Investigator Awards In Health Policy Research 53 Bay State Road
Boston University Health Policy Institute
Boston, MA 02215 		Tel: 1-617-353-9220, ext. 1
Fax: 1-617-353-9227
Email: rwjfihp@bu.edu
www.investigatorawards.org
www.rwjf.org
Investigators And Their Projects » Awards by Year:
Section Info
This section contains information about all of the projects and researchers that have been funded through the Investigator Awards program since the first grants were made in 1993. The indexes in this section can be used to identify investigators by name, area of expertise, or year of award. Throughout the site, you will find that each investigator’s name links to details including contact and project information.
»List Projects awarded in
Projects Awarded in 2000:
Investigator names link to complete details.
Robert A. Aronowitz, M.D.The Construction of Health Risk and the Demand for Disease Prevention, 1945-2000
Award Year: 2000

»Show Abstract
While many newly defined health risks have elicited major societal and biomedical responses such as screening tests and risk-reducing drugs, others have not. Dr. Aronowitz examines how values and interests of various stakeholders influence how we recognize, name, define, and respond to health risks. His project traces the history of these risks in the U.S. since World War II and seeks to explain how they have been discovered, promoted, and made the object of prevention practices. Case studies on cancer cluster investigations, in situ cancers, Lyme disease vaccines, lung cancer screening, and the association between homocysteine and coronary heart disease will be compiled. Findings should inform and provoke societal debate over new ways to better manage research on health risks as well as the demand for interventions to reduce them.
Peter Baldwin, Ph.D.The Influence of History and Tradition on Public Health Strategies: A Nationally Comparative Approach to the AIDS Epidemic
Award Year: 2000

»Show Abstract
This project explores why the public health response to the AIDS epidemic has varied so greatly in industrialized nations. By setting the approach to the AIDS epidemic in a broader historical context, Dr. Baldwin analyzes the factors that have determined AIDS responses in five countries - the U.S., France, Germany, Britain and Sweden. The study considers: local political traditions, social composition (ethnic and class), mutual interactions and inflections of other policies with public health measures, the nature of the state imposing the preventive response, the social policy infrastructure, as well as the power and political influence of the various interest groups most directly affected by the epidemic. The results should shed light on the determinants of public health policy and their broader political implications.
Nicholas A. Christakis, M.D., Ph.D., M.P.H.Health in Marriage: Policy Implications of Spousal Illness and Death
Award Year: 2000

»Show Abstract
There are major gaps in our understanding of how morbidity and mortality in one spouse affect the health and life of the other. Our rapidly aging population coupled with increased chronic disease, will likely result in serious health consequences for elderly individuals with ill or dying spouses. In his project, Dr. Christakis conducts an analysis based on observation, theory, and policy of the relationship between marriage and health. His conceptual framework draws on three related theories stress as a source of illness, the role of social support in mitigating disease and mortality, and social capital. Several health policy questions are addressed including: 1) when and how support services might best be delivered to newly-widowed individuals; 2) how to identify individuals at greatest risk; and 3) how marital health effects should be factored into the planning of health care services for the elderly.
Richard A. Deyo, M.D., M.P.H.
Donald L. Patrick, Ph.D., M.S.P.H.		Crossing the Threshold: How Experimental Medical Technology Becomes Standard Care
Award Year: 2000

»Show Abstract
New medical technologies are a leading cause of escalating health care costs. However, the process by which new technology is disseminated and utilized is highly variable. It is driven not only by scientific evidence but also by the high cultural value placed on health technology in the U.S., profit motives, political concerns, marketing, and the media. This project describes the transition of new technology from experimental to standard of care; the processes by which multiple stakeholders influence technology adoption; the ways in which evidence may be overwhelmed by political, socio-cultural, and financial forces; and the unintended medical, social, and economic consequences of disseminating unproven or marginal technology. Case studies of drugs, devices, behavioral regimens, and surgical innovations will be used to illustrate the process of adopting therapeutic technologies. The study also explores and critiques potential policy options for improving the process of technology adoption.
James E. Foster, Ph.D.Understanding Health Disparities from an Economic Perspective
Award Year: 2000

»Show Abstract
Recent discoveries linking income inequality and various health outcome measures have sparked debate among health analysts about this issue, its magnitude, causes, and linkages. Many economists remain skeptical about the importance or validity of this hypothesis. Using perspectives of economic theory, this study increases our understanding of the nature and causes of health inequalities. It provides a conceptual foundation for discussing health disparities; explores the validity of a conceptual framework for the relative income hypothesis; and uses both a relative education hypothesis and a proximate literacy hypothesis to analyze the interplay of other economic variables and health outcomes. The project contributes a new resource on the methods and evidence pertaining to health disparities; provides information about differences in education levels contributing to ill health; and considers how group characteristics affect individual outcomes.
Mindy T. Fullilove, M.D.Root Shock: The Consequences of African American Dispossession
Award Year: 2000

