From Minneapolis to Milan to Manila: What We Liked and Learned at the Summer Meetings

The students are back at my door, punctuating the end of an active summer conference season for those of us who study public health delivery systems, policy and economics. This post highlights a few of the studies presented during the summer meetings just in case you missed some. I find these meetings invaluable not only for scientific networking and idea-generation, but also for the early access they give us to newly emerging findings and novel applications of research methodologies. The journal articles will come, but for now they are still months away or more. I have no time to be comprehensive here given the unfinished manuscripts on my own desktop, so this post dashes unabashedly through just a few of the meeting sessions in which I had a hand. But in doing so, I hope to pique reader interest in browsing other sessions and studies featured at these meetings.

My summer science always starts with the AcademyHealth Annual Research Meeting (ARM) in June, which met for the first time in Minneapolis this year. I had the good fortune to chair a session at this meeting featuring new research on the interactions between health care and public health delivery systems. You can view my Heard in the Hallways preview of this session here:

Particularly notable in this session, Case Western’s Scott Frank and his colleagues present a comparative analysis of community health assessment and improvement activities led by hospitals vs. public health agencies in Ohio, which won AcademyHealth’s award for Best Research in the Public Health and Population Health category. This study, conducted through our RWJF-supported Public Health PBRN Program, found substantive differences in the types of health conditions and intervention strategies targeted by the two types of organizations, suggesting that there are some benefits (complementarities) when each type of organization leads their own assessment and planning process, along with some missed opportunities for coordination.

A related study featured in this session by Emily Johnson and colleagues at the University of Colorado finds that state laws requiring hospitals to publicly report their expenditures on community benefit activities results in significantly larger expenditure levels for both charity care and nonclinical activities. One of our RWJF-funded Postdoctoral Scholars in PHSSR, Sharla Smith from the University of Kansas Medical Center, rounded out the session with her study of how public health inter-organizational networks respond to economic shocks and governance structures. Using data from our National Longitudinal Survey of Public Health Systems, she shows that governance exerts a stronger influence on inter-organizational connectedness than do resource constraints.

For the second year in a row we organized a methods workshop on social network analysis in health services research, which featured some innovative research on physician networks using claims data by Harvard’s Bruce Landon, along with studies of interdisciplinary care teams by the University of Minnesota’s Doug Wholey, and our own work using network analysis to evaluate multi-sectoral public health delivery systems (see figures). We also joined colleagues at RWJF in presenting a session on the three new research programs being implemented as part of RWJF’s Culture of Health action framework. These sessions represent only a small fraction of the new research on public health services and systems presented at the ARM, including an entire adjunct Interest Group Meeting on public health systems research.

A month later many of us took our science abroad for the World Congress of the International Association for Health Economics in Milan, where the conference theme of nutrition and economics revisited the famous Latin maxim “De Gustibus Disputandum Non Est” – should preferences be treated as fixed or endogenous in health economic research? The conference featured a dizzying array of new studies conducted around the globe on public health issues that include taxes on sugar-sweetened beverages, enhanced food labeling requirements, incentives for fruit and vegetable intake, the economics of disaster preparedness, novel family planning interventions, and substance abuse prevention policies. As part of our panel on the economics of public health delivery, Johns Hopkins economist David Bishai presented new research demonstrating how county-level public health expenditures reduce disparities in mortality rates between counties with high and low African American populations. We followed this with an updated analysis of how Medicald spending and public health spending interact at both state and local levels to influence population health, resulting in some unintended consequences involving crowd-out. Maryam Nejad at the Institute for the Study of Labor rounded out our session with an analysis of how suburbanization fuels obesity rates over time, using people who move from city centers to the suburbs to identify these effects. The interplay of studies conducted in the U.S., in other high-income countries, and in low and middle-income countries at this meeting allowed for particularly insightful scientific discussion and debate.

August brought us to the 7000+ island nation of the Philippines and its capital city of Manila for the 2015 edition of the Global Forum on Research and Innovation for Health. Sponsored by the Council on Health Research for Development, this meeting pulls together a large and diverse collection of several thousand researchers, representatives from health industries, and policy officials from national ministries of health, finance, science and technology. The Global Forum provides a platform for sharing research on strategies for improving health and economic development in low-resource settings, with a focus on low and middle income countries and their relationships with more advanced economies. As part of a session on public-private partnerships, we shared updated research on the health and economic value of multi-sector alliances for public health delivery in the U.S., using data from the National Longitudinal Survey of Public Health Systems. Along the way we shared lessons learned about how to support productive research collaborations using the mechanism of practice-based research networks (PBRNs), and also reflected some of our work related to disaster risk reduction as part of the National Health Security Preparedness Index. Many other fascinating sessions at this meeting featured research on disaster preparedness, non-communicable disease control, harnessing big data in health, and building flexible research infrastructure.

As did Milan, Manila left me surprised and intrigued by the range of research studies on public health delivery, financing, and economics that are now underway in African, Asian, Latin American, and Caribbean countries, among other settings. Clearly there is much to be learned by comparing the structures, processes, and outcomes that play out across these diverse systems and population groups.

Of course these meetings over the last three months are far from the only venues where good science on public health delivery, policy and economics were discussed this summer. Not included in this post, but not to be overlooked, is the venerable NACCHO Annual Meeting that convened in July with an active research track featuring studies from many colleagues in PHSSR.

Don’t make us wait for the journal articles. If you saw some research not-to-be-missed this summer, you can post a comment about it below, nudge me on LinkedIn, tweet at me, or just show up during my office hours. My own research presentations and products always can be found in the research archive.

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