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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.

Jobs that require work outside the traditional daytime hours of approximately 8 AM to 6 PM have become ubiquitous across economically developed nations, but extensive research shows that shift work and long work hours may compromise employee health. Although employers recognize the potential harmful effects of shift work, many argue in favor of maintaining it, citing the nature of the work requiring a 24/7 schedule (e.g., public safety), maximization of production capacity in response to consumer demand, and in some cases, employee preference for long shifts to maximize days off and pay. In recent publications, P4A researcher Megan McHugh, doctoral student Adovich Rivera, and their colleagues from Northwestern’s Manufacturing and Health Research Program provide evidence on how shift work affects the incidence of chronic illness and overall worker well-being.<.p>

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.

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. 

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.