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The Rockefeller Foundation’s Rural Health Program and the Oil Nationalization Crisis in Iran, 1949-1951

March 26, 2024

This research report examines the efforts of the Rockefeller Foundation (RF) to build a rural health initiative in Iran from 1949 through 1951. It details the RF's progress in contributing toward improving Iranian public health during this period, and it analyzes the impact of the Iranian oil nationalization crisis that began in early 1951 on the Rockefeller Foundation's activities. Ultimately, this report argues that the oil nationalization crisis forced the RF to end its Iranian initiative in late summer 1951 without completing its work there, but these rural health initiatives nevertheless helped lay a foundation for Iran's later public health efforts and contributed to positive American-Iranian relations prior to the 1953 coup.

Insights from Nonelderly Adults with Disabilities on Difficulties Obtaining Home- and Community-Based Services and Other Health Care

March 14, 2024

In this brief, we examine challenges that adults with disabilities and members of their households face when trying to obtain home- and community-based services and other health care. Our analysis draws on nationally representative survey data and in-depth follow-up interviews with disabled adults who reported delaying or forgoing needed services.Many people with disabilities require home health care, personal assistance, physical or occupational therapy, medical equipment and supplies, and other home- and community-based services to live independently in their communities and meet complex medical needs. Despite shifts in public funding for long-term services and supports toward home and community settings over time, barriers to accessing home- and community-based services have persisted and worsened dramatically in the wake of the COVID-19 pandemic. These barriers intersect with and magnify other challenges people with disabilities face when navigating the health care system.We analyzed data on adults ages 18 to 64 who reported having disabilities in the December 2022 round of the Urban Institute's Well-Being and Basic Needs Survey. In May and June 2023, we conducted follow-up interviews with 25 survey participants who reported any delayed or unmet needs for selected home and community-based services. Members of a community advisory board with lived experience with disabilities and professional experience as disability advocates informed each stage of the research process.

Barriers to Accessing Medical Equipment and Other Health Services and Supports within Households of Adults with Disabilities

March 14, 2024

Using nationally representative survey data, we assessed the prevalence of delayed and unmet needs for medical equipment, supplies, and other vital services and supports among nonelderly adults with disabilities and members of their households. We also examined the types of equipment and supplies households had difficulty obtaining and the reasons for delayed or unmet needs.People with disabilities face persistent inequities in access to high-quality, affordable health care. These inequities include challenges obtaining consistent access to medical equipment and supplies and other health services and supports that are critical for their health and well-being and ability to live independently in their communities. Though people with disabilities of all ages are affected by these gaps in the health care system, nationally representative data on the experiences of adults under age 65 are limited.Our analysis draws on June 2022 data from the Urban Institute's Health Reform Monitoring Survey (HRMS), a nationally representative survey of adults ages 18 to 64 living in households. Survey questions on delayed and unmet needs were developed in collaboration with members of a community advisory board who have lived experience with disabilities and who serve as advocates for people with disabilities.

Lessons From the Field: Implementing Mental Health Employee Resource Groups (ERGs) & Recommendations for Future Success

January 26, 2024

NAMI-NYC partnered with fourteen organizations to learn about the impactful work they are doing through their disability/mental health ERGs to create a culture promoting good mental health and emotional wellness in the workplace. The goal was to bridge the gap between theory and practice to identify real-world applications of how ERGs are developed, what they focus on, and how they make an impact. To do so, we developed a survey based on a literature review of ERG best practices and workplace mental health programs. The survey was 45 qualitative and quantitative questions about governance, collaboration, and programming.This report presents the data learned from the survey and recommendations to support employees, leadership, Human Resources (HR), Diversity Equity, Inclusion, and Belonging (DEIB), and Wellness teams starting or enhancing disability/mental health ERGs. It provides strategies to set up a successful governance structure, leverage cross-department collaboration, and create meaningful programs to reduce stigma and promote good mental health among employees.

A Review of the Domains of Well-Being for Young People

January 10, 2024

Adolescence and young adulthood are critical life stages full of possibility, but to experience healthy development, young people need support in all aspects of their lives. During this life stage, people begin to gain independence, learn social skills and behaviors that shape the rest of their lives, and begin to develop their identities. The youth field—or people working with and doing research related to young people, such as policymakers, funders, researchers, and practitioners—needs information as it considers investments and interventions to support youth development, and everyone in the field would benefit from understanding the distinctive but interrelated domains of youth well-being that need nurturing. The attempt to measure youth well-being is not new, but the field needs to continue refining how it defines and measures these domains. Such refinement will provide a stronger toolset to set priorities, establish baseline levels, and track progress over time.This report describes eight domains of youth well-being and considerations for their measurement. It summarizes both traditional and emergent approaches to measurement and notable gaps in each area. It also includes key themes relevant to all domains, notably the critical need to include young people in the process of developing well-being concepts and indicators and to improve understanding of how well-being dynamics differ across identities.This is one in a series of resources developed by the Urban Institute to support members of the youth field in developing and measuring more holistic conceptions of youth well-being.

