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A New CHAS Dissertation Fellowship
and Congratulations, the First Recipient

As part of our continuing effort to target CHAS resources to meet academic needs, we are pleased to announce the creation of a new CHAS dissertation fellowship, a 1-year award for a doctoral student near completion of the dissertation. This fellowship is open to doctoral students across the UC campus whose work speaks to the health of disadvantaged populations.

We are especially pleased that Phyllis West Bell, is the fellowship's first recipient.

Phyllis is researching the poignant topic of caregiving arrangements for children of incarcerated women. Her study engages questions of great importance to correctional policy and to the design of family support and substance abuse treatment services.

Phyllis has a remarkably broad and varied background in social work and public health, including an African tour of duty in the Peace Corps.

She is working under the direction of a strong dissertation committee that includes chair Dodie Norton, Beth Angell, Gina M. Samuels, and Beth Ritchie of UIC. We wish her the best of luck in her promising dissertation project.

 

Spotlighting: Dr. Beth Angell

Dr. Angell received her BA in psychology at the University of North Carolina at Chapel Hill and her M.S.S.W. with a subconcentration in serious and persistent mental illness from the University of Wisconsin-Madison. As a social worker, she has practiced in the area of community-based services for people with long term mental illness, particularly via the assertive community treatment model.

These interests have likewise informed the focus of her Ph.D. in social welfare, which she completed at the University of Wisconsin-Madison, supported by an individual National Research Service Award for predoctoral fellows from the National Institute of Mental Health.

Dr. Angell's research interests broadly concern the interplay between informal social network ties, formal mental health services, and the community adjustment of people with serious mental illness. Her doctoral dissertation focused on the role of illness-related and environmental factors in determining the friendship networks of people with schizophrenia who were participating in assertive community treatment programs, and in turn, the effects of these ties on quality of life. She has published papers from this study in Schizophrenia Bulletin and Mental Health Services Research.

Subsequently, she has completed two studies that focus on the ways in which formal ties (e.g., service providers) provide both social support and social control functions, and the consequences of these functions on treatment adherence and the quality of care delivered. These studies were supported by a NARSAD Young Investigator Award and two grants from the John D. and Catherine T. MacArthur Foundation Network on Mandated Community Treatment. Relevant papers from Dr. Angell's research team are forthcoming in Social Service Review and the Journal of Behavioral Health Services and Research. Another area of interest in Dr. Angell's research program concerns the consequences of stigma on the adjustment and quality of life of people who have mental illnesses. One area in which stigma has a significant potential impact on life opportunities is in the area of employment.

Dr. Angell, together with an international collaborative team, is examining the perceptions of employers regarding their concerns about hiring people with mental illness and other behavioral health conditions, such as substance abuse and HIV/AIDS. This study, which will compare the perceptions and experiences of small business owners in Chicago, Beijing, and Hong Kong, is funded by the National Institute of Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and the Fogarty International Center.

Dr. Angell's role on the project as qualitative methodologist has been augmented by supplemental support from a CHAS Seed Grant, which will support the translation of qualitative data from Mandarin and Cantonese to English. Having these materials will permit the team to identify and interpret cross cultural differences in employer decision making strategies.

Spotlighting: Dr. Anirban Basu

University of Chicago medical researcher Anirban Basu reflects the range of interests here at CHAS. Dr. Basu holds a CHAS seed grant to develop his work on clinical trials.

Dr. Basu received his BS in Pharmaceutical Sciences from Jadavpur University, India, and an MS in Pharmaceutical Sciences at the University of Toledo, OH. He then switched his career direction to focus on the theoretical and empirical foundations of technology assessment with special interests in medical cost-effectiveness analysis (CEA). He got his second MS in Biostatistics at the University of North Carolina at Chapel Hill followed by a Ph.D. in Public Policy from the University of Chicago in 2004. He is now an Instructor of Medicine at University of Chicago and also holds a joint appointment as a Project Analyst with the Argonne National Laboratories at Chicago.

