EDITOR’S
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GrantWatch is funded in part by the Robert
Wood Johnson Foundation and the California
Wellness Foundation.
California
Health Policy
Report received:
Health Insurance: Can Californians Afford It?
Jon Gabel, Jeremy Pickreign, and Heidi Whitmore of NORC at the University
of Chicago, June 2007, 32 pp., including appendices, http://www.chcf.org/documents/insurance/Affordability07.pdf.
Funded by the California HealthCare Foundation (CHCF). Among the report’s
findings is that for health maintenance organization (HMO) coverage, “monthly
premiums for single coverage among California’s small employers increased
75 percent from 2003 to 2006.” Watson Wyatt Worldwide did the actuarial
analysis.
Related resource:
Trends
in the Golden State: Small-Group Premiums Rise Sharply While Actuarial
Values for Individual Coverage Plummet,”
Jon Gabel, Jeremy Pickreign, Roland McDevitt, Heidi Whitmore, Laura Gandolfo,
Ryan Lore, and Katy Wilson, Health Affairs Web Exclusive,
14 June 2007, http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.4.w488.
Funded by the CHCF. This article, which is a companion to the CHCF report
mentioned above, notes that “California consumers in the small-group
and individual markets face financial barriers to health coverage, in large
part because of rising health care costs.” The authors say that there
has been a “persistent and precipitous increase in underlying health
care costs” and suggest that state reform initiatives, such as that
proposed by California Gov. Arnold Schwarzenegger (R), “incorporate
strategies to confront” this cost growth.
Global
Health
Recent funding:
The University
of Washington (UW), Seattle, WA. This
university has launched its new Institute for Health Metrics and Evaluation, “a
new research center that will conduct independent, rigorous evaluations of
health programs worldwide,” according to a June 2007 press
release. The “goal
is to help guide international policymaking by providing high-quality data
and analysis on health needs and outcomes, and [by] assessing the performance
of health programs.” Chris Murray, a health economist who previously
directed Harvard University’s Initiative for Global Health, will direct
this UW institute. When it is “fully operational,” the institute
will have more than 100 faculty and staff members. Also, it will set up “an
international network of collaborating research centers.” Julio Frenk,
who is now at the Bill and Melinda Gates Foundation and was the former minister
of health of Mexico, will chair “an international board of health experts” that
will oversee the institute. Frenk said in the release that the institute
will work with the Health Metrics Network (HMN), which is hosted by the World
Health Organization. Read more about the HMN in the GrantWatch section of
the upcoming Jul/Aug 07 issue of Health Affairs, to
be released 16 July 2007, http://www.content/healthaffairs.org/cgi/content/full/26/4/1186.
$105 million. Funded by the Bill
and Melinda Gates Foundation.
$20 million. Funded by the University of Washington.
Report received:
Mirror, Mirror on the Wall: An International Update on
the Comparative Performance of American Health Care,
Karen Davis, Cathy Schoen, Stephen C. Schoenbaum, Michelle M. Doty, Alyssa
L. Holmgren, Jennifer L. Kriss, and Katherine K. Shea, 16 May 2007 (corrected
version), 39 pp., http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=482678.
Funded by the Commonwealth Fund. All authors are or were affiliated with
the fund. This report focuses on six countries: Australia, Canada, Germany,
New Zealand, the United Kingdom, and the United States. Having looked at
three Commonwealth surveys conducted in 2004 (Germany was not included in
that one), 2005, and 2006, the authors conclude is that “the U.S. health
care system ranks last or next-to-last on five dimensions of a high performance
health system: quality, access, efficiency, equity, and healthy lives.” According
to the report, however, the United States “does especially well in
providing preventive care for its population.” (Prevention measures
fall under the “quality” dimension.) The authors say that the
2006 survey of physicians “shows the U.S. lagging in adoption of information
technology and use of nurses to improve care coordination for the chronically
ill.” The report updates previously released 2004 and 2006 editions
of Mirror, Mirror.
Publication to be released
16 July 2007:
Health Affairs Jul/Aug 07 issue,
a thematic issue on global health care. Watch for it: On that day, go to http://www.healthaffairs.org/content/vol26/issue4.
This issue was funded by the Gates Foundation.
Health Philanthropy
Report received:
Knowledge to Action: Critical Health Issues and the Work
of Health Philanthropy over Twenty-five Years, Grantmakers
In Health (GIH), February 2007, 176 pp., http://www.gih.org/info-url2678/info-url_show.htm?doc_id=465303.
