DISSERTATION DEFENSE: AMY RASLEVICH
The Role of Race, Place, and Social Determinants of Health in Disparate Utilization of Pediatric Preventive Care Services in a Medicaid Population"
Public Health/Health Policy and Management
Committee:
Julie M. Donohue (advisor), Health Policy and Management
Tiffany-Gary Webb, Epidemiology
Mary L. Ohmer, Social Work
Kristin N. Ray, Pediatrics, Health Policy Institute
Ada O. Youk, Biostatistics
Abstract:
Pediatric well-child visits are especially important in childhood and have been associated with higher receipt of preventive services including immunizations and lead screenings, and lower rates of hospitalizations, emergency department visits, sick visits, and hospitalizations for ambulatory sensitive conditions. Though the services are nearly universally paid for by health insurance, there are significant racial disparities in the utilization of these services between Black and White Children. Much of this gap is likely driven by differences between enrollees in economics, education and environment, differences that are inextricably linked to our nation’s history of racism and discrimination.
This dissertation explores factors associated with disparities in the utilization of pediatric preventive services between Black and White children in the Pennsylvania Medicaid managed care program. Chapter 1 uses decomposition methodology to analyze what local area socio-economic factors are most associated with the disparity statewide, incorporating a comprehensive index measure of child opportunity in ZIP codes across the Commonwealth. This method explains almost 15% of the statewide disparity. Chapter 2 uses the same methodology but focuses on those children who live in ZIP codes that were graded by the U.S. government for mortgage risk in the 1930s, a program resulting in ratings that influence conditions and investments in those communities even today. The gap between Black and White use is much wider in this exclusively urban population, and the analytic model explains almost 25% of the difference. Chapter 3 attempts to reflect the experiences and perceptions of Black parents in Allegheny County whose children are enrolled in Medicaid and who must make the decisions on whether, when, and how their children receive preventive services. By centering their voices and reflections along with the modeled analyses, policies can be developed that are informed and nuanced in complementary ways, allowing for more efficient and effective strategy development and resource deployment.
Dial-In Information
Contact Amy Raslevich for Zoom information.
Monday, December 12 at 8:00 a.m. to 10:00 a.m.
Public Health, 1155
130 Desoto Street, Pittsburgh, 15261
EVENT TYPE
Defenses
TARGET AUDIENCE
Faculty, Graduate Students
UNIVERSITY UNIT
Department of Health Policy and Management
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Original source can be found here.
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