OREGON STATE UNIVERSITY

college of public health and human sciences

Climate report: Wildfires, snowmelt, coastal issues top Northwest risks

CORVALLIS, Ore. – The Northwest is facing increased risks from the decline of forest health, earlier snowmelt leading to low summer stream flows, and an array of issues facing the coastal region, according to a new climate assessment report.

Written by a team of scientists coordinated by the Oregon Climate Change Research Institute (OCCRI) at Oregon State University, the report is the first regional climate assessment released since 1999. Both the 1999 report and the 2013 version were produced as part of the U.S. National Climate Assessment; both Washington and Oregon produced state-level reports in 2009 and 2010.

OSU’s Philip Mote, director of the institute and one of three editors of the 270-page report (as well as the 1999 report), said the document incorporates a lot of new science as well as some additional dimensions – including the impact of climate change on human health and tribal issues. A summary of the report is available online at: http://occri.net/reports

Amy Snover, director of the Climate Impacts Group at the University of Washington, said there are a number of issues facing the Northwest as a result of climate change.

“As we looked across both economic and ecological dimensions, the three that stood out were less snow, more wildfires and challenges to the coastal environment and infrastructure,” said Snover, who is one of the editors on the report.

The report outlines how these three issues are affected by climate change.

“Studies are showing that snowmelt is occurring earlier and earlier and that is leading to a decline in stream flows in summer,” Mote said. “Northwest forests are facing a huge increase in wildfires, disease and other disturbances that are both direct and indirect results of climate change. And coastal issues are mounting and varied, from sea level rise and inundation, to ocean acidification. Increased wave heights in recent decades also threaten coastal dwellings, roads and other infrastructure.”

OCCRI’s Meghan Dalton, lead editor on the report, notes that 2,800 miles of coastal roads are in the 100-year floodplain and some highways may face inundation with just two feet of sea level rise. Sea levels are expected to rise as much as 56 inches, or nearly five feet, by the year 2100.

Earlier snowmelt is a significant concern in the Northwest, where reservoir systems are utilized to maximize water storage. But, Dalton said, the Columbia River basin has a storage capacity that is smaller than its annual flow volume and is “ill-equipped to handle the projected shift to earlier snowmelt…and will likely be forced to pass much of these earlier flows out of the system.”

The earlier peak stream flow may significantly reduce summer hydroelectric power production, and slightly increase winter power production.

The report was funded by the National Oceanic and Atmospheric Administration, through the Oregon Legislature’s support of the Oregon Climate Change Research Institute at OSU, and by in-kind contributions from the authors’ institutions.

Mote said new research has led to improved climate models, which suggest that the Northwest will warm by a range of three to 14 degrees (Fahrenheit) by the year 2100. “The lower range will only be possible if greenhouse gas emissions are significantly reduced.” In contrast, the Northwest warmed by 1.3 degrees from the period of 1895 to 2011.

Future precipitation is harder to project, the report notes, with models forecasting a range from a 10 percent decrease to an 18 percent increase by 2100. Most models do suggest that more precipitation will fall as rain and earlier snowmelt will change river flow patterns.

That could be an issue for agriculture in the future as the “Northwest’s diverse crops depend on adequate water supplies and temperature ranges, which are projected to change during the 21st century,” the report notes. Pinpointing the impacts on agriculture will be difficult, said Sanford Eigenbrode of the University of Idaho, another co-author.

“As carbon dioxide levels rise, yields will increase for some plants, and more rainfall in winter could mean wetter soils in the spring, benefitting some crops,” Eigenbrode pointed out. “Those same conditions could adversely affect other crops. It is very difficult to say how changing climate will affect agriculture overall in the Northwest, but we can say that the availability of summer water will be a concern.”

Mote said there may be additional variables affecting agriculture, such what impacts the changing climate has on pests, diseases and invasive species.

“However, the agricultural sector is resilient and can respond more quickly to new conditions than some other sectors like forestry, where it takes 40 years or longer for trees to reach a harvestable age,” noted Mote, who is a professor in OSU’s College of Earth, Ocean, and Atmospheric Sciences.

The Northwest has not to date been vulnerable to many climate-related health risks, the report notes, but impacts of climate change in the future are more likely to be negative than positive. Concerns include increased morbidity and mortality from heat-related illness, air pollution and allergenic disease, and the emergence of infectious diseases.

“In Oregon, one study showed that each 10-degree (F) increase in daily maximum temperature was associated with a nearly three-fold increase of heat-related illness,” said Jeff Bethel, an assistant professor in the College of Public Health and Human Sciences at OSU and one of the co-authors of the report. “The threshold for triggering heat-related illness – especially among the elderly – isn’t much.”

Northwest tribes may face a greater impact from climate change because of their reliance on natural resources. Fish, shellfish, game and plant species could be adversely affected by a warming climate, resulting in a multitude of impacts.

