Janet Hankin - Academia.edu (original) (raw)
Papers by Janet Hankin
Psychological Medicine, Feb 1, 1983
PubMed, Jul 1, 1987
The purpose of this study was to determine the extent to which members of families have similar a... more The purpose of this study was to determine the extent to which members of families have similar and interrelated health behavior. Utilization and morbidity data from more than 80,000 ambulatory visits by 693 families enrolled in a prepaid health plan for 6 consecutive years were examined using family membership as the major unit of analysis. Family members were found to resemble one another in their rates of use of services (r = 0.44; P less than 0.001). Parental influence on children's utilization is significant, mothers generally being two to three times more powerful than fathers in this regard. Apart from family size, structural characteristics of families contribute little to family health behavior. Family membership explains nearly one third of the variance of individual utilization even after family size and age and sex of family members are considered. A small proportion of families (5%) accounts for a disproportionately large share (12.3%) of health care utilization. Intrafamilial patterns of morbidity were apparent for several major groupings of diagnoses, most notably for acute health problems. Intrafamilial correlations were greatest among high-utilizing families. Families establish patterns of health behavior that are stable over time and therefore may be amenable to selective interventions. We conclude that health care planning, whether for service delivery or health education intervention, should consider family health data as an important information source.
Research in the sociology of health care, Aug 28, 2023
Journal of Public Policy & Marketing, Mar 1, 1998
Time-series analysis examines the impact of the alcohol warning label on in-pregnancy drinking by... more Time-series analysis examines the impact of the alcohol warning label on in-pregnancy drinking by 21,127 African-American pregnant women between 1986 and 1995. Controlling for patient characteristics and unemployment rate, the authors find that the label had a significant, modest impact on drinking. The results suggest that more intensive interventions are needed to reduce in-pregnancy drinking.
Psychological Medicine, 1983
SynopsisA total of 1921 consecutive adult patients seen in the Departments of Internal Medicine a... more SynopsisA total of 1921 consecutive adult patients seen in the Departments of Internal Medicine and Obstetrics–Gynaecology at a prepaid group practice completed a self-administered depressive symptomatology questionnaire, the Centre for Epidemiologic Studies Depression Scale (CES-D). New health practitioners and physicians, who were not mental health specialists, blindly judged the presence or absence of depressive symptomatology. Twenty-one per cent of the patients suffered from depressive symptoms according to the CES-D, but only 15% of these were judged to be depressed by their physician or new health practitioner. The variables which predict the recognition of depressive symptomatology are discussed.
Social Science & Medicine, 1986
Pediatrics, 1985
Earlier studies have shown that one in eight children persist in being high users of health care ... more Earlier studies have shown that one in eight children persist in being high users of health care services over long periods of time and, conversely, about the same proportion of children are consistently low users. As these studies failed to discover reasons for these persistent deviations from average, this study explored three possible explanations: persistent morbidity, mental health problem, and familial patterns of use. Although all three phenomena were associated with both persistence of high utilization of services as well as an overall large number of visits, the number of types of morbidity was the most significant correlate of high use. Children who were constantly low users of services were much more likely to have only a few types of morbidity whereas children who were constantly high users were much more likely to experience a wide variety of types of problems. These findings suggest that an understanding of the demand for health services requires an understanding of th...
Fetal Alcohol Syndrome, 2022
Contexts, 2010
For much of 2009 and early 2010, discussions of health care policies dominated national discourse... more For much of 2009 and early 2010, discussions of health care policies dominated national discourse in the United States. The prolonged and often acrimonious debates brought into sharp focus the enormous, complex, and highly fragmented system that provides health care in the United States. Considerable attention was also devoted to demonstrating the advanced state of this country's medical knowledge, technology, and health services.
