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August 2025 Meghan Bellerose, Linqing Zheng, Arielle Desir, Rachel E. Fabi, Laura R. Wherry, Maria W. Steenland,
Health insurance coverage increases access to recommended pregnancy care, but undocumented immigrants are not eligible for pregnancy Medicaid coverage without state uptake of alternative policy options. Twenty-four states and the District of Columbia (DC) offer public insurance to undocumented immigrants who are income eligible for pregnancy Medicaid through the Children’s Health Insurance Program From-Conception-to-End-of-Pregnancy option or state funds. More
August 2025 David H. Jernigan,
Alcohol is a causal factor in more than 200 disease and injury conditions in the human body. The Centers for Disease Control and Prevention (CDC) define excessive drinking as binge drinking (4 or more drinks for women, 5 or more for men on one occasion in the past month), heavy drinking (8 or more drinks for women, 15 or more for men in a week), and any drinking during pregnancy or by persons younger than age 21 years. More
August 2025 Hossein Zare, Gerard Anderson,
The American Hospital Association determined that in 2022 nonprofit hospitals spent $129 billion on community benefits. This is more than the entire budget for the US public health service. Different organizations estimate different amounts of community benefit spending depending on their definition of community benefit. More
August 2025 Philip M. Alberti,
For more than 2 years, I have started my speaking engagements with a simple message: “Health equity benefits all communities.” Although the message may be straightforward, health equity–focused scientists and advocates like me have done an inadequate and ineffective job making that point clear and believable through stories, data, and messaging. More
August 2025 Rick Mayes, Micah Johnson,
From 2004 to 2024, Medicare Advantage (MA) went from being a “policy disappointment,” covering 12% of all Medicare beneficiaries, to predominance, covering more than one-half (52%), with more growth predicted in the future. Drawing on an extensive review and synthesis of the literature, Medicare Payment Advisory Commission (MedPAC) reports, congressional committee hearings, and Centers for Medicare and Medicaid Services (CMS) data, this paper analyzes the evolution of Medicare and managed care in three parts More
August 2025 John Billimek, Melina Michelen, Patricia J. Cantero, Noraima Chirinos, Rocio Salazar, Mary Anne Foo, Samantha Peralta, Brittany N. Morey, Jacqueline J. Chow, Salvador Zarate, Sora Park Tanjasiri, Alana M. W. Lebrón,
Community health workers (CHWs) are frontline public health workers who support the well-being and capacity building of residents disproportionately affected by health inequities. The purpose of this study is to examine diverse perspectives on the conditions for CHW success as CHWs were engaged in rapidly implemented, highly responsive education, vaccination, and recovery efforts during the COVID-19 pandemic in a large county in Southern California. More
August 2025 David B. Joyce, Jeffrey Swanson,
Extreme Risk Protection Orders (ERPOs) are an effective legal tool for reducing firearm suicide by temporarily removing access to firearms for certain individuals who exhibit dangerous behavior. Unlike most state laws restricting access to firearms based on status, ERPOs are predicated on the assessment of future risk of harm to self or other, as determined by civil court file finding. Emerging research indicates that separating those in crisis from lethal means reduces firearm mortality. We assess Maine’s unique approach and consider whether it is a replicable policy option for other states or should be modified to comport with other states’ more broadly applicable model. More
July 2025 BRANDON D. L. MARSHALL, Kristen Pendergrass, Sara Whaley,
The US overdose crisis is one of the most severe and devastating public health problems of the 21st century. Since 1999, more than one million Americans have lost their lives to accidental drug overdose. More
July 2025 Justin Markowski,
Context: Community health centers (CHCs) are a critical and growing part of the health care safety net, doubling over the past 15 years to expand access to essential health care services to over 31 million patients in traditionally underserved communities. However, increasingly, CHCs have opened care delivery locations in communities already served by another CHC, potentially creating competitive markets with unknown implications for how this safety net operates. More
July 2025 Corey Davis, Amy Lieberman, Czarina Behrends,
The United States continues to experience a nearly unprecedented level of drug-related health harms, with over 105,000 Americans dying of overdose in 2023 alone. Although overall overdose deaths declined slightly from 2022 to 2023, rates for Black people continued to rise. Stimulants such as cocaine and methamphetamine are increasingly involved in overdose deaths, and xylazine and other contaminants continue to be prevalent in the illicit drug supply. More
July 2025 Jennifer Lacy-Nichols, Hedeeyeh Baradar, Eric Crosbie, Katherine Cullerton,
nformation about lobbying is crucial to alert the public about undue influence in government decision making. Yet, government disclosures of lobbying activities are rare internationally and vary considerably in their completeness and accessibility. Building on a framework to measure lobbying transparency, this study benchmarked national government disclosures to understand what information was shared and to develop recommendations to strengthen political transparency. More
July 2025 Abhery Das, Michael Esposito, Tim A. Bruckner, Hedwig Lee,
The justice system incarcerates nearly 2.3 million individuals in the United States. Black Americans comprise 40% of those incarcerated despite representing less than 15% of the population. Theoretical work posits that mass incarceration can erode social capital by straining social and family networks as well as inducing carceral churn and coercive mobility within Black communities. Scholars report that greater incarceration may influence population-level health, specifically in communities of color. However, previous work does not address whether incarceration, as well as the racial disparity in incarceration, corresponds with psychiatric help seeking in the Black community. More
