Open Access Publications

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Open access publications by faculty, postdocs, and graduate students in the Biden School of Public Policy & Administration.


Recent Submissions

Now showing 1 - 5 of 21
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    Understanding the social impacts of power outages in North America: a systematic review
    (Environmental Research Letters, 2023-05-09) Andresen, Adam X.; Kurtz, Liza C.; Hondula, David M.; Meerow, Sara; Gall, Melanie
    As demand for electricity increases on an already strained electrical supply due to urbanization, population growth, and climate change, the likelihood of power outages will also increase. While researchers understand that the number of electrical grid disturbances is increasing, we do not adequately understand how increased power outages will affect a society that has become increasingly dependent on a reliable electric supply. This systematic review aims to understand how power outages have affected society, primarily through health impacts, and identify populations most vulnerable to power outages based on the conclusions from prior studies. Based on search parameters, 762 articles were initially identified, of which only 50 discussed the social impacts of power outages in North America. According to this literature, racial and ethnic minorities, especially Blacks or African Americans, those of lower socioeconomic status, children, older adults, and those living in rural areas experienced more significant impacts from previous power outages. Additionally, criminal activity increased during prolonged power outages with both pro-social and anti-social behaviors observed. Providing financial assistance or resources to replace spoiled goods can reduce crime. Future research on this topic must consider the financial effects of power outages, how power outage impacts seasonally vary, and the different durations of power outage impacts.
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    Association of Area Deprivation With Primary Hypertension Diagnosis Among Youth Medicaid Recipients in Delaware
    (Jama Network Open, 2023-03-15) Baker-Smith, Carissa M.; Yang, Wei; McDuffie, Mary J.; Nescott, Erin P.; Wolf, Bethany J.; Wu, Cathy H.; Zhang, Zugui; Akins, Robert E.
    Key Points: Question: Is there an association between neighborhood measures of deprivation and hypertension diagnosis in youth? Findings: In this cross-sectional study of 65 452 Delaware Medicaid-insured youths aged 8 to 18 years between 2014 and 2019, residence in neighborhoods with a higher area deprivation index was associated with primary hypertension diagnosis. Meaning: These findings suggest that there is an association between greater neighborhood deprivation and a diagnosis of primary hypertension in youths, which may be an important factor to consider in assessing the presence and prevalence of hypertension in youths. Abstract: Importance: The association between degree of neighborhood deprivation and primary hypertension diagnosis in youth remains understudied. Objective: To assess the association between neighborhood measures of deprivation and primary hypertension diagnosis in youth. Design, Setting, and Participants: This cross-sectional study included 65 452 Delaware Medicaid-insured youths aged 8 to 18 years between January 1, 2014, and December 31, 2019. Residence was geocoded by national area deprivation index (ADI). Exposures: Higher area deprivation. Main Outcomes and Measures; The main outcome was primary hypertension diagnosis based on International Classification of Diseases, Ninth Revision and Tenth Revision codes. Data were analyzed between September 1, 2021, and December 31, 2022. Results: A total of 65 452 youths were included in the analysis, including 64 307 (98.3%) without a hypertension diagnosis (30 491 [47%] female and 33 813 [53%] male; mean [SD] age, 12.5 (3.1) years; 12 500 [19%] Hispanic, 25 473 [40%] non-Hispanic Black, 24 565 [38%] non-Hispanic White, and 1769 [3%] other race or ethnicity; 13 029 [20%] with obesity; and 31 548 [49%] with an ADI ≥50) and 1145 (1.7%) with a diagnosis of primary hypertension (mean [SD] age, 13.3 [2.8] years; 464 [41%] female and 681 [59%] male; 271 [24%] Hispanic, 460 [40%] non-Hispanic Black, 396 [35%] non-Hispanic White, and 18 [2%] of other race or ethnicity; 705 [62%] with obesity; and 614 [54%] with an ADI ≥50). The mean (SD) duration of full Medicaid benefit coverage was 61 (16) months for those with a diagnosis of primary hypertension and 46.0 (24.3) months for those without. By multivariable logistic regression, residence within communities with ADI greater than or equal to 50 was associated with 60% greater odds of a hypertension diagnosis (odds ratio [OR], 1.61; 95% CI 1.04-2.51). Older age (OR per year, 1.16; 95%, CI, 1.14-1.18), an obesity diagnosis (OR, 5.16; 95% CI, 4.54-5.85), and longer duration of full Medicaid benefit coverage (OR, 1.03; 95% CI, 1.03-1.04) were associated with greater odds of primary hypertension diagnosis, whereas female sex was associated with lower odds (OR, 0.68; 95%, 0.61-0.77). Model fit including a Medicaid-by-ADI interaction term was significant for the interaction and revealed slightly greater odds of hypertension diagnosis for youths with ADI less than 50 (OR, 1.03; 95% CI, 1.03-1.04) vs ADI ≥50 (OR, 1.02; 95% CI, 1.02-1.03). Race and ethnicity were not associated with primary hypertension diagnosis. Conclusions and Relevance; In this cross-sectional study, higher childhood neighborhood ADI, obesity, age, sex, and duration of Medicaid benefit coverage were associated with a primary hypertension diagnosis in youth. Screening algorithms and national guidelines may consider the importance of ADI when assessing for the presence and prevalence of primary hypertension in youth.