“When tribes ceded their lands and were restricted to small areas, it resulted in a loss of access to many species that lived there,” said Kathy Lynn, coordinator of the Tribal Climate Change Project at the University of Oregon and a co-author of the report. “Climate change may further reduce the abundance of resources. That carries a profound cultural significance far beyond what we can document from an economic standpoint.”

Snover said that the climate changes projected for the coming decades mean that many of the assumptions “inherent in decisions, infrastructure and policies – where to build, what to grow where, and how to manage variable water sources to meet multiple needs – will become increasingly incorrect.

“Whether the ultimate consequences of the climate impacts outlined in this report are severe or mild depends in part on how well we prepare our communities, economies and natural systems for the changes we know are coming,” Snover said.

Other lead co-authors on the report are Rick Raymondi, Idaho Department of Water Resources; W. Spencer Reeder, Cascadia Consulting Group; Patty Glick, National Wildlife Federation; Susan Capalbo, OSU; and Jeremy Littell, U.S. Geological Survey.

Story By: 
Source: 

Philip Mote, 541-737-5694; pmote@coas.oregonstate.edu; Amy Snover, 206-221-0222; aksnover@uw.edu

Multimedia Downloads
Multimedia: 

Major storm Coastal issues

Melting glacier Snowmelt

Trail Creek FireWildfires

Excess omega-3 fatty acids could lead to negative health effects

CORVALLIS, Ore. – A new review suggests that omega-3 fatty acids taken in excess could have unintended health consequences in certain situations, and that dietary standards based on the best available evidence need to be established.

“What looked like a slam dunk a few years ago may not be as clear cut as we thought,” said Norman Hord, associate professor in OSU’s College of Public Health and Human Sciences and a coauthor on the paper.

“We are seeing the potential for negative effects at really high levels of omega-3 fatty acid consumption. Because we lack valid biomarkers for exposure and knowledge of who might be at risk if consuming excessive amounts, it isn’t possible to determine an upper limit at this time.”

Previous research led by Michigan State University’s Jenifer Fenton and her collaborators found that feeding mice large amounts of dietary omega-3 fatty acids led to increased risk of colitis and immune alteration. Those results were published in Cancer Research in 2010.

As a follow-up, in the current issue of the journal Prostaglandins, Leukotrienes & Essential Fatty Acids, Fenton and her co-authors, including Hord, reviewed the literature and discuss the potential adverse health outcomes that could result from excess consumption of omega-3 fatty acids.

Studies have shown that omega-3s, also known as long chain polyunsaturated fatty acids (LCPUFAs), are associated with lower risk of sudden cardiac death and other cardiovascular disease outcomes.

“We were inspired to review the literature based on our findings after recent publications showed increased risk of advanced prostate cancer and atrial fibrillation in those with high blood levels of LCPUFAs,” Fenton said.

Omega-3 fatty acids have anti-inflammatory properties, which is one of the reasons they can be beneficial to heart health and inflammatory issues. However, the researchers said excess amounts of omega-3 fatty acids can alter immune function sometimes in ways that may lead to a dysfunctional immune response to a viral or bacterial infection.

“The dysfunctional immune response to excessive omega-3 fatty acid consumption can affect the body’s ability to fight microbial pathogens, like bacteria,” Hord said.

Generally, the researchers point out that the amounts of fish oil used in most studies are typically above what one could consume from foods or usual dosage of a dietary supplement. However, an increasing amount of products, such as eggs, bread, butters, oils and orange juice, are being “fortified” with omega-3s. Hord said this fortified food, coupled with fish oil supplement use, increases the potential for consuming these high levels.

“Overall, we support the dietary recommendations from the American Heart Association to eat fish, particularly fatty fish like salmon, mackerel, lake trout or sardines, at least two times a week, and for those at risk of coronary artery disease to talk to their doctor about supplements,” he said.

“Our main concern here is the hyper-supplemented individual, who may be taking high-dose omega-3 supplements and eating four to five omega-3-enriched foods per day,” Hord added. “This could potentially get someone to an excessive amount. As our paper indicates, there may be subgroups of those who may be at risk from consuming excess amounts of these fatty acids.”

Hord said there are no evidence-based standards for omega-3 intake and no way to tell who might be at health risk if they consume too high a level of these fatty acids.

“We’re not against using fish oil supplements appropriately, but there is a potential for risk,” Hord said. “As is all true with any nutrient, taking too much can have negative effects. We need to establish clear biomarkers through clinical trials. This is necessary in order for us to know who is eating adequate amounts of these nutrients and who may be deficient or eating too much.

“Until we establish valid biomarkers of omega-3 exposure, making good evidence-based dietary recommendations across potential dietary exposure ranges will not be possible.”

Sanjoy Ghosh from University of BC-Okanagan, Canada and Eric Gurzell from Michigan State University also contributed to this study, which was supported by grants from the National Institutes of Health and the Canadian Diabetes Association.

Story By: 
Source: 

Norman Hord, 541-737-5923

California’s new mental health system helps people live independently

CORVALLIS, Ore. – A new analysis by Oregon State University researchers of California’s mental health system finds that comprehensive, community-based mental health programs are helping people with serious mental illness transition to independent living.

