Transitioning to Fixed-Route Services

1998 ◽  
Vol 1623 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Carol R. Denson
Keyword(s):  
United States ◽  
Americans With Disabilities Act ◽  
Safety Net ◽  
The United States ◽  
Transportation Systems ◽  
Good News ◽  
Core Group ◽  
Know How ◽  
Special Services ◽  
The Cost

By 2002, it is expected that all fixed-route transportation systems in the United States will be accessible to people with disabilities. This is heralded as good news for riders who have been limited to traveling via special services (i.e., paratransit) and transit providers concerned with the cost of such services. Such optimism assumes—perhaps erroneously—that many riders will shift from paratransit to the newly accessible fixed-route systems. A survey was conducted that reveals that riders are generally satisfied with the service they receive and—despite imminent accessibility—are not eager to switch. The paratransit service, which the Americans with Disabilities Act (1990) regards as a “safety net” for those unable to use fixed-route transit, has become the primary mode of public transport for significant portions of its ridership. However, a core group of riders appears to be interested in changing, which, coupled with the finding that almost none of the survey respondents had received any form of travel training, suggests that there is cause for measured optimism. In addition to training, accessibility must be considered in systemic terms, built on the requirements that riders know how to use the fixed-route system and can get to and from buses, they believe they are welcome in the system, and they understand the costs and consequences of using paratransit. These results are achievable by educating riders, transit staff, and the general public. In addition, there needs to be informed manipulation of fixed routes.

scholarly journals The Trade and Environment Debate: Relevant for Southern Agriculture?

1994 ◽  
Vol 26 (1) ◽  
pp. 108-128 ◽  
Author(s):  
Mary A. Marchant ◽  
Nicole Ballenger
Keyword(s):  
United States ◽  
The United States ◽  
Environmental Standards ◽  
Trade And Environment ◽  
Agricultural Producers ◽  
International Debate ◽  
Policy Issues ◽  
Environment Policy ◽  
Know How ◽  
Trade Measures

AbstractThis paper introduces and briefly discusses the economics of two important trade and environment policy issues--international harmonization of environmental standards and the use of trade measures for environmental purposes. Both issues are likely to generate lively international debate among environmentalists, industry representatives, and trade negotiators over the next few years. As the international community seeks new multilateral rules in these areas, agricultural producers will want to know how they will be affected. Thus, this paper also examines the potential impacts of environmental policy on the competitiveness of commodities unique to the Southern region of the United States.

scholarly journals Home food procurement impacts food security and diet quality during COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meredith T. Niles ◽  
Kristen Brassard Wirkkala ◽  
Emily H. Belarmino ◽  
Farryl Bertmann
Keyword(s):  
United States ◽  
Food Security ◽  
Diet Quality ◽  
Technical Assistance ◽  
Safety Net ◽  
The United States ◽  
Dietary Quality ◽  
Home Food ◽  
Food Procurement ◽  
Food Insecure Households

Abstract Background Home food procurement (HFP) (i.e. gardening, fishing, foraging, hunting, backyard livestock and canning) have historically been important ways that people obtain food. Recently, some HFP activities have grown (e.g. gardening), while other activities (e.g. hunting) have become less common in the United States. Anecdotally, COVID-19 has sparked an increase in HFP evidenced by increased hunting licenses and shortages in seeds and canning supplies. HFP may have positive benefits for food security and diet quality, though research beyond gardening is especially limited in high-income countries. Methods We examine HFP activities since the COVID-19 pandemic began, and their relationship to food security and dietary quality using multivariable logit models and matching analysis with a statewide representative survey (n = 600) of residents of Vermont, United States. Results We find 29% of respondent households classified as food insecure since COVID-19, and higher prevalence of food insecurity among those experiencing a negative job change since COVID-19, households earning less than $50,000 annually, Hispanic and multi-race respondents. Nearly 35% of respondents engaged in HFP activities since the COVID-19 pandemic began; the majority of those gardened, and more than half pursued HFP activities more intensely than before the pandemic or for the first time. Food insecure households were more likely to pursue HFP more intensely, including more gardening, fishing, foraging, and hunting. Respondents who were food insecure, Black, Indigenous, People of Color, those with a negative job disruption, and larger households all had greater odds of increased intensity of HFP during the COVID-19 pandemic. HFP was significantly associated with eating greater amounts of fruits and vegetables; however, this effect was only significant for food secure households. Conclusion Overall, these results suggest that HFP activities have increased since the start of the COVID-19 pandemic, and may be an important safety net for food insecure households. However, HFP for food insecure households does not translate into the same higher fruit and vegetable intake as found among food secure HFP households, suggesting this population may be trying to maintain intake, or that they may have potential important resource or technical assistance needs. Long-term, HFP activities may have important food security and diet quality impacts, as well as conservation implications, which should be more thoroughly explored. Regardless, the increased interest and intensity of HFP demonstrates opportunities for educational and outreach efforts.

scholarly journals 1665. Using Electronic Health Records to Describe TB in Community Health Settings: a Cohort Analysis in a Large Safety-Net Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S819-S820
Author(s):  
Jonathan Todd ◽  
Jon Puro ◽  
Matthew Jones ◽  
Jee Oakley ◽  
Laura A Vonnahme ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Electronic Health Records ◽  
Safety Net ◽  
The United States ◽  
Research Network ◽  
Health Records ◽  
Treatment Regimens ◽  
Data Source ◽  
Electronic Health

