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CHAS e-newsletter provides policy briefs, service innovations, upcoming events and opportunities for health policy and services researchers at the University of Chicago.
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THE UNIVERSITY OF CHICAGO
School of Social Service Administration
CHAS eNews: June 2016
POLICY BRIEFS
A Taxonomy of Health Disparities Interventions Helps Move Research and Practice Forward
Racial and ethnic health disparities have been a research priority for over three decades; nonetheless, as CHAS Fellow, Marshall Chin (Department of Medicine) and colleagues note: “[t]here remains a critical need for evidence-based interventions that improve outcomes for minority patients.”  To advance this cause, Chin and colleagues developed a taxonomy of disparities interventions based on a comprehensive, systematic review of studies published since 1979.  The taxonomy provides an important tool for organizing and evaluating the disparities literature in terms of “tactics,” “strategies,” and “levels,” and yields a number of important findings, including that the majority of interventions have been targeted at educating patients, rather than changing provider behavior or systems.  As Chin and colleagues note: “Although patient education is critical, alone it may be insufficient to address the complex, systemic issues causing disparities in health care.”  Based on this and other findings, Chin and colleagues issue a series of recommendations, providing a critical platform for moving disparities research forward.  The taxonomy is also available as a searchable, online database, for use by practitioners, policymakers, and others.  For more, please see: Clarke, A. R., Goddu, A. P., Nocon, R. S., Stock, N. W., Chyr, L. C., Akuoko, J. A., & Chin, M. H. (2013). Thirty Years of Disparities Intervention Research: What Are We Doing to Close Racial and Ethnic Gaps in Health Care? Medical Care, 51(11).
Neighborhood-Level Foreclosure Rates Increase Risk for Depression Among Older Adults
CHAS Fellow Kate Cagney (Sociology) and colleagues shed new light on the importance of economic and neighborhood-level risk factors for depression in older adults.  The study, which links data from two waves of the National Social Life, Health, and Aging Project, with zip-code level foreclosure rates from the 2007-2009 Great Recession, finds neighborhood-level foreclosure rates to be a significant predictor of depression in older adults. As the authors report: “For all 3 stages of the foreclosure process, residing in an area that underwent an increase in the percentage of housing stock foreclosed increased the risk of developing significant depressive symptoms.”  As the first study of its kind, the findings have important implications, highlighting the mental health costs of the recent economic downturn, as well as pointing to neighborhood economic-context as a key risk factor for depression in older adults.  More details related to this brief can be found at: Cagney KA, Browning CR, Iveniuk J, and English N.  (2014).  The Onset of Depression During the Great Recession: Foreclosure and Older Adult Mental HealthAmerican Journal of Public Health, 104 (3): 498-505.  
California’s Early Expansion Under the ACA Significantly Increased Coverage for Low-Income Adults, Especially Latinos
California is one of a handful of states that pursued the ACA’s “early expansion” option, which gave states the flexibility to expand their Medicaid programs prior to 2014.  Much effort has gone into understanding the experience of early expansion states, but California is an especially salient case, given the size and diversity of its population, and its optional county-level implementation.  In a recent study, CHAS Fellow Kao-Ping Chua (Department of Medicine) and colleagues use data from the American Community Survey (ACS) to compare coverage changes in California’s early expansion versus nonexpansion counties.  Compared to nonexpansion counties, they find a significant increase in public coverage in expansion counties, especially among Latinos, a decrease in uninsurance rates, positive spillover effects on children, and no evidence of crowd-out for private insurance.  Despite these gains, they note that significant coverage gaps remained, indicating the need for ongoing research, particularly substate and subgroup analysis, for which, they argue, the ACS represents an especially useful datasource.   Find more research details in the original article:  Sommers, B. D., Chua, K.-P., Kenney, G. M., Long, S. K. and McMorrow, S. (2015), California's Early Coverage Expansion Under the Affordable Care Act: A County-Level Analysis. Health Services Research.
Perceived Family And Teacher Support Mitigate the Effects of Exposure to Community Violence Among Palestinian Youth
Numerous studies have documented the effects of the Arab-Israeli conflict and associated violence on Palestinian youth, but few have considered how nonpolitical community violence—a construct studied extensively in other contexts—may also be taking a toll. CHAS Fellow Neil Guterman (SSA) and colleagues help fill this gap.  Drawing from a sample of 1,930 Palestinian youth, and utilizing multiple methods, including Structural Equation Modeling, Guterman and colleagues find that Palestinian youth are exposed to community violence at rates similar to other populations, and that this exposure is predictive of PTSD symptoms.  However, they also find that perceived family and teacher support mitigate this effect, with gender, age, and socidemographic factors also playing a role. The study highlights the importance of addressing the effects of community—not just political—violence on Palestinian youth and suggests that, as in other contexts, exposure to community violence is a critical issue affecting adolescent development, and that family and teacher support may play a key protective role.  To see more details on this research, please refer to: Leshem, B., Haj-Yahia, M., & Guterman, N. (2016). The Role of Family and Teacher Support in Post-traumatic Stress Symptoms Among Palestinian Adolescents Exposed to Community Violence. Journal Of Child & Family Studies, 25(2), 488-502.
ANNOUNCEMENTS
 