Published in the October issue of the American Journal of Public Health, this study has important implications for the way that states finance and deliver mental health programs, and speaks to the effectiveness of well-funded, comprehensive community programs.

In November of 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs, known as Full Service Partnerships (FSP). While community-based, these programs are different from usual mental health services programs in most states because they provides a more intensive level of care and a broader range of mental health services and supports, such as medication management, crisis intervention, case management and peer support.

It also provides services such as food, housing, respite care and treatment for co-occurring disorders, such as substance abuse.

“We found that these programs promoted independent living in the community among people who had serious mental illness but had not been served or underserved previously,” said Jangho Yoon, an assistant professor of health policy and health economist in OSU’s College of Public Health and Human Sciences and lead author of the study. “Overall, it reduced their chance of living on the street or being incarcerated in jails and prisons.”

The researchers looked at data from 43 of California’s 53 counties, resulting in a sample of 9,208 adults over the course of four years. They found that participants who stayed enrolled in the program continuously, without interruption, were 13.5 percent more likely to successfully transition to independent living.

However, they found that non-white patients were less likely to live independently, and more likely to end up in jail or homeless.

“Although FSPs represent the most well-funded comprehensive community-based programs in the country, they are still community programs and therefore program participation is voluntary,” Yoon said.  “My guess is that minorities may not benefit fully from these programs in their communities possibly due to greater stigma, and less family/social supports. But it needs further investigation.”

Patients with schizophrenia and bipolar disorders were also less likely to benefit from the community programs, because of the nature and severity of their mental health issues.

Yoon is an expert on health management policy, specifically policy around the area of mental health. He said other states haven’t followed California’s lead, in part because of the cost of such extensive programming. Yoon said some of the funding made possible by the federal Patient Protection and Affordable Care Act, which includes $460 million for community mental health services for states to use, may help other states to create similar programs.

“Nobody would disagree that the public mental health system has historically been under-funded in the U.S.,” he said. “The message for other states is clear: investment in well-funded, recovery-oriented, comprehensive community mental health programs clearly improves lives of people with serious mental illness, and may also save money from reduced dependency and incarcerations in this population.”

Tim Bruckner of the University of California, Irvine, and Timothy Brown of the University of California, Berkeley, contributed to this study, which was jointly funded by the California Department of Mental Health and the California Health Care Foundation.

Story By: 
Source: 

Jangho Yoon, 541-737-3839

Autistic children with better motor skills more adept at socializing

CORVALLIS, Ore. – In a new study looking at toddlers and preschoolers with autism, researchers found that children with better motor skills were more adept at socializing and communicating.

Published online today in the journal Research in Autism Spectrum Disorders, this study adds to the growing evidence of the important link between autism and motor skill deficits.

Lead author Megan MacDonald is an assistant professor in the College of Public Health and Human Sciences at Oregon State University. She is an expert on the movement skills of children with autism spectrum disorder.

Researchers tested 233 children ages 14 to 49 months diagnosed with autism.

“Even at this early age, we are already seeing motor skills mapping on to their social and communicative skills,” MacDonald said. “Motor skills are embedded in everything we do, and for too long they have been studied separately from social and communication skills in children with autism.”

Developing motor skills is crucial for children and can also help develop better social skills. MacDonald said in one study, 12-year-olds with autism were performing physically at the same level as a 6-year-old.

“So they do have some motor skills, and they kind of sneak through the system,” she said. “But we have to wonder about the social implications of a 12-year-old who is running like a much younger child. So that quality piece is missing, and the motor skill deficit gets bigger as they age.”

In MacDonald’s study, children who tested higher for motor skills were also better at “daily living skills,” such as talking, playing, walking, and requesting things from their parents.

“We can teach motor skills and intervene at young ages,” MacDonald said. “Motor skills and autism have been separated for too long. This gives us another avenue to consider for early interventions.”

MacDonald said some programs run by experts in adaptive physical education focus on both the motor skill development and communicative side. She said because autism spectrum disorder is a disability that impacts social skills so dramatically, the motor skill deficit tends to be pushed aside.

“We don’t quite understand how this link works, but we know it’s there,” she said. “We know that those children can sit up, walk, play and run seem to also have better communication skills.

This study was coauthored by Catherine Lord of Weill Cornell Medical College and Dale Ulrich of the University of Michigan. It was supported by the National Institutes of Health, the Simons Foundation, First Words and Blue Cross Blue Shield Foundation of Michigan.

Story By: 
Source: 

Megan MacDonald, 541-737-3273

Multimedia Downloads
Multimedia: 

Megan MacDonald
Researcher Megan MacDonald practices important motor skills, like throwing a ball, with a child. (photo courtesy of OSU College of Public Health and Human Sciences)

People with rare diseases are at more risk for poor quality of life, study finds

CORVALLIS, Ore. – People with rare diseases are at high risk for experiencing poor quality of life, including increased levels of anxiety, depression, pain, fatigue and limited ability to participate in society, a new study from an Oregon State University shows.

