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Health Policy and Management

Department News and Updates


September 2020

Faculty at the Bloomberg School and the School of Medicine were awarded a new training grant from the National Institute on Aging for almost $2.5 million dollars over five years. The T32 training grant will support pre- and post-doctoral scholars who are interested in person- and family-oriented health services and outcomes research that relates to aging populations.

Jennifer Wolff, PhD, Eugene and Mildred Lipitz professor and director of the Roger C. Lipitz Center for Integrated Health Care in the Department of Health Policy and Management and Cynthia Boyd, MD, Interim Division Director of Geriatric Medicine and Gerontology and professor in the School of Medicine are the co-directors of the grant. They will collaborate closely with Sarah Szanton, PhD, MSN, RN and colleagues in the School of Nursing and other health services researchers, gerontologic nursing researchers, and geriatricians with a strong commitment to bringing together students and fellows in these disciplines to strengthen the connections between the Schools.

The training program will focus on the skills and experiences needed to lead multi-disciplinary, collaborative research teams. Pre-doctoral trainees will study curriculum in public health and gerontology including epidemiology, biostatistics, health services, health policy, and research ethics. In close consultation with their training program advisor team, post-doctoral trainees will complete core training grant curriculum courses and additional courses required to complement their prior academic experience. Trainees will also participate in a year-long practicum experience, ongoing mentored research projects, and yearly integrative activities. These components will provide students with a solid foundation in health services and outcomes research while providing the opportunity to pursue specialized training in focal areas of interest.

HPM Faculty to Join the National Academy’s Committee on the Equitable Allocation of Vaccine for the Novel Coronavirus 

August 2020

Dan Polsky HeadshotDaniel Polsky, PhD, Bloomberg Distinguished Professor of Health Economics and Director of the Hopkins Business of Health Initiative with joint appointments in the Carey Business School and the Bloomberg School, has been named to the National Academy of Science, Engineering, and Medicine and the National Academy of Medicine’s new committee to develop a framework for vaccine allocation to assist policymakers in the domestic and global health communities in planning for equitable allocation of the COVID-19 vaccine. The framework would seek to inform the decisions by health authorities, as they create and implement national and or local guidelines for vaccine allocation.

The committee, which first met on July 24, will consider what criteria should be used in setting equitable allocation priorities, how that criteria should be applied to determine who will receive the vaccine first, and what populations should be subsequently added to the list. The committee will take into consideration health disparities, high-risk individuals, high-risk occupations, geographic distribution of active COVID-19 cases, and countries/populations involved in clinical trials. Finally, the committee will address barriers with communicating to the American public about vaccine allocation equity and ways to mitigate vaccine hesitancy.

Polsky, and the rest of the committee will create a draft of the proposed framework for public comment and hold a public workshop to collect feedback from external stakeholders and partners.

Please find more information about the committee and up-to-date information on meetings here.

Shannon Frattaroli Named New Director of the Johns Hopkins Center for Injury Research and Policy

July 2020

Shannon Frattaroli HeadshotShannon Frattaroli, PhD, associate professor in the Department, has been named the next director of the Johns Hopkins Center for Injury Research and Policy. Frattaroli will follow the Center’s current director, Andrea C. Gielen, ScD, ScM, professor in Health, Behavior and Society, who has served in that role since 2006.

Frattaroli currently serves as the Center’s deputy director and director of outreach. In these roles, she provides guidance on critical injury prevention issues to policymakers, safety advocates, public health practitioners, the media, and the public. As Center director, Frattaroli will continue to apply rigorous scientific methods and bring research to public health practice and policy while keeping the Center on the front lines of addressing new injury challenges.

Frattaroli has more than 20 years of experience in the field of injury prevention. She specializes in using qualitative research methods to study injury prevention policy and program implementation. Her work includes contributions to fire prevention, domestic violence prevention, and home safety, among other topics. In 2019, she helped launch a massive open online course (MOOC), The Opioid Epidemic: From Evidence to Impact, which features 10 online modules that provide learners with evidence-based and actionable solutions to curbing the epidemic at the local, state, and national level.

The Center, based in the Department, currently focuses on four core areas of injury prevention: home safety and preventing injuries that occur at home, with a strong focus on children and older adults; substance use and overdoses; transportation safety and improving the safety of motor vehicles and roads for all users; and violence, with a focus on intimate partner and sexual violence.

Established in 1987 by renowned epidemiologist Sue Baker, MPH, the Center has played a leading role in some of public health’s biggest injury-prevention success stories, including the enactment of laws that make driving safer by introducing graduated driver licensing for teen drivers, pioneering a widely used injury severity score system, and creating innovative prevention interventions for children and families. The Center is one of only nine centers for excellence in injury research funded by the Centers for Disease Control and Prevention.

Former Center directors include Stephen P. Teret, JD, MPH, professor emeritus, and Ellen J. Mackenzie, PhD, MSc, Dean of the Bloomberg School of Public Health.

HPM Faculty Launch New Center to Address Alzheimer’s Disease and Related Dementias

July 2020

Abstract HeadFaculty in the Department of Health Policy and Management and Carey Business School have received $4.5 million dollar grant from the National Institute on Aging over a five-year period to establish the Hopkins’ Economics of Alzheimer’s Disease and Services (HEADS) Center, a new research center that seeks to improve the care and lives of those affected by Alzheimer’s disease and related dementias. The Center will be led by Jennifer Wolff, PhD, Eugene and Mildred Lipitz Professor of Health Policy and Management and Director of the Roger C. Lipitz Center for Integrated Healthcare in the department and Daniel Polsky, PhD, Bloomberg Distinguished Professor of Health Economics and Director of the Hopkins Business of Health Initiative.

