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Health policy

Stanford Health Policy Seminar: Anna Grummon

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Anna Grummon, Stanford Pediatrics

Anna H. Grummon is an assistant professor in the Department of Pediatrics at the Stanford School of Medicine. She is a behavioral scientist whose work seeks to identify and evaluate policies that encourage healthy eating and help us live long, healthy lives. In her work, Grummon uses randomized trials, quasi-experiments, and simulation modeling to examine how food policies like warning labels, beverage taxes, and food assistance programs affect what we eat and how healthy we are. She also studies strategies for encouraging people to choose foods that are more environmentally sustainable. Grummon holds a PhD and MSPH in Health Behavior from the University of North Carolina Chapel Hill and a BA with Honors in Human Biology from Stanford. She completed her postdoctoral training at Harvard.

Talk Title: Improving Diet Through Food Policy

Abstract: Unhealthy diet is a leading cause of death in the US. Policy changes could improve diet and help prevent the 500,000 deaths attributable to unhealthy diet in the US each year. This talk will provide evidence about the potential for three policies to improve diet: warning labels for sugary drinks, mandatory calorie disclosures on restaurant menus, and minimum price laws for sugary drinks. Using data from randomized controlled trials, quasi-experiments, and simulation models, we examine how these policies are likely to affect consumer behavior, the food supply, and population health outcomes like obesity.   

 

 

 

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Registration

Hybrid Seminar: Lunch will be provided for on-campus participants.
Please register if you plan to attend, both for in-person and via Zoom.

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Encina Commons, Room 119
615 Crothers Way
Stanford, CA 94305

Seminars

Department of Health Policy Symposium: Advancing Health Equity

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Stanford Department of Health Policy Health Equity Symposium Header

 

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Stanford Medicine's new Department of Health Policy held its inaugural departmental symposium on October 6, convening thought leaders and experts in medicine, law, economics and data science. Speakers discussed innovative policy work and scalable solutions for improving health equity. Panelists addressed how to reduce persistent health disparities from three angles: social determinants of health, technology and innovation, and access and affordability.

Discover the powerful role health policy can serve in ensuring the health of all people, not just a privileged few.

 

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Keynote Speaker: Kirsten Bibbins-Domingo, PhD, MD

Talk Title: Building Equity in the Research Enterprise

Editor in Chief, Journal of the American Medical Association (JAMA) and JAMA Network

Professor of Epidemiology & Biostatistics and Medicine, University of California, San Francisco

 

 

 

 

 

Opening Remarks by Stanford Medicine Dean Lloyd Minor

Terrance Mayes, Associate Dean for Equity and Strategic Initiatives

 

 

Panel 1 — Social Policy: Strategies for Addressing Structural Determinants of Health

 

 

Moderator

Alyce Adams, Stanford Health Policy

Alyce Adams, Stanford Medicine Innovation Professor, Professor of Epidemiology and Population Health, Professor of Health Policy

Panelists

Jeremy Goldhaber-Fiebert

Jeremy Goldhaber-Fiebert, Professor of Health Policy

 

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Gilbert Gonzales, Vanderbilt

Gilbert Gonzales, Assistant Professor at the Center for Medicine, Health & Society at Vanderbilt University

 

Adrienne Sabety, Stanford Health Policy

Adrienne Sabety, Assistant Professor of Health Policy

 

 

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​Panel 2 — Technology: Optimizing Innovation for Health Impact and Equity

 

 

Joshua Salomon of Stanford Health Policy

Moderator: Josh Salomon, Professor of Health Policy, Director of the Prevention Policy Modeling Lab

 

 

Panelists

Joshua Makower, Stanford

Joshua Makower, Boston Scientific Applied Biomedical Engineering Professor, Director of the Stanford Byers Center for Biodesign

Grant Miller Stanford Health Policy

Grant Miller, Henry J. Kaiser, Jr. Professor, Professor of Health Policy

 

Sherri Rose Stanford Health Policy

Sherri Rose, Associate Professor of Health Policy, Co-Director of the Health Policy Data Science Lab

 