The study is believed to be the first large-scale study of adults living in the U.S. that are diagnosed with a rare disease or disorder, said Kathleen Bogart, an assistant professor of psychology in the College of Liberal Arts at OSU

“These findings suggest that the quality of life needs of people with rare diseases are not being met and that more work is needed to provide psychosocial support for this group,” said Bogart, whose work focuses on the psychosocial implications of disability. “There is a disparity here and intervention is needed.”

The findings were published this month in Orphanet Journal of Rare Diseases. Veronica Irvin, an assistant professor in OSU’s College of Public Health and Human Sciences, co-authored the paper. 

About 350 million people worldwide live with at least one rare disease, and there are about 7,000 diseases classified as rare because they affect small numbers of people. Rare is defined in the U.S. as fewer 200,000 Americans at one time; in Europe, fewer than 1 in 2,000 people.

The new paper is part of a larger, multi-part study, the Adults with Rare Disorders Support project, to assess the psychosocial support needs of people with a variety of rare diseases and disorders.  

While each disease may have its own set of characteristics and health impacts, researchers have found that people with rare diseases often share similar characteristics and experiences – including little information or treatment, lengthy times to diagnosis and isolation. Because of this shared experience, they may also benefit from similar types of psychosocial supports, Bogart said.

“Even though their diseases are different, their experience is similar,” Bogart said. “There is some benefit to looking at this group collectively, rather than trying to work with each small rare disease group independently.” 

For the study, researchers surveyed more than 1,200 U.S. residents with rare diseases, asking them to complete questionnaires about their disease and their quality of life.

The survey group represented 232 different rare diseases, including ataxia, Bell’s palsy, Ehlers Danlos syndrome, mast cell disorders and narcolepsy, and 13 percent of the group had more than one rare disease. The researchers also found that study participants waited on average nine years before receiving a correct diagnosis. 

Compared to a representative sample of U.S. residents, people with rare diseases experienced worse anxiety than 75 percent of the population; worse depression than 70 percent of the population; worse fatigue than 85 percent of the population; worse pain than 75 percent of the population; worse physical functioning than 85 percent of the population and worse ability to participate in society than 80 percent of the population.

Those with rare diseases also had poorer quality of life than U.S. residents with common chronic conditions such as heart disease, diabetes or arthritis, Bogart said. 

“There is something specific about having a ‘rare’ disease that contributes to poorer quality of life,” she said. “Many people struggle with getting an accurate diagnosis, which also can lead to a constant de-legitimization of their experience, with people wondering if it is ‘all in your head.’”

Study participants with systematic and rheumatic diseases had the poorest quality of life profiles, and those with neurological diseases also had very poor quality of life. People with developmental anomalies experienced fewer quality of life problems than the other groups. 

The findings suggest that quality of life issues such as psychosocial support should receive more priority from organizations and funding agencies that support people with rare diseases and disorders, Bogart said. Supporting quality of life is especially important for people living with one of the 95 percent of rare disorders that have no effective treatments.

Including psychosocial support in organizational mission statements, providing psychosocial support through support groups or conferences and making funding for psychosocial support a priority could help address quality of life issues for people with rare diseases, in part by helping reduce stigma and isolation and improving access to information and treatments. 

“Some people with rare diseases may never meet another person with that disease,” Bogart said. “That can be very isolating. Conferences are one way to bring people with similar experiences together to share. It helps them feel connected, normalized and validated.”

People with rare diseases who are experiencing poor quality of life also should seek support from a mental health professional, a rare disease group and/or peers with rare disorders, she said. 

“The beauty of these quality of life of findings is that they are not disease-specific,” Bogart said. “There are already umbrella groups that can provide this kind of support to people with rare diseases, regardless of their individual diseases.”

Next, the researchers plan to meet with focus groups of participants from the first phase of the study to further explore quality of life issues. The goal is to identify effective supports and develop interventions that could help people with rare diseases improve their quality of life. 

“We’d like to come up with a blueprint of ways for these support organizations to provide help,” Bogart said. “This is something we could do on a very broad level to help a lot of people and maximize the use of very limited resources.”

Story By: 
Source: 

Kathleen Bogart, 541.737-1357, Kathleen.bogart@oregonstate.edu

Multimedia Downloads
Multimedia: 

Kathleen Bogart

Kathleen Bogart

Intervention offered in kindergarten readiness program boosts children’s self-regulation skills

CORVALLIS, Ore. – Adding a daily 20 to 30 minute self-regulation intervention to a kindergarten readiness program significantly boosted children’s self-regulation and early academic skills, an Oregon State University researcher has found.

Self-regulation skills – the skills that help children pay attention, follow directions, stay on task and persist through difficulty – are critical to a child’s success in kindergarten and beyond. The intervention, co-developed and tested by OSU’s Megan McClelland, a nationally-recognized expert in child development, uses music and games to help preschoolers learn and practice self-regulation skills.