Alzheimer’s disease is a progressive brain disorder that slowly destroys memory and thinking skills and limits the ability to carry out basic daily activities. Health care and long-term services and supports are not well organized or financed to meet the needs of the 5.8 million Americans living with Alzheimer’s disease. As a result, the financial consequences are significant and quality of care is too often poor, leading to undue burden on those who are affected by the disease. As the numbers of persons who are living with the disease are expected to grow in the coming years, the challenges for individuals and society will be compounded.

The HEADS Center will focus on both understanding the full range of care needs and identifying and advancing solutions that address accessibility, affordability, quality, and equity of care. “The Center builds on the vision that led to the creation of the Roger C. Lipitz Center for Integrated Health Care and its focus on advancing cutting-edge research, translating new knowledge to policymakers, key stakeholders, and people directly impacted by these diseases, and putting research into practice,” says Wolff.

The Center will take a cross-school, interdisciplinary approach to build collaborations among faculty across the University. The Center will include the following initiatives:

“This model builds off of the Hopkins Business of Health Initiative, where we improve health systems through research, applying business principals to addressing challenges, and identifying cost-effective health interventions that have both financial and social value,” says Polsky.

Stay tuned for more information on the Center!

HPM Faculty Works with U.S. Representative to Support New Bill Targeting Social Determinants of Health

July 2020

Keshia Pollack Porter HeadshotKeshia M. Pollack Porter, Associate Dean for Faculty and professor in the Department of Health Policy and Management, collaborated with Representative T.J. Cox (CA-21) on new legislation that encourages the study various tools that can highlight how policy changes affect health equity. The bill--Assimilating Health and Equity Assessments into Decision-making (AHEAD) Act--was introduced earlier this month and seeks to encourage the use of Health Impact Assessments and other tools focused on identifying the root causes of poor health through social determinants of health, including education, safe environments, housing, transportation, economic development, and access to food.

Health Impact Assessments is a tool that can help communities, decision-makers, and practitioners consider how proposed policies, programs, projects, and plans could affect public health and health equity. Heath Impact Assessments bring together public health expertise, scientific data, and community input to consider the potential health benefits and consequences of a proposal, including a policy, before it becomes law. Pollack Porter’s work with Health Impact Assessments includes using the tool to guide local and national decisions, teaching a graduate level course on the topic, and scholarly work on HIAs.

“This bill emphasizes the need to study how to optimally include health and equity consideration in policy decisions across multiple sectors, such as criminal justice, transportation, education, and housing,” says Pollack Porter.

The bill will help direct the Department of Health and Human Services to commission the National Academies to study how to incorporate health impact assessments and other evidence-based analysis tools into federal policymaking processes.

Read the full bill here.

HPM Doctoral Student receives the Doctoral Research on Urban Issues Award from the 21st Century Cities Initiative at Johns Hopkins University

July 2020 

Crystal Lee Perez HeadshotCrystal Lee Perez, a PhD candidate in Health Policy and Management, received a Doctoral Research Award on Urban Issues from the 21st Century Cities Initiative at the Johns Hopkins University. Perez’s research examines healthy kids’ meal policies and their implementation as well as correlates of kids’ meal purchases in restaurants. The findings will seek to inform policymakers, advocates, government agencies, and restaurants about the implementation of healthy kids’ meal policies and potential impacts on childhood obesity and healthy eating behaviors.

Broadly, healthy kids’ meal policies aim to improve the nutritional composition of kids’ meal via default beverage options, incentives, or nutritional requirements. The most popular healthy kids’ meals policies aim to improve the kids’ menu and drink choices at restaurants by replacing sugary drinks with healthier alternatives such as water, milk, or 100 percent juice with no added sweeteners. Restaurants that adopt healthy kids’ meals policies result in kids’ meals with higher nutritional value, increasing families’ access to healthier options while also maintaining their freedom of choice.

Healthy kids’ meal policy reform is key in addressing childhood obesity, which affects 1 in 5 children in the U.S. and disproportionately impacts marginalized populations. Currently, 18 states and localities have adopted healthy kids’ meal policies, but with variation in how they are written, implemented, and enforced.

The 21st Century Cities Research Award promotes the research of 12 graduate students working toward a doctoral degree for innovative dissertation research focusing on policy-relevant urban research that closely aligns with the organization’s s interest areas. Perez is one of 12 other doctoral students who received the award. Other awardee’s projects focus on topics such as urban greening, immigration, policing, disaster relief, access to healthy food, and discrimination in health care in cities in the U.S. and around the world.

To learn more about the Perez’s project and the award read more here.

The Johns Hopkins Center for Gun Policy and Research Hosts Second Summer Youth Institute 

July 2020

This summer, the Johns Hopkins Center for Gun Policy and Research invited 63 youth from 23 states in 52 different cities for the second Summer Youth Institute. During the four-day institute, Students had the opportunity to learn from some of the nation’s leading academic researchers studying gun policy and gun violence prevention, including Daniel Webster, ScD, MPH, and Cassandra Crifasi, PhD, MPH, the director and deputy director of the Center. In addition to learning from academic researchers, students also interacted with various community leaders on the front lines of gun violence prevention and advocacy efforts. Based in cities such as Baltimore, New York City, and Los Angeles, these organizations include violence interrupters engaging with those at highest risk for gun violence, advocates for police reform, organizers of hospital-based strategies, and more.

Due to safety precautions with the COVID-19 pandemic, this year’s Summer Youth Institute--Reducing Gun Violence in America: Evidence for Change--was held virtually. Learning sessions were balanced with experiential learning exercises, small breakout group work, and activities to help students enhance their understanding of policy and effectively use data to advance their advocacy goals.