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Panel 3 — Access & Affordability: How to Finance and Deliver Health Care Innovations Equitably

 

 

Michelle Mello

Moderator: Michelle Mello, Professor of Health Policy, Professor of Law​

 

Panelists

Nicole Cooper, UnitedHealth

Nicole Dickelson Cooper, Senior Vice President at UnitedHealth Group 

 

Stacie B. Dusetzina, Vanderbilt

Stacie Dusetzina, Associate Professor of Health Policy at Vanderbilt University Medical Center

 

Maria Polyakova Stanford University

Maria Polyakova, Assistant Professor of Health Policy

 

 

Vindell Washington Verily Life Sciences

Vindell Washington, Chief Clinical Officer of Verily Health Platforms and CEO of Onduo

 

 

#StanfordHealthEquity

WATCH ENTIRE EVENT HERE

Learn More about Stanford Health Policy

Our People, Our Reserch and Our Mission to Improve Health

 

Advancing Health Equity Slideshow by Beth Duff-Brown

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this live activity for a maximum of 4.0 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

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McCaw Hall, Arrillaga Alumni Center

Symposiums

Protecting Reproductive Health Information after Fall of Roe v. Wade

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Beth Duff-Brown
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The Supreme Court ruling eliminating the constitutional right to an abortion could also result in women’s personal reproductive health data being used against them, warns Stanford Health Policy’s Michelle Mello.

The Dobbs v. Jackson Women’s Health Organization ruling could, for example, lead to a woman’s health data in clinician emails, electronic medical records, and online period-tracking platforms being used to incriminate her or her health-care providers, Mello said.

“Ultimately, broader information privacy laws are needed to fully protect patients and clinicians and facilities providing abortion services,” writes Mello, a professor of health policy and law in this JAMA Health Forum article with colleague Kayte Spector-Bagdady, a bioethicist from the University of Michigan. “As states splinter on abortion rights after the Dobbs Supreme Court decision, the stakes for providing robust federal protection for reproductive health information have never been higher.”

Eight states banned abortions on the same day the Dobbs ruling came down, and 13 states that had “trigger bans” that, if Roe v. Wade were struck down, would automatically prohibit abortion within 30 days. Other states are considering reactivating pre-Roe abortion bans and legislators in some states intend to introduce new legislation to curb or ban the medical procedure.”

Three Potential Scenarios

The authors note these new abortion restrictions may clash with privacy protections for health information, laying out three scenarios that could impact millions of women. And, they note, “despite popular misconceptions about the breadth of the Privacy Rule of the Health Information Portability and Accountability Act (HIPAA) and other information privacy laws, current federal law provides little protection against these scenarios.”

The first scenario is that a patient’s private health information may be sought in connection with a law-enforcement proceeding or civil lawsuit for obtaining an illegal abortion. HIPAA privacy regulations and Fourth Amendment rights against unreasonable searches and seizures won’t help physicians and hospitals resist such investigative demands, the authors write. And though physician-patient communications are ordinarily considered privileged information, the scope of that privilege varies greatly from state to state. “In many cases medical record information has been successfully used to substantiate a criminal charge,” the authors write.

Ultimately, broader information privacy laws are needed to fully protect patients and clinicians and facilities providing abortion services.
Michelle Mello
Professor of Health Policy, Law

The second privacy concern is the potential use of health-care facility records to incriminate an institution or its clinicians for providing abortion services. Relevant records could include electronic health records, employee emails or paging information and mandatory reports to state agencies. Clinicians may not realize that if they are using an institutional email address or server, their institution likely has direct access to information and communications stored there, which can be used to search for violations. State Freedom of Information Act (FOIA) laws also allow citizens to request public records from employees of government hospitals and clinics.

“Additionally, state mandatory reporting laws for child abuse might be interpreted to cover abortions — particularly if life is defined as beginning at fertilization,” the authors note.

The third scenario is that information generated from a woman’s online activity could be used to show she sought an abortion or helped someone to do so. Many women use websites and apps that are not HIPAA-regulated or protected by patient-physician privilege, such as period-tracking apps used by millions of women that collect information on the timing of menstruation and sexual activity.