American Journal of Psychiatry, 1980
The differential use ofmedical services by patients with and those without a diagnosis ofmental d... more The differential use ofmedical services by patients with and those without a diagnosis ofmental disorder was examined infour adult populations by age, sex, diagnosis, and medical department used. The four settings offered comprehensive services to patients t'ho varied greatly in socioeconomic status. In allfour settings patients it'ith a diagnosis ofmental disorder used all services and general health services more than patients without such a diagnosis. Results document increased medical morbidity and a greater likelihood ofa diagnosis ofan ill-defined condition in patients with mental disorder than thatfound in patients without a diagnosis ofmental disorder.
American Journal of Psychiatry, 1980
American Journal of Diseases of Children, 1984
The relationship between the use of services of children constantly enrolled in a prepaid group p... more The relationship between the use of services of children constantly enrolled in a prepaid group practice medical plan for six years and the completeness of their preventive care were examined. Children who were consistently low users of services were more likely to be lacking one or more components of standard preventive care, particularly general health assessments in older children and vision, hearing, and tuberculosis screening in younger children. Teenage children who were low users were at some risk of not receiving their tetanus-diphtheria immunization on time. The relationship between low use of services and incomplete preventive care persisted after controlling for the severity of morbidity, although children with more severe morbidity were somewhat less likely to be missing preventive care. Health facilities and practitioners should pay special attention to assessing the need for standard preventive care in children who are infrequent users of services.
Medical Care, 1998
This report investigates three aspects of drug abuse treatment costs, with special emphasis on sy... more This report investigates three aspects of drug abuse treatment costs, with special emphasis on systematic differences among employers: (1) predictors of drug abuse treatment costs; (2) differentials in drug abuse treatment costs across employers; and (3) differential impacts of patient and employer characteristics on drug abuse treatment costs. The study used multiple regression analysis of behavioral cost functions. It decomposed cost differences into employer and variable effects using an algebraic method that accounted for differences in cost functions and in population characteristics. An insurance claims database was used from 10 large self-insured employers for a 3-year period starting January 1989. Marginal inpatient costs generally exceeded average costs, leading to slightly increasing costs per day as length of stay increased. Marginal outpatient costs were generally about the same as average costs, implying that outpatient drug treatment maintained constant unit costs as utilization increased. Decomposition of cost differences among employers suggested that observed differences among employers and/or their carriers (who administer the benefits for the self-insured employers) and providers appeared to be at least as important as differences among the characteristics or the utilization of the people that they cover. National health policies aimed at reducing costs are likely to have differing impacts on different employers. Employers with high costs relative to the characteristics of their covered population may be able to achieve significant cost savings. Employers serving populations with greater risk factors may find it difficult to cut costs further.
Applied Behavioral Science Review, 1998
This study examines exposure to the alcoholic beverage warning label among a sample of 1,107 Detr... more This study examines exposure to the alcoholic beverage warning label among a sample of 1,107 Detroit area women in 1995. The analysis was conducted at two levels: 1) What are the predictors of label exposure? and 2) Once exposed to the label, what are the predictors of correct knowledge of the warning message? Thirty-nine percent of all women (59% of
Ethnicity & disease, 2007
Research to eliminate health disparities in the United States is best approached from the perspec... more Research to eliminate health disparities in the United States is best approached from the perspective of population health. The objectives of this paper are to: (a) describe how ongoing research at the eight national Centers for Population Health and Health Disparities (CPHHD) is using a population health perspective and a community-based approach to advance the field of health disparities research; and (b) to discuss potential implications of such research for health policies that target some of the determinants of population health.
Health policy quarterly
A follow-up assessing uses of findings from NIMH-supported research on health and mental health s... more A follow-up assessing uses of findings from NIMH-supported research on health and mental health services utilization in organized health care settings revealed a range of applications across the study sites. The research, conducted primarily for national policy purposes, had an impact on study sites in the following areas: clinician perceptions and attitudes about mental health services provided; program directions; fiscal policy; and further related research. Research team composition and dissemination of study findings are discussed in relation to the applications made.