Abstract Background Over 80% of tuberculosis (TB) cases in the United States are attributed to reactivation of latent TB infection (LTBI). Eliminating TB in the United States requires expanding identification and treatment of LTBI. Centralized electronic health records (EHRs) are an unexplored data source to identify persons with LTBI. We explored EHR data to evaluate TB and LTBI screening and diagnoses within OCHIN, Inc., a U.S. practice-based research network with a high proportion of Federally Qualified Health Centers. Methods From the EHRs of patients who had an encounter at an OCHIN member clinic between January 1, 2012 and December 31, 2016, we extracted demographic variables, TB risk factors, TB screening tests, International Classification of Diseases (ICD) 9 and 10 codes, and treatment regimens. Based on test results, ICD codes, and treatment regimens, we developed a novel algorithm to classify patient records into LTBI categories: definite, probable or possible. We used multivariable logistic regression, with a referent group of all cohort patients not classified as having LTBI or TB, to identify associations between TB risk factors and LTBI. Results Among 2,190,686 patients, 6.9% (n=151,195) had a TB screening test; among those, 8% tested positive. Non-U.S. –born or non-English–speaking persons comprised 24% of our cohort; 11% were tested for TB infection, and 14% had a positive test. Risk factors in the multivariable model significantly associated with being classified as having LTBI included preferring non-English language (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 4.09–4.32); non-Hispanic Asian (aOR 5.17, 95% CI 4.94–5.40), non-Hispanic black (aOR 3.02, 95% CI 2.91–3.13), or Native Hawaiian/other Pacific Islander (aOR 3.35, 95% CI 2.92–3.84) race; and HIV infection (aOR 3.09, 95% CI 2.84–3.35). Conclusion This study demonstrates the utility of EHR data for understanding TB screening practices and as an important data source that can be used to enhance public health surveillance of LTBI prevalence. Increasing screening among high-risk populations remains an important step toward eliminating TB in the United States. These results underscore the importance of offering TB screening in non-U.S.–born populations. Disclosures All Authors: No reported disclosures

scholarly journals Decline in Marriage Associated with the COVID-19 Pandemic in the United States

2020 ◽  
Vol 6 ◽  
pp. 237802312098032
Author(s):  
Brandon G. Wagner ◽  
Kate H. Choi ◽  
Philip N. Cohen
Keyword(s):  
United States ◽  
The United States ◽  
Cumulative Number ◽  
Short Term ◽  
Know How ◽  
The Social ◽  
Reporting Delays ◽  
Social Upheaval ◽  
Near Future ◽  
Do So

In the social upheaval arising from the coronavirus disease 2019 (COVID-19) pandemic, we do not yet know how union formation, particularly marriage, has been affected. Using administration records—marriage certificates and applications—gathered from settings representing a variety of COVID-19 experiences in the United States, the authors compare counts of recorded marriages in 2020 against those from the same period in 2019. There is a dramatic decrease in year-to-date cumulative marriages in 2020 compared with 2019 in each case. Similar patterns are observed for the Seattle metropolitan area when analyzing the cumulative number of marriage applications, a leading indicator of marriages in the near future. Year-to-date declines in marriage are unlikely to be due solely to closure of government agencies that administer marriage certification or reporting delays. Together, these findings suggest that marriage has declined during the COVID-19 outbreak and may continue to do so, at least in the short term.

scholarly journals SWK-11. ASSESSMENT OF THE INDIRECT COSTS ASSOCIATED WITH PROTON THERAPY TREATMENT FOR ALBERTA PATIENTS REFERRED OUT OF COUNTRY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel
Keyword(s):  
United States ◽  
Proton Therapy ◽  
Malignant Tumors ◽  
Indirect Costs ◽  
The United States ◽  
Current Data ◽  
Opportunity Costs ◽  
Proton Treatment ◽  
Out Of Pocket Expenses ◽  
The Cost

Abstract BACKGROUND Proton therapy for benign and malignant tumors has dosimetric and clinical advantages over photon therapy. Patients in Alberta, Canada are referred to the United States for proton treatment. The Alberta Heath Care Insurance Plan (AHCIP) pays for the proton treatment and the cost of flights to and from the United States (direct costs). This study aimed to determine the out-of-pocket expenses incurred by patients or their families (indirect costs). METHODS Invitation letters linked to an electronic survey were mailed to patients treated with protons between 2008 and 2018. Expenses for flights for other family members, accommodations, transportation, food, passports, insurance, and opportunity costs including lost wages and productivity were measured. RESULTS Fifty-nine invitation letters were mailed. Seventeen surveys were completed (28.8% response rate). One paper survey was mailed at participant request. Nine respondents were from parent/guardian, 8 from patients. All patients were accompanied to the US by a family member/friend. Considerable variability in costs and reimbursements were reported. Many of the accompanying family/friends had to miss work; only 3 patients themselves reported missed work. Time away from work varied, and varied as to whether it was paid or unpaid time off. CONCLUSIONS Respondents incurred indirect monetary and opportunity costs which were not covered by AHCIP when traveling out of country for proton therapy. Prospective studies could help provide current data minimizing recall bias. These data may be helpful for administrators in assessing the societal cost of out-of-country referral of patients for proton therapy.

Physical therapy research and researchers in the United States: good news and bad news

1997 ◽  
Vol 2 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Lynn Snyder-Mackler ◽  
Stuart Binder-Macleod ◽  
Paul F. Mettler
Keyword(s):  
United States ◽  
Physical Therapy ◽  
The United States ◽  
Bad News ◽  
Good News

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

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