This was the Center’s second year facilitating the Summer Youth Institute. The program, directed by Rebecca G. Williams, research associate in the Department of Health Policy and Management and a core member of the Center, is designed to enhance students’ understanding of scientific evidence, policies, and programs relevant to preventing gun violence, building advocacy skills, and foster networking opportunities. After the Institute, youth are equipped with skills to deliver oral testimony, critique policy proposals, and apply communications skills to their advocacy work. The Institute also encourages students to identify solutions through collaboration and collective action with their peers, ultimately empowering them to advance policies and programs to reduce gun violence in their own communities.

“By being a participant in this Institute, I have expanded my knowledge as a youth advocate. I can proudly say that coming out of this institute, I have learned more about gun culture in various areas in the country, the wide variety of gun policies and the logistics behind them, as well as gun violence prevention tactics,” says one student.

The Institute was made possible through a generous and collaborative sponsorship on behalf of the Joyce Foundation, the Bloomberg American Health Initiative, the Hope and Heal Fund of California, and the California Wellness Foundation.

Congratulations to Health Policy Research Scholars 2020 Graduates! 

July 2020

HPRS LogoThe Health Policy Research Scholars (HPRS) program—a Robert Wood Johnson Foundation leadership program aimed at doctoral students from marginalized backgrounds and/or populations that are underrepresented in specific doctoral disciplines—held their first graduation ceremony celebrating 31 scholars for the completion of the program on Saturday, July 18, 2020. The graduates, whose multi-disciplinary work focuses on advancing health equity and building a culture of health, earned their certificates during a virtual ceremony.

The ceremony, led by program director, Keshia M. Pollack Porter, included remarks from leadership at the Robert Wood Johnson Foundation, well wishes from the Health Policy Research Scholar community members, including faculty in the department, former program directors, and scholars’ mentors, coaches, and fellow alumni.

“Change can and will come. It's important in those moments to know who you are, where you come from, and what you stand for,” said the keynote speaker Dr. Mustafa Santiago Ali, Vice President of Environmental Justice, Climate, and Community Revitalization for the National Wildlife Federation. Ali paid tribute to the late Representative John Lewis and many others for their leadership in building a more just and equitable world.

The graduation was the culminating event of the Summer Institute for all three current cohorts of scholars. The Summer Institute included a week of virtual workshops and social events, including communication workshops with the Alan Alda Center for Communicating Sciences and the FrameWorks Institute, mock visits to the Hill, a health equity training with Human Impact Partners, and inspiring leadership presentations from the scholars. The scholars also participated in evening trivia, virtual yoga, and energizing walks together.

The recording of the graduation ceremony, including Dr. Ali’s remarks, is available here. Learn more about the Health Policy Research Scholars program and their goal to advance health equity. The program will welcome a new cohort of up to 60 scholars on September 1.

COVID-19 Cases and Deaths in Federal and State Prisons Significantly Higher Than in U.S. Population

July 2020

Prison and COVIDA new study by researchers at the Johns Hopkins Bloomberg School of Public Health and the UCLA Law COVID-19 Behind Bars Data Project found that the number of U.S. prison residents who tested positive for COVID-19 was 5.5 times higher than the general U.S. population, with a prisoner case rate of 3,251 per 100,000 residents as compared to 587 cases per 100,000 in the general population.

The researchers also found the death rate of U.S. prisoners was 39 deaths per 100,000 prison residents, higher than that of the U.S. population at 29 deaths per 100,000 people. After adjusting for age and sex differences between the two groups, the death rate would be three times higher for prisoners compared to the general U.S. population.

They also found that COVID-19 cases in prisons increased by 8.3 percent per day compared to 3.4 percent in the general population. 

The study, led by Brendan Saloner, PhD, associate professor in the Department of Health Policy and Management, analyzed cases and deaths from March 31 to June 6, 2020 drawing information from departments of corrections, external medical examiner reports, data from the Centers for Disease Control and Prevention, and the U.S. Census Bureau’s American Community Survey. 

“COVID-19 Cases and Deaths In Federal and State Prisons” was published July 8 in JAMA and was written by Brendan Saloner, Kalind Parish, Julie A. Ward, Grace DiLaura, and Sharon Dolovich.

Read more about the study here.

Read more about the study in ABC News, CBS News, the Associated Press, CNN, NY Daily News, Medical News Today, HealthDay, Healthline, and The Crime Report.

Linking Hospital and Other Records can Predict Both Fatal and Nonfatal Opioid Overdoes, Study Suggests 

July 2020

Data linkageA new study by researchers at the Johns Hopkins Bloomberg School of Public Health found  that the odds of a fatal opioid overdose were 1.5 times higher for individuals with one to two visits to the emergency department for any medical issue than for people with no hospital visits.  

The researchers also found that individuals with a hospital visit where opioid use disorder was addressed were 2.9 times more likely to die from an overdose over the coming year, compared with other people. The results showed that men had 2.4 higher odds of fatal overdose and 1.4 times higher odds of nonfatal overdose compared to women. Predictors of overdose include hospital visits, release from prison, and patterns of medication use.  
In collaboration with the Maryland Department of Health and the state’s Health Information Exchange, Brendan Saloner, PhD, associate professor at the Bloomberg School and faculty member in the department, led the study using data from five Maryland databases to better understand opioid-related overdoses and fatalities. Maryland is one of the first states to have linked records across databases to help identify those at risk for opioid overdose. 

 The study sample included more than 2.29 million linked records for MD residents ages 18 – 80 years with one or more record in any of the databases in 2015. The researchers then used statistical modeling to predict opioid-related overdoses in 2016 based on 2015 data. Fatal opioid overdoses were analyzed using medical records and nonfatal opioid overdoses from emergency department or inpatient hospital-settings data. 
The findings, published online June 24 in  JAMA Psychiatry, suggest that risk of an overdose can be accurately predicted by leveraging information found across databases. Study findings also suggest that predictive data analytics could be used to more effectively target these strategies towards those with the greatest risk by identifying groups that could most benefit from intensive support services such as peer counselors. 

