd immunity and increasing the risk of outbreaks. Recent studies have revealed that Phoenix is the metropolitan area with the highest number of nonmedical exemptions in the country with vaccination rates below herd immunity. This thesis investigates the role of the law in enabling low vaccination rates and develops a set of policy recommendations that lawmakers may use as a tool to restore these rates to herd immunity levels. To do this, an in-depth literature review was performed and supplemented with a case study of California’s policy response to the 2014 Disneyland measles outbreak. This information was synthesized into an in-depth policy analysis addressing the political, social, practical, and economic factors of the issue and four potential policy responses for state lawmakers. Based on the analysis and California’s example, eliminating nonmedical vaccine exemptions was identified as the most effective policy option to reach the intended goal of restoring vaccination rates to herd immunity levels. This policy option is both the most cost-effective and productive in reaching herd immunity but infringes the most on parental rights and will be met with the most significant political pushback. Despite these challenges, lawmakers should take this policy step to protect our community and the most vulnerable among us.
ContributorsSaxon, Mary Elizabeth (Author) / Reddy, Swapna (Thesis director) / Speer, Matthew (Committee member) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
In Arizona black women have a preterm birth rate of 40% higher than any other women. Black women in Maricopa County have the highest incidence of low birthweight and preterm birth. Preterm birth has been linked to cerebral palsy, blindness, cognitive difficulties, and ultimately, infant mortality. Preterm birth is defined by the World Health Organization as delivery of an infant before 37 weeks of gestation. Low birth weight is defined as 1500g or less with extremely low birthweight being 1000g or less. Infants with low birth weight contribute disproportionately to infant mortality. Chronic, toxic stress is a heavy contributor to the racial health disparity of preterm birth and low birth weight. Chronic stress may affect preterm birth by dysregulating the hypothalamic-pituitary-adrenal axis, altering the release of cortisol, leading to altered immune function, thus increasing infection and inflammation response (Giuregescu et. al). Studies have shown racial injustice is related to inflammatory stress response. This stress is exacerbated by the long history of injustice and neglect in healthcare due to implicit bias. Recommendations for improvement of this disparity includes cultural competency training for all healthcare professionals and mindfulness yoga training paired with Focused Support Groups for pregnant women for reducing racial stress.
ContributorsOfori, Shana (Author) / Reddy, Swapna (Thesis director) / Cox, Deborah J. (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
In recent months, the current administration has proposed a series of recent federal policy changes, namely the Public Charge Rule, intended to limit immigrants into the U.S. on the basis of financial grounds. In essence, the Public Charge Rule redefines the term “public charge”. Under this policy, most applicants for permanent residency who use any number of public benefits—including Medicaid, government housing, and the Supplemental Nutrition Assistance Program (SNAP)—count toward being flagged as a public charge, or an individual likely to become dependent on the government for subsistence; this will count against them in residency status applications. Even in the wake of the recent Supreme Court ruling and early implementation of the policy, the Public Charge Rule has shown increasing disenrollment from public benefits along with a growing climate of fear, mistrust, and misinformation in relation to connecting with the healthcare system. This policy particularly threatens low-income children, the majority of which are U.S.-born legal citizens, who are incredibly vulnerable to poor health outcomes without longitudinal, preventive health services. Recent studies show that two million children legally eligible for Children’s Health Insurance Program (CHIP) could be disenrolled from the program due to this climate of uncertainty. This policy brief investigates the role of health systems and providers in bracing for the expected impacts and develops a set of policy recommendations that providers and health administrators may use as a tool for protecting patient health and ensuring patient-centered care. To achieve this, a literature review was performed with a compilation of current population health trends and a historical case study. This compilation of data was analyzed to better understand the current political, social, and economic landscape in the United States. From this, three potential policy recommendations were outlined for health providers. Based on current research and the analysis conducted, community engagement and policy advocacy was identified as the most effective policy option for health providers to best provide patient-centered care. However, a more holistic solution should be considered for states that serve populations that are deemed high-need, namely Arizona. Education within clinic walls for providers and patients will bridge the misinformation gap and build shared understanding between provider and patient. Beyond clinic walls, community engagement and policy advocacy mends community mistrust of health systems. Further pilot investigation is warranted at high-utilization medical centers.
