Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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Arden Morris is a health services researcher, professor of surgery, and director of S-SPIRE Center. She has used claims, clinical datasets, and mixed methods to focus on race/ethnicity, socioeconomic position, and quality and outcomes of cancer care. More recently, she has focused on financial toxicity of cancer care and patient out-of-pocket costs that may influence their treatment decisions.

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Joshua Salomon, PhD, is a Professor of Health Policy and a Senior Fellow at the Freeman Spogli Institute for International Studies. His research focuses on public health policy and priority-setting, including modeling patterns and trends in major causes of global mortality and disease burden; evaluation of health interventions and policies; and measurement and valuation of health outcomes. He is director of the Prevention Policy Modeling Lab, a multi-institution research consortium that conducts health and economic modeling relating to infectious disease. During the COVID-19 pandemic, Dr. Salomon has worked extensively with policymakers on data synthesis, modeling and decision analysis to inform the public health response.

Encina Commons Room 114, 615 Crothers Way, Stanford, CA 94305-6006
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Professor, Health Policy
Senior Fellow, Freeman Spogli Institute for International Studies
josh_salomon-headshot_2023.jpg PhD

Joshua Salomon is a Professor of Health Policy in the Department of Health Policy at Stanford School of Medicine, Senior Fellow in the Freeman Spogli Institute for International Studies, and founding Director of the Prevention Policy Modeling Lab. Trained in health policy and decision science, Dr. Salomon leads multidisciplinary research teams dedicated to producing rigorous, actionable evidence to improve the public’s health and reduce health disparities. His work — supported by the National Institutes of Health, Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation — combines data synthesis and mathematical modeling to measure and forecast health outcomes and evaluate public health programs and strategies, with particular emphasis on infectious diseases. He has spearheaded methodological innovation in measurement and valuation of health, infectious disease modeling and forecasting, and cost-effectiveness analysis. His applied modeling work on HIV/AIDS, tuberculosis, viral hepatitis, COVID-19 and other major health challenges informs local, state, national and international policies to improve health and wellbeing, particularly among under-served populations in the United States and around the world.  

Dr. Salomon established the multi-institution Prevention Policy Modeling Lab in 2014 to conduct health and economic modeling that guides reasoned public health decision-making relating to infectious disease. He has co-authored more than three hundred original peer-reviewed research articles and mentored dozens of graduate and post-graduate trainees in health policy, medicine and public health. Prior to joining the Stanford Faculty, Dr. Salomon served as a policy analyst in the Department of Evidence and Information for Policy at the World Health Organization in Geneva, and as Professor of Global Health at Harvard T.H. Chan School of Public Health. As Associate Chair for Academic Affairs and Strategy in the Department of Health Policy at Stanford, he works on faculty recruitment and development, and leads strategic initiatives to promote interdisciplinary collaborative research, practice partnerships and policy translation.

Collaboration

In this recent Stanford Report article, Salomon talks about how he helped gather faculty, trainees, and other researchers from Stanford and elsewhere to lend expertise in infectious disease modeling and data analytics in hopes of informing the public health response to the COVID-19 pandemic locally and nationwide. This quickly-assembled unit used county data to build models that were updated in real-time and shared with county epidemiologists to track the impact of the epidemic, underlying transmission trends, and potential effectiveness of public health measures.

The unit also advised county epidemiologists on developing their own models for planning and envisioning different scenarios. “In the early weeks especially, we were learning more about the virus every day,” Salomon explained, “but we hadn’t yet seen the first peak of what would eventually turn into multiple waves, so there was a lot of uncertainty about when that peak might arrive, how high it could be, and what would happen next.”

Read Stanford Report Article

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David Chan, MD, PhD, is an Associate Professor of Medicine and an investigator at the Department of Veterans Affairs, and a Faculty Research Fellow at the National Bureau of Economic Research. Drawing on labor and organizational economics, he is interested in studying how information is used in health care, how this affects productivity, and implications for design. He is the recipient of the 2014 NIH Director’s High-Risk, High-Reward Early Independence Award to study the optimal balance of information in health information technology for patient care.

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A new study co-authored by Stanford Health Policy's Maya Rossin-Slater finds that 71% of New York and New Jersey employers surveyed during COVID-19 said they backed paid family leave — up from nearly 62% in 2019, before the coronavirus outbreak.

What’s more, the research released by the National Bureau of Economic Research as a working paper finds the jump in support was driven by employers that were previously opposed to the policy, and not just neutral about it.

“The big roadblock to passing paid family leave legislation is a concern that small businesses are not supportive and that it would be challenging for them,” Rossin-Slater says. “We find that’s not the case.”