“There are many instances of internet service providers sharing user data with law enforcement, and prosecutors obtaining and using cellphone data in criminal prosecutions,” write Mello and Spector-Bagdady, adding commercially collected data are also frequently sold to or shared with third parties.

“Thus, pregnant persons may unwittingly create incriminating documentation that has scant legal protection and is useful for enforcing abortion restrictions,” they said.

The immediate problem, Mello notes, is in the states that have already banned abortion or passed restrictive laws.

“There could be a problem with states trying to reach outside their borders to prosecute people, but that could well be unconstitutional,” Mello said.

Some states’ laws sweep abortion pills into the definition of illegal abortions, she said, and there are legal obstacles to supplying the pills across state lines.

“There is a lot of energy going into figuring out a workaround right now, but it’s too soon to call,” Mello said.

Recommended Protections

So how can clinicians and health-care facilities protect their patients and themselves?

When counseling patients of childbearing age about reproductive health issues, clinicians should caution their patients about putting too much medical data online and refer them to expert organizations that will help them minimize their digital footprint.

When documenting reproductive health encounters, the authors said, clinicians should ask themselves: “What information needs to be in the medical record to assure safe, good-quality care, buttress our claim for reimbursement, or comply with clear legal directives?” For example, does information about why a patient may have experienced a miscarriage need to be recorded?

Patients and clinicians should be aware that email and texting may be seen by others, so conversations among staff about reproductive health issues may best be conducted by phone or in person.

Finally, if abortion-related patient information is sought by state law enforcement officials, a facility’s attorney should be consulted about asserting physician-patient privilege and determining whether the disclosure is mandated by law.

Michelle Mello

Michelle Mello

Professor of Health Policy, Law
Focuses on issues at the intersection of law, ethics and health policy.
Profile

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Fake or Fact news on coronavirus
Q&As

Does Free Speech Protect COVID-19 Vaccine Misinformation?

While some might say making or spreading known false statements related to the COVID-19 vaccine should be criminalized, the First Amendment, which guarantees free speech, continues to provide protection for people who promulgate such faulty information. So, how can the spread of misinformation be stopped without quashing free speech?
Does Free Speech Protect COVID-19 Vaccine Misinformation?
Health Law Illustration
Commentary

U.S. Public Health Law — Foundations and Emerging Shifts

The COVID-19 pandemic has focused attention on the complex and sometimes conflicting relationship between individual rights and public health protection.
U.S. Public Health Law — Foundations and Emerging Shifts
Supreme Court
Q&As

A Look at the Supreme Court Ruling on Vaccination Mandates

Two Stanford law, labor and health experts explain the legal and health implications of the Supreme Court ruling that struck down the Biden administration's COVID-19 vaccine mandate for large companies, while upholding another federal regulation calling on health-care workers in federally funded facilities to be vaccinated.
A Look at the Supreme Court Ruling on Vaccination Mandates
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Michelle Mello writes that the overturning of Roe v. Wade — ending federal protection over a woman's right to an abortion — could also expose her personal health data in court.

Health Equity Lecture Series — No Equity Without Sovereignty: Intersections of Indigenous Health and Data

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Desi Small-Rodriguez
Desi Small-Rodriguez, PhD, is an Assistant Professor of Sociology and American Indian Studies at the University of California, Los Angeles. As a social demographer, she applies critical quantitative and mixed methods to research at the intersection of race, indigeneity, data, and inequality. An indigenous woman (Northern Cheyenne and Chicana), Small-Rodriguez specializes in survey research in partnership with Indigenous communities and other marginalized populations. She grounds her research in Indigenous studies, sociology of race and ethnicity, political sociology, sociology of knowledge, critical demography, health policy research, and science and technology studies. She directs the Data Warriors Lab, which is an Indigenous social science laboratory that connects researchers, students and Indigenous communities to build data that support "strong self-determined Indigenous futures."