Psychological Medicine, 1983
Population and Environment, 1984
Psychological Medicine, Feb 1, 1983
PubMed, Jul 1, 1987
The purpose of this study was to determine the extent to which members of families have similar a... more The purpose of this study was to determine the extent to which members of families have similar and interrelated health behavior. Utilization and morbidity data from more than 80,000 ambulatory visits by 693 families enrolled in a prepaid health plan for 6 consecutive years were examined using family membership as the major unit of analysis. Family members were found to resemble one another in their rates of use of services (r = 0.44; P less than 0.001). Parental influence on children's utilization is significant, mothers generally being two to three times more powerful than fathers in this regard. Apart from family size, structural characteristics of families contribute little to family health behavior. Family membership explains nearly one third of the variance of individual utilization even after family size and age and sex of family members are considered. A small proportion of families (5%) accounts for a disproportionately large share (12.3%) of health care utilization. Intrafamilial patterns of morbidity were apparent for several major groupings of diagnoses, most notably for acute health problems. Intrafamilial correlations were greatest among high-utilizing families. Families establish patterns of health behavior that are stable over time and therefore may be amenable to selective interventions. We conclude that health care planning, whether for service delivery or health education intervention, should consider family health data as an important information source.
Research in the sociology of health care, Aug 28, 2023
Journal of Public Policy & Marketing, Mar 1, 1998
Time-series analysis examines the impact of the alcohol warning label on in-pregnancy drinking by... more Time-series analysis examines the impact of the alcohol warning label on in-pregnancy drinking by 21,127 African-American pregnant women between 1986 and 1995. Controlling for patient characteristics and unemployment rate, the authors find that the label had a significant, modest impact on drinking. The results suggest that more intensive interventions are needed to reduce in-pregnancy drinking.
Psychological Medicine, 1983
SynopsisA total of 1921 consecutive adult patients seen in the Departments of Internal Medicine a... more SynopsisA total of 1921 consecutive adult patients seen in the Departments of Internal Medicine and Obstetrics–Gynaecology at a prepaid group practice completed a self-administered depressive symptomatology questionnaire, the Centre for Epidemiologic Studies Depression Scale (CES-D). New health practitioners and physicians, who were not mental health specialists, blindly judged the presence or absence of depressive symptomatology. Twenty-one per cent of the patients suffered from depressive symptoms according to the CES-D, but only 15% of these were judged to be depressed by their physician or new health practitioner. The variables which predict the recognition of depressive symptomatology are discussed.
Social Science & Medicine, 1986
Pediatrics, 1985
Earlier studies have shown that one in eight children persist in being high users of health care ... more Earlier studies have shown that one in eight children persist in being high users of health care services over long periods of time and, conversely, about the same proportion of children are consistently low users. As these studies failed to discover reasons for these persistent deviations from average, this study explored three possible explanations: persistent morbidity, mental health problem, and familial patterns of use. Although all three phenomena were associated with both persistence of high utilization of services as well as an overall large number of visits, the number of types of morbidity was the most significant correlate of high use. Children who were constantly low users of services were much more likely to have only a few types of morbidity whereas children who were constantly high users were much more likely to experience a wide variety of types of problems. These findings suggest that an understanding of the demand for health services requires an understanding of th...
Fetal Alcohol Syndrome, 2022
Contexts, 2010
For much of 2009 and early 2010, discussions of health care policies dominated national discourse... more For much of 2009 and early 2010, discussions of health care policies dominated national discourse in the United States. The prolonged and often acrimonious debates brought into sharp focus the enormous, complex, and highly fragmented system that provides health care in the United States. Considerable attention was also devoted to demonstrating the advanced state of this country's medical knowledge, technology, and health services.