Dr. Basu’s research interests are in cost-effectiveness of medical interventions, decision analysis methodology, health econometrics and applied health services research. He has researched the theoretical and empirical foundations in CEA and value of information analyses in the context of prostate cancer and schizophrenia. In schizophrenia, he is specifically interested in assessing the cardiovascular risks associated with antipsychotic medications and the resulting economic burden of these side-effects that has substantial implications for cost-effectiveness analysis in this field. He is the recipient of the NARSAD Young Investigator Award for his work in this area. In cancer, he has worked on comparing treatment modalities based on effectiveness in the context of both prostate and breast cancers. He is currently working on identifying and measuring spillover effects of patient’s health to their family members and incorporating these effects in cost-effectiveness analysis of screening and treatments in prostate cancer.

Dr. Basu has worked extensively on the econometrics of costs data and technology assessment and has published several papers in this area. Dr. Basu compared performance of exponential conditional mean estimators to survival models for modeling cost data and also worked on generalized approaches for modeling skewed outcomes data that uses the generalized gamma distribution and encompasses several other standard covariate adjustment models used in practice. Dr. Basu has also worked on extending the generalized linear model framework to include flexible link and variance structures that can be estimated using the extended estimating equations. He is currently working on causal estimation of effects of treatments for substance abuse on associated outcomes.

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Spotlighting: Dr. Elbert Huang, M.D.

CHAS is proud to profile Dr. Elbert Huang, Assistant Professor of Medicine in the Section of General Internal Medicine of the University of Chicago. Dr. Huang received his M.D. from Harvard and joined the University of Chicago in 2001. Dr. Huang currently has two main lines of research that explore the challenges of improving quality of care in primary care practice. The common theme of both research topics is that they address the constraints, either clinical or financial, that clinicians face in clinical practice.

The first line of research is in the area of medical decision making for older patients with type 2 diabetes. Patients over 65 years of age represent over 40% of patients living with type 2 diabetes and present a unique challenge for clinicians. Important clinical differences exist among such patients that may determine whether the medications needed to achieve treatment goals developed for the general population are beneficial or harmful. Dr. Huang is funded by the National Institute of Aging to develop a simulation model of type 2 diabetes specifically designed for elderly patients and to evaluate the impact of patient heterogeneity on the effectiveness and cost-effectiveness of varying levels of glucose control. The intent of this project is to better define the quality of life effects of daily preventive medications which have become increasingly complex over the past decade.

In a second area of research, Dr. Huang is leading efforts in the evaluation of the costs and cost-effectiveness of the Health Disparities Collaborative (HDC), a quality improvement program initiated by the Health Resources and Services Administration’s Bureau of Primary Health Care. The HDC is a quality improvement program being implemented in the nation's federally-qualified community health centers (HCs) . HCs differ from other outpatient clinics in that they are specifically charged with caring for underinsured and uninsured patients and receive federal grant support to do this. Many of these patients are ethnic/racial minorities. HC patients have a particularly difficult set of medical and socioeconomic problems that lead to fragmented health care that HC providers must attempt to redress. In this setting, quality improvement programs can represent a substantial expense as well as a highly promising approach to delivering high quality care to a high risk population.

Dr. Huang and his team have conducted health economic evaluations of the Diabetes HDC program from the perspectives of society and the health center. Based on the initial 4-year clinical impact of the Diabetes HDC program, Dr. Huang has found that the HDC is cost-effective for society, if the clinical benefits are sustained over the life time of patients. However, for health centers, quality improvement programs represent new financial burdens, and Dr. Huang’s case studies has essentially quantified this burden and presented a taxonomy for discussing Quality Improvement cost issues. These results have important implications for the design of financial incentives that encourage the delivery of high quality of care.

The results of both of these studies highlight the challenge that health centers and other outpatient facilities face in bringing about improvements in chronic care management. Improving care may be of good value for society but the short-term financing of such efforts is so limited that undertaking a Quality Improvement program can threaten the financial life of a center.

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Spotlighting: Judith Levine

Judith A. Levine, PhD is Assistant Professor in the School of Social Service Administration. Her fields of special interest include poverty and social policy, social stratification, low-wage work, gender inequality, sociology of the family, health, and economic sociology. Professor Levine’s research agenda includes investigating the causes, consequences and policy treatments of inequality using quantitative and qualitative methods. She has had a long-standing interest in understanding poor women's welfare program participation and employment patterns.

