scholarly journals COVID-19 Policy Differences across US States: Shutdowns, Reopening, and Mask Mandates

2020 ◽  
Vol 17 (24) ◽  
pp. 9520
Author(s):  
Xue Zhang ◽  
Mildred E. Warner
Keyword(s):  
Growth Rate ◽  
Health Insurance ◽  
Low Income ◽  
Minority Groups ◽  
State Level ◽  
State Governments ◽  
Access To Health ◽  
Short Period ◽  
The Us ◽  
The Impact

This work used event study to examine the impact of three policies (shutdowns, reopening, and mask mandates) on changes in the daily COVID-19 infection growth rate at the state level in the US (February through August 2020). The results show the importance of early intervention: shutdowns and mask mandates reduced the COVID-19 infection growth rate immediately after being imposed statewide. Over the longer term, mask mandates had a larger effect on flattening the curve than shutdowns. The increase in the daily infection growth rate pushed state governments to shut down, but reopening led to significant increases in new cases 21 days afterward. The results suggest a dynamic social distancing approach: a shutdown for a short period followed by reopening, combined with universal mask wearing. We also found that the COVID-19 growth rate increased in states with higher percentages of essential workers (during reopening) and higher percentages of minorities (during the mask mandate period). Health insurance access for low-income workers (via Medicaid expansion) helped to reduce COVID-19 cases in the reopening model. The implications for public health show the importance of access to health insurance and mask mandates to protect low-income essential workers, but minority groups still face a higher risk of infection during the pandemic.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

scholarly journals The Impact of Policy Measures on Human Mobility, COVID-19 Cases, and Mortality in the US: A Spatiotemporal Perspective

2021 ◽  
Vol 18 (3) ◽  
pp. 996
Author(s):  
Yun Li ◽  
Moming Li ◽  
Megan Rice ◽  
Haoyuan Zhang ◽  
Dexuan Sha ◽  
...  
Keyword(s):  
Growth Rate ◽  
Human Mobility ◽  
Public Information ◽  
Key Factors ◽  
Information Campaigns ◽  
Rapid Spread ◽  
The Us ◽  
Policy Measures ◽  
The Impact ◽  
At Home

Social distancing policies have been regarded as effective in containing the rapid spread of COVID-19. However, there is a limited understanding of policy effectiveness from a spatiotemporal perspective. This study integrates geographical, demographical, and other key factors into a regression-based event study framework, to assess the effectiveness of seven major policies on human mobility and COVID-19 case growth rates, with a spatiotemporal emphasis. Our results demonstrate that stay-at-home orders, workplace closures, and public information campaigns were effective in decreasing the confirmed case growth rate. For stay-at-home orders and workplace closures, these changes were associated with significant decreases (p < 0.05) in mobility. Public information campaigns did not see these same mobility trends, but the growth rate still decreased significantly in all analysis periods (p < 0.01). Stay-at-home orders and international/national travel controls had limited mitigation effects on the death case growth rate (p < 0.1). The relationships between policies, mobility, and epidemiological metrics allowed us to evaluate the effectiveness of each policy and gave us insight into the spatiotemporal patterns and mechanisms by which these measures work. Our analysis will provide policymakers with better knowledge regarding the effectiveness of measures in space–time disaggregation.

Environmental Health

2019 ◽  
pp. 363-386
Author(s):  
Barry S. Levy
Keyword(s):  
Environmental Health ◽  
Global Climate Change ◽  
Low Income ◽  
Minority Groups ◽  
Global Climate ◽  
Social Injustice ◽  
Marginalized Populations ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact

This chapter describes the adverse impact of social injustice on environmental health. Environmental pollution is a social injustice for all people, with a disproportionate impact on low- and middle-income countries and, within countries, low-income people, minority groups, and other marginalized populations. The chapter describes the evolution of the environmental justice movement and the studies that have demonstrated disproportionate exposures and the disproportionate occurrence of pollution-related diseases among low-income people, minority groups, and other marginalized populations. A separate section describes the environmental and health consequences of global climate change. Three text boxes focus on childhood lead poisoning, the impact of natural disasters on social justice, and on the new interdiscipilinary field of planetary health.

Resisting Openness

2020 ◽  
pp. 51-90
Author(s):  
Christian Freudlsperger
Keyword(s):  
Trade Liberalization ◽  
Historical Development ◽  
State Governments ◽  
Best Value ◽  
Short Period ◽  
The Us ◽  
Canadian Provinces ◽  
Run Up ◽  
Municipal Level ◽  
The Eu

The third chapter of Trade Policy in Multilevel Government introduces the field of procurement as a hard case of trade liberalization. Contracting in line with the principle of ‘best value for money’ curtails public actors’ ability to rely on procurement as a directed means of redistribution. Nevertheless, this principle has served as the rallying cry of an international regime of procurement liberalization that has gradually evolved since the 1970s and whose historical development is described here. In a second step, the chapter elaborates on the patterns of openness and resistance to procurement liberalization among the three multilevel polities chosen for analysis. Over the entire period of observation, the US states’ openness has been comparatively low. Intermittently, their resistance had decreased in the run-up to the 1994 GPA. In recent years, however, the number of states willing to be bound by international procurement disciplines plummeted to virtually zero. As for the Canadian provinces and territories, the picture shifted in recent years. Especially in the negotiations on CETA, they permitted the EU wholesale access to their procurement markets. Within a short period, the Canadian provinces’ position on international procurement liberalization thus witnessed a veritable sea change. Finally, in the EU case, openness on part of member state governments has consistently proved highest among the three cases. Already within the scope of the 1979 GATT Code, all EC members’ central procurement was covered, albeit modestly. In the 1994 GPA and its 2012 revision, the EU covered its procurement on the national, regional, and municipal level.