»Show Abstract
Title I of the Housing Act of 1949 was an important federal initiative that funded urban revitalization. Directed at older, core city neighborhoods, these urban renewal projects disproportionately affected African Americans. Dr. Fullilove's project explores the contribution of spatial dislocation policies to current health disparities. It will improve our understanding of how urban renewal affected African American life and health, how it has contributed to direct and indirect causes of illness and the depletion of social cohesion and other capital. Situation analysis will be used to assess the history and impact of urban renewal in Newark, Roanoke, Pittsburgh, San Francisco, and St. Louis. The study addresses two specific policy issues the contribution of spatial dislocation to excess morbidity and mortality as well as the potential for using post-conflict resolution to remedy the harm done to displaced African Americans.
Richard L. Hall, Ph.D.With the Help of Their Friends: Lobbyists and Legislators in Health Policymaking
Award Year: 2000

»Show Abstract
Exploring the role and influence of interest groups in policymaking, Dr. Hall will build on previous experience in developing a new theoretical framework, which casts lobbying in a different light. Rather than influencing legislators' positions, lobbying is viewed as a form of legislative subsidy (a grant of staff time, legislative intelligence, policy information) selectively given to congressional allies in order to more effectively fight for proposals on which the legislator and the group agree. The theory assumes that, to have a real impact, a legislator must engage in labor intensive and costly activities, which exceed available financial resources. Health legislation and agency rulemaking will be explored to help public health advocates better understand how to overcome impediments to important policy proposals. Data will be obtained from a variety of sources including interviews with lobbyists and legislative staff.
Sydney A. Halpern, Ph.D.Human Experimentation and Public Policy
Award Year: 2000

»Show Abstract
Controversy surrounding federally mandated oversight of human-subjects research has redoubled in recent years as news of regulatory problems receive increased public attention. Advocates continue to call for reform and changes, yet neither scholarship nor public discourse has offered much insight into the sources of recurrent controversies. Dr. Halpern will provide a historically grounded account linking current regulatory problems to both the oversight system and the relations among institutional actors, which shaped its emergence. She will clarify: 1) why the system assumed its current form; 2) what forces and actors shape regulatory practices and possibilities for change; 3) what procedures for handling human experimentation have not been pursued; 4) how policy choices come to be framed; and 5) how regulatory arrangements helped to create or failed to solve policy problems. Her resulting work will describe processes that foster or inhibit change, unintended consequences of reforms, and precedents for alternative oversight measures.
Rudolf Klein, M. A., (Ph.d. hon.)
Theodore R. Marmor, Ph.D.		Political Analysis: Applications to Health Care and Health Policy
Award Year: 2000

»Show Abstract
Professors Marmor and Klein seek to improve the understanding of health care policymaking while contributing to a more informed discussion of options among academics and policymakers. Building on their earlier work, they will focus on the politics of decision making in the widest sense: the constraints and opportunities created by existing institutions, administrative capacities, and the structure of interests in the health policy arena. The project will provide a framework for analyzing the dynamics of the policy process and categorizing health care issues. The investigators will draw on the findings of other health policy studies and use them to test the framework. Among the specific topics to be addressed are the political struggles over systemic reform, rationing, prevention, professional accountability, consumer empowerment, health panics, and moral crusades.
Sara Rosenbaum, J.D.
Joel Teitelbaum, J.D., LL.M.		Civil Rights and the American Health Care System: Conceptualizing a Law and Policy Framework in the New Health Environment for Title VI of the 1964 Civil Rights Act
Award Year: 2000

»Show Abstract
Despite the high level of attention on health care discrimination during the debate over the Civil Rights Act of 1964, health care as a civil right has received relatively little attention since enactment. By examining the potential for using civil rights law to address disparities in access to care and health outcomes, the investigators will create a new framework for applying Title VI of the Act to today's health care system. The project addresses major policy questions in relation to Title VI enforcement efforts at a time when health care services have been transformed and dominated by integrated delivery systems. Professors Rosenbaum and Teitelbaum will evaluate the need to modernize the legal structure of Title VI to account for delivery system changes. Their work will provide policymakers with a clearer picture of health care discrimination, remedies for discriminatory practices, and legal principles on which the duty not to discriminate should rest.
Burton A. Weisbrod, Ph.D.Nonprofit, For-Profit, and Governmental Provision of Health Care: Does Institutional Form Matter?
Award Year: 2000

»Show Abstract
Health care services in the U.S. are provided by an amalgam of for-profit, nonprofit, and governmental institutions. Dr. Weisbrod's project examines whether and, if so, how institutional form matters in health care delivery and what it suggests for improved policymaking. Building on his and other's earlier work, he explores the fundamental question of what nonprofit and governmental organizations contribute to health care that is not provided by the private sector. He focuses on the problems of rewarding organizational performance in forms that, while socially valuable, are privately unprofitable. He also explores difficulties that private enterprise confronts when outputs are complex and costly to measure. Differences in institutional behavior will be examined in a variety of service delivery settings. The results should shed light on the policy debate about the organization of the health care system and the desired balance between private, nonprofit, and governmental providers.