Rossin-Slater, an associate professor of health policy and a senior fellow at the Stanford Institute for Economic Policy Research (SIEPR), also finds that views about paid family leave became more favorable among employers with at least one worker who used it during the pandemic. Both New York and New Jersey offer the benefit under state law. The employers were also subject to a temporary paid family leave provision that was included in a 2020 federal stimulus package but has since expired.

The study comes at a critical moment in the years-long, bipartisan effort to pass a federal law providing workers with partially paid leave to take time off to care for family or their own medical issues. The United States is one of six countries without national paid leave — despite polls showing Americans overwhelmingly want it. A plan to offer four weeks of paid leave is part of President Biden’s proposed Build Back Better Act, which the House of Representatives is expected to vote on soon.

Opponents of current and past efforts to pass federal paid leave legislation say that it would be too costly and burdensome, especially for small employers. Rossin-Slater dented that argument in a separate study earlier this year of the impacts of New York’s paid leave policy on select indicators of profitability. She and her co-authors found that small businesses were not adversely affected by the policy on these measures, and actually reported that it was easier to deal with worker’s absences once the policy was in place.

This latest study will be published in a journal of the American Sociological Association, Socius: Sociological Research for a Dynamic World.

Understanding how attitudes change, especially during a pandemic, is insightful for thinking about where this policy is ultimately headed.
Maya Rossin-Slater
Associate Professor of Health Policy

Leave-Taking Led to Higher Support

The findings are not only timely, but they also provide the strongest evidence yet of how COVID has changed employers’ minds about paid family leave, Rossin-Slater says. Since 2016, she and her co-authors — Ann Bartel, Meredith Slopen, and Jane Waldfogel of Columbia University, and Christopher Ruhm of the University of Virginia — have been surveying employers with 10-99 employees in New York, New Jersey, and Pennsylvania to learn about the effects of paid family leave. As part of their annual questionnaire, they have asked firms in New York and New Jersey to share their overall attitudes toward the policy. This is how they were able to reliably gauge in this latest study how small business owners and managers were feeling about paid leave on the eve of the pandemic.

Another advantage of the survey is that it focuses on employers’ experiences with paid family leave during COVID and not, as most other polls have done, only on workers.

Rossin-Slater says that assessing employers’ overall attitudes, in addition to measuring effects on operational issues, provides further evidence as to whether businesses are harmed by paid leave.

“Actual views provide a summary of how businesses think the policy is affecting operations,” she says. “If it was a disaster and really hard for them, they’re probably not going to be very supportive. The opposite is likely if their experience was smooth and not complicated.”

In all, 539 New York and New Jersey businesses that participated in the 2019 survey also responded in 2020, rating their opinions on paid family leave according to a 5-point scale. The researchers analyzed changes in opinions within each firm and controlled for other factors that could have changed over the time period, such as the total number of employees and their characteristics. They found that the share of employers reporting that they were very or somewhat supportive of the policy rose by 9.6 percentage points, from 61.6 percent to 71.2 percent. Meanwhile, the portion of firms that were somewhat or very opposed declined by 8.8 percentage points, to 11.2 percent.

The increase in support was somewhat larger among employers with 50-99 workers, although the rise in favorable opinions was also meaningful among even the smallest employers in the study. The researchers also found that employee use of state paid leave during COVID was associated with more favorable employer views.

“What’s striking,” Rossin-Slater says, “is that during COVID — when it’s become incredibly clear how important it is for workers to be able to take time off work with pay and job protection to care for ill family members or for kids who are out of school — employers became even more supportive of paid family leave.”

Rossin-Slater says that one drawback to the study is its relatively small sample size. Over the years, she and her collaborators have surveyed 4,711 employers. Of the 1,151 that responded to the 2020 survey, 887 were operating. About two-thirds of those still in business answered questions about their attitudes toward leave and whether workers used it during the pandemic.

Even so, shedding any light on what employers think about paid family leave is important, she says.

“As economists, we focus a lot on measurable impacts like productivity or turnover rates, and those are important to quantify,” Rossin-Slater says. “But at the end of the day, whether these policies get passed is ultimately a political question, and people’s attitudes shape the public discourse in this country. Understanding how attitudes change, especially during a pandemic, is insightful for thinking about where this policy is ultimately headed.”