Prepared in celebration of GIH’s twenty-fifth anniversary, this book
looks at ten health issues—among them, access to care, HIV/AIDS, mental
health, public health, and racial and ethnic disparities in care—and
considers “changes in the health sector and in health policy” over
this quarter-century “and the work of health foundations in addressing
these challenges,” according to the GIH Web site. Each topic’s
chapter includes an essay, “fast facts,” and suggestions for
further reading. One chapter discusses how health philanthropy itself “has
evolved.” The report concedes that “grantmakers continue to grapple
with how best to measure a foundation’s overall effectiveness and gauge
its impact.” This volume is good for those new to the field of health
philanthropy or to grant seeking and is a good summary for those of us who
have been following health philanthropy for many years. The report also provides
a helpful “Health Milestones 1982–2006” timeline, which
lists a number of major events.
Public
Health
Recent funding awarded:
Florida Public Health Institute (FPHI), Lantana, FL. This
institute, envisioned as “a center for excellence in public health,” according
to a 29 May 2007 Palm Beach County Health Department press
release, “is
well on its way to becoming a reality.” It will be a collaborative
effort of the county health department, the State of Florida, the town of
Lantana, and community groups. Jean M. Malecki, director of the county health
department, was a key player in getting the institute—“a collaborative,
community-based, integrated approach to public health that will have long
term benefit for the state”—started. Claude Earl Fox, a research
professor at the University of Miami’s medical school and a former
administrator of the Health Resources and Services Administration (HRSA),
was recently named executive director of the institute. He will maintain
his affiliation with the university.
The FPHI will be located
on some 145 acres of land owned by the State of Florida. The institute’s campus will include “a respiratory hospital,
public health clinics, public health laboratories, and educational/administrative
space to support the Institute and affiliated academic partners,” according
to the FPHI master plan. Also, “excellence is achieved and maintained
first through excellent public health patient care,” it explains. “Excellent
patient care also creates important public health data that can be used by
researchers to seek better ways of disease prevention and control.” Then,
in completing a cycle, the results of these data can “be used in improving
the education of public health providers.”
Malecki’s staff, working with Fox, applied for and received the grants
listed below. The Fostering Emerging Institutes Matching Grant Program is
run by the New Orleans–based National Network of Public Health Institutes
(NNPHI) and funded by the Robert
Wood Johnson Foundation (RWJF).
The NNPHI defines a public health institute as “a multi-sector entity
able to function as a convener to improve health status and foster innovations
in health systems.” This NNPHI program aims “to enhance states’ public
health capacity” and help emerging institutes to “operate with
heightened efficiency and direction,” according to its Web
site. The
Fostering Emerging Institutes matching grant, along with the dollars from
the Brumback Fund, support core organizational development for the Florida
institute. The NNPHI will also provide the FPHI with “technical assistance,
which includes mentoring, tools, and resources that will focus on building
a sustainable organization,” Erin Bertschy of the NNPHI said.
Most recently, the FPHI
received “seed funding” from the Quantum
Foundation, according to an 18 June 2007 press release. That grant will support
the institute’s core staffing. Quantum’s “leadership sees
the FPHI as part of its overall strategy to invest in health-related initiatives
that develop coordinated systems of care in the areas of care access, disease
prevention, and health promotion.” A Quantum spokesperson explained
to Health Affairs, “Our money will serve Palm Beach
County,” but the state of Florida “will indeed benefit as we
collaborate” with others statewide, and “other regions can duplicate
our efforts.”
She said that the FPHI
is “already affiliated” with several
universities around the state. (These are Florida A&M University, Florida
Atlantic University, Florida International University, Nova Southeastern
University, University of Miami, University of North Florida, and University
of South Florida.) Also, the FPHI is affiliated with the Florida Department
of Health and hopes to work with the Pan American Health Organization (PAHO)
in the future.
$1,050,000 over three years. Funded by the Quantum
Foundation.
$100,000 over
two years. Funded by the Brumback Fund. This fund is named for a physician
who directed the Palm Beach County Health Department for many years “and is held by the University of Miami
for distribution in that county,” the Quantum spokesperson said.
$100,000 over two
years. Funded by the RWJF-funded Fostering Emerging Institutes Matching
Grant Program.
Substance
Abuse Prevention:
Recent report:
Wasting
the Best and the Brightest: Substance Abuse at America’s
Colleges and Universities, National Center on Addiction and
Substance Abuse (CASA) at Columbia University, March 2007, 231 pp., including
appendices, notes, and bibliography, http://www.casacolumbia.org/supportcasa/item.asp?cID=12&PID=155.
