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Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity. 厌倦被排斥:剥夺公民权的结构性种族主义是对人口健康平等的威胁。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-02-01 DOI: 10.1377/hlthaff.2021.01414
Patricia A Homan, Tyson H Brown
{"title":"Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity.","authors":"Patricia A Homan,&nbsp;Tyson H Brown","doi":"10.1377/hlthaff.2021.01414","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01414","url":null,"abstract":"<p><p>Theoretical research suggests that racialized felony disenfranchisement-a form of structural racism-is likely to undermine the health of Black people, yet empirical studies on the topic are scant. We used administrative data on disproportionate felony disenfranchisement of Black residents across US states, linked to geocoded individual-level health data from the 2016 Health and Retirement Study, to estimate race-specific regression models describing the relationship between racialized disenfranchisement and health among middle-aged and older adults, adjusting for other individual- and state-level factors. Results show that living in states with higher levels of racialized disenfranchisement is associated with more depressive symptoms, more functional limitations, more difficulty performing instrumental activities of daily living, and more difficulty performing activities of daily living among Black people. However, there are no statistically significant relationships between racialized disenfranchisement and health among White people. These findings suggest that policies aiming to mitigate disproportionate Black felony disenfranchisement not only are essential for political inclusion but also may be valuable tools for improving population health equity.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"219-227"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
Racism And Health: Efforts By Funders To Address The Issue. 种族主义与健康:资助者解决这一问题的努力。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-02-01 DOI: 10.1377/hlthaff.2021.02024
{"title":"Racism And Health: Efforts By Funders To Address The Issue.","authors":"","doi":"10.1377/hlthaff.2021.02024","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.02024","url":null,"abstract":"","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"311-312"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Potential For Bias In Machine Learning And Opportunities For Health Insurers To Address It. 机器学习中潜在的偏见以及医疗保险公司解决这一问题的机会。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-02-01 DOI: 10.1377/hlthaff.2021.01287
Stephanie S Gervasi, Irene Y Chen, Aaron Smith-McLallen, David Sontag, Ziad Obermeyer, Michael Vennera, Ravi Chawla
{"title":"The Potential For Bias In Machine Learning And Opportunities For Health Insurers To Address It.","authors":"Stephanie S Gervasi,&nbsp;Irene Y Chen,&nbsp;Aaron Smith-McLallen,&nbsp;David Sontag,&nbsp;Ziad Obermeyer,&nbsp;Michael Vennera,&nbsp;Ravi Chawla","doi":"10.1377/hlthaff.2021.01287","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01287","url":null,"abstract":"<p><p>As the use of machine learning algorithms in health care continues to expand, there are growing concerns about equity, fairness, and bias in the ways in which machine learning models are developed and used in clinical and business decisions. We present a guide to the data ecosystem used by health insurers to highlight where bias can arise along machine learning pipelines. We suggest mechanisms for identifying and dealing with bias and discuss challenges and opportunities to increase fairness through analytics in the health insurance industry.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"212-218"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 20
How Price Regulation Is Needed To Advance Market Competition. 如何需要价格管制来促进市场竞争。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.01235
Robert A Berenson, Robert B Murray
{"title":"How Price Regulation Is Needed To Advance Market Competition.","authors":"Robert A Berenson,&nbsp;Robert B Murray","doi":"10.1377/hlthaff.2021.01235","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01235","url":null,"abstract":"<p><p>In US health policy, conventional wisdom holds that market competition and price regulation are mutually exclusive strategies to stem high and rising provider prices. This incorrect assumption centers on the belief that robust competition in US commercial health insurance markets must include provider price competition. Other developed countries, however, commonly implement price regulation to support competition over important care delivery components other than prices, including quality of care and patient choice, and to provide stronger incentives for providers to improve operating efficiency. Conventional US policy wisdom also holds that price regulation inevitably will fail because of excessive complexity or succumb to the interests of regulated entities. This analysis challenges conventional wisdom by urging policy makers to consider regulations that limit out-of-network provider prices and establish flexible hospital budgets. Each of these proposals would require less administrative complexity and burden than other proposed approaches. We conclude that it is time to move discussions from whether to regulate hospital prices to determining how best to do so.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"26-34"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Expanding Services And Tailoring Outreach To Prevent Suicide. 扩大预防自杀的服务和服务范围。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.01886
Charlotte Huff
{"title":"Expanding Services And Tailoring Outreach To Prevent Suicide.","authors":"Charlotte Huff","doi":"10.1377/hlthaff.2021.01886","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01886","url":null,"abstract":"<p><p>In the face of perennially high suicide rates, Utah's health system leaders and community advocates work together to stem the tide.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"8-12"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
After A Death, Bringing Stillbirth Prevention To The US. 死亡后，将死产预防带到美国。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.00745
