Urban Institute

Housing outcomes in Aotearoa New Zealand are deeply intertwined with wellbeing, yet public discussion often focuses on isolated issues, rather than the housing system as a whole. This article offers a transdisciplinary, plain-language systems model to make visible the interconnections and trade-offs that complicate housing policy. Our Housing Outcomes and Multi-system Effects (HOME) model begins with a wellbeing lens by identifying how housing affordability, agency, place and house quality affect wellbeing, and progressively builds outwards to show how economic, social and regulatory systems shape these foundations. By emphasising system-wide relationships rather than single-lever fixes, the model provides a tool for those working across housing, social policy, urban development and infrastructure seeking deeper insight into how New Zealand’s housing system operates and where opportunities for more effective policy and practice may lie.

The goal of this study is to explore the association between racial/ethnic, sex, and age category concordance and participant retention and weight loss among participants enrolled in the National Diabetes Prevention Program lifestyle change program (National DPP LCP). This analysis was conducted using a sample of 653 participants who were enrolled in a 12-month National DPP LCP at one of 17 Chicago community-based organizations between June 2019 and July 2023. Using multilevel logistic regression modeling, we examined the association between participant lifestyle-coach racial/ethnic, sex, and age category concordance and retention, as well as weight loss. All models controlled for coach education, coach training, program-engagement level, as well as participant education, sex, age, and race/ethnicity if not already accounted for in the concordance variable. In adjusted models, we observed a statistically significant relationship between race/ethnic concordance and increased odds of retention. There was no significant relationship between demographic concordance and weight change > = 3%. Our findings suggest that there is increased odds of retention among racially concordant pairs. We did not observe a significant relationship between gender and age concordant pairs and retention nor race, gender, and age concordant pairs and weight loss. Our findings suggest that National DPP LCP programs could consider racial concordance in their program design and implementation as a factor to boost participant retention.

The proliferation of artificial intelligence (AI) clinical decision support technologies requires careful consideration of payment policies under the Medicare Physician Fee Schedule. In this Policy Insight, we identify key challenges faced by policy makers and the Centers for Medicare and Medicaid Services (CMS), and we discuss the interplay between the Medicare Physician Fee Schedule and the adoption of AI technologies in care delivery. The resource-based relative value scale methodology, which determines Medicare Physician Fee Schedule rates, was not designed for software-based technologies and requires both comprehensive adaptation and implementation reform. We recommend developing a policy framework for coverage determinations for AI technologies, reforming the resource-based relative value scale, creating clear reimbursement pathways for AI technologies, and implementing cost-effectiveness analysis to ensure that marginal Medicare expenditures yield proportional improvements in health care delivery and outcomes.

The current study presents a replication and extension of the “Nebraska Model” for counting missing persons and examining the scope of missing American Indian/Alaska Native (AI/AN) persons. Here, we test the Nebraska Model in New Mexico and then utilize an Extended Model that comprises additional sources of data specific to New Mexico. We conduct 12 monthly point-in-time counts of all missing persons in New Mexico and compare the results of the Nebraska Model (i.e., four data sources) and the Extended Model (i.e., seven data sources) in identifying unique missing persons and missing persons by racial/ethnic groups. We first find that the Extended Model outperforms the Nebraska Model: more than 350 unique missing persons were identified using the Extended Model including nearly 50% of AI/AN missing persons. Then, using the Extended Model we estimate an average annual missing persons rate for New Mexico of 4.5 per 10,000 persons compared to 9.1 per 10,000 AI/AN persons in New Mexico. We discuss findings in the context of data quality and transparency regarding the study of missing persons and missing AI/AN persons and conclude with calls for additional research on the context of missing persons for prevention and intervention efforts.

O suicídio configura-se como uma das mais graves e negligenciadas crises de saúde pública global, com dados da Organização Mundial da Saúde (OMS) apontando centenas de milhares de mortes evitáveis anualmente. Para além de um evento individual, deve ser compreendido como um fenômeno complexo e multifatorial, cujas raízes se aprofundam em solo ético, filosófico e social. Certos grupos estão desproporcionalmente vulneráveis: homens, devido à socialização violenta e à tendência a suprimir as emoções; usuários de drogas psicoativas e pessoas com transtornos mentais, como a depressão, sem acesso a cuidados adequados; e populações minorizadas e marginalizadas, expostas cotidianamente à violência estrutural, à exclusão e à precarização das condições de existência. O artigo se propõe a traçar um panorama histórico-filosófico, elencando alguns casos de eminência pública, a fim de dar visibilidade ao tema, normalmente envolto em silente tabu. Na medida em que deve ser compreendido como um fenômeno complexo, de natureza histórica, cultural, individual e coletiva, tratar o suicídio abertamente é não apenas uma medida de prevenção, mas também um ato político de enfrentamento das desigualdades que transformam vidas em artigos descartáveis.

Accurate self-assessment is critical for faculty professional development, yet this area remains largely underexplored in dental education. To address this gap, this study investigated the alignment between dental faculty members' self-assessment regarding their teaching, mentoring, and leadership skills and evaluations from professional colleagues and institutional leaders. Dental faculty from the ADEA Leadership Institute's in-person cohorts (2021-2024) used the Leadership Practices Inventory (LPI 360) assessment to evaluate leadership skills. Data from approximately 80 faculty participants, complemented by 8 to 10 observer evaluations per faculty, were analyzed for alignment between self-assessments and external evaluations, with considerations of gender and academic rank. Statistical analyses employed the Mann-Whitney U test with a significance level at p<0.05. The results revealed that faculty generally underrated their leadership abilities relative to observers, with the area of "team building and collaboration" scoring highest and "inspiration of shared vision" lowest. Combined self-ratings showed no significant gender differences (male: 48.5 ± 7.2, female: 49.3 ± 6.8), though females demonstrated more modest self-assessments, especially in the areas of "modeling behavior skills with integrity and ethics" and "encouragement of innovation," while males' self-ratings were closer to observer ratings. Differences by rank showed assistant professors rated themselves higher in innovative areas, while associate professors were more self-critical. This study identified significant differences in how dental faculty assess their own leadership practices, influence by gender and academic rank. The findings highlight the importance of incorporating external feedback into customized professional development programs to enhance leadership effectiveness in dental education.

Medicare Advantage (MA) enrollment has grown rapidly over recent years, and enrollees may now choose from among a large number of MA plans. However, the market remains highly concentrated, with a few very large insurers. Using MA administrative data, we analyzed trends in insurer concentration during the period 2013-23 and its relation to MA payments and plan characteristics. We documented a significant shift toward less concentration, but concentration remained high. The average number of insurers per county increased, and the Herfindahl-Hirschman Index measure of market concentration declined. Reduced concentration was associated with lower Medicare payments and individual premiums, higher plan rebates, and less enrollee cost sharing. The estimated effects, however, were quantitatively small. Our findings suggest that further reductions in MA insurer concentration may yield only modest benefits for Medicare beneficiaries and the program unless concentration falls well below current levels.