Public Health

This project will evaluate the impact of resolutions declaring racism a public health crisis on subsequent policy development and implementation.

Ten years after the passing of the Affordable Care Act—the most comprehensive health care reform of the past half-century—most of the previously uninsured continue to lack coverage. Policymakers and members of the public have expressed growing support for expanding the role of public financing of health care. The “public option” and “Medicare for All” have emerged as important contenders for health policy reform. Both policies are rooted in widening access to the lower prices of the public system to make health care more affordable for all.

Public health practitioners and tobacco control advocates agree that pre-emption (a higher level of government stripping lower levels of government of their authority over a specific subject matter) has an adverse impact on tobacco control efforts. Pre-emptive state laws may prohibit local tobacco control measures, such as restrictions on marketing and promotion of tobacco products, licensure of tobacco products, smoking in public or private sites, and on youth access to tobacco products.

State pre-emption is an emerging and highly contentious policy movement with potentially significant consequences on population health. Yet robust analyses to examine whether pre-emption affects health have yet to be conducted. Furthermore, pre-emption’s effect on geographic inequities in health has been largely neglected in policy debates. But it is becoming increasingly clear that state pre-emption laws could reshape the spatial distribution of health, with profound consequences for health care delivery systems and state and local budgets.

Local governments are often on the forefront of enacting innovative public health policy, and local control over public health issues is especially vital to address social inequities. Pre-emption removes the ability of local governments to enact these laws and may hinder public health policy adoption and diffusion within a state and across the country.

The impact of the opioid epidemic on children, their families, and on child-serving systems (early childhood education, schools, child welfare, etc.) is not well understood. This exploratory project will examine some of the most critical dimensions, urgent challenges, and important nuances for policymakers and others, drawing on a review of the existing literature and a deeper dive into two states at the forefront of the opioid epidemic.

In January 2020, the Supreme Court allowed the Department of Homeland Security to implement a new rule regarding the definition of “public charge.”  Our team is collecting primary data from two distinct populations to explore awareness of the public charge rule, sources of information about the rule, and how the rule may affect decisions on obtaining medical care and participating in public programs.

Childhood vaccines play a major role in minimizing the incidence of vaccine-preventable disease. While all states accommodate medical vaccine exemptions, certain states also allow for waivers on the basis of religious or philosophical objections.

Springfield, Massachusetts is a mid-sized city with a large community of color population experiencing socioeconomic and health inequities. Historically there has been little infrastructure in Springfield to support active transportation and recreational walking and biking, so in 2015, Springfield City Council adopted a city-wide “Complete Streets” resolution.

The U.S. is one of three industrialized countries without universal access to paid sick leave. Thirty-five percent of all full-time employees lack this coverage. Among low-income and part-time employees, uninsurance rates exceed 80 percent. In addition to concerns about inequality, worker well-being, and productivity, a lack of paid sick leave also contributes to the spread of disease, when ill workers are forced to choose between their health and their job.

This project investigates efforts in Michigan to address the needs of the “super-utilizer” population — individuals with serious health care and social needs who account for the majority of public health care expenditures in the United States. While there has been a growing number of interventions aimed this population, the existing evidence regarding impact is limited. The research is examining existing and potential policies that address the needs of super-utilizers while decreasing avoidable ED utilization and hospitalizations, and reducing health care costs.