July 2025 Hannah L.F. Cooper, Anna L. Mullany, Snigdha Peddireddy, Simone Wien, Melvin "Doug" Livingston, Whitney S. Rice, Anne L. Dunlop, Michael R. Kramer, Madison Haiman, Lasha S. Clarke, Natalie D. Hernandez-Green, Angélica Meinhofer,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers… More
July 2025 Gabriela Plasencia, Kamaria Kaalund, Olurotimi Kukoyi, Viviana Martinez-Bianchi, Andrea Thoumi,
Populations that identify as Latino/a/e/x or Hispanic (herein referred to as Latine) in the United States continue to face disproportion-ate health… More
July 2025 Noa Krawczyk, Hillary Samples,
The United States is facing an ongoing mental health and substance use crisis. In 2023, 58.7 million US adults had a past-year mental illness, 46.3 million had a substance use disorder (SUD), and 20.4 million had both. More
June 2025 Hannah Rahim, Aaron S. Kesselheim,
Prescription drug prices in the United States are substantially higher than in other high-income countries, with US prices reported to be an average of 2.78 times those of other countries in the Organisation for Economic Co-operation and Development.1 In response to these high prices, along with an opaque supply chain that can lead to substantial discrepancies in prices across different payors, states have passed drug price transparency laws that require manufacturers to disclose information on drug prices. More
June 2025 MATTHEW S. McCOY, MARTHA E. GAINES, STEVEN JOFFE, Genevieve Pham-Kanter, EMILY A. LARGENT, Bernard Lo, HOLLY FERNANDEZ LYNCH, ALLISON M. WHELAN, Michelle M. Mello,
Leaders at many of the country’s top academic medical centers earned—in addition to their institutional salaries—hundreds of thousands of dollars a year as directors of pharmaceutical and device companies. Critics have urged academic institutions to rethink conflict of interest policies governing leaders’ outside activities, which are understood to pose not only individual conflicts for leaders themselves but also institutional conflicts for their academic employers. More
June 2025 Magdalena Cerdá, DANIEL B. NEILL, ELLICOTT C. MATTHAY, JOHNATHAN A. JENKINS, BRANDON D. L. MARSHALL, Katherine Keyes,
People in the United States are dying at record numbers from overdose. Overdose deaths increased from fewer than 17,000 deaths in 1999 to an estimated 100,000 deaths approximately 25 years after, with a peak of almost 108,000 deaths in 2022. Racial/ethnic minoritized groups are now particularly affected: in 2023, the highest rates of overdose were among non-Hispanic Black and American Indian/Alaska Native Americans. Although overdoses increasingly involve both opioids and stimulants, opioids contribute to over three-quarters of all overdose deaths, primarily driven by illegally manufactured synthetic opioids like fentanyl. More
June 2025 Marco Thimm-Kaiser, Katherine Keyes,
The potential adverse effects of social media use for adolescents have received substantial attention. In response, a growing number of state-level social media regulations are emerging in the United States. These policy interventions are being implemented in the context of mixed scientific evidence, forcing policymakers to weigh the need for proactive regulation against the limitations of extant research. We explore policymakers’ publicly stated rationales for social media regulations and contextualize their claims within extant scientific literature. More
June 2025 Annette M. Dekker, Adrian Yen, Andrea Larco Canizalez, Yesenia Perez, David Salazar, Bita Ghafoori, Dorit Saberi, Breena R. Taira,
The Trauma Recovery Center (TRC) model brings comprehensive care to underserved victims of crime, with improvements in PTSD symptoms and quality of life. Funding concerns were the central limitation in model implementation according to TRC staff. More
May 2025 Kate McEvoy, Hannah Maniates,
Medicaid has both greatly advanced the scope and integration of mental health and substance use disorder services among payers and remains a work in progress with respect to scaling and funding these services across the country. More
April 2025 Rachel Donnelly, Mateo P. Farina,
Mental health (e.g., anxiety, depression) continues to be a major public health concern in the United States that impacts millions of individuals, their families, and communities. Approximately 21% of adults 18 years and older, or 55 million adults, reported symptoms of recent depression in 2022, demonstrating the wide reach of mental health challenges. More
April 2025 Jonathan Purtle, Amanda I Mauri, David Frederick,
In this article, we provide an overview of emergent models for funding crisis systems in the United States and the policy and service contexts related to these models. Our review assesses the status of crisis system financing recommendations proposed by Hogan and Goldman proposed in 2020 and complements prior reports about financing crisis services. More
April 2025 Briana S. Last, Jane M. Zhu,
See all articles in the special issue, Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers Do? Access… More
April 2025 Jane M. Zhu, Ruth Rowland, Inga Suneson, Deborah J. Cohen, K. John McConnell, Daniel Polsky,
Behavioral health access gaps are well documented in Medicaid, in which managed care now covers most enrollees, and for which there are typically fewer options for going out-of-network for care. Despite the growing role of managed care organizations (MCOs) in financing and delivering behavioral health services, little is known about MCO levers that can improve access to care. More
April 2025 Brendan Saloner,
This Perspective examines the role of Medicaid in the innovation of substance use disorder (SUD) treatment. In 2023, an estimated 49 million Americans met criteria for an SUD and more than 100,000 people died of a drug overdose. Compared with the general population, people with SUD experience worse self-rated health, a higher burden of other chronic diseases, and more hospital care. More