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    Civil society and democratization: The role of service-providing organizations amid closing civic spaces
    (Public Administration and Development, 2023-02-04) Moldavanova, Alisa; Onishi, Tamaki; Toepler, Stefan
    This article argues that current democracy promotion strategies relying on rights-claiming advocacy NGOs are falling short of their democratization goals, as authoritarian regimes are closing the space through restrictions on the NGOs that attempt to carry them out. In response, we suggest a reexamination of earlier approaches to involving civil society in democratization efforts by shifting the focus back on service-providing civil society organizations that have largely become side-lined in democracy-building agendas. Specifically, service providers tend to be more capable of functioning “under the radar” thus contributing to democracy in both direct and indirect ways, and thus escaping closing space restrictions. The key concerns about their independence from the state, as well as under what conditions the state may be less successful in coopting the independent service-providers, however, remain unresolved and warrant future research.
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    Adaptation to compound climate risks: A systematic global stocktake
    (iScience, 2023-02-17) Simpson, Nicholas P.; Williams, Portia Adade; Mach, Katharine J.; Berrang-Ford, Lea; Biesbroek, Robbert; Haasnoot, Marjolijn; Segnon, Alcade C.; Campbell, Donovan; Musah-Surugu, Justice Issah; Joe, Elphin Tom; Nunbogu, Abraham Marshall; Sabour, Salma; Meyer, Andreas L.S.; Andrews, Talbot M.; Singh, Chandni; Siders, A.R.; Lawrence, Judy; van Aalst, Maarten; Trisos, Christopher H.; The Global Adaptation Mapping Initiative Team
    Highlights: • Compound climate impacts are particularly hard to adapt to • Compound vulnerabilities and exposures constrain adaptation capabilities • Inappropriate responses to climate change can lead to maladaptation • Compound impacts can have cascading effects on response options Summary: This article provides a stocktake of the adaptation literature between 2013 and 2019 to better understand how adaptation responses affect risk under the particularly challenging conditions of compound climate events. Across 39 countries, 45 response types to compound hazards display anticipatory (9%), reactive (33%), and maladaptive (41%) characteristics, as well as hard (18%) and soft (68%) limits to adaptation. Low income, food insecurity, and access to institutional resources and finance are the most prominent of 23 vulnerabilities observed to negatively affect responses. Risk for food security, health, livelihoods, and economic outputs are commonly associated risks driving responses. Narrow geographical and sectoral foci of the literature highlight important conceptual, sectoral, and geographic areas for future research to better understand the way responses shape risk. When responses are integrated within climate risk assessment and management, there is greater potential to advance the urgency of response and safeguards for the most vulnerable. Graphical abstract at:
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    Differences in Household Preparedness and Adaptation for COVID-19
    (Disaster Medicine and Public Health Preparedness, 2022-12-07) Clay, Lauren A.; Kendra, James
    Objective: To quantify differences in preparedness for and adaptations to COVID-19 in a cohort sample of New York City residents. Methods: A proportional quota sample (n = 1020) of individuals residing in New York City during the COVID-19 pandemic participated in a Qualtrics web survey. Quotas were set for age, sex, race, and income to mirror the population of New York City based on the 2018 American Community Survey. Results: Low self-efficacy, low social support, and low sense of community increased the odds of securing provisions to prepare for COVID-19. Being an essential worker, poor mental health, and having children in the household reduced the likelihood of engaging in preparedness practices. Essential workers and individuals with probable serious mental illness were less likely to report preparedness planning for the pandemic. Conclusions: The findings contribute to evolving theories of preparedness. There are differences across the sample in preparedness types, and different kinds of preparedness are associated with different household characteristics. Findings suggest that public officials and others concerned with population wellbeing might productively turn attention to education and outreach activities indexed to these characteristics.
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