The intervention was added to a three-week summer school readiness program at a large school district on the East Coast for children entering kindergarten that had no prior preschool experience. The school district asked McClelland and her colleagues to evaluate their use of the intervention. It was the first opportunity for researchers to evaluate the program’s effectiveness in a “real-world” setting, where teachers, rather than researchers, led the students through self-regulation games. 

The researchers found that use of these games daily for three weeks improved the children’s self-regulation skills. They also found that the children’s broader school readiness skills, including early math and literacy skills, improved as a result of the intervention and the children saw greater-than-expected growth in the months following the program.

“It was a test to see if the results of this intervention look similar in a less-controlled environment, and it appears that they do,” said McClelland, the Katherine E. Smith Healthy Children and Families Professor in the College of Public Health and Human Sciences. “It helps demonstrate the feasibility and scalability of this kind of program.” 

The findings add to McClelland’s growing body of research demonstrating the value of teaching self-regulation skills to children entering kindergarten, particularly those who are at higher risk of struggling academically in school and opens the door for the intervention to be used more widely by teachers and schools.

The evaluation of the school district program was published recently in the journal Early Childhood Research Quarterly. Co-authors are Robert J. Duncan and Sara A. Schmitt of Purdue University and Maura Burke of Fairfax County Public Schools. Duncan and Schmitt both earned their doctorates at OSU. 

The school district added the self-regulation intervention at some schools participating in a summer “Bridge to Kindergarten” in 2013. It was also offered in 2014 and 2015. Researchers evaluated data from about 150 children from each year.

“The school district wanted an explicit focus on self-regulation in this program designed to get children ready for kindergarten,” McClelland said. 

Teachers were trained to lead the children through the intervention, which uses movement and music-based games that increase in complexity over time and encourage the practice of self-regulation skills. The games require few materials and the children can help make the props as part of their lessons.

One game is “Red Light, Purple Light,” which is similar to “Red Light, Green Light.” The instructor acts as a stoplight and holds up construction-paper circles to represent stop and go. Children follow color cues, such as purple is stop and orange is go, and then switch to the opposite, where purple is go and orange is stop. 

Other games include “Freeze,” where the children are encouraged to do the opposite of the teacher’s instructions; and “Sleeping,” where the children pretend to sleep and then wake up as something different and must remain in that character.

Additional rules are added later to increase the complexity of the game. The game requires children to listen and remember instructions, pay attention to the adult leading the game and resist natural inclinations to stop or go. 

“The findings from this evaluation support our previous randomized controlled studies of this program, which is a promising sign that the intervention will also be effective in practical applications,” McClelland said. “If we can make the program more accessible to schools and teachers, and still ensure quality, it becomes more feasible to share it more widely.”

McClelland and the intervention’s co-developer, Shauna Tominey of OSU, also wrote a guide for parents and teachers in 2015. “Stop, Think, Act: Integrating Self-regulation in the Early Childhood Classroom,” (Routledge) is designed to help preschool teachers and parents understand self-regulation and help children ages 3-6 build those skills through developmentally appropriate games, songs and more. 

Source: 

Megan McClelland, 541-737-9225, megan.mcclelland@oregonstate.edu

Multimedia Downloads
Multimedia: 

Sara Schmitt plays with a child

Sara Schmitt

Researcher Megan McClelland

Megan McClelland

Birth outcomes improve after implementation of coordinated care organizations, study finds

CORVALLIS, Ore. – Oregon women on Medicaid were more than 10 percent less likely to have babies with low birthweight or abnormal conditions following the state’s implementation of coordinated care organizations, a new study from Oregon State University has found.

Coordinated care organizations, or CCOs, are regional networks of health care providers who work together to treat patients. The innovative approach to providing Medicaid services, which includes coordination of physical health care, mental health care and dental care, was implemented in Oregon in 2012.

CCOs are Oregon’s version of Medicaid accountable care organizations; nine other states are also using accountable care models for their Medicaid programs and eight other states are considering adopting similar models. The CCO model emphasizes prevention and use of medical services to improve health outcomes and reduce costs.

Medicaid is a federal health insurance program for people with limited resources, including low-income adults, children, the elderly and people with disabilities. Oregon’s Medicaid program is known as the Oregon Health Plan. Compared to women with private insurance, women on Medicaid are at higher risk for adverse neonatal outcomes, and in Oregon, over 40 percent of women who give birth are on Medicaid.

The findings of the new study show improvements in low birthweight and abnormal conditions among infants born to women enrolled in Medicaid following implementation of CCOs, a potential indicator of the CCO model’s effectiveness.

Low birthweight identifies all babies weighing less than 2500 grams – about 5.5 pounds - at birth. Abnormal conditions were identified on the birth certificate and include admission to the NICU, assisted ventilation for more than six hours, presence of a seizure or serious neurologic dysfunction, and others. 

“We know that improving birth outcomes leads to better health and also reduces health care costs throughout life,” said the paper’s lead author, S. Marie Harvey, associate dean and distinguished professor in Oregon State University’s College of Public Health and Human Sciences.