“Among a people such like their own”: Thai Nursing Students in the Philippines, 1920-1931

January 5, 2024

In the early twentieth century, the Rockefeller Foundation (RF) worked to expand the nursing profession in the Philippines and in Thailand. Using the close geographic proximity and the well-established circulation of health professionals between the two countries, the RF helped sponsor six Thai nursing students to study abroad in Manila. Due to the status of the Philippines as a colony of the US, while Thailand was not within the US's official purview, the encounter between the colonized nursing instructors and the Thai nursing students learning within a colonial system created contradictory positions of power. Depending on who perceived this crossing, it could reflect the expanding influence for different parties invested in nursing education, either the Foundation, Filipino medical workers, Thai elites, or both Thai and Filipino women. This report examines these crossings and the approximate relationships of domination that supported and confounded the US empire. For example, rather than American colonizers' relationships with Filipinos, I examine the roles of Filipino women, Filipino men, and Thai women who participated in uneasy and shifting tensions of domination. These relationships of power were contested and circulated in complicated forms, not just unilaterally, but within expansive spheres attached to US ambitions within Asia, as well as the Philippines and Thailand's own ambitions for sovereignty and modernity. Lastly, this report examines Filipino women's fraught relationship to power vis-a-vis science and medicine, which also represented (even if incompletely, temporarily, and immemorably) both the domination and the collaboration of Thai women.

Achieving a Racially and Ethnically Equitable Health Care Delivery System in Massachusetts: A Vision and Proposed Action Plan

December 13, 2023

This report proposes a vision and plan for action—collectively a statewide Health Equity Action Plan—for achieving a racially and ethnically equitable health care delivery system in Massachusetts. The report is accompanied by an Executive Summary, as well as a Health Equity Action Plan Toolkit (Toolkit) of interventions, policies, and programs that organizations in the health care delivery system can deploy to achieve their health equity goals.The causes and impact of health inequities in Massachusetts, as elsewhere, are multiple, complex, and inter-related. Inequities in access to adequate housing, food, education, and other vital needs are stark and directly impact people's health. Many populations experience health inequities, including people of color and people for whom English is not their primary language, as well as those with disabilities and those in the LGBTQ+ community. The focus of this report is on racial and ethnic inequities in the health care delivery system and therefore can be considered a first phase in a larger system-wideeffort to eliminate all inequities that affect people's health.

Climate change and women’s health and rights: women voices from MENA

December 11, 2023

The Middle East and North Africa (MENA) region faces severe climate change impacts, with rising temperatures, water scarcity, desertification and extreme weather events. It is projected to experience high rates of warming, with a potential 4°C increase by 2071–2100 (UNICEF, 2022). Rising heat and humidity levels may exceed the limits of human tolerance. The region also grapples with social inequities, conflicts, poverty, water scarcity and gender inequality. Climate change exacerbates these challenges, acting as a 'threat multiplier' that reinforces existing inequalities. Gendered impacts of climate change are evident, especially in relation to sexual and reproductive health and rights (SRHR). SRHR, including family planning and reproductive choices, are crucial for overall wellbeing, but climate change is affecting bodily autonomy and reproductive decisions, particularly for women and girls.Despite the evident effects of climate change in the region, which disproportionately affect women and girls, there is a significant lack of evidence on how climate change impacts their SRHR and access to sexual and reproductive health services. The primary objective of this research is therefore to thoroughly examine and understand the relationship and interconnection between SRHR and climate change in the MENA region, drawing insights from the lived experiences of women, including young women, across the region. Building upon these real-life experiences and a comprehensive literature review, the research proposes essential recommendations for the stronger integration of gender-sensitive policies and financing mechanisms to enhance women's resilience and adaptive capacity in addressing the impacts of climate change. Simultaneously, they aim to improve women's access to SRHR services while addressing systemic gender inequalities, discrimination and exclusion.

Communities Need Clinics: The Abortion Care Ecosystem Depends on Independent Clinics

December 5, 2023

This annual overview of the abortion access landscape in the United States details the little-known yet critical role that independent community clinics play in keeping abortion care accessible. 

Needs Assessment of Youth Mental Health and Well-being in Northeast Minnesota

December 1, 2023

This report presents the results of surveys and interviews with youth, caregivers of youth, and school staff. Topics include mental health services and resources, well-being, home environment, school environment and peer relationships, community environment, and more.

Report: U.S. Counties with the Highest Maternal Mental Health Risk and Lowest Resources Revealed

November 29, 2023

The risk factors contributing to maternal mental health (MMH) disorders are complex and known to disproportionately impact communities of color, rural communities, and other groups facing systemic inequities. However, until recently, little has been known regarding the geographic county-level distribution of risk nor the available MMH provider resources.Earlier this year, with financial support from Plum Organics, the Policy Center released the first-of-its kind interactive map to track MMH risk and providers by county. The map uncovered an immense need for increased access to MMH providers and programs.The report illustrates where, in the U.S., mothers are at the greatest risk for suffering from maternal mental health disorders and where the greatest need for providers are. An estimated 62 million birthing-age, American women, or 96% of the potential perinatal population live in maternal mental health professional shortage areas. 13,885 providers are needed across the United States to fill these shortage gaps.

Fact Sheet: Maternal Mental Health

November 29, 2023

This fact sheet explores the prevalence and range of disorders associated with maternal mental health disorders.