Journal of Public Health Policy最新文献

The access to care benefits of Affordable Care Act (ACA) Medicaid expansions are important for 45-64-year-old adults who are living below 100% of the Federal Poverty Level, a particularly vulnerable group in the United States (US). Gaining coverage from Medicaid expansions should improve access to healthcare and affect social determinants of health, including financial behavior. We analyzed data from 2009 to 2018 from the National Financial Capability Survey (NFCS) and utilize a difference-in-differences model to compare outcomes changes in states with and without expansion before and after the ACA Medicaid expansions. Overall, Medicaid expansion was associated with increased healthcare access for 45-64-year-olds, potentially resulting in better healthcare experience. Results indicate effects of the Medicaid expansion on the financial behavior of 45-64-year-olds, with evidence of credit card bills being paid in full, higher banking activities, and better financial preparedness. These findings have important implications for financial regulators and healthcare policymakers.

Current evidence implicates educational pressures and reduced outdoor time as major causes of myopia. This paper examines the ongoing battle against the myopia epidemic in East Asia, including its cultural offshoots such as Singapore, where over 80% of young adults are myopic. East Asian societies share deeply rooted Confucian values that attach great importance to education and familial obligations, with heavy parental investment in education and the perception that academic excellence reflects filial piety. Coupled with a strong emphasis on standardised test results, East Asian children face intense educational pressures from a young age. Existing education-based myopia prevention strategies focus either on top-down school reforms to promote more outdoor time for students during school hours or on bottom-up awareness initiatives encouraging lifestyle changes. However, the entrenched Confucian worldview suggests that more extensive top-down reforms aimed at reducing competition in education, combined with widespread bottom-up awareness initiatives targeting the public-particularly parents, given their active involvement in children's education outside of school-may be required to truly turn the tide on myopia.

Armenia's early adoption of telemedicine began with the National Aeronautics and Space Administration (NASA) collaboration following the 1988 Spitak earthquake, providing critical medical support. The 2022 legalization of telemedicine by the Armenian Ministry of Health marked a significant step toward improving healthcare delivery. Current regulations only apply to doctors and lack clear terminology for different telemedicine interactions, highlighting the need for broader and more inclusive policies. Despite regulatory progress, telemedicine adoption in Armenia faces challenges such as insufficient digital literacy, infrastructure, and integration into medical education and practice.

Health care provider retention is important for mitigating workforce shortages in underserved areas. The National Health Service Corps (NHSC) provides loan repayment for a two or three-year service commitment from clinicians to work in underserved areas. Prior studies have mixed findings as to what influences clinician retention and have focused mainly on individual-level background characteristics. We used measures of NHSC clinicians' work environment during their service experience, in addition to background characteristics, to identify patterns of experiences, and assess whether these patterns were associated with post-service intentions. We observed that technical assistance and job resources were more influential on clinicians' intentions, compared to individual- or community-level characteristics. Organizations with efficient and supportive work environments may help retain clinicians in underserved areas.

HIV criminalization laws may discourage HIV testing. We tested whether California's 2018 HIV criminalization law reform increased the likelihood of past-year HIV testing compared to Nevada, which did not reform its HIV criminalization law. We fitted two difference-in-differences logistic regression models: one for all respondents reporting behaviors that increase the chances of getting or transmitting HIV, and one for male respondents reporting these behaviors. All analyses accounted for the complex survey design of BRFSS. HIV criminalization reform was significantly associated with an increased likelihood of past-year HIV testing. After reform, the predicted marginal probability of past-year HIV testing increased by six percentage points. By comparison, probabilities of a past-year HIV test decreased in Nevada. HIV criminalization law reform may increase the likelihood of getting tested by individuals who engage in behaviors that increase the chances of getting or transmitting HIV.

Regions worldwide experienced uncontrolled COVID-19 outbreaks at different times, leading to increased health concerns yet decreased support for stringent containment measures. We aimed to understand this contradiction by examining the factors influencing attitudes toward COVID-19 containment policies in Hong Kong. Using two waves of panel data collected before and after the 2022 major outbreak N = 1148), we determined that concerns over politicization and economic implications, rather than health concerns, led to a decline in favorable attitudes. The study also revealed that political stance moderated the effect of politicization but not economic concern. Based on these findings, we offer several suggestions for public health institutions to improve public favorability: Institutions should undertake sustained efforts to reduce the politicization of containment policies. Providing economic support measures and detailed explanations to the public can help mitigate concerns. Additionally, institutions should respond more promptly to the public's economic concerns during health crises.

During the COVID-19 pandemic, national policymakers implemented many public health social measures to cease the spread of the disease, while, those interventions also affected population health behaviors, including drinking alcohol. We analyzed national survey data of 7731 respondents to investigate drinking behavioral patterns, as well as measure the strength of association between social measures and alcohol consumption among the Thai populations during the COVID-19 pandemic. We demonstrated that perceptions on temporary suspension of entertainment events and a ban on alcohol sales during the pandemic were significantly associated with alcohol consumption behaviors. Specifically, the negative perceptions of these social measures were associated with the increase of drinking: OR = 1.42; 95% CI = [1.19, 1.69] and OR = 2.50; 95% CI = [2.11, 2.97], respectively. We recommended to assess the long-term effects of targeted social measures on drinking behavior, especially the post pandemic.

In May 2020, New York State restricted the sale of flavored e-liquids, excluding tobacco flavor. We conducted a Web-based survey to assess support and changes in use behavior between July and October 2020 (n = 946), with a follow-up between April and June 2021 (n = 542). Most electronic nicotine delivery system (ENDS) users (n = 82/55) continued to use, with 39%/33% reporting continuing to purchase flavored e-liquids, 20%/32% reporting using tobacco flavor, 5%/6% reporting quitting ENDS and smoking cigarettes, and 8%/3% reporting quitting ENDS and not smoking cigarettes. In 2020, 65% of non-users, 53% of cigarette users, 34% of cigarette/ENDS users, and 18% of ENDS users supported this policy restriction on e-liquids. Similar results were observed in 2021. Many ENDS users continued purchasing flavored e-liquids, suggesting that compliance with the policy can be improved. Cigarette smoking did not appear to increase. Continued evaluation of how restrictions on sales of products influence use is critical to understanding the long-term impact on behavior.