“This study used only one year of data after CCO implementation, but if you can move the needle on these important health outcomes that quickly, it bodes well for the future of CCOs.”

The findings were published this month in the journal Medical Care Research and Review. Co-authors are Lisa Oakley, Jangho Yoon and Jeff Luck of OSU.

The OSU researchers received a five-year federal grant to examine the impacts of the CCO model and the 2014 Affordable Care Act expansion of Medicaid on the health of women of reproductive age and their children up to age 2.

Past research has shown that improving birth outcomes for babies reduces their risk of immediate and long-term complications, including neurologic problems, gastrointestinal issues, infections and Sudden Infant Death Syndrome. Improving birth outcomes also reduces medical costs throughout a child’s life, said Oakley, a co-author of the paper and a post-doctoral researcher at OSU.

“A low birthweight begins a negative trajectory for a child and, importantly, it is an area where health policy and practice can have an impact,” Harvey said.

The researchers reviewed birth outcomes for nearly 100,000 infants born in Oregon between 2011 and 2013 to examine the impact of CCOs on neonatal outcomes during the first year of implementation.

They found that the likelihood of Medicaid enrollees giving birth to low birthweight babies decreased by 13.4 percent, while the likelihood of a baby being born with abnormal conditions decreased by 10.4 percent.

The improved birth outcomes were not found among Hispanic women or those living in rural areas of the state, Harvey said. This may be an indication that CCOs’ efforts to improve maternal care were focused more generally on all women and did not reach or target Hispanic women as effectively as non-Hispanic women.

Women in rural areas may face other obstacles to accessing care, including long travel distances and limited numbers of providers, Harvey said. Overall, CCOs are still a relatively new concept and some regions may be having more success than others.

“Additional years of data will help us better understand the CCO effect and will also help us evaluate how the expansion of Medicaid impacts the health and healthcare of women and their infants,” Oakley said.

 


 

Editor’s note: The research was supported by the National Center for Chronic Disease Prevention and Health Promotion and the Centers for Disease Control under award number 1U01DP004783-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control.



Story By: 
Source: 

S. Marie Harvey, 541-737-3824, Marie.harvey@oregonstate.edu

Multimedia Downloads
Multimedia: 

Newborn baby

infant

U.S. social policies helped keep child poverty rates from climbing during Great Recession

CORVALLIS, Ore. – Social policies enacted in the United States during the Great Recession appear to have kept child poverty rates stable during a critical period when such programs were most needed because of a struggling economy, an Oregon State University researcher has found in a new study.

The 2008-09 recession offers a valuable window to study the impact of important safety net programs such as unemployment, welfare, food stamps and tax credits, said David Rothwell, an assistant professor in OSU’s College of Public Health and Human Sciences and the study’s lead author. 

“If nothing had been done during these years, poverty would have increased a lot because wages were down so much during that time,” Rothwell said. “These policies offset what otherwise would likely have been a five percent increase in child poverty rates during that period.”

The findings were published in the latest issue of the Journal of Marriage and Family. The study’s co-author is Annie McEwen of Carleton University in Ottawa, Ontario, Canada. 

Rothwell studies poverty and its impact on families and children. Experiencing poverty in childhood can have lifetime impacts for those children; past research has shown that children who grow up in poverty are more likely to struggle in school, earn less money throughout life; and experience family instability as adults.

“There are long-term economic benefits to investing in economic security for families with young children,” Rothwell said. 

The goal of the most recent study was to better understand how public policy efforts impacted poverty rates during the recession, specifically for children living in unmarried households, where the head of the household is not married. Children in these unmarried households are at a greater risk of poverty, and that risk increases during times of economic turmoil.

In addition, the number of children living in unmarried households has risen dramatically over the last few decades, but many common social welfare policies were developed as part of the New Deal in response to the Great Depression in the 1930s or in the 1960s as part of the Great Society, when most children lived in married families. 

“Family life has changed so much. We wanted to better understand how different policies affect different types of family households,” Rothwell said. “It’s also important for policymakers to understand how our existing social welfare programs are affecting today’s families. The safety net is really thin.”

For the study, Rothwell analyzed child poverty rates in the U.S. and four countries with similar demographics and legal traditions: the United Kingdom, Ireland, Canada and Australia. Between 2007 and 2010, child poverty declined in Canada and the United Kingdom; increased in Australia and Ireland; and remained unchanged in the United States.

Changes in income accounted for the decline in Canada and the increases in Australia and Ireland. In contrast, changes to the social safety net offset a potential increase in poverty in the United States and were associated with poverty reductions in the United Kingdom.

The findings indicate that existing or enhanced social welfare programs such as the American Recovery and Reinvestment Act of 2009 were able to offset impacts of wage declines during that period in the U.S., and policies had a similar effect in the United Kingdom. Though it is difficult to make comparisons from country to country, because each country experienced the recession differently, the findings highlight how investments in social welfare programs during that period affected child poverty rates in each country, Rothwell said.