“A lot of the individuals with the highest risk for an overdose come in contact with the hospital or prison system,” says Saloner. “There’s a high opportunity in those places to help those individuals and we can save a lot of lives if we focus efforts there.” 

Predicting Opioid Overdose Using Linked Statewide Medical and Criminal Justice Data: A Cross-Sectional Predictive Modeling Study was written by Brendan Saloner, Hsien Yen Chang, Noa Krawczyk, Lindsey Ferris, Matthew Eisenberg, Thomas Richards, Klaus Lemke, Kristin E Schneider, Michael Baier and Jonathan Weiner

Read the press release

HPM Doctoral Student Receives Dissertation Grant From the Horowitz Foundation for Social Policy 

July 2020

Molly Headshot Molly Merrill-Francis, a doctoral candidate in the department, is the recipient of a competitive dissertation grant from the Horowitz Foundation for Social Policy. Merrill-Francis, one of twenty-five scholars who received the award, is using econometric models to examine the association between state minimum wage laws and occupational injury. Her dissertation, The Impact of State Minimum Wage Laws on Occupational Injury, uses fifty-state longitudinal analysis to examine the association between state minimum wage laws and worker health. The findings will help inform a contemporary policy discussion about the health outcomes of increasing the minimum wage and its potential impacts on workers’ health. Outcomes also have implications for other high priority discussions, including disability benefits, workers compensation, and uncompensated healthcare.

The Horowitz Foundation awards grant proposals for policy-related research in all major areas of the social sciences. Only doctoral students whose dissertation proposals have been approved by their committees are eligible to apply.

Race Differences in Characteristics and Experiences of Black and White Caregivers of Older Americans 

July 2020

Chanee HeadshotA new study by researchers at the Johns Hopkins Bloomberg School of Public Health found that Black caregivers provided more than 40 hours of care per week when caring for an older adult with dementia, someone living below the federal poverty line, or adults eligible for Medicaid as compared to white caregivers.  

The research, led by Chanee D. Fabius, PhD, assistant professor in the Roger C. Lipitz Center for Integrated Health Care at the Bloomberg School, analyzed survey responses from 1,548 Black and white caregivers using data from the National Health and Aging Trends Study (NHATS)  and National Study of Caregiving (NSCO)--nationally representative surveys better understand trends in aging and caregiving over time.  

The study found that Black caregivers were more likely to provide more care to older adults with greater impairment under circumstances involving greater financial strain than white caregivers. Approximately one-third of Black caregivers reported using support services as compared to about a quarter of white caregivers. Additionally, 83.4 percent of Black caregivers were more likely to report perceived gains, such as feelings of confidence in their care giving abilities or feelings of closeness to the person receiving care as compared to 62.7 percent white caregivers. Black caregivers were also less likely to report emotional difficulty than white caregivers (17.9 percent vs. 28.2 percent). These differences remained in place after adjusting for caregiving context, stressors, and sources of support.  

The findings, published online May 13 in The Gerontologist, highlight racial disparities in caregiving settings and differences in experiences between Black and white caregivers. The research underscores the need for additional support such as paid family leave and faith and community-based programming to better support community-dwelling low-income older adults and their family and unpaid caregivers. 

Race Differences in Characteristics and Experiences of Black and White Caregivers of Older Americans was written by Chanee D FabiusJennifer L Wolff, and Judith D Kasper

Reducing Law Enforcement Violence and Building Trust: Data to Guide Enforcement of Gun Laws in Baltimore 

June 2020

Abstract NeighborhoodA new report from researchers at The Johns Hopkins Center for Gun Policy and Research finds broad “stop-and-search” practices used for many years by the Baltimore police to look for illegally possessed guns have minimal, if any impact on gun violence. Not only do these practices result in mental and physical harm to those who are unjustifiably searched, they undermine community trust in police.

The research, led by Daniel Webster and Cass Crifasi, also found that residents of communities most impacted by gun violence in Baltimore want more focused and accountable law enforcement to reduce gun violence. Highly focused enforcement of gun laws consistently led to fewer shootings in Baltimore and in other cities where research on focused gun carrying suppression has been studied. The same was true for focused-deterrence initiatives which couple the prospects of incarceration for shootings with social supports to support those at highest risk for committing violence.

The authors also make a series of recommendations for approaches to enforcing gun laws in Baltimore that are focused, effective, constitutional, and respectful of community concerns. Specifically, Baltimore police should adopt a more focused strategy to enforce gun laws that is driven by intelligence and data from criminal investigations; targets high-risk individuals; is led by small teams of officers trained in constitutional policing and working out of police districts; and is conducted with close supervision and oversight to promote trust in the police in local communities.

The report, Reducing Violence and Building Trust: Data to Guide Enforcement of Gun Laws in Baltimore, draws from focus groups and household surveys in West and East Baltimore that experience high levels of gun violence, analyses of law enforcement data in Baltimore, law enforcement practices in other cities, a 2018 review of proactive policing by the National Academies of Science, Engineering and Medicine, and a survey of practices from other law enforcement agencies.

Read more about the report, a Q&A with the report’s authors, and listen to a bonus episode of the Bloomberg School's podcast, Public Health on Call, with the report's authors.

picture of hospital bedCOVID-19 Hospitalizations Could Mean Significant Out-of-Pocket Medical Costs for Many Americans

June 2020

If past hospitalizations for pneumonia and other respiratory illnesses are any guide, many Americans could face high out-of-pocket medical costs for COVID-19 hospitalizations despite the fact that many insurers have waived their cost-sharing requirements, according to a new study from researchers at Johns Hopkins Bloomberg School of Public Health.

The researchers analyzed out-of-pocket costs incurred by people who had been hospitalized with pneumonia, acute bronchitis, lower respiratory infections, and acute respiratory distress syndrome from January 2016 through August 2019. Using de-identified insurance claims for 34,395 unique hospitalizations during the study period, the researchers found out-of-pocket costs were particularly high for consumer-directed health plans--which typically feature lower premiums, compared to standard plans, but higher deductibles that can be paid via a tax-advantaged health savings account.