A print copy for $25 may also be ordered at this Web site. The report is
funded by the American Legacy Foundation, Sally Engelhard Pingree and the
Charles Engelhard Foundation, Hillswood Foundation, Norval Stephens and the
Stephens Charitable Trust, National Institute on Drug Abuse (NIDA), two individuals,
two universities, and numerous college fraternities and sororities. Members
of the commission that produced this report include Nancy Kassebaum Baker,
Harvey V. Fineberg, Cheryl G. Healton, Herbert Pardes, Charles A. Sanders,
and Louis W. Sullivan. In the introduction to the report, Joe Califano, CASA
chairman and president, calls substance abuse “an alarming public health
crisis on college campuses” across the United States. He comments, “It
is time to take the ‘high’ out of higher education.” This
report looks at use of alcohol, controlled prescription drugs, illegal drugs,
tobacco, and steroids, as well as “poly-substance use” (using
more than one addictive substance at a time); the “increasing consequences
of college student substance use and abuse”; possible causes of student
substance abuse; and “what colleges should do and are doing to prevent
or reduce student substance use.” Part of one section of the report
is devoted to prevention of legal liability in instances of substance abuse.
The report has recommendations for a variety of stakeholders, including the
National Collegiate Athletic Association (NCAA) and federal and state governments.
Several of these recommendations have to do with advertising and marketing
practices. Among CASA’s recommendations for state governments are to
ban smoking on state school campuses, “enforce state substance abuse
laws,” and raise taxes on tobacco and alcohol.
Alcohol remains “the main drug of abuse” on campuses, the report
says; however, “since the early 1990s, the proportion of students abusing
controlled prescription drugs [such as OxyContin and Ritalin] has exploded.” CASA
says that colleges should care about substance abuse on campus because it “compromises
academic performance”; colleges “have a public health obligation”;
and abuse has important “legal implications.” The report also
says that “white students are likelier to use and abuse all forms of
drugs [including tobacco and alcohol here] than are minority students.” Other
interesting findings are that “fraternity or sorority members are likelier
than non-members to be . . . binge drinkers” (63.8 percent versus 37.4
percent). (Here, such drinkers are defined as those who have consumed five
or more alcoholic beverages at one sitting during the past two weeks.) Also, “the
greater a student’s level of religiosity” was, “the less
likely the student is to drink, smoke or use other drugs.” CASA’s
board members include Columba Bush, Jamie Lee Curtis, David A. Kessler, and
Louis Sullivan.
Related resources:
“California
Proposition 36: The Substance Abuse and Crime Prevention Act of 2000,” Web site maintained by
the Drug Policy Alliance, http://www.prop36.org/.
Evaluation
of the Substance Abuse and Crime Prevention Act: Final Report, Darren
Urada and Angela Hawken of Integrated Substance Abuse Programs, University
of California, Los Angeles (UCLA), released 13 April 2007, 203 pp.,
including appendices, http://www.adp.ca.gov/PDF/SACPAEvaluationReport.pdf.
This evaluation of the fourth year under California’s Proposition 36
was funded by California’s Department of Alcohol and Drug Programs.
Prop 36 was approved by voters in the state in November 2000. UCLA’s
Web site notes that this “study is timely and of policy significance,
as the California governor’s May budget revision [was then] weeks away
and the state Legislature is debating the future” funding of the law.
Coauthor Darren Urada told Health Affairs 25 June
2007 that the future funding status for Prop 36 is still unknown. He explained
that “the California legislature has not yet passed a final statewide
budget”; funding for Substance Abuse and Crime Prevention Act activities
is a part of that overall budget. A conference committee of the legislature
is determining how much funding Prop 36 will get. Urada said that it is his
understanding that the total expected to be approved by that panel “should
be higher” than what Governor Schwarzenegger proposed. In response to
an inquiry from Health Affairs, a staff member with
the California Legislative Analyst’s Office confirmed this information
on 28 June 2007, but events are evolving, he indicated.
“Is
There a College Substance Abuse Crisis?” Maia
Szalavitz, Statistical Assessment Service (STATS), 21 March 2007, http://www.stats.org/stories/2007/is_there_college_crisis_mar21_07.htm.
See what Szalavitz’s criticisms of the CASA report mentioned above
are. STATS is a nonprofit, nonpartisan “resource on the use and abuse
of science and statistics in the media.” Located in Washington, D.C.,
it is an affiliate of George Mason University and is also affiliated with
the nonprofit and nonpartisan Center for Media and Public Affairs.
“Meeting
Reviews Progress on Prescription Opioid Misuse,” NIDA Notes 21,
no. 3, http://www.nida.nih.gov/NIDA_notes/NNvol21N3/BBoard.html.
Read in this NlDA publication about a March 2007 meeting on “a growing
public health challenge: balancing appropriate pain treatment with efforts
to minimize prescription opioid misuse.” NIDA and the American Medical
Association cosponsored the meeting in conjunction with the National Institutes
of Health Pain Consortium.
“The
Promise of Prop. 36,” R. Konrad Moore, San
Francisco Chronicle, 23 May 2007, http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2007/05/23/EDGF2PVK7O1.DTL.
This opinion piece was written by a supervising deputy public defender for
Kern County, California.