 

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Desi Small-Rodriguez, PhD Assistant Professor, Sociology and American Indian Studies, UCLA
Seminars

Lizzy Constantz

Encina Hall, 616 Serra Mall, Stanford, CA 94305

 

 

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MPH

Lizzy Constantz serves as the Program Manager for the Stanford Human Trafficking Data Lab. She is a graduate of the Johns Hopkins Bloomberg School of Public Health, where she studied human trafficking and human rights, culminating in a Masters thesis analyzing the correlates of early child marriage in Ethiopia. Prior to her work in public health, Lizzy developed an expertise in translation and clinical research, as well as programs and operations management. As Program Manager, she is eager to use her background and education to advance the lab's initiatives.

Program Manager

Lauren Lamson

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Lauren Lamson is a Research Data Analyst with Stanford’s Center for Health Policy. She has a background in development economics as well as expertise in econometrics and statistical analysis. Lauren has previously worked with Stanford's Global Center for Gender Equality, the Bill & Melinda Gates Foundation, and the University of New South Wales on research projects related to the intersection of gender and health outcomes. She holds an MSc in International & Development Economics from the University of San Francisco and a BA from The Evergreen State College. 

Research Data Analyst

Research Talk with David Molitor — A Causal Concentration-Response Function for Air Pollution: Evidence from Wildfire Smoke

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David Molitor
David Molitor is an Associate Professor of Finance and Economics at Gies College of Business, University of Illinois at Urbana-Champaign, and a Research Associate at the National Bureau of Economic Research (NBER). His research explores how location and the environment shape health and health care delivery in the United States. He is a Principal Investigator of the Illinois Workplace Wellness Study, a large-scale field experiment of workplace wellness conducted at the University of Illinois. His work has been supported by the National Institutes of Health, the National Science Foundation, the Social Security Administration, J‑PAL North America, and the Robert Wood Johnson Foundation. Molitor's research has been published in leading academic journals including The American Economic Review, The Quarterly Journal of Economics, and The Review of Economics and Statistics and has been covered by media outlets including The New York Times, The Wall Street Journal, and The Washington Post.

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Zoom Link 

Meeting ID: 990 6232 4907

Password: 764436

Seminars

Preventing Preterm Deliveries Using a Digital Approach

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Jason Wang and his team working on a project to prevent preterm births received a $150,000 grant from the Richard King Mellon Foundation to complete their randomized control trial testing a digital app that tries to prevent recurrent preterm births.

PretermConnect uses a digital strategy for prevention and follow-up of preterm births in Allegheny County, PA, to optimize the health and well-being of mothers and children. Instead of the standard care, Stanford Health Policy is collaborating with the University of Pittsburg Medical Center (UPMC) in the randomized control trial with women who have delivered a preterm baby. The women are invited to participate and then randomly put into the group that uses the digital or a control group who received paper-based discharge packets with supplemental health education on postpartum care.

“This grant allows us to continue recruiting participants through UPMC and expanding PretermConnect’s features to enhance user engagement, including a function to search for resources by geography and topic,” said Wang, MD, a professor of pediatrics and health policy. “We also intend to scale the project with additional content on high-risk infant follow-up and preterm-specific developmental care guidelines, additional engagement features — and eventually support for different languages, starting with Spanish.”

In the long term, we hope to see an overall decrease in infant morbidity and mortality, by way of reducing preterm births.
Jason Wang
Professor of Pediatrics and Health Policy

The women in the digital app group receive in-app health education and resources to improve well-being for mothers and their infants. The app includes a social interaction feature designed to foster social connections and promote self-care. They have enrolled 30 women during the pilot phase and 15 mother-infant dyads in the randomized control trial, with a goal of reaching 250.

“The digital approach also allows us to administer brief surveys and gather information on dynamic social determinants of health more frequently than can be done through traditional means,” said Shilpa Jani, an SHP project manager. She said social determinants of health — such as persistent housing instability, food insecurity and concerns of personal safety — contribute to chronic stress and health issues as well as an increased risk of pregnancy and birth complications.

“Adverse effects of social determinants of health along with health complications of preterm deliveries may exacerbate morbidities for the mother and child,” Jani said, adding that preterm-related causes of death accounted for two-thirds of infant deaths in 2019 in the United States.

