Journal Of Health And Human Services Administration[JOURNAL]
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200 papers
Working toward a conceptual definition of child neglect.
Tang CM
J Health Hum Serv Adm · 2008 · PMID 19209564
The phenomenon of child neglect has been nebulous due to limited research on child neglect and the meshing of child neglect with child abuse. There are disagreements among neglect researchers about several important issu...
The phenomenon of child neglect has been nebulous due to limited research on child neglect and the meshing of child neglect with child abuse. There are disagreements among neglect researchers about several important issues, such as whether to frame child neglect as a child's unmet needs or as omissions in parental behavior. It has therefore been difficult to develop a standard conceptual definition of child neglect. In this article, a conceptual definition of child neglect is proposed. The definition's stand on a few important issues is discussed. Finally, how the conceptual definition can guide the formulation of operational definitions for both research and practice is described.
Organizational characteristics, financial performance measures, and funding sources of faith based organizations.
Lampkin L, Raghavan K
J Health Hum Serv Adm · 2008 · PMID 19209563
This study examined the impact of organizational characteristics and financial performance measures of faith based organizations (FBOS) in Pennsylvania and Ohio on the decisions of the funding sources. Organizational cha...
This study examined the impact of organizational characteristics and financial performance measures of faith based organizations (FBOS) in Pennsylvania and Ohio on the decisions of the funding sources. Organizational characteristics of size, age, and type of service, and financial performance measures such as expense, liquidity, and solvency ratios were gathered from the data on IRS form 990 for 97 FBOS for the period of 1995 to 2004. The study found that the 1996 Charitable Choice provisions and the 2001 Office of Faith-Based and Community Initiatives have led to increased government funding for FBOS. The results showed that government funding of FBOS is affected positively by age of the FBO, and negatively by its size. For smaller FBOS, savings ratio had a negative relationship to government funding and a positive relationship to direct public support. For social service FBOS government funding was positively affected by age and negatively affected by size and debt ratio, while days-cash-on-hand had a negative impact on direct public support. All of the above relationships were statistically significant.
Why public health needs relationship management.
Wise K
J Health Hum Serv Adm · 2008 · PMID 19209562
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 he...
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.
Mental health services availability and admission of the seriously mentally ill from the emergency department.
Moseley C, Shen J, Cochran C
J Health Hum Serv Adm · 2008 · PMID 19209561
This study used a cross-sectional, multiple logistic regression design to examine the relationship between mental health service availability and the admission of 111,527 seriously mentally ill (SMI) patients from the em...
This study used a cross-sectional, multiple logistic regression design to examine the relationship between mental health service availability and the admission of 111,527 seriously mentally ill (SMI) patients from the emergency department (ED) in New York State in 2002. The study found that SMI patients were admitted from the ED in counties that were mental health professional shortage areas and in counties with less long-term inpatient psychiatric days. Contrary to expectations, counties with community mental health centers (CMHCs) had more admissions than counties without CMHCs. The results support prior research that indicates the need for more specialized mental health services for the SMI, including more psychiatric beds.
HMOs' consumer-friendliness and preventive health care utilization: exploratory findings from the 2002 Medical Expenditure Panel Survey.
Xiao Q, Savage GT
J Health Hum Serv Adm · 2008 · PMID 18998526
Research should move beyond the simple dichotomy between HMO and non-HMO care provision, and embrace the multidimensional aspects of HMOs. Doing so, we argue, helps address the issue of HMO performance. We used a consume...
Research should move beyond the simple dichotomy between HMO and non-HMO care provision, and embrace the multidimensional aspects of HMOs. Doing so, we argue, helps address the issue of HMO performance. We used a consumer-centered approach to distinguish multiform HMOs and asked the questions, "Do HMOs differ in their consumer-friendly characteristics?" and if so, "Are these characteristics associated with different preventive health care utilization outcomes?" In this exploratory study, the consumer-friendly characteristics of both Medicaid HMOs and private HMOs were examined in relationship to consumers' utilization of preventive care services. HMOs did differ in their consumer-friendly characteristics, and some of these characteristics were significantly associated with the utilization of preventive care services.
Does providing uninsured adults with free or low-cost primary care influence their use of hospital emergency departments?
Zahradnik AG
J Health Hum Serv Adm · 2008 · PMID 18998525
This study analyzes one component of the health care safety net to determine whether or not being enrolled in a free or low-cost primary care physician access program subsequently affects emergency room utilization by un...
This study analyzes one component of the health care safety net to determine whether or not being enrolled in a free or low-cost primary care physician access program subsequently affects emergency room utilization by uninsured adults ages 18 through 64. The study is a quantitative analysis of more than 40,000 individual patient records. An Intensity of Use Indicator (IUI) was developed for tracking individual and group ED utilization trends. The IUI should prove useful to hospital and other not-for-profit organizations concerned with tracking cost effectiveness of programs for uninsured adults.
Workplace lactation program: a nursing friendly initiative.
