Social and Economic Determinants of Infant Ill Health in 159 Georgia Counties: A Comparison Study

Prematurity and low birth weight (LBW) are important causes of infant morbidity in Georgia and the United States. Georgia county-level data were used to explore the relationships between prematurity and LBW and two social and economic determinants of health: race and poverty status. Spearman rank correlations and Friedman and Wilcoxon signed rank tests were used. Prematurity and LBW were positively associated with poverty status and the presence of large African American populations. While causation cannot be inferred from correlative data, this analysis highlights the need to consider the role of social and economic factors in infant morbidity. It also highlights the need to target interventions and services to geographic areas most in need

A Role For Scenario Planning In Rural Hospitals

Highlights: Scenario planning typically focuses on the future, beyond the normal strategic planning horizon. It has been used primarily by large organizations, but it can be useful to organizations of any size trying to develop strategy for the future. COVID-19 has arguably broadened planners’ perspectives, thus emphasizing potential benefits from scenario planning for organizations, both large and small. Rural hospitals may find some scenario planning beneficial.Background: Formal introduction of scenario planning in the U.S. can be traced to Herman Kahn’s use of stories in military planning. Royal Dutch-Shell’s use of scenario planning is widely noted as the first big organizational use. Scenario planning involving plausible future oil pricing that differed from a mere extrapolation of current prices positioned the company to weather unexpected oil market shocks in the 1970s. The requirement to break from status quo, extrapolated forecasting—thereby forcing deeper strategic conversation—is the primary strength of scenario planning. Scenario planning usually focuses on the longer-term—beyond a normal time horizon for strategic planning (Schwartz, 1991), but there is no rule to prohibit its use in a shorter horizon. By asking the question of what might happen, scenario planning can be useful to any organization trying to develop strategy for the future. While it has been utilized by primarily large organizations, this approach offers meaningful contributions to organizations, no matter its size

Public Health for Young Adults Day: Recruiting the Next Generation

Background: Public Health for Young Adults Day (PHYA Day) is a one-day program designed to educate high school-age students about the principles and values of the five core areas of public health. The goal of PHYA Day is to foster interest and ultimately increase recruitment into the field of public health. This goal is essential due to the impact of the economic recession of 2008. It was estimated that the local public health workforce decreased from 191,000 to 168,000 across the nation between 2008 and 2013. In spite of 2008’s recession, a well-trained, competent public health workforce remains an imperative component of effective public health service delivery. The researchers believe that PHYA Day encourages young people to explore the idea of a public health-focused career by increasing their knowledge of the field as a whole. Methods: A pre- and post-test survey was used to evaluate this program, determine if participants gained an interest in joining the public health workforce, and measure the learning outcomes of those participants. After gaining proper Institutional Review Board approval the evaluation was completed in April 2015. Results: When the averages of the post-test were compared to those of the pre-test the results showed that there was a significant gain in knowledge among participants. Conclusions: Based off of their findings the researchers were able to conclude that PHYA Day is effective in educating high school age students about the options that the public health field have to offer and therefore may increase the number of young adults choosing public health as a career

CEO Turnover in Georgia Rural Hospitals, 2011-2017

Highlights: The average annual turnover rate in Georgia rural hospitals between 2011 and 2017 was 24%, with a low of 17% in 2012 and in 2015 and a high of 37% in 2016. Between 2011 and 2017, rural hospitals had on average, approximately two CEO changes, with 46% reporting three or more CEO changes. Annual turnover rates were found to be consistently higher in rural prospectively paid (PPS) hospitals, compared to Critical Access Hospitals (CAHs). Background: Hospital chief executive officer (CEO) turnover rates have increased nationally over the last decade, increasing from 15% in 2007 to 18% in 2017, and after reaching a peak of 20% in 2013 (American College of Healthcare Executives [ACHE], 2008; ACHE, 2018). Unexpected leadership turnover can be disruptive for organizations operating in an ever-dynamic environment like healthcare. The existing literature indicates an inverse relationship between CEO turnover and hospital performance, with a stronger negative impact of turnover on performance in nonprofit hospitals (Brickley & Van Horn, 2002) and among small rural hospitals (Alexander & Lee, 1996). In 2018, the American College of Healthcare Executives (ACHE) estimated the CEO turnover rate in Georgia hospitals to be 20%, higher than the national rate of 18%. There is, however, a dearth of literature on CEO turnover in rural hospitals in the state. The purpose of this research brief is to describe CEO turnover in Georgia’s rural hospitals between 2011 and 2017