The researchers found that average out-of-pocket spending for these respiratory hospitalizations was $1,961 for patients with consumer-directed plans compared to $1,653 for patients in traditional, usually smaller-deductible plans. The out-of-pocket cost gap was lowest for older patients ages 56 to 64 years, and greatest—$2,237 vs. $1,685—for patients 21 years and younger.

The study, published online June 15 in the American Journal of Preventive Medicine, was written by Matthew D. EisenbergColleen L. Barry, Cameron Schilling, and Alene Kennedy-Hendricks

Read more

woman looking out windowNew Survey Finds Large Increase in Psychological Distress Reported Among U.S. Adults During the COVID-19 Pandemic 

June 2020

The percent U.S. adults who reported symptoms of psychological distress increased more-than-threefold—from 3.9 percent in 2018 to 13.6 percent in April 2020, according to a new study by researchers at the Johns Hopkins Bloomberg School of Public Health and the SNF Agora Institute at Johns Hopkins University. Young adults ages 18 to 29, adults across ages in low-income households, and Hispanics across ages expressed the highest psychological distress.

Using NORC AmeriSpeak, a nationally representative online survey panel, researchers collected survey responses from 1,468 adults ages 18 years and older. The researchers compared new survey responses to an identical measure from the 2018 National Health Interview Survey. The data were collected during the COVID-19 pandemic, which has negatively affected mental health and disrupted access to mental health services.

The survey found that 19.3 percent of adults with annual household incomes less than $35,000 reported psychological distress in 2020 compared to 7.9 percent in 2018, an increase of 11.4 percentage points. Nearly one-fifth, or 18.3 percent, of Hispanic adults reported psychological distress in 2020 compared to 4.4 percent in 2018, a more than four-fold increase of 13.9 percentage points. The researchers also found that psychological distress in adults age 55 and older almost doubled from 3.8 percent in 2018 to 7.3 percent in 2020.

The study, published June 3 in a research letter in JAMA, was written by Beth McGinty, Rachel Presskreischer, Hahrie Han, and Colleen L. Barry.

Read more about the findings in the press release, HUB article, or listen to an episode of the Public Health On Call podcast. 

Brendan Saloner HeadshotNew Study Shows Increase in Substance Use Disorder Treatment Admissions After Medicaid Expansion

A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health found 36 percent more people entered treatment for substance use disorder in states that expanded Medicaid insurance coverage after four years as compared to states that did not.

The paper, published in the March issue of Health Affairs, suggests that Medicaid expansion under the Affordable Care Act is improving access to substance use treatment and also increasing the availability of federal dollars to support drug treatment programs. 

A research team, led by Brendan Saloner, associate professor in the Bloomberg School’s department of health policy and management, analyzed the Treatment Episode Data Set, a federally mandated database for specialty treatment providers that accept public funding. Using treatment admissions and insurance coverage data, the researchers analyzed states before and after Medicaid expansion between 2010 and 2017. 

They found the largest changes in admission for intensive outpatient programs and those seeking medications for opioid use disorder. Medicaid also paid for 89 percent more admissions for substance-use treatment in states that expanded coverage as compared to those that did not expand.

cass crifasi headshotHPM Faculty Receives Grant to Develop a Virtual Reality Program to Assess Firearm Use

Cassandra Crifasi, PhD, MPH, deputy director of the Johns Hopkins Center for Gun Policy and Research and assistant professor in the department of health policy and management, has received a two-year, $500,000 grant from the Packard Foundation to develop and study a virtual reality program for civilian firearm use.

The grant will support the development of a range of immersive virtual reality simulations of common scenarios to test individuals’ ability to make decisions about using a firearm under pressure. Researchers will also study the accuracy with which a participant uses a firearm in each of the situations. Participants will be recruited via gun ranges, gun shops, and through existing networks, and randomly assigned to different simulations.

Over the last fifty years, most states have eased laws regulating concealed firearms. Currently, fifteen states do not require a special license for a civilian to carry a firearm in most public places. In states that do require a license to carry concealed firearms, many do not require an applicant to demonstrate he or she can fire a firearm safely or accurately before purchase. Currently, there is no federal law mandating firearms training for civilians considering carrying firearms in public in the U.S.

Crifasi’s research focuses on policies and programs that improve safety and prevent injury. Her research areas include violence prevention, firearm policies, and evaluation of policy changes on public safety.

prescription drug bottle HPM Faculty Join the Nation’s First Prescription Drug Affordability Panel

Drs. Gerard Anderson, professor, and Joseph Levy, assistant scientist, in the Department of Health Policy and Management have been appointed to Maryland’s first Prescription Drug Affordability Panel. This panel, the first in the U.S., will help set prescription drug costs for Maryland residents, starting with prescription drugs whose prices are more than $30,000 dollars per year or have a price increase of at least $3,000 dollars from one year to the next.

Nationwide, high prescription drug prices are increasingly making medications unaffordable. The board was created by Maryland’s state legislature in 2019 to set upper payment limits for prescription drugs purchased by state, county or local governments beginning in 2022. Public hearings across the state will help inform the Board which drugs should be investigated. Other states are looking to establish similar boards and will look to Maryland for guidance.

Anderson was appointed by Maryland Attorney General Brian Frosh and Levy was appointed by Maryland Governor Larry Hogan. Each will serve a five-year term that can be renewed.

Anderson is director of the Center for Hospital Finance and Management at the Bloomberg School. His research focuses on drug and health pricing, and he testifies regularly before Congress, state legislatures, and federal agencies. Levy is a health economist who studies the cost-effectiveness of medical technologies, primarily in orthopedic trauma; as well as state and federal polices related to drug pricing.