American Journal of Psychiatry, 1980
The differential use ofmedical services by patients with and those without a diagnosis ofmental d... more The differential use ofmedical services by patients with and those without a diagnosis ofmental disorder was examined infour adult populations by age, sex, diagnosis, and medical department used. The four settings offered comprehensive services to patients t'ho varied greatly in socioeconomic status. In allfour settings patients it'ith a diagnosis ofmental disorder used all services and general health services more than patients without such a diagnosis. Results document increased medical morbidity and a greater likelihood ofa diagnosis ofan ill-defined condition in patients with mental disorder than thatfound in patients without a diagnosis ofmental disorder.
American Journal of Psychiatry, 1980
American Journal of Diseases of Children, 1984
The relationship between the use of services of children constantly enrolled in a prepaid group p... more The relationship between the use of services of children constantly enrolled in a prepaid group practice medical plan for six years and the completeness of their preventive care were examined. Children who were consistently low users of services were more likely to be lacking one or more components of standard preventive care, particularly general health assessments in older children and vision, hearing, and tuberculosis screening in younger children. Teenage children who were low users were at some risk of not receiving their tetanus-diphtheria immunization on time. The relationship between low use of services and incomplete preventive care persisted after controlling for the severity of morbidity, although children with more severe morbidity were somewhat less likely to be missing preventive care. Health facilities and practitioners should pay special attention to assessing the need for standard preventive care in children who are infrequent users of services.
Medical Care, 1998
This report investigates three aspects of drug abuse treatment costs, with special emphasis on sy... more This report investigates three aspects of drug abuse treatment costs, with special emphasis on systematic differences among employers: (1) predictors of drug abuse treatment costs; (2) differentials in drug abuse treatment costs across employers; and (3) differential impacts of patient and employer characteristics on drug abuse treatment costs. The study used multiple regression analysis of behavioral cost functions. It decomposed cost differences into employer and variable effects using an algebraic method that accounted for differences in cost functions and in population characteristics. An insurance claims database was used from 10 large self-insured employers for a 3-year period starting January 1989. Marginal inpatient costs generally exceeded average costs, leading to slightly increasing costs per day as length of stay increased. Marginal outpatient costs were generally about the same as average costs, implying that outpatient drug treatment maintained constant unit costs as utilization increased. Decomposition of cost differences among employers suggested that observed differences among employers and/or their carriers (who administer the benefits for the self-insured employers) and providers appeared to be at least as important as differences among the characteristics or the utilization of the people that they cover. National health policies aimed at reducing costs are likely to have differing impacts on different employers. Employers with high costs relative to the characteristics of their covered population may be able to achieve significant cost savings. Employers serving populations with greater risk factors may find it difficult to cut costs further.
Applied Behavioral Science Review, 1998
This study examines exposure to the alcoholic beverage warning label among a sample of 1,107 Detr... more This study examines exposure to the alcoholic beverage warning label among a sample of 1,107 Detroit area women in 1995. The analysis was conducted at two levels: 1) What are the predictors of label exposure? and 2) Once exposed to the label, what are the predictors of correct knowledge of the warning message? Thirty-nine percent of all women (59% of
Ethnicity & disease, 2007
Research to eliminate health disparities in the United States is best approached from the perspec... more Research to eliminate health disparities in the United States is best approached from the perspective of population health. The objectives of this paper are to: (a) describe how ongoing research at the eight national Centers for Population Health and Health Disparities (CPHHD) is using a population health perspective and a community-based approach to advance the field of health disparities research; and (b) to discuss potential implications of such research for health policies that target some of the determinants of population health.
Health policy quarterly
A follow-up assessing uses of findings from NIMH-supported research on health and mental health s... more A follow-up assessing uses of findings from NIMH-supported research on health and mental health services utilization in organized health care settings revealed a range of applications across the study sites. The research, conducted primarily for national policy purposes, had an impact on study sites in the following areas: clinician perceptions and attitudes about mental health services provided; program directions; fiscal policy; and further related research. Research team composition and dissemination of study findings are discussed in relation to the applications made.
Psychological Medicine, 1983
Population and Environment, 1984