Health Policy
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Item 1998 Consumer Assessment of Health Plans in Delaware(Insitute for Public Administration, 1998-04) Jacobson, Eric D.; Reyes, Raul M.; Ratledge, Edward C.Item 1999 Consumer Assessment of Health Plans in Delaware(Institute for Public Administration, 2000-04) Jacobson, Eric D.; Fan, Weifeng; Gross, Christie R.; Ratledge, Edward C.Item Access to Healthy Food: A Guide for Delaware Local Governments(Institute for Public Administration, 2019-07) Michalowski, Allison; Scott, MarciaWhy are some individuals healthier than others? Social determinants of health—conditions where people live, work, and play—affect a wide range of quality of life outcomes. Poorly designed physical environments, sedentary lifestyles, and inadequate nutrition can all impact a person’s health. Our communities need basic elements to support health equity for all people. These elements include access to nutritious food, a quality education, good jobs, affordable housing, equitable health care, parks and recreation, and dependable transportation. Local governments (i.e., towns, cities, and counties) are recognizing the need to plan for, design, and implement policies to foster healthy and complete communities. Attention has focused on improving the built environment to foster walkable-, bikeable-, and transit-friendly communities; planning to address sprawling land use patterns; and advancing Complete Streets for people of all ages and abilities. Traditionally, food insecurity has been regarded as a public health issue. Recently, local governments have become more attentive to address and incorporate healthy food access as part of local public policy agendas. This guide recognizes the important role that Delaware local governments can play in improving access to healthy food. Comprehensive plans and community design, policies and regulatory tools, and local partnerships are key strategies that can be utilized by Delaware local governments.Item Aging in Community Opportunities for Delaware’s Senior Population: The Significance of Accessible Community Transportation Options(2014-11) O'Hanlon, JuliaAccess to affordable and reliable transportation for the elderly is a concern for many communities, especially in rural areas where service is practically nonexistent. As defined by the National Aging in Place Council (NAPC), aging in place (i.e., aging in community), is “the ability to continue to live in one’s home safely, independently, and comfortably, regardless of age, income, or ability level. It means living in a familiar environment, and being able to participate in family and other community activities (2014).” The World Health Organization (2007) notes that aging in place/community aims to reverse or lesson the decrease in functional capacity that occurs with age. As a comprehensive approach to staying in one’s community/home, aging in place involves a variety of issues facing senior citizens, including housing, finance, health, education, recreation, and transportation.Item Delaware Senior Center Funding Formula(Institute for Public Administration, 2001-09) Jacobson, Eric D.; Moody, Stephanie; Schieffert, Lisa; Gross, ChristieItem Demographics and Profiles of Delaware’s Elderly(Institute for Public Administration, 2005-05) Jacobson, Eric; O'Hanlon, Julia; Condliffe, Simon; Bennett, Carrie; Sloan, MicheleItem Health Policy Issue Brief 3 - Access to Healthy Foods in the Built Environment(2011-10) Jacobson, Eric; O'Hanlon, Julia; Clark, AmyWhile the United States boasts one of the most abundant food supplies in the world, disparities in access, affordability, and quality have continued to plague communities and neighborhoods throughout the country. With millions of Americans without access to healthy foods, the alarming rates of obesity and diet-related diseases will continue to increase. However, it has recently been demonstrated through promising programs and policies that the challenges to increasing access to healthy foods in underserved communities can be resolved. Delaware continues to be involved in the discussion surrounding this important issue and by utilizing the resources available in the online Toolkit (www.ipa.udel.edu/healthyDEtoolkit), those involved are provided the necessary tools to do so. It is hoped that continuing research on the issue will encourage local, state, and national attention and allow policymakers, community leaders, and advocates to explore solutions that address the role that access to healthy foods plays in promoting healthy economies, healthy communities, and healthy people.Item Health Policy Issue Brief 4 - Access to Healthy Foods in the Built Environment(2015-07) Jacobson, Eric; Homsey, Andrew; Pragg, Sarah; Floros, Emily; Stump, Jessica; Clark, Amy; Miller, PattiWhile the United States boasts one of the most abundant food supplies in the world, disparities in access, affordability, and quality of healthy foods have continued to plague communities across the country. Millions of Americans are living without access to healthy foods, and the alarming rates of obesity and dietrelated diseases continue to increase. Nevertheless, many promising practices and policies implemented within diverse communities demonstrate that the challenges to increasing access to healthy foods in underserved communities can be resolved. Continued research on the issue will encourage local, state, and national attention and allow policymakers, community leaders, and advocates to explore solutions that address the role that access to healthy foods plays in promoting healthy economies, healthy communities, and healthy people.Item The Health-Impact Assessment (HIA): A Useful Tool(2011-02) Jacobson, Eric; DeCoursey, William J.; Rosenberg, NatalieThe purpose of this quick guide is to introduce