UChicago CHAS Partners With Sciences Po’s LIEP for Workshop Series on Health Innovation and Reform in US and France
The first workshop was held at the University of Chicago's Center in Paris from May 26-27, 2016.  CHAS participants included Deb Gorman-Smith, Colleen GroganJeanne C. Marsh and Harold Pollack.  Other US participants were prior Michael M. Davis lecturer John Brekke (University of Southern California) and Fred Ssewamala and Constance A. Nathanson, both of Columbia University.  Look for workshop outcomes to be posted to the CHAS workshops webpage soon.
 
CHAS Stakeholders Trying to Eliminate HIV in Chicago
Several CHAS Executive Committee members, CHAS Fellows and CHAS Seed grant awardees have been actively engaged in a large-scale federally funded program to apply elimination approaches to the HIV epidemic.  The Chicago Center for HIV Elimination (CCHE) utilizes "social, sexual and other risk networks to identify 1) pathways of HIV transmission; 2) how behavior and influence are transmitted through these same networks; and 3) how these networks can be leveraged for integrated  prevention interventions that utilize existing strategies fitted to context, network and community."  As Director of the CCHE, CHAS Fellow, John Schneider (Department of Medicine) researches and implements methods for employing existing social networks to prevent new HIV transmission events. SSA Faculty member and CHAS Fellow Alida Bouris, is a Co-Director for the CCHE, where she develops family-based interventions to prevent the spread of HIV and STIs in Latino and African American young men. SSA Faculty member and CHAS Fellow Dexter Voisin, is a Co-Director for the CCHE, where he examines the negative impact of community violence on social and health outcomes including the spread of HIV.   Other CHAS personnel actively involved with the CCHE include CHAS Executive Committee member Harold Pollack (SSA) and CHAS Seed grant awardee Brandon Hill (Ci3). For more information on CCHE developments, please refer to their website.
UPCOMING EVENTS

Michael Davis
Lecture Series:


Will resume Fall 2016 and Spring 2017
Location: SSA
Time: Tuesdays, 12:00pm


Big Data in Health Workshop:
August 2016 (TBA)


Social Work and the ACA:
November 2016 (TBA)


 
CONFERENCE REMINDERS


Addiction Health Services Research (AHSR 2016)
Seattle, WA
October 13-15, 2016
 

Society for Social Work and Research
New Orleans, LA
January 11-15, 2017


Academy Health Annual Research Meeting
New Orleans, LA
June 25-27, 2017


American Public Health Association
Atlanta, GA
November 4-8, 2017

 
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