ContributorsPatel, Nina (Author) / Reddy, Swapna (Thesis director) / Wilson, Natalia (Committee member) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
This thesis uses the Foucauldian model of the biopolitical state to explain the regulation of refugee women’s bodies who have undergone female genital cutting/mutilation (FGC/M). The main theoretical framework for this thesis is inspired by Dr. Khiara Bridges’ work: Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization (2011). Her book explains how “material and societal conditions appear to affirm the veracity of race” (Bridges, 2011, 10). She describes pregnancy as a “racially salient event” that inevitably engages racial politics. In her book, she illustrates how the material body is the primary sign of racial difference (Bridges, 2011, 47). I argue that race and culture are inscribed in the body, and FGC/M is a physical representation of that inscription. As a result, a physical representation of racialization opens women with FGC/M to far more scrutiny and regulation. I define the United States and France as biopolitical states whose values and agendas regulate and police bodies to behave according to their norms. The value set that underlies the United States is predicated on principles of sovereignty, federalism, and an emphasis on a Puritanical work ethic where an individual must earn their benefits from the state. In France, however, there is less stigma surrounding social welfare but there is forced cultural assimilation that results in a singular, secular French identity. These value systems then inform the tools to police behavior. The tools, or systems, I have identified for this thesis are the adoption of human rights instruments into domestic law, refugee policy, healthcare systems, and regulation of women’s reproductive health. All of these macro-level systems then inform individual patient-provider relationships since those interactions are not independent of these systems. I argue that refugee women who have undergone FGC/M deviate from these prescribed norms and thus are subjugated to overwhelming biopolitical regulation.
ContributorsRamakumar, Asha Anjali (Author) / Reddy, Swapna (Thesis director) / Switzer, Heather (Committee member) / College of Health Solutions (Contributor) / Dean, W.P. Carey School of Business (Contributor) / School of Social Transformation (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Given the high prevalence of out-of-hospital cardiac arrest (OHCA), the low survival rate, the high morbidity rate, and the significant cost to both the patient and the system, it is imperative that we address any and all factors that contribute to recognition of a OHCA case, any barriers that prevent chest compressions, and improve medical care to treat OHCA events in order to increase survival rate, decrease morbidity, and lessen the economical burden of cardiac arrest events. Additionally, understanding the relationship between seizures and OHCA can help medical professionals, including Neurologists and other doctors, to explain to the public when one should call into EMS regarding a seizure-like event in the event of a possible OHCA. This would help to address and alleviate the result of this major public health concern.
ContributorsShee, Kameron James (Author) / Reddy, Swapna (Thesis director) / Sirven, Joseph (Committee member) / College of Health Solutions (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden of disease is greater in rural areas, as well as rates of physical injury. There are many intersecting influencing factors including, but not limited to, barriers to access needed healthcare, issues regarding the quality of healthcare provided, the ability to pay for healthcare and other socioeconomic considerations are both causes and consequences of poor health and healthcare access.
The health disparities between rural and urban communities in the United States are not uniquely American. This rural-urban divide in health outcomes is present across the world and, closer to home, across North America. In addition to reviewing the current literature surrounding barriers to health and healthcare access in the United States, we will also use southern neighbor Mexico’s history and their pursuit of rural equity (universally and in health/healthcare access) to contrast initiatives that the U.S. has attempted, with the intent of exploring new theories of rural healthcare provision. By combining the history of social medicine in Mexico with literature on barriers to healthcare access, I hope to highlight areas of innovation and improvement in the American health care delivery system.
The purpose of this paper is to review the current literature regarding health disparities among rural Americans, possible causes of such disparities and current strategies to improve health, healthcare access and healthcare quality in rural America in order to recommend the most effective, practical solutions to improve rural mortality, morbidity and quality of life.
The health disparities between rural and urban communities in the United States are not uniquely American. This rural-urban divide in health outcomes is present across the world and, closer to home, across North America. In addition to reviewing the current literature surrounding barriers to health and healthcare access in the United States, we will also use southern neighbor Mexico’s history and their pursuit of rural equity (universally and in health/healthcare access) to contrast initiatives that the U.S. has attempted, with the intent of exploring new theories of rural healthcare provision. By combining the history of social medicine in Mexico with literature on barriers to healthcare access, I hope to highlight areas of innovation and improvement in the American health care delivery system.