Professor Levine is currently engaged in a two-wave longitudinal qualitative study comparing women’s experience in the low-wage labor market pre- and post-welfare reform. Professor Levine was the recipient of a CHAS Seed Grant in 2005 to aid this research project. In addition, she has collaboratively examined the effects of welfare reform on health insurance coverage for disadvantaged women. In other work, she and Harold Pollack and Clifton Emery are examining the causal links between adolescent motherhood and children’s subsequent outcomes.

Professor Levine graduated magna cum laude in Sociology from Harvard University and earned an M.A. and Ph.D. in Sociology from Northwestern University. Before coming to SSA, she was a Robert Wood Johnson Scholar in Health Policy at the University of Michigan.

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Spotlighting: Diane Whitmore Schanzenbach

Diane Whitmore Schanzenbach is an assistant professor in the Harris School with interests in health policy. In recent work, she has studied the effect of the Federal school lunch program on childhood obesity, on the inter-generational transmission of obesity, and on food stamps’ impact on household consumption, health, and birth outcomes.

In current work, she is investigating the impact of the Medicaid expansions – which provided health insurance to low-income children, and has been shown to improve their health – on students’ academic achievement. She is also studying the impact of school accountability programs like No Child Left Behind on the availability of school recess and gym classes, and the impact of these changes on child obesity and use of ADHD medication.

Dr. Schanzenbach is affiliated with the Center on Human Potential and Public Policy and the Population Research Center and at the University of Chicago. From 2002-04, she was a post-doctoral fellow in the Robert Wood Johnson Foundation’s Scholars in Health Policy Research Program at the University of California at Berkeley. She graduated magna cum laude from Wellesley College in 1995 with a B.A. in economics and religion, and received a Ph.D. in economics in 2002 from Princeton University.

Dr. Schanzenbach was the recipient of a CHAS Seed-Grant Award in 2006, for her research: "Measuring the Impact of School Policies on Chilhood Obesity", and is continuing her research with a grant from the Robert Wood Johnson Foundation. Our congratulations to Dr. Schanzenbach!

 

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Spotlighting: Julia Henly

Julia R. Henly is an Associate Professor in the School of Social Service Administration at the University of Chicago. She is also a faculty affiliate of the University of Chicago Center for Human Potential and Public Policy and a research affiliate of the National Poverty Center at the University of Michigan. She received her PhD in Social Work and Social Psychology at the University of Michigan in 1994. Before coming to the University of Chicago, she was a faculty member in the Department of Social Welfare at the University of California, Los Angeles. Henly’s research focuses on family poverty, low-wage employment, child care and welfare policy, and the informal support networks of low-income families.

With Susan Lambert, Dr. Henly is Co-Principal Investigator of the Scheduling Intervention Study, a randomized experimental study designed to assess the effects of a workplace intervention intended to improve scheduling practices in entry-level retail jobs. The intervention is targeted at making work time more predictable and flexible for hourly workers, with the goal of reducing work-family conflict and improving the health and well-being of workers. The study also examines the return on investment of the intervention at the store level. Dr. Henly is also Principal Investigator and Director of the Study of Work-Child Care Fit, a qualitative investigation of the work-family management strategies of low-wage retail workers.

Dr. Henly is the 2007 recipient of the Society for Social Work and Research Best Scholarly Contribution Award, for her paper, co-authored with Sandra Danziger, University of Michigan, and Shira Offer, Bar-Ilan University, entitled "The Contribution of Social Support to the Material Well-Being of Low Income Families, " which appeared in the Journal of Marriage and Family (vol 67: 122-140).

Dr. Henly’s work has appeared in several peer-reviewed journals such as Journal of Marriage and Family, Social Work Research, Children and Youth Services Review, and Journal of Social Issues, as well as several edited book volumes.

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Spotlighting: Andrew Sullivan

From 12:00 to 1:30 on Wednesday April 18, Andrew Sullivan will be speaking on the title “Living Through and Beyond a Plague: HIV in America and the World” as a special Michael Davis Seminar Series event. The event will be held in the lobby of the School for Social Service Administration, 969 East 60th Street, Chicago.

