As the world struggles with the rapidly evolving pandemic of novel coronavirus disease (COVID-19), evidence and experience suggest that low-income and marginalized communities in our global society will bear the biggest impact. Weknow this because, with our colleagues in Boston, Haiti, Uganda, and Sierra Leone, we have worked in under-resourced, overstretched, and overwhelmed health systems for our whole careers. We know we will see the devastating impact of this pandemic on those who are already marginalized; COVID-19 will amplify existing inequities, and we must act swiftly to leave no one behind. (Author introduction)
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Reference Type: Journal ArticleYear: 2020
As the world struggles with the rapidly evolving pandemic of novel coronavirus disease (COVID-19), evidence and experience suggest that low-income and marginalized communities in our global society will bear the biggest impact. Weknow this because, with our colleagues in Boston, Haiti, Uganda, and Sierra Leone, we have worked in under-resourced, overstretched, and overwhelmed health systems for our whole careers. We know we will see the devastating impact of this pandemic on those who are already marginalized; COVID-19 will amplify existing inequities, and we must act swiftly to leave no one behind. (Author introduction)
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Reference Type: Journal ArticleYear: 2019
Since 1965 the purpose of Title I of the federal Elementary and Secondary Education Act has been to improve the educational outcomes of economically disadvantaged students and reduce achievement gaps. This paper presents analysis of data from a nationally representative sample of African American and Latinx kindergartners who attended public schools operating school-wide Title I programs in the 2010–11 school year. The purpose of analysis was to examine the associations between Title I programming and achievement gaps. The results indicated that African American students in high poverty, high minority schools made greater gains in reading in schools that used Title I for reduced class size. African American and Latinx students in high poverty, high minority schools made greater gains in mathematics in schools that used Title I for professional development. Findings were scrutinized via propensity score weighting, which revealed the tangled nature of school context, child and family characteristics, and student learning. Suggestions for future research include random assignment...
Since 1965 the purpose of Title I of the federal Elementary and Secondary Education Act has been to improve the educational outcomes of economically disadvantaged students and reduce achievement gaps. This paper presents analysis of data from a nationally representative sample of African American and Latinx kindergartners who attended public schools operating school-wide Title I programs in the 2010–11 school year. The purpose of analysis was to examine the associations between Title I programming and achievement gaps. The results indicated that African American students in high poverty, high minority schools made greater gains in reading in schools that used Title I for reduced class size. African American and Latinx students in high poverty, high minority schools made greater gains in mathematics in schools that used Title I for professional development. Findings were scrutinized via propensity score weighting, which revealed the tangled nature of school context, child and family characteristics, and student learning. Suggestions for future research include random assignment studies and local partnerships to determine effective uses of Title I monies. (Author abstract)
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Reference Type: Stakeholder ResourceYear: 2019
Teaming up with the National Association of Workforce Boards, UpSkill America developed a new tool that explains just how these organizations can help you. The tool provides an overview of what the public workforce system does and connects you to resources to start taking advantage of its services.
This tool is the latest in a series released in the past year, thanks to a grant from Walmart to support UpSkill America’s work to equip businesses with tools to educate, train, and support frontline workers’ development to advance their careers. The work builds on UpSkill America’s 2017 UpSkilling Playbook for Employers. (Edited author summary)
Teaming up with the National Association of Workforce Boards, UpSkill America developed a new tool that explains just how these organizations can help you. The tool provides an overview of what the public workforce system does and connects you to resources to start taking advantage of its services.
This tool is the latest in a series released in the past year, thanks to a grant from Walmart to support UpSkill America’s work to equip businesses with tools to educate, train, and support frontline workers’ development to advance their careers. The work builds on UpSkill America’s 2017 UpSkilling Playbook for Employers. (Edited author summary)
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Reference Type: ReportYear: 2019
The Health Profession Opportunity Grants (HPOG) Program awards grants to organizations that provide education and training to Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals for healthcare occupations that pay well and are in high demand. A National Evaluation of 27 grants awarded in 2015 as part of the second round of HPOG grants (HPOG 2.0) is currently underway. The National Evaluation Descriptive Evaluation will include an interview study of participant experiences in HPOG 2.0.
This report presents a research design plan for the interview study of participant experiences. The goal of these in-depth interviews is to gain insights into the motivations, decision making, expectations, and experiences of HPOG 2.0 program participants. The interview study will draw on interviews with up to 140 HPOG 2.0 program participants selected from across the country. (Author abstract)
The Health Profession Opportunity Grants (HPOG) Program awards grants to organizations that provide education and training to Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals for healthcare occupations that pay well and are in high demand. A National Evaluation of 27 grants awarded in 2015 as part of the second round of HPOG grants (HPOG 2.0) is currently underway. The National Evaluation Descriptive Evaluation will include an interview study of participant experiences in HPOG 2.0.
This report presents a research design plan for the interview study of participant experiences. The goal of these in-depth interviews is to gain insights into the motivations, decision making, expectations, and experiences of HPOG 2.0 program participants. The interview study will draw on interviews with up to 140 HPOG 2.0 program participants selected from across the country. (Author abstract)
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Reference Type: Journal ArticleYear: 2019
Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.
Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.
Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado,...
Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.
Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.
Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado, Illinois, Minnesota, New Jersey, and New Mexico) and 4 nonexpansion (Florida, Nebraska, North Carolina, and Texas) states.
Interventions/Exposure Policy implementation in January 2014.
Main Outcomes and Measures Changes in insurance coverage, outcomes (mortality, morbidity, failure to rescue, and length of stay), and discharge to rehabilitation.
Results A total of 283 878 patients from Medicaid expansion states and 285 851 patients from nonexpansion states were included (mean age [SD], 41.9 [14.1] years; 206 698 [36.3%] women). Adults with injuries in expansion states experienced a 13.7 percentage point increase in discharge to rehabilitation (95% CI, 7.0-7.8; baseline: 14.7%) that persisted across inpatient rehabilitation facilities (4.5 percentage points), home health agencies (2.9 percentage points), and skilled nursing facilities (1.0 percentage points). There was also a 2.6 percentage point drop in failure to rescue and a 0.84-day increase in length of stay. Rehabilitation changes were most pronounced among patients eligible for rehabilitation coverage under the 2-midnight (8.4 percentage points) and 60% (10.2 percentage points) Medicaid payment rules. Medicaid expansion increased rehabilitation access for patients with the most severe injuries and conditions requiring postdischarge care (eg, pelvic fracture). It mitigated race/ethnicity-, age-, and sex-based disparities in which patients use rehabilitation.
Conclusions and relevance This multistate assessment demonstrated significant changes in insurance coverage and discharge to rehabilitation among adult trauma patients that were greater in Medicaid expansion than nonexpansion states. By targeting subgroups of the trauma population most likely to be uninsured, rehabilitation gains associated with Medicaid have the potential to improve survival and functional outcomes for more than 60 000 additional adult trauma patients nationally in expansion states. (Author abstract)