Angeletti MA
J Health Hum Serv Adm · 2008 · PMID 18998524
The U.S. is experiencing a nursing shortage that is threatening its quality of healthcare. One contributing factor that has been identified is the level of dissatisfaction that nurses have with their working conditions....
The U.S. is experiencing a nursing shortage that is threatening its quality of healthcare. One contributing factor that has been identified is the level of dissatisfaction that nurses have with their working conditions. Health Services Organizations can use female and family friendly initiatives, such as workplace lactation programs to demonstrate that they are willing to support a female employee's task of balancing familial and profession roles. By meeting the needs of breastfeeding mothers, organizations can have a positive impact on employees' levels of satisfaction, which can positively impact recruitment efforts, productivity and retention.
Variation in infant birth weight: socioeconomic factors versus medical conditions.
Hunter KG, Taslimi MM
J Health Hum Serv Adm · 2008 · PMID 18998523
This paper seeks to determine the relative effect of socioeconomic variables and medical conditions in explaining changes in infant birth weight, specifically, low birth weight (LBW). Using ordinary least squares regress...
This paper seeks to determine the relative effect of socioeconomic variables and medical conditions in explaining changes in infant birth weight, specifically, low birth weight (LBW). Using ordinary least squares regression, we first analyze the effects of these variables on the birth weight of 621 infants. Four of the independent variables--gestational age in number of days, sex, parity, and health insurance--are statistically significant (P<.05) and explain 64 percent of the variation in infant birth weight. But in a subset of 18 infants born with LBW to mothers < or = 18 years of age or 35 > or = years of age, only gestational age in number of days is statistically significant.
Establishing values-based leadership and value systems in healthcare organizations.
Graber DR, Kilpatrick AO
J Health Hum Serv Adm · 2008 · PMID 18998522
The importance of values in organizations is often discussed in management literature. Possessing strong or inspiring values is increasingly considered to be a key quality of successful leaders. Another common theme is t...
The importance of values in organizations is often discussed in management literature. Possessing strong or inspiring values is increasingly considered to be a key quality of successful leaders. Another common theme is that organizational values contribute to the culture and ultimate success of organizations. These conceptions or expectations are clearly applicable to healthcare organizations in the United States. However, healthcare organizations have unique structures and are subject to societal expectations that must be accommodated within an organizational values system. This article describes theoretical literature on organizational values. Cultural and religious influences on Americans and how they may influence expectations from healthcare providers are discussed. Organizational cultures and the training and socialization of the numerous professional groups in healthcare also add to the considerable heterogeneity of value systems within healthcare organizations. These contribute to another challenge confronting healthcare managers--competing or conflicting values within a unit or the entire organization. Organizations often fail to reward members who uphold or enact the organization's values, which can lead to lack of motivation and commitment to the organization. Four key elements of values-based leadership are presented for healthcare managers who seek to develop as values-based leaders. 1) Recognize your personal and professional values, 2) Determine what you expect from the larger organization and what you can implement within your sphere of influence, 3) Understand and incorporate the values of internal stakeholders, and 4) Commit to values-based leadership.
Commentary: health and economic development in the Mississippi Delta Region.
Graham GN
J Health Hum Serv Adm · 2008 · PMID 18575155
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Commentary: health and economics in the Mississippi Delta: problems, opportunities.
Smith BH
J Health Hum Serv Adm · 2008 · PMID 18575154
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Commentary: reflections on the culture of the Lower Mississippi Delta: challenges and opportunities.
Hyland S
J Health Hum Serv Adm · 2008 · PMID 18575153
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Health and economic development: reframing the pathway.
Mirvis DM, Clay JA
J Health Hum Serv Adm · 2008 · PMID 18575152
The papers included in this symposium provide a compelling rationale for the role of health as an engine of economic growth, and thus for investing in health improvement as an important step in improving economic growth...
The papers included in this symposium provide a compelling rationale for the role of health as an engine of economic growth, and thus for investing in health improvement as an important step in improving economic growth in the Mississippi Delta. This newer model of the relation between health and wealth, positioning health as an investment and as an important determinant of economic growth, has substantial implications for health-related public policy and for the business sector. Societal support of health promoting initiatives through public policy, especially for children and for the poor, are important efforts for improving health and for realizing the economic benefits of health improvement.
Am I my brother's keeper? A proposal to determine state governments' affirmative duty to advance public health.
Ryan KW, Card-Higginson P, Thompson JW
J Health Hum Serv Adm · 2008 · PMID 18575151
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The population health and income nexus in the Mississippi River Delta Region and beyond.
Bloom DE, Bowser DM
J Health Hum Serv Adm · 2008 · PMID 18575150
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 State...
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.
Still a long way to go for the Lower Mississippi Delta.
Gnuschke JE, Hyland S, Wallace J … +2 more , Hanson R, Smith S
J Health Hum Serv Adm · 2008 · PMID 18575149
It is difficult to separate the demographic, social, and economic changes that have occurred in the Delta. The complex fabric that forms the Delta cannot be broken into parts for simple analysis. Healthcare issues cannot...
