Creating Healthier, More Equitable Communities

The places where we live, learn, work, and play all contribute to our ability to become and stay healthy. A Culture of Health means everyone has the basics to be as healthy as possible—like access to quality education, employment opportunities, and safe, clean neighborhoods across rural and urban settings. 

Consequences of Work Requirements in Arkansas: Two-Year Impacts on Coverage, Employment, and Affordability of Care

Arkansas implemented Medicaid work requirements in June of 2018. To maintain coverage in the state, adults ages 30-49 were required to work 20 hours a week, participate in “community engagement” activities, or qualify for an exemption. By April 2019, when a federal judge halted the policy, more than 18,000 adults had lost coverage. As an update to research published in 2018, Benjamin D. Sommers, Lucy Chen, Robert J. Blendon, E. John Orav, and Arnold M. Epstein analyzed the policy effects before, during, and after implementation in this Health Affairs brief.

Benjamin Sommers

Assessment of Perceptions of the Public Charge Rule Among Low-Income Adults in Texas

A recent expansion of the federal “public charge” rule allows the government to deny immigrants permanent residency based on their income or health status or if they participate in programs that did not previously trigger the rule, such as Medicaid or the Supplemental Nutritional Assistance Program [SNAP]. Critics contend that this will dissuade individuals from participating in programs or obtaining medical care. In this JAMA Network Open paper, Benjamin D. Sommers, Heidi Allen, Aditi Bhanja, Robert J. Blendon, John Orav, and Arnold M. Epstein examine perceptions of the new public charge rule and its potential impacts on public program participation and medical care among low-income adults in Texas.

Benjamin Sommers

Among Low-Income Women In San Francisco, Low Awareness of Paid Parental Leave Benefits Inhibit Take-Up

Paid family leave policies have the potential to reduce health disparities, yet access to paid leave remains limited and unevenly distributed in the United States. The US is the only OECD country that does not provide paid leave for new parents, and just 8 states and the District of Columbia have passed partially-paid family leave policies. In a new paper, Julia Goodman of the OHSU-PSU School of Public Health, Will Dow of UC Berkeley, and Holly Elser of Stanford University examine the impact of the 2017 San Francisco Paid Parental Leave Ordinance (PPLO), the first in the US to provide parental leave with full pay. 

William H. Dow

State Legislative Strategies to Pass, Enhance, and Obscure Preemption of Local Public Health Policy-Making

Local governments are often innovators of public health policymaking, and local control over public health issues that are vital to addressing social inequities. But states are increasingly preempting, or prohibiting, local control over public health issues. In a new paper, Jennifer Pomeranz and Diana Silver of the New York University School of Global Public Health, systematically identified strategies to pass, obscure, or enhance preemption in five policy areas.

Jennifer Pomeranz

Contraceptive Access Policies as a Gateway to Improved Health and Equity

Quality preventive medical care remains one of the most important tools for mitigating diseases like cancer, hypertension and heart disease, which are leading causes of death and disability in the U.S. However, due to persistent social and economic inequities, preventive services remain inaccessible to many people.

Does Private Insurance Provide More Medical Care?

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.

Medicaid Access as an Economic Buffer Against Job Loss and Instability

From 2013-2015, more than 3 million U.S. workers became unemployed and nearly a third were unable to return to work by 2018. Unexpected job losses can be devastating for individuals and families. However, a job loss and a sudden gap in health coverage creates an added layer of financial distress for households with costly medical needs. These households must absorb the costs of their health care needs or risk experiencing negative health effects.

Income Support and Children's Health Trajectories

Approximately 16 percent of children in the U.S. live in families with incomes below the federal poverty threshold, potentially creating negative long-term effects that are experienced over the life-course. The Supplemental Security Income (SSI) program provides cash assistance to low-income children with disabilities, expanding family budgets and potentially allowing low-income parents to better protect the health of vulnerable children. However, few studies have evaluated the impact of this policy.

Mandated Sick Pay: Coverage, Utilization, and Welfare Effects

The United States is one of three OECD countries that does not provide universal access to paid sick leave for all employees. Over the past years, just 12 states have passed sick pay mandates. In a new working paper, P4A researcher Nicolas R. Ziebarth of Cornell University and colleagues Catherine Maclean and Stefan Pichler provide first-of-its-kind evidence on how state-level sick pay mandates affect coverage rates, sick leave utilization, and labor costs.

Nicolas R. Ziebarth, Catherine Maclean

Renovating Subsidized Housing: The Impact On Tenants’ Health

Many public and subsidized housing developments in the U.S. are aging and in need of significant repairs. In a new article in Health Affairs, Ingrid Gould Ellen, Kacie L. Dragan, and Sherry Glied from the P4A Research Hub at New York University Robert F. Wagner Graduate School of Public Service, study the impact of a recent renovation and transfer program of public housing in New York City on the health and well-being of residents.

Sherry Glied