Read more about the panel in the Washington PostThe Baltimore SunCBS, and WTOP

Teach Out LogoJohns Hopkins Center for Gun Policy and Research and the Center for Teaching and Learning Launch New Online Learning Experience on Firearm Purchaser Licensing

The Johns Hopkins Center for Gun Policy and Research and the Center for Teaching and Learning at the Johns Hopkins Bloomberg School of Public Health are launching the University’s first-ever Teach-Out, a free and open online learning event on firearm purchaser licensing policies on January 20, 2020.

The four-week event, Firearm Purchaser Licensing: The Background Check Policy Not Enough People are Talking About, is led by Cassandra Crifasi, PhD ’14, MPH, deputy director of the Center for Gun Policy and Research and assistant professor in the Bloomberg School’s Department of Health Policy and Management.

Learning materials include an overview of firearm licensing policies and evidence of effectiveness, materials on the social context of licensing, including public opinion polling and differences across geographic areas and groups. In addition to guest lecturers, Crifasi will lead a weekly interactive discussion forum with students and invite them to participate in call-to action activities in their own communities.

The Teach-Out complements the Center for Gun Policy and Research’s MOOC (Massive Open Online Course),
Reducing Gun Violence in America: Evidence for Change, offered on Coursera, the online learning platform. The new Teach-Out is shorter, since it focuses on one gun-policy topic, and includes interactive discussion until the learning event ends on February 16, 2020. The Teach-Out also encourages participants to commit to some action or behavior change. The learning materials will also be available on the Gun Center’s website.

Pre-enrollment is open. Enroll and learn more.

Opioid MOOC Injury Center Faculty Launch New MOOC on Opioid Epidemic

Shannon Frattaroli, PhD, and colleagues from the Johns Hopkins Bloomberg School of Public Health recently launched a Massive Open Online Course (MOOC) on the opioid epidemic on the online learning platform Coursera. The course, “Opioid Epidemic: From Evidence to Impact,” features 10 online modules that provide learners with evidence-based and actionable solutions to curbing the epidemic at the local, state, and national level.

The course curriculum builds off the 2017 report “The Opioid Epidemic: From Evidence to Impact” prepared by the Bloomberg School and the Clinton Health Matters Initiative with input from a team of national experts. Learners can enroll at any time and complete coursework at their own pace.

Frattaroli, the course’s lead instructor, is associate professor in the Bloomberg School’s Department of Health Policy and Management and core faculty in the Johns Hopkins Center for Injury Research and Policy, for which substance use prevention is a priority focus area. The Center is one of nine Injury Control Research Centers funded by the National Center for Injury Prevention and Control within the Centers for Disease Control and Prevention.

Enrollment is ongoing.

Learn more about the course.

Department Chair, Colleen L. Barry, Elected into National Academy of Medicine                      

Colleen Barry HeadshotColleen L. Barry, PhD, MPP, Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Bloomberg School of Public Health, was elected into the National Academy of Medicine. She joins three more faculty members of the Johns Hopkins University to be elected in 2019. 

Through its domestic and global initiatives, the National Academy of Medicine works to address critical issues in health, medicine, and related policy. New members are elected by current members through a selective process that recognizes people who have made major contributions to the advancement of the medical sciences, health care, and public health. 

Barry's research focuses on how health and social policies can affect a range of outcomes for individuals with substance use disorders and mental illness, including access to medical care and social services, care quality, health care spending, financial protection and mortality. In addition, she conducts empirical research to understand how communication strategies influence public attitudes about addiction, mental illness and violence. A focus of this work is to identify evidence-based approaches to reducing stigma. She has led research studies funded by the NIH and various foundations including the Robert Wood Johnson Foundation, the Commonwealth Fund and the Arnold Foundation. She has authored over 180 peer-reviewed publications on a range of health policy and public health topics in journals such as the New England Journal of MedicinePediatricsHealth Affairs and the American Journal of Public Health. Barry holds a joint appointment in the Department of Mental Health and is founding co-director of the Johns Hopkins Center for Mental Health and Addiction Policy Research. She is a core faculty member with the Johns Hopkins Center for Gun Policy and Research. She is Principal Investigator of the Johns Hopkins NIMH T32 Mental Health Services and Systems Training Grant. She serves on various national advisory boards on policy related to addiction, mental health and violence. She recently served as a member of the National Academy of Medicine Consensus Panel on Medication Treatment for Opioid Use Disorder. Barry is also co-chair of the Forum on Mental Health and Substance Use Disorders of the National Academies of Sciences, Engineering, and Medicine.

Join us as we congratulate Colleen! 

The Center for Health Services and Outcomes Research (CHSOR) Celebrates 50 Years of Excellence

CHSOR 50 symposiumThis October, the Center for Health Services and Outcomes Research (CHSOR, formerly Health Services Research and Development Center) celebrated its 50th anniversary. CHSOR conducts multidisciplinary research on health care policies and practices, with a special focus on their impact on quality of care and patient-centered outcomes, and a particular attention to vulnerable population groups.

Faculty members conduct research covering a wide range of topics and issues including quality of care, patient-reported outcomes and other patient outcome measures, program evaluation, health policy, patient safety, shared decision making, health care providers, systems and organizations, innovative methods and their applications, patient and community engagement, health information technology, aging, end of life care, comparative effectiveness research, applied microeconomics and economic evaluation.

CHSOR was established in 1969 and is one of the oldest in the United States devoted to research on health care. Over the years, the Center has made several important contributions to the field including studies of the use, outcomes and cost of health and mental health services for people with severe mental illnesses, work demonstrating the value of mammograms in detecting breast cancer and reducing breast cancer mortality, and various studies in gerontology, including the National Health and Aging Trends Study (NHATS). Other research conducted at the Center includes Patient-reported outcomes assessment tools, including the Sickness Impact Profile, the Child Health and Illness Profile, and Asthma outcomes and the creation of the ACG® System for case-mix categorization and the Center for Population Health Information Technology (CPHIT).