health-impact assessment—an exciting and relatively new analytic approach to planning healthier communities. “How are existing or planned land use, community design, and transportation policies, projects, or programs affecting or likely to affect public’s health?” (NACCHO). Recently endorsed by the nationwide health promotion plan Healthy People 2020, health-impact assessment is one method local communities can use to begin to address this question. In today’s society, media coverage of health topics such as smoking and obesity has become the norm. Issues that used to be thought of as individual problems have grown into public health concerns and are forcing society to rethink how choices made in various sectors affect health. Health-impact assessments (HIAs) are rapidly growing practices within the United States that can help decision-makers outside of the health sector evaluate the potential health effects of proposed projects and policies. An HIA can be defined as “a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population” (1999 Gothenburg consensus statement). It is becoming increasingly clear that many of the things that determine health, disease, or injury lie outside of the traditional health sector. Uncovering these determinants is imperative in restoring the nation’s health. Both revolutionary and surprisingly intuitive, the HIA methodology simply seeks to evaluate public-policy decisions on their likely human outcomes. With the central and sole assumption that peoples’ health, vitality, and longevity ought to guide significant policy decisions, HIAs can be used as a planning tool to confront the social determinants of health amid the growing consensus that there are many social, environmental, and economic factors that affect health. There are vast opportunities for the use of HIAs. They can be used to assess the health impacts of seemingly small plans to those of complex land-development efforts. For example, deciding where to place a playground may seem irrelevant, but the realization that children must cross a busy highway to get there could lead to plan revisions that make access more practical and lead to greater use and physical activity. Decisions made regarding community design, development and policy implementation have the potential to impact the health of surrounding populations. safely than when they have the perception of a “neighborhood expressway.”Item Healthy & Walkable Communities(2007-09-21T18:24:58Z) Lehman, Megan Dively; Boyle, Michelle; DeCoursey, William J.; Mix, TroyThis document is intended to serve as a resource for Delaware municipalities wishing to improve the walkability of their towns and, in so doing, the activity levels and health of their residents. In addition to conducting research, IPA staff and students are working with a handful of Delaware towns to identify a study area. Each study area is jointly walked and assessed with regard to its strengths and deficiencies. Phase one of this project will be completed in June 2007, with each municipality having received a written report with suggested implementation items from IPA. Also, potential sources of funding will be identified. During phase two, and possible subsequent phases, the Healthy/Walkable Communities team will offer continued assistance to the initial set of towns and begin the process with new communities.Item Healthy Communities: A Resource Guide for Delaware Municipalities(2008-08-28T20:07:37Z) Scott, Marcia; Boyle, Michelle; Eckley, Jason; Lehman, Megan Dively; Wolfert, KaitlinWalkable communities result from careful planning and community design that provides active living opportunities. The resource guide shows how improving the walkability of a community can lead to environmental, health, and economic benefits. The guide stresses that community leaders can catalyze changes by communicating a compelling vision, identifying and mobilizing stakeholders, nurturing strategic partnerships, and building consensus. With broad-based participation and support, public policies and plans can be developed and implemented for a pedestrian-friendly community. The guide offers strategic tools to develop these policies and plans, provides tips for writing a funding proposal, and lists technical assistance and funding resources. Finally, the resource guide provides examples of recreation programming to promote awareness and use of pedestrian-friendly infrastructure, showcases examples of walkable municipalities in Delaware, and highlights outcomes of the University of Delaware’s Healthy/Walkable Communities Initiative.Item Healthy Communities: The Comprehensive Plan Assessment Tool(2010-12-22) Beck, ClaireThe Healthy Communities Comprehensive Plan Assessment Tool is a checklist‐based document designed to aid Delaware municipalities in the process of writing comprehensive plans that emphasize planning for and building healthier communities. This tool is intended for use by local government officials, planning commissions, or other individuals involved in writing or updating their community’s comprehensive plan. By focusing on policy initiatives and urban design guidelines that can increase physical activity and encourage healthier lifestyles, the Comprehensive Plan Assessment Tool will ultimately result in comprehensive plans that set the stage for a new era of health‐focused community planning. One goal of this Assessment Tool is to stress that planning for healthy communities is about more than just walkability. There are several elements of community planning and design that contribute to whether or not a particular community fosters healthy lifestyles. Many of these elements are included in the focal item of this document, the Comprehensive Plan Healthy‐ Community Checklist. This checklist provides a user‐friendly format for guidance and