Wang and Jani said the immediate project goals include increasing health education for preterm baby care, improving postpartum maternal health, and encouraging usage of local resources in Allegheny County. They eventually hope to see reductions in risk for subsequent preterm delivery and infant mortality and postpartum depression, as well as increases in mother-infant bonding and larger proportions of breastmilk feeding.

Jason Wang Stanford Health Policy

Jason Wang

Professor of Pediatrics and Health Policy
Develops tools for assessing and improving the quality of health care
Profile
Shilpa Jani

Shilpa Jani

Research Data Analyst
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A father with his son and daughter (paid family leave)
News

New Study Shows Support for Paid Family Leave Grew During Pandemic

In a blow to arguments that a federal paid leave law would harm small businesses, a new study co-authored by SHP's Maya Rossin-Slater finds that support for paid leave among small employers is not only strong, but also increased as the pandemic added new strain to the work-life juggle.
New Study Shows Support for Paid Family Leave Grew During Pandemic
Pupils raise their hands in class.
News

Babies Born Too Early Likely to Face Educational and Lifelong Behavioral Setbacks

SHP's Lee Sanders and his Stanford colleagues found that after adjusting for socioeconomic status and compared with full-term births, moderate and late preterm births are associated with increased risk of low performance in mathematics and English language arts, as well as chronic absenteeism and suspension from school.
Babies Born Too Early Likely to Face Educational and Lifelong Behavioral Setbacks
COVID Contact Tracing
News

Contact-tracing App Curbed Spread of COVID in England and Wales

SHP's Jason Wang writes in this Nature article that digital contact tracing has the potential to limit the spread of COVID-19.
Contact-tracing App Curbed Spread of COVID in England and Wales
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SHP researchers awarded grant to continue their clinical trial testing out a digital app they hope will prevent preterm births.

Research in Progress with Sherri Rose: New and Ongoing Projects at the Interface of Machine Learning for Health Policy

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Sherri Rose, PhD  is an Associate Professor of Health Policy at the Stanford School of Medicine and Co-Director of the Health Policy Data Science Lab. Her research is centered on developing and integrating innovative statistical machine learning approaches to improve human health and health equity. Within health policy, Dr. Rose works on risk adjustment, ethical algorithms in health care, comparative effectiveness research, and health program evaluation. She has published interdisciplinary projects across varied outlets, including Biometrics, Journal of the American Statistical Association, Journal of Health Economics, Health Affairs, and New England Journal of Medicine. In 2011, Dr. Rose coauthored the first book on machine learning for causal inference, with a sequel text released in 2018. She has been Co-Editor-in-Chief of the journal Biostatistics since 2019.

Dr. Rose has been honored with an NIH Director's New Innovator Award, the ISPOR Bernie J. O'Brien New Investigator Award, and multiple mid-career awards, including the Gertrude M. Cox Award and the Mortimer Spiegelman Award, the nation’s highest honor in biostatistics, given to a statistician younger than 40 who has made the most significant contributions to public health statistics. She was named a Fellow of the American Statistical Association in 2020 and received the 2021 Mortimer Spiegelman Award, which recognizes the statistician under age 40 who has made the most significant contributions to public health statistics. Her research has been featured in The New York Times, USA Today, and The Boston Globe. 

Title: New and Ongoing Projects at the Interface of Machine Learning for Health Policy

 

Register in advance for this meeting: https://stanford.zoom.us/meeting/register/tJIpdOispzojH9bzpXrF3_VpYcbPN9Hcgbbw After registering, you will receive a confirmation email containing information about joining the meeting.

Sherri Rose

Encina Commons,
615 Crothers Way
Stanford, CA 94305-6006

 

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Professor, Health Policy
sherri_rose-portrait.jpg
PhD

Sherri Rose, Ph.D. is a Professor of Health Policy and Co-Director of the Health Policy Data Science Lab at Stanford University. Her research is centered on developing and integrating innovative statistical machine learning approaches to improve human health and health equity. Within health policy, Dr. Rose works on risk adjustment, ethical algorithms in health care, comparative effectiveness research, and health program evaluation. She has published interdisciplinary projects across varied outlets, including Biometrics, Journal of the American Statistical Association, Journal of Health Economics, Health Affairs, and New England Journal of Medicine. In 2011, Dr. Rose coauthored the first book on machine learning for causal inference, with a sequel text released in 2018. She has been Co-Editor-in-Chief of the journal Biostatistics since 2019.