CHSOR’s research is supported by major federal agencies, including the National Institutes of Health, the Agency for Healthcare Research and Quality and the Department of Defense; by the Patient-Centered Outcomes Research Institute; by Johns Hopkins University and Johns Hopkins Medicine; and by private foundations and industry.

Jennifer Wolff HeadshotJennifer Wolff, Awarded $2.5 Million Grant To Improve Advanced Care Planning in Primary Care for Persons with Cognitive Impairment

Dr. Jennifer Wolff, professor in the department of health policy and management at the Johns Hopkins Bloomberg School of Public Health, has received a five-year, $2.5 million grant from the National Institute on Aging. Dr. Wolff will conduct a randomized controlled trial of a communication intervention in primary care that engages family caregivers in advance care planning of older adults with cognitive impairment.

Alzheimer’s disease and related dementias are among the most disabling and costly of all health conditions. However, persons with dementia often do not receive a diagnosis, and are less likely to complete an advance directive than persons without dementia. Family caregivers of persons with dementia are often heavily involved in scheduling and attending medical visits and providing care in the community, but are commonly not well prepared to assume a role in medical decision-making.

The study will seek to facilitate advance care planning between primary care providers, patients and family caregivers by incorporating a range of strategies known to improve communication outcomes. Findings from the study will provide critical information to improve care planning in primary care settings, places where persons with Alzheimer’s disease and related dementias are often diagnosed and medically managed.

Dr. Wolff is the Eugene and Mildred Lipitz Professor and Director of the Roger C. Lipitz Center for Integrated Health Care. She is a leader in research and policy relating to the care of persons with complex health needs and disabilities.

Judy Kasper HeadshotJudith Kasper, Awarded $45 Million Grant to Support Continuation of the National Health and Aging Trends Study  

Dr. Judith Kasper, professor in the department of health policy and management at the Johns Hopkins Bloomberg School of Public Health, has received a five-year $45 million grant from the National Institute on Aging. Dr. Kasper and her team, including researchers at the Bloomberg School, Johns Hopkins Medicine, University of Michigan, and other universities, will use the grant to continue the National Health and Aging Trends Study (NHATS), a nationally representative study of disability trends and  trajectories later in life.

This is the third five-year cycle of funding awarded to support the ongoing aging trends study. Dr. Kasper has been principal investigator of the National Health and Aging Trends Study (NHATS) since 2008.

The number of people age 65 and older is projected to make up 20 percent of the U.S. population by 2030. The study is gathering comprehensive, high-quality data to address the implications of an aging population for services to meet the anticipated needs for long-term services and supports, family caregiving, and a host of other family and societal issues.

The study has collected data through in-person interviews with Medicare beneficiaries ages 65 and older since 2011. Participants are asked about their living environments, routine activities, assistance from others, and participation in valued activities. To date, over 3,000 researchers have registered to use NHATS data, and findings from their work appear in a wide variety of scientific publications on topics including quality of end-of-life care, use of devices or environmental features to compensate for functional declines, barriers to participation in activities, and dementia caregiving.

Vivek Murthy Headshot19th Surgeon General of the United States To Join Bloomberg School as Distinguished Policy Scholar

Dr. Vivek H. Murthy, the 19th U.S. Surgeon General and previous Vice Admiral of the U.S. Public Health Service Commissioned Corps, will join the Johns Hopkins Bloomberg School of Public Health as the Distinguished Policy Scholar, beginning in September 2019.

Murthy served as U.S. Surgeon General under President Barack Obama, focusing his tenure on pressing public health issues, from the opioid epidemic and e-cigarettes to vaccine-preventable illness and emotional well-being. He released the first Surgeon General’s Report on substance use disorders as well as the first federal report on e-cigarettes and youth.

The Distinguished Policy Scholar program, housed in the Bloomberg School’s department of health policy and management, was created to bring national policy leaders to campus to collaborate with faculty and students on pressing public health challenges. During a year-long residence, the Distinguished Policy Scholar takes part in wide-ranging research, education, and public health practice activities in partnership with faculty.

Murthy follows Michael Botticelli, former director of the White House Office of National Drug Control Policy, who served as Distinguished Policy Scholar at the Bloomberg School in 2018. Other former Distinguished Policy Scholars include former Congressman Henry Waxman, of California, and former Governor Ronnie Musgrove, of Mississippi.

Alyssa Moran, Awarded $1.6 Million to Evaluate Healthy Restaurant Kids' Meal Policy

Alyssa Moran Headshot Alyssa Moran, ScD, assistant professor in the Johns Hopkins Bloomberg School of Public Health’s Department of Health Policy and Management, has been awarded a $1.6 million dollar grant by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The four-year grant will support evaluating a healthy restaurant kids meals policy in New York City.

More than a dozen cities and states have passed healthy kids meals policies to help prevent childhood obesity. These policies seek to reduce child consumption of sugar-sweetened beverages by requiring restaurants to serve beverages such as water, milk, or 100 percent  juice instead of sugary beverages as the default choice with children’s meals.

These policies have potential to reduce sugary drink consumption, however, there are virtually no data on how healthy kids meals policies influence children’s eating behaviors or health. The goal of this research is to evaluate the effects of a healthy kids meals policy passed in New York City on children’s fast-food meal orders, dietary intake, and cost-effectiveness. The study will provide the first empirical evidence on the degree to which healthy kids meals policies impact child nutrition.

Angie Cradock, ScD, MPE, senior research scientist at the Harvard T.H. Chan School of Public Health, is co-principal investigator.