review during the comprehensive‐planning process.Item Healthy Communities: The Walkability Assessment Tool(2010-12-22) O'Hanlon, Julia; Scott, JacquelynAs indicated in a number of recent research studies and articles, an increase in moderate physical activity among Americans could substantially improve the nation’s public health. Given Delaware’s current obesity trends, it is important to keep the state’s residents active and engaged. Walking is one of the easiest and cheapest ways to stay physically fit. In addition to keeping residents physically active and healthy, community spaces that promote walking can draw people together safely and provide more opportunities for people of all ages and abilities to stay socially connected and engaged. Local areas with good pedestrian networks can also have substantial economic and environmental benefits to a local area.Item The Impact of Senior Centers and Geriatric Healthcare Policy(Institute for Public Administration, 2004-12) Jacobson, Eric; O'Hanlon, Julia; Bennett, Carrie; McCloskey, SarahItem A Landscape of School-Based Health Centers in Delaware(Institute for Public Administration, 2019-12) Chesser, Margaret CulpepperA school-based health center (SBHC), also referred to as a student wellness center, is a method of healthcare delivery that provides school-aged youth with comprehensive physical, mental, and preventive health services delivered by qualified medical and behavioral providers in a school setting. These health centers are designed to mitigate the barriers to health-care services that students may face, such as lack of transportation, health-care providers, and insurance coverage. It has been well documented that school-based health centers can effectively address such barriers and reduce emergency room visits in school-aged children and adolescents. These wellness centers are cost-beneficial and have the potential to close health disparity gaps between racial groups.3 In Delaware, every public high school has opened a school-based health center and key stakeholders are advocating for the expansion of schoolbased wellness programs to provide care in elementary schools. The following brief will examine the history and role of school-based health centers on a national and a statewide level, the differences between high school health centers and elementary school health centers, the existing model of high school-based health centers in Delaware, and the pilot public elementary school-based health centers, the first of which opened in April 2018.Item Leading Tomorrow’s Senior Centers(Institute for Public Administration, 2009-07) Jacobson, Eric D.; O'Hanlon, Julia; Scott, JacquelynAmerican society has traditionally desired “quick fixes” such as prescription drugs to treat physical and mental health conditions, which may contribute to the one-third of older adults over the age of 65 who lead sedentary lifestyles. However, a growing body of research suggests that disease-prevention approaches and healthier behaviors can offer longer-term societal and economic benefits. Senior centers can enhance individuals’ health-behavior change through preventive approaches and high-quality programs. Given today’s fiscal environment, senior centers may be interested in learning more about economically savvy approaches to promoting healthy lifestyles through community-based programs and services known to prevent the onset of chronic conditions and risk of injury. The participation in health-promoting and disease-preventing programs will further assist older adults in overcoming barriers to mobility and transportation, maintaining independence, and achieving better overall health and well-being.Item Optimizing Services for Delaware’s Seniors: Applying Delaware’s Funding Formula(Institute for Public Administration, 2001-09) Jacobson, Eric D.; Moody, StephanieItem Planning for Age-Friendly Communities: An Assessment of Two Sussex County Communities(Institute for Public Administration, 2019-10) O'Hanlon, JuliaBetween October 2017 and June 2018, a literature review was conducted and meetings with community leaders and stakeholders of two Sussex County communities were hosted to help identify the communities’ capacity to promote aging in place through aging-friendly criteria and domains endorsed by the American Association of Retired Persons (AARP), American Planning Association, Village to Village Network, and other nationally recognized organizations with interests in supporting and planning for communities’ increasing older adult populations.Item The Quality of Health Care in Delaware: What Delawareans Say About Their Healthcare Experience(2005-06-28T16:36:16Z) Jacobson, Eric; Kennedy, Erin; Whitmore, Charles; Ratledge, EdwardThe purpose of this report is to illustrate how Delawareans rate various health care providers and report on their specific experiences with the health care system—presenting summary results from the 2003 Delaware CAHPS study. The CAHPS survey instrument is a useful guide to policymakers seeking to improve both Delaware’s health plans and the health care providers deliver to patients. It is the intent of this report to supply the relevant stakeholders and policymakers with objective, experience-based information regarding the quality of health care provided in Delaware. Equipped with three years of survey data (2001-2003), we generate comparisons of Delaware to national data benchmarks. We also discuss overall ratings and experiences with care within Delaware, health plan enrollment characteristics, and differences across plan types and regions.Item Quality of Health Care in Delaware: What Delawareans Say About Their Health Care Experience, 2002 Delaware CAHPS Notes(Institute for Public Administration, 2003) Jacobson, Eric D.; Whitmore, Charles; McCloskey, Sarah; Ratledge, Edward C.