Mr. Sullivan is a prominent journalist and social commentator. He writes for Atlantic magazine, is the former editor of the New Republic, and writes for many other publications. His daily blog reaches millions of readers. He is the author of many books, including a current best-seller: The Conservative Soul: How We Lost It, How to Get It Back. His other works include Love Undetectable: Reflections on Friendship, Sex and Survival, Virtually Normal, and Same-Sex Marriage: Pro and Con: A Reader. This being the University of Chicago, I should note that Mr. Sullivan holds a doctorate in political theory from Harvard University. This is surely related to his most recent book, Intimations Pursued: Voice of Practice in the Conversation of Michael Oakeshott.

See AndrewSullivan.com, The Daily Dish, and Royce Carlton.

Photo Courtesey Royce Carlton Inc.

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Spotlighting: Alvaro Moncayo

Doctor Alvaro Moncayo, MD is an Associate Researcher of the Universidad de los Andes in Bogota, Colombia (2001-date) and formerly the Director of the Program on Research and Control of Chagas Disease at the World Health Organization in Geneva, Switzerland (1979-2001) presented the Michael Davis Seminar on 23 May 2007 on the subject of International Cooperation for Disease Control: The Case of Chagas Disease in Latin America.

This disease, named after Carlos Chagas the Brazilian Doctor who first described it in 1909, occurs only in Latin America and causes irreversible chronic myocardial lesions in young adults. The effects of Chagas disease results in high economic loses in the affected countries.

Dr. Moncayo's presentation focused on the control of Chagas disease by interrupting its transmission by blood-sucking Triatomine bugs, in a coordinated international program in the Southern Cone countries in Latin America. The transmission of Chagas disease by vectors and by blood transfusion has been interrupted and certified in Uruguay in1997, in Chile in 1999 and in Brazil in 2006 and so the incidence of new infections by T.cruzi in the whole continent has decreased by 70 per cent. The cost-benefit analysis of the investments of the vector control program in Brazil indicate that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the Program is a health investment with good return

A background article concerning Dr. Moncayo's work can be found <<here>>, his May 23 Davis Seminar presentation may be found <<here>>. Please also visit Dr. Moncayo's bio at the Universidad de los Andes <<here>>. Any one wishing to contact Dr. Moncayo may do so at: Alvaro Moncayo.

 

Spotlighting: Tamara Konetzka

Dr. Konetzka conducts research in health economics, aging and long-term care, quality of care, hospital markets, workforce issues, and Medicare and Medicaid policy, focusing on the relationship between economic incentives and quality of care. She holds a Ph.D. in health economics from the University of North Carolina at Chapel Hill and a master’s in economics from the University of Pennsylvania, where she also completed a post-doctoral fellowship. She has been on the faculty of the Department of Health Studies at the University of Chicago since 2004. An important body of work stemming from her dissertation examines spillover effects between Medicaid and Medicare policies in nursing homes. Forthcoming publications include a causal analysis of the nursing home staffing-outcomes relationship in Health Services Research, an assessment of the appropriateness of mandated hospital minimum staffing ratios in Medical Care, and an analysis showing the diminished ability of managed care to control hospital costs in Inquiry.

Dr. Konetzka’s current work generally involves econometric analysis of large data sets and focuses largely on incentives faced by nursing homes to provide care of sufficient or high quality. One phenomenon that policy makers as well as nursing home providers and consumers have to consider is the rising rate of malpractice litigation in nursing homes. One of Dr. Konetzka’s research projects examines the links between malpractice litigation and quality of care, i.e. whether the threat of litigation acts as a deterrent to poor quality. This work was funded in part through CHAS pilot funds and will be presented at the meetings of the American Economic Association in January 2008. Another stream of long-term-care work involves evaluation of the impact of public reporting of quality on nursing home quality, including unintended consequences. In the hospital sector, she is studying how the profitability of different conditions affects the quality of care for those conditions when hospitals face financial stress.

Earlier in her career, Dr. Konetzka was a research director for a large nursing home association in Washington D.C., where she conducted impact assessments on regulatory issues affecting institutional long-term care, managed research on the development of quality indicators across long-term care settings, and conducted large, national surveys of the assisted living industry.  She teaches courses in aging and health policy and health services research methods.

 

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