Dr. Rose has been honored with an NIH Director’s Pioneer Award, NIH Director's New Innovator Award, the ISPOR Bernie J. O'Brien New Investigator Award, and multiple mid-career awards, including the Gertrude M. Cox Award. She was named a Fellow of the American Statistical Association in 2020 and received the 2021 Mortimer Spiegelman Award, which recognizes the statistician under age 40 who has made the most significant contributions to public health statistics. Her research has been featured in The New York Times, USA Today, and The Boston Globe. 

She received her Ph.D. in Biostatistics from the University of California, Berkeley and a B.S. in Statistics from The George Washington University before completing an NSF Mathematical Sciences Postdoctoral Research Fellowship at Johns Hopkins University. Prior to joining the faculty at Stanford University, Dr. Rose was on the faculty at Harvard Medical School in the Department of Health Care Policy.

Dr. Rose comes from a low-income background and is committed to increasing justice, equity, diversity and inclusion (JEDI) in the mathematical and health sciences. Included in this work are her roles as founding Co-Director of the Stanford Population Health Summer Research Program: Advancing Health Equity and Diversity (AHEaD) and Co-Chair of Stanford Health Policy’s JEDI Committee. She also teaches the course Decoding Academia: Power, Hierarchies, and Transforming Institutions and is organizer of the Health Equity Lecture Series at Stanford Health Policy. While Chair of the American Statistical Association’s Biometrics Section, she established the Annie T. Randall Innovator Award, which honors Mrs. Randall’s pioneering career in government amid pervasive racism and recognizes early career trailblazers.

Co-Director, Health Policy Data Science Lab
Associate Professor of Health Policy Stanford University

Research in Progress Seminar: Alex Chan — Customer Discrimination and Quality Signals: A Field Experiment with Healthcare Shoppers

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Title: Customer Discrimination and Quality Signals: A Field Experiment with Healthcare Shoppers

Abstract: This paper provides evidence that customer discrimination in the market for doctors can be largely accounted for by statistical discrimination. I evaluate customer preferences in the field with an online platform where cash-paying consumers can shop and book a provider for medical procedures based on an experimental paradigm called validated incentivized conjoint analysis (VIC). Customers evaluate doctor options they know to be hypothetical to be matched with a customized menu of real doctors, preserving incentives. Racial discrimination reduces patient willingness-to-pay for black and Asian providers by 12.7% and 8.7% of the average colonoscopy price respectively; customers are willing to travel 100–250 miles to see a white doctor instead of a black doctor, and somewhere between 50–100 to 100–250 miles to see a white doctor instead of an Asian doctor. Further, providing signals of provider quality reduces this willingness-to-pay racial gap by about 90%, which suggests that statistical discrimination is an important cause of the gap. Actual booking behavior allows cross-validation of incentive compatibility of stated preference elicitation via VIC. 

Alex Chan, MPH

Alex Chan is a PhD candidate in Health Economics, and a Gerhard Casper Stanford Graduate Fellow. He has research interests in health economics, experimental economics, market design, and labor economics. His projects look at the causes and consequences of discrimination and diversity in medicine, U.S. Health Policy (especially organ transplantation), and market design in health policy and medicine. He holds an MPH from Harvard University. Before Stanford, he developed extensive experience in the healthcare industry starting as a McKinsey consultant, and most recently as Senior Vice President of Market Strategy with Optum/UnitedHealth before joining academia.

Personal Website: https://www.alexchan.net 

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https://stanford.zoom.us/meeting/register/tJEsdOGppjMtGtPVKFHk0vX_TMCK5PzMa_Mv

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PhD Candidate in Health Economics Department of Health Policy, Stanford University
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