“This cross-national research helps us understand the magnitude of the role policy plays in protecting children and families most at risk,” he said. “The U.S was hit hard by the recession, but the social welfare policies used during those years were effective in halting what would’ve been a troubling increase in child poverty.” 

Further research is needed to understand how the post-recession recovery has affected poverty rates. Some countries, including the U.S., have since scaled back their recession-era social welfare programs or let short-term programs expire, Rothwell said. Researchers also would like to better understand which social programs – welfare, food assistance, tax credits or other benefits – had the most impact on families.

During the most recent recession, the social welfare system lifted many vulnerable families above poverty. To reduce poverty in the long run, it’s important to make sure families are accessing eligible benefits and to consider increasing the adequacy of existing programs, Rothwell said. 

Story By: 
Source: 

David Rothwell, 541-737-1081, david.rothwell@oregonstate.edu

Multimedia Downloads
Multimedia: 

David Rothwell

David Rothwell, MSW, PhD

Oregon State University breaks record with $441 million in research grants

CORVALLIS, Ore. –Oregon State University crossed the $400 million threshold in grants and contracts for the first time in the fiscal year that ended June 30, including being awarded a grant to build a $122 million regional research vessel.

Oregon State received $441 million from state and federal governments, businesses and foundations for research on a wide range of projects in natural resources, health, engineering and science across the state and around the world. Federal agencies provided $315 million (71 percent), and additional funds came from state agencies, businesses and foundations.

“OSU research spurs solutions to problems and serves and involves people, communities and businesses across the state and world,” said Cynthia Sagers, OSU vice president for research. “Investment in research affects our daily lives —  the food we eat, health care, the environment — and pays back dividends in economic growth for Oregonians. Researchers are starting new businesses and assisting established companies.”

Altogether, Oregon State’s research revenues leapt 31 percent over last year’s record-breaking total of $336 million. Over the past 10 years, OSU’s research revenues have more than doubled and exceed those of Oregon’s public universities combined.

OSU research totals surged in June with a $122 million grant from the National Science Foundation for a new regional research vessel, which will be stationed at the university’s Hatfield Marine Science Center in Newport. It was the largest single grant ever received by the university.

Revenues from business and industry — including technology testing, sponsored contracts and licensing of innovations developed at the university — grew to $34 million last year, up 10 percent from the previous year.

“Our latest success is the result of hard work and strategic decisions by our faculty and partners in business, local and state government and the federal delegation,” Sagers said.

Based on past OSU research, startup companies such as Agility Robotics (animal-like robot motion), Outset Medical (at-home kidney dialysis) and Inpria (photolithography for high-performance computer chips) are attracting private investment and creating jobs. Advances in agricultural crops (winter wheat, hazelnuts, small fruits and vegetables) and forest products (cross-laminated timber panels for high-rise construction) are bolstering rural economies as well.

Since it began in 2013, the Oregon State University Advantage program has provided market analysis and support services to more than 70 local technology businesses and start-up companies. 

Other major grants last year included:

  • Up to $40 million by the U.S. Department of Energy for testing systems for ocean wave energy technologies;
  • $9 million for a next-generation approach to chemical manufacturing known as RAPID, in partnership with the Pacific Northwest National Laboratory;
  • $6.5 million from the U.S. Defense Advanced Research Projects Agency to make artificial-intelligence systems more trustworthy;
  • A combined $1.15 million in state, federal and foundation funding for a state-of-the-art instrument known as an X-ray photoelectron spectroscopy system. The XPS system brings world-class capabilities to the Pacific Northwest to address challenges in surface chemistry. Partners included the Murdock Charitable Trust, the Oregon Nanoscience and Microtechnologies Institute (ONAMI), the Oregon Built Environment and Sustainable Technologies Center and the National Science Foundation.

 “Whether it’s with the fishing and seafood industries on our coast, federal labs working on energy and the environment or local governments concerned about jobs and education, partnerships with business, government and other research organizations are absolutely vital to our work,” said Sagers. “We care about these relationships, the benefits they bring to our communities and the educational opportunities they create for our students.”

Research has long been a hallmark of graduate education, and undergraduate students are increasingly participating in research projects in all fields, from the sciences to engineering, health and liberal arts. OSU provided undergraduates with more than $1 million last year to support projects conducted under the mentorship of faculty members.

“Research is fundamental to President Ray’s Student Success Initiative,” said Sagers. “Studies show time and again that students who participate in research tend to stay in school, connect with their peers and find meaningful work after they graduate. Research is a key part of the educational process.”

Federal agencies represent the lion’s share of investment in OSU research. That investment has more than doubled in the last five years. The National Science Foundation provided the largest share of funding, followed by the U.S. Department of Agriculture, the U.S. Department of Health and Human Services and Department of Energy. 

