Center for Health Policy, IU Richard M. Fairbanks School of Public Health

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https://hdl.handle.net/1805/14313

The Center for Health Policy (CHP) is the research hub of the department of Health Policy and Management. Our mission is to generate evidence that informs decision-making in Indiana and beyond. CHP Fellows and staff conduct rigorous research and evaluation on health system performance and health policy issues, with a specific focus on: population health and analytics; substance misuse and mental health services; and public health systems and services research.

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Vaping Among Indiana Youth
(2020-03-01) Kooreman, Harold
The U.S. Surgeon General and other public health officials have described the use of e-cigarettes, or vaping, by young people as an epidemic. E-cigarettes are electronic devices that heat a liquid (called e-liquid) typically containing nicotine, flavoring, and other chemicals to produce an aerosol that is inhaled by a user. Although nicotine is the most common drug that young people vape, vaping marijuana is also increasing in popularity. Although the long-term health effects of vaping are not currently known, e-cigarettes do pose a number of risks to young people. First, the use of e-cigarettes serves as a gateway to future combustible cigarette use. Second, because most e-liquid contains nicotine and because the adolescent brain is particularly sensitive to nicotine, the use of e-cigarette products places young people at heightened risk for nicotine dependence. Third, the chemicals contained in e-liquid have never been approved by the Food and Drug Administration for inhalation.
Marijuana Use in Indiana: A Look at Cannabis Laws in and Around Indiana
(Center for Health Policy, 2020-04-01) Gutta, Jyotsna; Greene, Marion S.
Though under federal law marijuana is still considered an illicit drug, many states have enacted policies decriminalizing and/or legalizing marijuana to some degree. In 14 states (including Indiana), possession, use, cultivation, sale or distribution of marijuana is illegal. Indiana is bordered by states with varying marijuana policies: Kentucky (illegal), Ohio (medical use), and Michigan and Illinois (medical and recreational use). One emerging trend of concern is the use of marijuana products (THC) in e-cigarettes, especially among young people.
The Impact of the COVID-19 Pandemic on Behavioral Health in Indiana
(The Center for Health Policy, 2021-06-01) Kooreman, Harold; Gutta, Jyotsna; Bandali, Elhaam; Greene, Marion S.
As of January 2021, the Johns Hopkins Coronavirus Resource Center has confirmed more than 20 million SARS-CoV-2 cases and over 350,000 deaths in the United States alone and 100 million cases and more than 2 million deaths globally. As of December 31, 2020, over half a million Hoosiers had tested positive for COVID-19 and more than 8,000 had died as a result of complications from the disease. This report is a review on the impact the COVID-19 pandemic had (and has) on the mental and behavioral health of Hoosiers. Specifically, we reviewed pandemic-related stress on children, parents, and the elderly; substance use, misuse, and overdose deaths; mental health concerns; suicide; domestic violence; and child abuse and neglect. The current report is a summary of findings. It provides a snapshot in time. Data and conclusions were relevant and timely at the time the report was produced.
Mental Health, Substance Misuse, and Suicide: Shared Risk and Protective Factors
(The Center for Health Policy, 2018-06-01) Hilts, Katy; Greene, Marion S.
Mental illness, substance misuse, and suicide are complex conditions with serious public health implications. Evidence suggests that these disorders often co-occur and share many of the same risk and protective factors. Additionally, certain populations are at an increased risk of developing substance use disorders, mental illness, or engaging in suicidal behaviors. Nationally and in Indiana, several factors, including stigma, an undersized mental health workforce, and limited treatment options, inhibit the effective identification and treatment of these conditions.
Community Conditions Favorable for Substance Abuse
(The Center for Health Policy, 2018-04-01) Jacinto, Corey; Greene, Marion S.
The probability of whether an individual engages in substance use is associated with several risk and protective factors. Effective prevention requires understanding these factors. The social-ecological model considers the complex interactions between individual, relationship, community, and societal factors. This can help us understand substance use in a public health context and design strategies to address the problem across multiple levels.
The Impact of Substance Use on the Developing Brain
(The Center for Health Policy, 2017-07-01) Kooreman, Harold E.
Most peoples’ first exposure to alcohol, tobacco, and other drugs typically occurs during adolescence, a time when the brain changes rather dramatically. The maturation process of the adolescent brain is reflected in a greater propensity to take part in risky activities such as unprotected sex, reckless driving, and substance use. Alcohol, nicotine, and marijuana, the most commonly used substances by teens, have all been tied to disruptions in normal brain development. These structural changes are associated with higher rates of cognitive impairments and academic difficulties, higher rates of future substance use and substance use disorders, and higher rates of mood and psychotic disorders.
Opioid Overdoses in Indiana: A Closer Look at Opioid Type
(The Center for Health Policy, 2018-06-01) Kooreman, Harold E.
The misuse of prescription and illicit opioids remains at epidemic proportions, costing the United States billions of dollars annually. Overdose deaths in both the U.S. and Indiana have seen a dramatic increase over the past ten years. Until recently, prescription opioids were responsible for the greatest number of overdose deaths, but now have been surpassed by fatalities involving heroin and illicitly manufactured narcotics, primarily fentanyl.
Medicated-Assisted Treatment in Indiana
(The Center for Health Policy, 2019-03-01) Kooreman, Harold
Opioid misuse and addiction continues to affect many Americans. Medication-assisted treatment (MAT) using methadone, buprenorphine, or extended-release naltrexone in combination with behavioral therapy is the most effective intervention for opioid use disorders (OUDs). Despite its effectiveness, methadone to treat OUDs is not widely available. Buprenorphine is more accessible, as it can be prescribed by medical doctors, nurse practitioners, and physician assistants who have received specialized training and obtained a waiver from the DEA. Naltrexone is a non-narcotic and can be prescribed by any healthcare professional who has prescription privileges.
Polypharmacy Among Prescription Drug Users
(The Center for Health Policy, 2017-08-01) Omenka, Issac; Greene, Marion S.
Polypharmacy, i.e., the misuse of multiple prescription drugs or prescription medication with other substances, is highly problematic. Whether unintentional or deliberate, misuse of multiple drugs can lead to adverse effects including addiction; drug-drug interactions; and overdose, potentially resulting in death. Polypharmacy is not uncommon; almost 84 percent of prescription drug misusers receiving substance abuse treatment in Indiana reported using at least one additional substance, most commonly alcohol or marijuana.
Social Determinants of Health and Their Impact on Mental Health and Substance Misuse
(The Center for Health Policy, 2020-01-01) Sanner, Lindsey M.; Greene, Marion S.
Health and wellbeing are shaped by many factors beyond healthcare and behavioral choices, including conditions that make up our social, economic, and physical environments. These factors are often referred to as social determinants of health (SDoHs). SDoHs not only affect our physical health, but they also can have an impact on a person’s mental wellbeing and substance use. These social determinants of health can be grouped into five major categories: 1. Neighborhood and built environment 2. Health and healthcare 3. Social and community context 4. Education 5. Economic stability To address SDoHs effectively, a “health in all policies” approach that integrates health considerations into policymaking across sectors is essential.

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