It is difficult to separate the demographic, social, and economic changes that have occurred in the Delta. The complex fabric that forms the Delta cannot be broken into parts for simple analysis. Healthcare issues cannot be separated from economic issues, and neither of these issues can be separated from social, political, and other factors of race and power that form the fabric of the Delta. While this analysis disaggregates the data into separate and distinct sections, the reader should be aware of the complex interactions of the performance measures. The clear interaction of health and economic data cannot be overstated and neither can the relationships between education, productivity, employment, income, and social progress. Health is one aspect of investing in human capital and, like education, has its support in the basic mix of public and private goods. Social goods require social investments, and public safety, education, and health are frequent exceptions to the rules of the marketplace. In many areas of the Delta, the allocation of scarce federal and state financial resources to address the problems of the Delta has served to relieve some of the region's distress. The commitment to long-term intervention has, however, varied widely over time.
The health of the Delta Region: a story of increasing disparities.
Cosby AG, Bowser DM
J Health Hum Serv Adm · 2008 · PMID 18575148
The Delta region of the U.S. has substantial disparities in health outcomes. For four of the leading causes of death in the United States (cardiovascular disease, cancer, stroke, and injury) residents of the Delta region...
The Delta region of the U.S. has substantial disparities in health outcomes. For four of the leading causes of death in the United States (cardiovascular disease, cancer, stroke, and injury) residents of the Delta region are between 1.16 (cancer) and 1.45 (injury) times as likely to die as residents of the United States in general. Delta region residents are also more likely to have higher BMI, higher blood pressure, more diabetes, and are more likely to smoke. From 1968 to 1982, mortality rates in the Delta region and in the U.S. fell rapidly and in parallel. Beginning in the 1980s, these two rates continued to decline but began to diverge, with less improvement in the Delta region than in the United States in general. From 1968 to 1982, mortality disparities in the Delta were about 90 excess deaths per 100,000. By 2004, mortality disparities in the Delta had doubled to about 187 excess deaths per 100,000. Put differently, the Delta region had approximately 18,000 excess deaths in 2004, deaths that would not have occurred had the region achieved the average rate of mortality experienced by the remainder of the nation.
Health as an economic engine: evidence for the importance of health in economic development.
Mirvis DM, Chang CF, Cosby A
J Health Hum Serv Adm · 2008 · PMID 18575147
Most discussions on the relationships between health and economic conditions have focused on the impact of differences in personal finances or national economic conditions on health. Recently, however, the role of health...
Most discussions on the relationships between health and economic conditions have focused on the impact of differences in personal finances or national economic conditions on health. Recently, however, the role of health as an 'economic engine' has been promoted. This paradigm proposes that better health leads to economic development. Evidence from historical, national, and transnational studies have shown that improved health increases economic growth through impacts on micro- and macro-economic factors. In this review, we will summarize the evidence supporting these concepts as a basis for discussing their implications for underdeveloped regions within the United States.
A portrait of the Delta: enduring hope and enduring despair.
Neaves TT, Feierabend N, Butts CC … +1 more , Weiskopf WL
J Health Hum Serv Adm · 2008 · PMID 18575146
Place is an integral part of human identity. Not only does place define where people are, but it also helps determine who they are. The basic methods of answering questions concerning locational features often fail to de...
Place is an integral part of human identity. Not only does place define where people are, but it also helps determine who they are. The basic methods of answering questions concerning locational features often fail to detail the relationships between one feature and another. It has become increasingly important for researchers to define and gain a deeper understanding of such characteristics. The Mississippi Delta is a land with a rich, storied history and a slow-growing, agriculturally based economy. Over the past two decades, much attention has been focused on the Mississippi Delta with its slowed population growth, deteriorating economy, low education levels, and poor health outcomes. Understanding the relationship between location and relation is key to understanding the Mississippi Delta-a place rooted with a plantation legacy left reeling with postbellum socioeconomic challenges. Although the socio-cultural and political status of the Delta is tarnished with despair, the desire to remedy the situation remains hopeful.
Health and economic development: introduction to the symposium.
Clay JA, Mirvis DM
J Health Hum Serv Adm · 2008 · PMID 18575145
This symposium explores the role of health as an 'economic engine' in the lower Mississippi River Delta region of the United States. The health as an economic engine model proposes that health is an important and perhaps...
This symposium explores the role of health as an 'economic engine' in the lower Mississippi River Delta region of the United States. The health as an economic engine model proposes that health is an important and perhaps critical determinant of economic growth and development. This model is the reverse of the more commonly considered paradigm in which economic conditions are major determinants of health status. This reframing of the conventional pathway draws upon an existing and extensive internationally-based body of knowledge, predominantly from research done in Africa and Asia. We suggest, in this symposium, that the health as an economic engine model can also be applied within the United States, particularly in regions that are economically underdeveloped and have poor health. This reframing has significant implications for population health policy as public health advancement can be legitimately argued to be an investment rather than just an expense. Viewing health as an economic engine supports a call to community-based participatory action on the part of policy makers, researchers, and educators to further both public and private investment in health, particularly for children and the poor.
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