-30-

Project summaries and FY17 research totals for OSU colleges are posted online:

College of Agricultural Sciences: http://agsci.oregonstate.edu/our-best/research-awards-2016-17

College of Earth, Ocean, and Atmospheric Sciences: http://ceoas.oregonstate.edu/research/map/

College of Education: http://education.oregonstate.edu/research-and-outreach

College of Engineering:  http://engineering.oregonstate.edu/fy17-research-funding-highlights

College of Forestry: http://www.forestry.oregonstate.edu/college-forestry-continues-advance-research-efforts#

College of Liberal Arts: http://liberalarts.oregonstate.edu/cla-research/2017-research-summary

College of Pharmacy: http://pharmacy.oregonstate.edu/grant_information

College of Public Health and Human Sciences: http://health.oregonstate.edu/research/funding-highlights 

College of Science: http://impact.oregonstate.edu/2017/08/research-funding-continues-upward-trajectory/

College of Veterinary Medicine: http://vetmed.oregonstate.edu/research-highlights

Video b-roll is available with comments by Cindy Sagers, vice president of research, at https://youtu.be/pkGD-lhVTwo.

 

Story By: 
Source: 

Cynthia Sagers, vice president for research, cynthia.sagers@oregonstate.edu, 541-737-0664

    

Multimedia Downloads
Multimedia: 

Go Baby Go Car

Pacific Marine Energy Center

Cassie the robot

ShakeTable2

Research%20Vessel%202-logo

Coordinated care organizations lead to more timely prenatal care

CORVALLIS, Ore. – Pregnant women on Medicaid are more likely to receive timely prenatal care following Oregon’s implementation of coordinated care organizations, or CCOs, which are regional networks of health care providers who work together to treat patients, a new study has shown.

“We found that under the CCO model, the timeliness of prenatal care was significantly improved for Oregon women on Medicaid, with more women beginning care in the first trimester of their pregnancies,” said the study’s co-author, S. Marie Harvey, associate dean and distinguished professor in Oregon State University’s College of Public Health and Human Sciences.

“This is an indication that Oregon’s use of CCOs is helping close the gap in timeliness of care for women on Medicaid versus those who are not on Medicaid.”

The findings were published in the Maternal and Child Health Journal. Co-authors are Lisa Oakley, Jangho Yoon and Jeff Luck of OSU. It is the first study to be published from a five-year federal grant to study the impacts of the expansion of Medicaid in Oregon on the health of women of reproductive age and their children up to age 2.

Medicaid is a federal health insurance program for people with limited resources, including low-income adults, children, the elderly and people with disabilities. In Oregon, Medicaid is provided through the Oregon Health Plan.

OSU researchers are awaiting data to examine the impact of Medicaid expansion, which began in 2014. In the meantime, they examined how the coordinated care organization model, an innovative approach implemented in Oregon in 2012, affected access to and use of prenatal care, Harvey said.

CCOs are Oregon’s version of an accountable care organization; nine other states are also using accountable care models for their Medicaid programs and eight other states are considering adopting similar models.

Oregon implemented the CCO model – which includes coordination of physical health care, mental health care and dental care – for providing Medicaid services in 2012. The hope was to focus on prevention and better management of chronic conditions, ultimately improving care and reducing costs.

Each CCO is allocated a fixed sum of funds to provide all necessary patient services and incentives to meet specific benchmarks that are critical to overall health and wellbeing. Benchmarks include decreasing emergency room usage, increasing use of dental sealants for children, using electronic health records, screening for colorectal cancer and providing timely prenatal care.

Early and regular prenatal care throughout a pregnancy plays a critical role in the health and wellbeing of mother and baby, the researchers said. Women on Medicaid generally begin prenatal care later in pregnancy and have fewer medical visits during their pregnancy than their non-Medicaid enrolled peers.

“Prenatal care is important because these visits provide opportunities for practitioners to evaluate and address health concerns for both mom and baby and discuss other important topics such as risks of smoking, the importance of good nutrition and other issues that could impact a pregnancy,” said Oakley, the paper’s lead author and a post-doctoral researcher at OSU.

After the first year of CCO implementation, mothers on Medicaid were more likely to receive prenatal care starting in the first trimester of pregnancy compared to the year before implementation, the researchers found.  

However, the improvement was more prominent among white and Asian women and those in urban areas, suggesting more work is needed to reach women in other racial and ethnic groups and those living in rural areas, Harvey said.

“For women in rural areas, issues such as transportation may be keeping them from accessing coverage,” she said. “In addition, cultural or language barriers may prevent some women of color from obtaining care.”

Researchers also noted that they saw no improvement in the proportion of women receiving adequate prenatal care; adequate care was measured by the number of prenatal care appointments a woman received after taking into account when she began prenatal care and the age of the baby at birth.

“This study used only the first year of data after CCO implementation; because of the initial positive impact of CCOs on prenatal care timeliness, we hope that additional years of data will demonstrate improvements in prenatal care adequacy, as well,” Oakley said.

Story By: 
Source: 

S. Marie Harvey, 541-737-3824, Marie.harvey@oregonstate.edu