Early Medicaid Expansions and Drug Overdose Mortality in the USA: a Quasi-experimental Analysis

Purpose – Asset recovery proceedings increasingly target corrupt foreign officials who acquire lavish assets as a result of capital gained through criminal acts. One extremely difficult issue arising in asset recovery proceedings is whether the capital used to acquire the assets can be traced to a criminal act. The purpose of this paper is to critique US tracing procedure through comparative analysis. Design/methodology/approach – A prominent series of cases brought by the USA and France against assets owned by Teodoro “Teodorín” Nguema Obiang, second Vice President of the Republic of Equatorial Guinea, produced mixed results on the tracing element. This paper utilizes a qualitative comparative case analysis to examine the US and French cases. Findings – The US results reflect serious weaknesses in the US law as compared to more effective French asset recovery procedure. Originality/value – Though this paper is certainly a comparative case study analysis, nearly identical facts and two different jurisdictions reaching separate conclusions bring us in the legal community as close as we can realistically come to quasi-experimental research. Comparative research in this area is severely lacking and sorely needed. The mechanisms identified in the French system clearly show flaws that are present in the US system.

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Drug Overdose Trends among Black Indiana Residents: 2013-2017

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v11i1.9916 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Raven Helmick

Keyword(s):

Mortality Rate ◽

Drug Overdose ◽

Rate Increase ◽

Mortality Rates ◽

Time Frame ◽

Minority Population ◽

Racial Inequalities ◽

Specific Mortality ◽

Overdose Mortality ◽

Overdose Deaths

ObjectiveTo understand trends in race-specific mortality rates between blacks and whites to discover any racial inequalities that might exist for drug overdose deaths. To delve into the types of drugs that are prominently involved in black drug overdose deaths from 2013-2017 in the state of Indiana.IntroductionBlack Hoosiers, the largest minority population in Indiana, make up almost 10% of the state’s population, and accounted for 8% of the total resident drug overdose deaths from 2013-2017 compared to whites at 91%. However, a closer look at race-specific mortality rates might reveal racial inequalities. Therefore, the purpose of this project was to analyze drug overdose morality rates among white and black Hoosiers to discover possible racial inequalities and to discover trends in drug involvement in overdose deaths among blacks.MethodsDrug overdose deaths that occurred in Indiana between 2013 and 2017 were identified using the underlying and contributing cause of death ICD-10 codes and abstracted from the Indiana State Department of Health’s annual finalized mortality dataset. Race-specific drug overdose death rates were calculated and compared among racial groups. Drug overdose deaths in blacks were examined for trends over time and by the types of drugs involved.ResultsBetween 2013 and 2017, drug overdose mortality rates for whites increased from 17.05 to 27.28 per 100,000. Blacks saw a higher rate increase during this same time frame: from 10.74 to 30.62 per 100,000, surpassing the mortality rate of whites by the end of 2017. Drug overdose deaths in blacks increased 197% from 2013-2017 and drug specific mortality rate increases were seen across all drug category’s. Opioids, which were involved in 61% of the 2017 drug overdose deaths among blacks, had a rate increase from 3.05 to 18.62 per 100,000 between 2013 and 2017. Drug specific overdose mortality rate increases were also seen for overdoses involving cocaine (1.76 to 10.62 per 100,000), benzodiazepines (0.32 to 3.08 per 100,000), and psychostimulants other than cocaine (0.16 to 1.69 per 100,000) such as amphetamines.ConclusionsWhile white Hoosiers had higher drug overdose mortality rates between 2013 and 2016, black Hoosiers had a greater mortality rate increase and surpassed the mortality rate in whites in 2017. Opioids, the most frequently involved substance in overdose deaths among blacks from 2013-2017, showed increasing rates during this time period. However, increases in drug specific overdose mortality rates for cocaine, benzodiazepines, and psychostimulants other than cocaine also call for public health attention. These results promote the inclusion of minority health experts in drug overdose prevention efforts and issue a call for future prevention efforts to be targeted toward the state’s largest minority population.

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Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns

International Journal of MCH and AIDS (IJMA) ◽

10.21106/ijma.284 ◽

2019 ◽

Vol 8 (2) ◽

pp. 89-100 ◽

Cited By ~ 4

Author(s):

Gopal K Singh ◽

Isaac E. Kim, Jr. ◽

Mehrete Girmay ◽

Chrisp Perry ◽

Gem P. Daus ◽

...

Keyword(s):

Pain Management ◽

Social Determinants ◽

Drug Overdose ◽

The United States ◽

Opioid Epidemic ◽

The Us ◽

Drug Overdoses ◽

Race Ethnicity ◽

Overdose Mortality ◽

Racial Ethnic

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population. Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peerreviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018. Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities. Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioidepidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction. Key words: â€¢ Opioids â€¢ Drug overdose â€¢ Mortality â€¢ Pain management â€¢ Treatment â€¢ Race/Ethnicity â€¢ Social determinants â€¢ Health disparities Copyright Â© 2019 Singh et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effectiveness of culturally adapted Strengthening Families Programme 6-11 years among Portuguese families

