Exploring the Business of Health

As I settled into my internship here at the CDC in the Division of Adolescent and School Health (DASH), I developed a weekly routine and began working on multiple projects. Two of these early projects, both research-oriented, really stood out as both interesting to me and important for the policy team and division.

The first one involved taking a closer look at big pharmaceutical retailers, their development of health clinics in the retail space, and what impact they may have on schools and adolescents. These retail clinics provide vaccinations and other basic medical treatments inside their stores through a nurse practitioner. The DASH policy team was mainly interested in how the proliferation and success of these retail clinics may impact school-based clinics, because so many people do not have insurance or a primary care physician; and what this means for expanding access to care. The Affordable Care Act (ACA) does have some funding for capital improvement for school-based clinics and one large pharmaceutical retailer already provides grants for these school-based clinics through the School-Based Health Alliance. For this project, I reviewed the laws and regulations retailers are interested in to see what implications they have for the delivery of health care to teens and their families.  I found that Massachusetts has the most comprehensive regulations for these retail clinics, limiting what can be done in the retail space. By conducting this research, I was able to see the interaction between big-business, government, and non –governmental organizations when it comes to providing health care in America.

My other early research project was just as interesting, but dealt with a very different subject matter: abstinence until marriage sexual health education. Organizations that advocate for young people have contacted DASH and expressed concerns about the framework mandated in the Social Security law Sec 510 (http://www.ssa.gov/OP_Home/ssact/title05/0510.htm) and funding Congress has recently reauthorized to abstinence until marriage programs. These organizations are concerned the framework is biased and discriminatory, and that it could endanger the lives and health of youth. To give the policy team a better understanding of the concerns of these advocates, my research involved reviewing data showing what types of sexual health education, if any, schools/districts provide. I found that nearly all in our study that teach sexual health teach the benefits of abstinence, but only some teach a full range of protective measures. I looked at sexual risk behaviors shown on the YRBS and rising rates of STDs among youth, and I calculated the numbers of high school students who may be at risk for diseases, teen pregnancy, infertility, ectopic pregnancies, and even death.  I was somewhat surprised by what I found about the lack of sexual health education. Although I received limited sexual health education having gone to school in Georgia, I was surprised it was similar across the country.

Both of these projects required outside research to better understand the landscape DASH is operating within, an important piece of information for the policy team to have. This research also served as a great baseline for my work later on in the internship, as it provided a general overview of the current state of sexual education and health care.