Moran conducts research on policies to improve nutrition in early childhood, and has worked on child nutrition policies at the state and local levels, serving as a technical adviser to New York City’s Nutrition Strategy Program and New York State’s Advancing Prevention Agenda.

The Johns Hopkins Center for Injury Research and Policy Awarded $4.2 Million from CDC to Study Injury Research and Prevention Including Medication Storage and Opioid Prescription Laws

Andrea Gielen

The Johns Hopkins Center for Injury Research and Policy in the department of health policy and management at the Johns Hopkins Bloomberg School of Public Health has received a five-year grant of $4.3 million from the Centers for Disease Control and Prevention to study effective solutions to the costly impact of injuries.

The award will focus on interventions and translation of research specifically in medication storage and disposal among older adults in tribal communities, child sexual abuse prevention strategies, promoting the use of safety technologies to better protect teen drivers and determining the impact of opioid prescribing laws on fatal motor vehicle crashes. Additionally, the new funding will support new online and in-person learning opportunities that expand partnerships, training and technical assistance to community stakeholders.

Founded in 1987, the Johns Hopkins Center for Injury Research and Policy prioritizes research in home safety, substance use and overdose, transportation safety and violence with a focus on groups that are at higher risk for experiencing certain types of injury, including children, older adults, veterans and trauma survivors.

“There are proven effective solutions to many injury problems,” says Andrea C. Gielen, ScD, center director, professor and principal investigator. “However, access to those solutions is often not equitably distributed across the population. We place a high priority on addressing inequities in our research projects, as well as in our training and outreach activities with practice partners that share our commitment to reducing disparities in injury rates.”

Keshia M. Pollack Porter HeadshotBloomberg School to House National Health Policy Research Scholars Center

Keshia M. Pollack Porter, PhD, associate dean for faculty development, director of the Institute of Health and Social Policy and professor in the department, will lead a major new initiative funded through the Robert Wood Johnson Foundation to house the Health Policy Research Scholars national program center at the Bloomberg School. The program will support doctoral students who are underrepresented in nonclinical disciplines such as economics, sociology, and political science, as well as more traditional public health fields such as epidemiology and nutrition. It is a four-year, competitive leadership training program in health policy that complements the students’ doctoral training.

Dan Polskey Cropped HeadshotDaniel Polsky, Bloomberg Distinguished Professor

The department welcomed Daniel Polsky, PhD as the School’s 40th Bloomberg Distinguished Professor in March 2019.  He is also has an appointment at Carey Business School. Dr. Polsky is a national leader in health policy and economics. His work focuses on exploring how healthcare is organized, managed, financed and delivered, especially for low-income and vulnerable populations. He joins Hopkins from the University of Pennsylvania where he was a professor in both the Perelman School of Medicine and the Wharton School. He was the executive director of the Leonard Davis Institute for Health Economics, a leading research center focused on an interdisciplinary approach to healthcare delivery and policy. Recently, Dr. Polsky was elected to the National Academy of Medicine, serving on its Health and Medicine Committee, and its Board on Population Health and Public Health Practice. He also currently serves on the Congressional Budget Office's Panel of Health Advisors. 

Darrell Gaskin Headshot Darrell Gaskin, Recipient of Presidential Early Career Award for Scientists and Engineers

Darrell Gaskin, William C. and Nancy F. Richardson Professor in the department of health policy and management at the Johns Hopkins Bloomberg School of Public Health, is a recipient of the Presidential Early Career Award for Scientists and Engineers. The award is the highest honor presented by the U.S. government to scientists who demonstrate leadership in research, science and technology. 

Since 1996, the award has been given to scientists, engineers and others whose leadership and research provide outstanding contributions to science, technology, education and mathematics. The White House Office of Science and Technology Policy coordinates the award with participating departments and agencies. The National Institutes of Health nominated Dr. Gaskin for this award. 

Dr. Gaskin works to promote policies and practices that improve access to care and quality of care that focus on improving racial and economic disparities in health care. He is director of the Hopkins Center for Health Disparities Solutions. His research primarily focuses on hospital quality disparities, access to health care for minority, low-income, uninsured and other vulnerable populations as well as evaluating strategies to address cardiovascular disease risk factors. His research has helped in identifying and understanding the impacts of geographical place and contextual factors on disparities and has encouraged policymakers to support community-level interventions to address them.

Colleen Barry Cropped HeadshotDepartment Chair Helps Author New Report on The Treatment of Opioid Use Disorder in Care Settings

Colleen L. Barry, PhD, Fred & Julie Soper Professor and Chair of the department was a member of a National Academies of Sciences, Engineering and Medicine consensus panel that authored a new report on the evidence base for medications to treat opioid use disorder. The report titled Medications for Opioid Use Disorders Save Lives concluded that withholding or failing to provide medications for the treatment of opioid use disorder in any care setting is denying medical treatment. It also highlights major barriers to the use of medications to treat opioid use disorder, including stigma towards substance use, inadequate education and training of professionals responsible for working with people with opioid use disorder and current regulations about these medications not supported by research. Dr. Barry and the committee highlighted the critical need to greatly expand lifesaving medication treatment for opioid use disorder.

The Johns Hopkins Center for Gun Policy and Research Launches Free Massive Open Online Course

 MOOC Picture This spring, the Johns Hopkins Center for Gun Policy and Research launched the first massive open online course (MOOC) on gun violence prevention. The free 6-week course titled Reducing Gun Violence in America: Evidence for Change provides students of all ages with knowledge about the scope of gun violence in America, relevant legal issues, evidence-based data surrounding current and proposed gun violence policies and an understanding of interventions that have demonstrated the greatest impact. Daniel Webster and Cassandra Crifasi, the center’s director and deputy director, both professors in the department, created the course to help people understand the research on gun violence and the broad range of potential strategies to address the problem. Currently, the course has more than 3,100 people enrolled across North America, Europe, Asia and South America.