Journal of Children s Services ◽

10.1108/jcs-02-2014-0010 ◽

2015 ◽

Vol 10 (2) ◽

pp. 151-160 ◽

Cited By ~ 1

Author(s):

Cátia C. A. Magalhães ◽

Karol L. Kumpfer

Keyword(s):

Cultural Adaptation ◽

Family Intervention ◽

International Norms ◽

Effect Sizes ◽

Content Type ◽

Culturally Adapted ◽

Quasi Experimental ◽

The Usa ◽

Equivalent Control ◽

Strengthening Families

Purpose – The purpose of this paper is to compare the outcomes from the Portuguese Strengthening Families Programme (SFP) with those from other countries to see if they are equally effective despite the new context. SFP was selected for cultural adaptation because comparative effectiveness reviews find that SFP is the most effective parenting and family intervention (Foxcroft et al., 2003, 2012). Standardised cultural adaptations of SFP have resulted in successful outcomes in 35 countries. Design/methodology/approach – The outcomes for the SFP six to 11 years Portuguese families (n=41) were compared to the SFP six to 11 years international norms (n=1,600) using a quasi-experimental, non-equivalent control two group pre- and post-test design. A 2×2 ANOVA generated the outcome tables including p-values and Cohen’s d effect sizes. Standardised test scales were used and measured 21 parenting, family and child risk and protective factors. Findings – Statistically significant positive results (p < 0.05) were found for 16 or 76.2 per cent of the 21 outcomes measured for Portuguese families. The Portuguese effect sizes were similar to the SFP international norms for improvements in the five parenting scales (d=0.61 vs 0.65), five family scales (d=0.68 vs 0.70) and seven children’s scales (d=0.48 vs 0.48) despite these norms having larger effect sizes than the USA norms. Hence, the cultural adaptation did not diminish the outcomes and SFP Portuguese families can benefit substantially from SFP participation. Originality/value – A Portuguese culturally adapted version of SFP had never been developed or evaluated; hence, this paper reports original findings.

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Changes in social vulnerability to flooding: a quasi-experimental analysis

Natural Hazards ◽

10.1007/s11069-021-05145-2 ◽

2022 ◽

Author(s):

J. Connor Darlington ◽

Niko Yiannakoulias ◽

Amin Elshorbagy

Keyword(s):

Experimental Analysis ◽

Social Vulnerability ◽

Quasi Experimental

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A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths

Journal of General Internal Medicine ◽

10.1007/s11606-020-05641-4 ◽

2020 ◽

Vol 35 (6) ◽

pp. 1709-1714 ◽

Cited By ~ 1

Author(s):

Jennifer M. Boggs ◽

Arne Beck ◽

Debra P. Ritzwoller ◽

Catherine Battaglia ◽

Heather D. Anderson ◽

...

Keyword(s):

Experimental Analysis ◽

Suicide Attempts ◽

Quasi Experimental ◽

Lethal Means

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Out-of-pocket spending and financial burden among low income adults after Medicaid expansions in the United States: quasi-experimental difference-in-difference study

BMJ ◽

10.1136/bmj.m40 ◽

2020 ◽

pp. m40 ◽

Cited By ~ 8

Author(s):

Hiroshi Gotanda ◽

Ashish K Jha ◽

Gerald F Kominski ◽

Yusuke Tsugawa

Keyword(s):

United States ◽

Affordable Care Act ◽

Low Income ◽

Financial Burden ◽

Healthcare Spending ◽

Difference In Difference ◽

Quasi Experimental ◽

Premium Contributions ◽

Medicaid Expansions ◽

Experimental Difference

Abstract Objective To examine the association between expansion of the Medicaid program under the Affordable Care Act and changes in healthcare spending among low income adults during the first four years of the policy implementation (2014-17). Design Quasi-experimental difference-in-difference analysis to examine out-of-pocket spending and financial burden among low income adults after Medicaid expansions. Setting United States. Participants A nationally representative sample of individuals aged 19-64 years, with family incomes below 138% of the federal poverty level, from the 2010-17 Medical Expenditure Panel Survey. Main outcomes and measures Four annual healthcare spending outcomes: out-of-pocket spending; premium contributions; out-of-pocket plus premium spending; and catastrophic financial burden (defined as out-of-pocket plus premium spending exceeding 40% of post-subsistence income). P values were adjusted for multiple comparisons. Results 37 819 adults were included in the study. Healthcare spending did not change in the first two years, but Medicaid expansions were associated with lower out-of-pocket spending (adjusted percentage change −28.0% (95% confidence interval −38.4% to −15.8%); adjusted absolute change −$122 (£93; €110); adjusted P<0.001), lower out-of-pocket plus premium spending (−29.0% (−40.5% to −15.3%); −$442; adjusted P<0.001), and lower probability of experiencing a catastrophic financial burden (adjusted percentage point change −4.7 (−7.9 to −1.4); adjusted P=0.01) in years three to four. No evidence was found to indicate that premium contributions changed after the Medicaid expansions. Conclusion Medicaid expansions under the Affordable Care Act were associated with lower out-of-pocket spending and a lower likelihood of catastrophic financial burden for low income adults in the third and fourth years of the act’s implementation. These findings suggest that the act has been successful nationally in improving financial risk protection against medical bills among low income adults.

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