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Maya Rossin-Slater

Associate Professor of Health Policy
Focuses on family health and policies targeting disadvantaged populations
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The Department of Health Policy's Inaugural Health Equity Panel

Panelists for the Department of Health Policy's inaugural Health Equity Panel discuss the health disparities exacerbated by the COVID-19 pandemic, as well as families and health and consequences from lack of gender equity, and the impact of Medicaid on access to care, insurance coverage, racial disparities and maternal and infant health. Panel video is embedded in this story.
The Department of Health Policy's Inaugural Health Equity Panel
Maya Rossin-Slater Stanford Health Policy
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Maya Rossin-Slater Wins Faculty Women’s Forum Award

The awards honor individuals for their outstanding work supporting women at Stanford through role modeling, allyship, leadership and sponsorship.
Maya Rossin-Slater Wins Faculty Women’s Forum Award
Stanford's Jessica Grembi collects water samples in Iraq.
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Rosenkranz Prize Winners Focus on Child and Maternal Health

This year’s Rosenkranz Prize winners are both working to better understand preeclampsia in pregnancies and a form of childhood malnutrition in lower-resourced countries in an effort to find medical interventions.
Rosenkranz Prize Winners Focus on Child and Maternal Health
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A father with his son and daughter (paid family leave) Nathan Dumlaou/Unsplash
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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.

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Paidamoyo Chapfuwa is a postdoctoral research fellow mentored by Prof. Sherri Rose at Stanford Health Policy. She received B.S.E. with distinction, MS, and PhD degrees in electrical and computer engineering from Duke University. Paidamoyo was advised throughout her PhD by Profs. Lawrence Carin and Ricardo Henao. 

Paidamoyo's research focuses on developing causal survival analysis methods to enable individualized decision-making from clinical data such as electronic health records and more recently, immunomics. Her work leverages statistical machine (deep) learning advances in causal inference, generative modeling, and Bayesian nonparametrics. Her work has culminated in publications at main machine learning venues such as IEEE, ACM, ACL, and ICML.

Post-doctoral Research Fellow
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Division of Primary Care and Population Health, Department of Medicine
Stanford University School of Medicine, Medical School Office Building, 1265 Welch Road,
Stanford, CA 94305, USA

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Assistant Professor, Medicine
croppedbewerbungsfoto_2018-06-08.jpg MD, PhD, MPH

Pascal Geldsetzer is an Assistant Professor of Medicine in the Division of Primary Care and Population Health. He has been a study coordinator and postdoctoral research fellow with the Harvard T.H. Chan School of Public Health in Tanzania and Eswatini, completed the Young Professionals Program of the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) in Namibia, and was a German National Merit Scholar.

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A new four-paper series in The Lancet exposes the far-reaching effects of modern warfare on women’s and children’s health.

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Paul H. Wise
Eran Bendavid
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On August 17, 2020, the Los Angeles Unified School District launched a program to test more than 700,000 students and staff for SARS-CoV-2. The district is paying a private contractor to provide next-day, early-morning results for as many as 40,000 tests daily. As of October 4, a total of 34,833 people had been tested at 42 sites. The program is notable not only because it’s ambitious, but also because it’s unusual: testing is conspicuously absent from school reopening plans in many other districts. Typically, exhaustive attention has instead focused on physical distancing, face coverings, hygiene, staggering of schedules, and cohorting (dividing students into small, fixed groups). Although the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the National Academies of Sciences, Engineering, and Medicine, and state officials have urged schools to prepare for Covid-19 cases, they have offered strikingly little substantive guidance on testing. Immediate attention to improving testing access and response planning is essential to the successful reopening of schools.

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New England Journal of Medicine
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Michelle Mello
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2020
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When an experienced provider opts to leave a healthcare workforce (attrition), there are significant costs, both direct and indirect. Turnover of healthcare providers is underreported and understudied, despite evidence that it negatively impacts care delivery and negatively impacts working conditions for remaining providers. In the Veterans Affairs (VA) healthcare system, attrition of women’s health primary care providers (WH-PCPs) threatens a specially trained workforce; it is unknown what factors contribute to, or protect against, their attrition.

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Journal of General Internal Medicine
Authors
Susan M. Frayne
Jonathan Shaw
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2020
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Master's Student Alumni, Health Policy
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Valerie Peicher is an Academic General Pediatrics Fellow at Stanford. She is interested in creating policy level changes to improve the health of children in mixed-status Latino families. Valerie is the proud daughter and granddaughter of immigrants. She grew up in South Florida, studied biological sciences and Hispanic studies at Rice University, taught high school biology in South Florida, attended medical school at Baylor College of Medicine, and completed her pediatrics residency at the University of Miami/Jackson Memorial Hospital. While at Stanford, Valerie will participate in LEAD and obtain a Masters in the Science of Health Policy to help create a more inclusive future.

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