The purpose of this paper is to review the current literature regarding health disparities among rural Americans, possible causes of such disparities and current strategies to improve health, healthcare access and healthcare quality in rural America in order to recommend the most effective, practical solutions to improve rural mortality, morbidity and quality of life.
ContributorsSt Martin, Zachary (Author) / White, Adrienne (Thesis director) / Reddy, Swapna (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
The world of podcasting has exploded in popularity in recent years. This medium is being used in education as well as in the public sector to share ideas, news, and stories. This paper reviews the research behind podcast success as a news form and in the educational sector and the implications of these findings for the future. Podcast listeners tend to listen to podcasts for entertainment and, notably, to diversify their time while completing other tasks. New ways to directly stream media from portable devices and advances in the internet have helped bolster the popularity of this media form. Podcasting proved to be successful in higher education as students tended to perform better when given access to podcasts. However, they were only successful when using podcasts as classroom adjuncts. This implies that educational podcasts must be produced differently than ones intended for the public. By reviewing the neuroscience behind language, emotion and memory, it was found that narrative formats that also evoked emotions had a positive ability in enhancing the listeners learning and memory. Keeping this in mind, the developed podcast aimed to bridge educational material to the general public by utilizing narrative as a vessel in which to deliver complex information about medicine, science and neuroscience. The accessibility and virtually non-existent barriers to the podcasting world offer a breadth of knowledge and opinions that have numerous factors of social influence. The impact of podcasting on the modern world deserves more research in sociology and psychology as it continues to grow in popularity.
ContributorsCharbel, Milad (Author) / Sirven, Joseph (Thesis director) / Reddy, Swapna (Committee member) / School of Life Sciences (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it is suggested that state legislatures and the federal government adopt the rising trend of expanding scope of practice to the extent of the care providers' certification. This is a movement has garnered support throughout the country and 20 states already allow for nearly autonomous practice by advanced practice nurses (APNs). This paper looked at systematic review, peer-reviewed papers, state/federal legislation and labor statistics to demonstrate how this move could increase access to healthcare providers as well as decrease cost by nearly 25%. This paper also evaluated how to formalization of nursing education has had positive impacts on the French healthcare system. Additionally, it evaluated a more specific look at Arizona and used data provided by the Arizona Board of Nursing and The Arizona Medical Board to make a compelling argument as to why this is a viable option for solving the disparity between rural and urban healthcare. The conclusion of the paper was to push policy makers to make the statutory constraints of the profession closer to the certification the people receive in their education as opposed to relying on case law. Additionally, it would be helpful to use technological innovations, like project echo, to help these professionals practice in rural areas. This will ultimately lead to a healthcare system that better serves the needs of all populations, as well as decreasing the overall cost of care.
ContributorsKingsbury, Andrew (Author) / Brian, Jennifer (Thesis director) / McGregor, Joan (Committee member) / Reddy, Swapna (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.
ContributorsThomas, Christy Maria (Author) / Reddy, Swapna (Thesis director) / Essary, Alison (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The Patient Protection and Affordable Care Act (ACA) was created in 2010 to ensure American Citizens to obtain healthcare in which one way is to apply for Medicaid as more persons became eligible under expansion of coverage. The policies concerning Medicaid expansion has not federally mandated that every state adopt Medicaid expansion by Supreme Court decision, therefore it has been questioned in its ability by the current presidential cabinet which has led the Republican House of Representatives to create reforms of the current health law. The reforms to Medicaid expansion included the use of block grants or per capita caps through the American Health Care Act (AHCA) in which either of the reform would give more power and funding rights to the states themselves. However, the Senate withdrew the bill before voting as majority did not agree with the provisions and wanted current health care law to remain as is. With this bill not having been passed, other options of reforms are going to be considered by the Republican House of Representatives and the President. In the meantime, it is evident that states that have not yet expanded Medicaid should apply for a waiver to adopt the Medicaid expansion policies. This is because under the ACA's Medicaid expansion there has been a decrease in uninsured persons nationally, including the state of Arizona.
ContributorsMcLeod, Valerie (Author) / Reddy, Swapna (Thesis director) / Riley, William (Committee member) / Barrett, The Honors College (Contributor)
Created2017-05