Taking Social Cohesion to Task: Perceptions of Transgender Military Inclusion and Concepts of Cohesion

2019 ◽  
Author(s):  
Jennifer Spindel ◽  
Robert Ralston
Keyword(s):  
Political Ideology ◽  
General Public ◽  
Minority Groups ◽  
Us Military ◽  
The Us ◽  
Elite Level ◽  
Unit Effectiveness ◽  
Original Survey ◽  
The Impact ◽  
Unit Cohesion

Abstract Recent political debates over the inclusion of transgender servicemembers in the US military center around the impact such inclusion will have on unit cohesion and effectiveness. Missing from the debate, however, are the perceptions of those who do the soldiering. What are their perceptions of cohesion? Do they, like political leaders and the general public, believe unit cohesion leads to military effectiveness? In other words, how much does the narrative at the elite level—that insists excluding minority groups is a military necessity—match the perceptions of those who serve? Drawing on an original survey of 151 current and former members of the US military, our results suggest that servicemembers’ perceptions mirror those in the general public: political ideology is correlated with beliefs that minority groups disrupt unit cohesion. We find that conservatives are more likely to believe that the inclusion of transgender soldiers will negatively impact cohesion and undermine unit effectiveness. Moreover, conservatives are more likely to endorse a conceptualization of cohesion that hinges on the social—“people like me” or “band of brothers”—dynamics of cohesion rather than more professional, task-oriented conceptions of cohesion. However, military experience affects these perceptions: respondents with combat experience, who held/hold a higher rank, and who are currently serving are more likely to endorse a task-based conception of cohesion that ties cohesion to professionalism and competence, rather than social identity.

scholarly journals Catastrophic health expenditure incidence and its equity in China: a study on the initial implementation of the medical insurance integration system

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Huan Liu ◽  
Hong Zhu ◽  
Jiahui Wang ◽  
Xinye Qi ◽  
Miaomiao Zhao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Low Income ◽  
Health Expenditure ◽  
Concentration Index ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Integration System ◽  
Integration Policies ◽  
The Impact

Abstract Background By 2013, several regions in China had introduced health insurance integration policies. However, few studies addressed the impact of medical insurance integration in China. This study investigates the catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated and non-integrated areas in China in 2013. Methods The primary data are drawn from the fifth China National Health Services Survey in 2013. The final sample comprises 19,788 households (38.4%) from integrated areas and 31,797 households (61.6%) from non-integrated areas. A probit model is employed to decompose inequality in the incidence of catastrophic health expenditure in line with the methodology used for decomposing the concentration index. Results The incidence of catastrophic health expenditure in integrated areas is higher than in non-integrated areas (13.87% vs. 13.68%, respectively). The concentration index in integrated areas and non-integrated areas is − 0.071 and − 0.073, respectively. Average household out-of-pocket health expenditure and average capacity to pay in integrated areas are higher than those in non-integrated areas. However, households in integrated areas have lower share of out-of-pocket expenditures in the capacity to pay than households in non-integrated areas. The majority of the observed inequalities in catastrophic health expenditure can be explained by differences in the health insurance and householders’ educational attainment both in integrated areas and non-integrated areas. Conclusions The medical insurance integration system in China is still at the exploratory stage; hence, its effects are of limited significance, even though the positive impact of this system on low-income residents is confirmed. Moreover, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and use of health services significantly affect the equity of catastrophic health expenditure incidence and are key issues in the implementation of future insurance integration policies.

scholarly journals The impact of a federal cigarette minimum pack price policy on cigarette use in the USA

2017 ◽  
Vol 27 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Nathan J Doogan ◽  
Mary Ellen Wewers ◽  
Micah Berman
Keyword(s):  
State Level ◽  
Price Policy ◽  
Potential Effect ◽  
Cigarette Use ◽  
Level Data ◽  
The Us ◽  
Minimum Price ◽  
The Status ◽  
The Usa ◽  
The Impact

BackgroundIncreasing cigarette prices reduce cigarette use. The US Food and Drug Administration has the authority to regulate the sale and promotion—and therefore the price—of tobacco products.ObjectiveTo examine the potential effect of federal minimum price regulation on the sales of cigarettes in the USA.MethodWe used yearly state-level data from the Tax Burden on Tobacco and other sources to model per capita cigarette sales as a function of price. We used the fitted model to compare the status quo sales with counterfactual scenarios in which a federal minimum price was set. The minimum price scenarios ranged from $0 to $12.ResultsThe estimated price effect in our model was comparable with that found in the literature. Our counterfactual analyses suggested that the impact of a minimum price requirement could range from a minimal effect at the $4 level to a reduction of 5.7 billion packs sold per year and 10 million smokers at the $10 level.ConclusionA federal minimum price policy has the potential to greatly benefit tobacco control and public health by uniformly increasing the price of cigarettes and by eliminating many price-reducing strategies currently available to both sellers and consumers.

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