Covid-19 and Social Determinants of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs

Background The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined. Aim The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic. Methods The study was a qualitative study using data from 28 semi-structured interviews with representatives from 14 MMCOs, including state-specific markets of eight national and regional managed care organizations. Data were analyzed using thematic analysis. Results Four themes emerged: the impact of the pandemic, SDOH response efforts, an expanding definition of SDOH, and managed care beyond COVID-19. Specifically, participants discussed the impact of the pandemic on enrollees, communities, and healthcare delivery, and detailed their evolving efforts to address member nonmedical needs during the pandemic. They reported an increased demand for social services coupled with a significant retraction of community social service resources. To address these emerging social service gaps, participants described mounting a prompt and adaptable response that was facilitated by strong existing relationships with community partners. Conclusion Among MMCOs, the COVID-19 pandemic has emphasized the importance of addressing member social needs, and the need for broader consideration of what constitutes SDOH from a healthcare delivery standpoint

87th Annual Georgia Public Health Association Meeting & Conference Report

The 87th Annual Meeting of the Georgia Public Health Association (GPHA) was held in Atlanta, Georgia, on March 22-23, 2016, with pre-conference (March 21st) and post-conference (March 23rd) Executive Board meetings. As Georgia’s leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. In recent years the venue for the GPHA annual conference has been Atlanta, with the 2017 GPHA Annual Meeting and Conference also scheduled to be held in Atlanta. Several new initiatives were highlighted as part of this year’s conference. These included three pre-conference workshops, expansion of academic sponsorships, an enhanced exhibit hall integrated with the poster sessions, silent auction, breaks and President’s Reception, an information booth, and an inaugural administration section track. The 2016 Annual Meeting & Conference added the Certified in Public Health (CPH) Continuing Education (CE) designation. The theme for the conference was Understanding Public Health: Research, Evidence and Practice, which reflects the science of public health

Strategic Implications of COVID-19: Considerations for Georgia’s Rural Health Providers

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. Proactive adoption of telehealth is essential to stake a value-added position in delivery of healthcare. Creating a regional ecosystem that both supports, and receives support from, local businesses and potential workforce members is vital to building and maintaining a thriving organization. Rural healthcare providers must consider these strategies to ensure that they are able to continue delivering their mission of improving the health of the populations they serve

Strategies for Improving Profitability of Rural Hospitals: Are Profitable Hospitals Doing Something Different?

THE TOP FIVE STRATEGIES adopted by rural hospitals for the purposes of improving financial performance included improving patient satisfaction and care experience, adding new service lines or expanding existing service lines, community outreach, employee engagement, and physician engagement. Profitable hospitals were more likely than other hospitals to have implemented cost-cutting and internal and external stakeholder engagement strategies. Background Nationwide, hospitals, as well as policy makers, are exploring strategies for improving the financial viability of rural hospitals. These efforts are in response to the critical need for sustainable hospital infrastructure in rural America and the negative impact the lack thereof can have on rural health. This study sought to describe efforts undertaken by rural hospitals to improve financial sustainability

Fulfilling Community Health Assessment Requirements: Lessons Learned From Facilitating State-Wide Community Health Forums

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency. Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums. Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status. Conclusion: Lessons learned from these state-wide community health forums can be applied to improve the overall process of gathering data for a comprehensive CHA throughout Georgia or other areas interested in pursuing public health agency accreditation