Marny Smith
{"title":"After A Death, Bringing Stillbirth Prevention To The US.","authors":"Marny Smith","doi":"10.1377/hlthaff.2021.00745","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.00745","url":null,"abstract":"<p><p>A mother whose son was stillborn at thirty-six weeks is working to import stillbirth prevention policies from abroad.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"147-149"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact Of Household Health Insurance Coverage Gains On Children's Achievement In Iowa: Evidence From The ACA. 爱荷华州家庭健康保险覆盖范围增加对儿童成就的影响:来自ACA的证据。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.01222
George L Wehby
{"title":"The Impact Of Household Health Insurance Coverage Gains On Children's Achievement In Iowa: Evidence From The ACA.","authors":"George L Wehby","doi":"10.1377/hlthaff.2021.01222","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01222","url":null,"abstract":"<p><p>Low family income is associated with worse child academic achievement. Little is known about how health insurance expansions affect children's achievement in low-income households. This study examined the effects of the Affordable Care Act's coverage expansions primarily for Medicaid and Marketplace enrollment, beginning in 2014, on children's academic achievement in Iowa. The study employed a unique linkage of birth certificates and data on standardized school tests for children in Iowa and took advantage of differences in uninsurance rates across areas in the state before the ACA insurance expansions. There is evidence that the ACA expansions beginning in 2014 were associated with higher reading scores after three years for children born to mothers with a high school education or less. There is no consistent evidence of an effect on math scores. Overall, these findings suggest broad spillover benefits from health insurance expansions to the well-being and development of children in low-income households that should be part of the continuing policy debate surrounding state and national health insurance reforms.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"35-43"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
The ACA Medicaid Expansion And Perinatal Insurance, Health Care Use, And Health Outcomes: A Systematic Review. ACA医疗补助扩大和围产期保险、医疗保健使用和健康结果:系统回顾。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.01150
Meghan Bellerose, Lauren Collin, Jamie R Daw
{"title":"The ACA Medicaid Expansion And Perinatal Insurance, Health Care Use, And Health Outcomes: A Systematic Review.","authors":"Meghan Bellerose,&nbsp;Lauren Collin,&nbsp;Jamie R Daw","doi":"10.1377/hlthaff.2021.01150","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01150","url":null,"abstract":"<p><p>The Affordable Care Act (ACA) Medicaid expansion increased Medicaid eligibility for low-income adults regardless of their pregnancy or parental status. Variation in states' adoption of this expansion created a natural experiment to study the effects of expanding public insurance on insurance coverage, health care use, and health outcomes during preconception, pregnancy, and postpartum. We conducted a systematic review of relevant literature on this topic, analyzing twenty-four studies published between January 2014 and April 2021. We found that the ACA Medicaid expansion increased preconception and postpartum Medicaid coverage with corresponding declines in uninsurance, private insurance coverage, and insurance churn. There was limited evidence that Medicaid expansion increased perinatal health care use or improved infant birth outcomes overall, although some studies reported reduced racial and ethnic disparities in rates of prenatal and postpartum visit attendance, maternal mortality, low birthweight, and preterm births. Stronger data collection on preconception and postpartum outcomes with sufficient sample sizes to stratify by race and ethnicity is needed to assess the full impact of the ACA and emerging Medicaid policy changes, such as the postpartum Medicaid extension.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"60-68"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39873467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 26
National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic. 2020年的国家医疗保健支出:应对COVID-19大流行的联邦支出推动的增长。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 Epub Date: 2021-12-15 DOI: 10.1377/hlthaff.2021.01763
Micah Hartman, Anne B Martin, Benjamin Washington, Aaron Catlin, The National Health Expenditure Accounts Team
{"title":"National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic.","authors":"Micah Hartman,&nbsp;Anne B Martin,&nbsp;Benjamin Washington,&nbsp;Aaron Catlin,&nbsp;The National Health Expenditure Accounts Team","doi":"10.1377/hlthaff.2021.01763","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01763","url":null,"abstract":"<p><p>US health care spending increased 9.7 percent to reach $4.1 trillion in 2020, a much faster rate than the 4.3 percent increase seen in 2019. The acceleration in 2020 was due to a 36.0 percent increase in federal expenditures for health care that occurred largely in response to the COVID-19 pandemic. At the same time, gross domestic product declined 2.2 percent, and the share of the economy devoted to health care spending spiked, reaching 19.7 percent. In 2020 the number of uninsured people fell, while at the same time there were significant shifts in types of coverage.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"13-25"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39727861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 48
Foundations Help Improve Health In Prison And Jail And After Release. 基金会帮助改善监狱和出狱后的健康状况。
IF 9.7
Health affairs (Project Hope) Pub Date : 2022-01-01 DOI: 10.1377/hlthaff.2021.01912
{"title":"Foundations Help Improve Health In Prison And Jail And After Release.","authors":"","doi":"10.1377/hlthaff.2021.01912","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01912","url":null,"abstract":"","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"150-151"},"PeriodicalIF":9.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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