PURPOSE: To examine a nested model that predicts adolescent risky behavior, health care use, and health care expenditures from individual characteristics, such as age and gender, and community characteristics such as social capital and community-level risky behavior rates. METHODS: Claims and encounter data were used to classify adolescents enrolled in Florida's Healthy Kids Program into two groups: those who engaged in risky behavior (ARB) and those who did not (NRB). Hierarchical linear modeling techniques were used to predict the odds of risky behavior, the odds of health care use, and health care expenditures based on individual and community characteristics. RESULTS: ARB consumed significantly more health care services than NRB, and their higher use and charges were attributable not only to individual level factors (i.e., age, gender, presence of special health care need, metropolitan residence status), but also to community level factors (i.e., social capital, risky behavior rates, violence, and ethnic/racial composition) as well. In particular, community investment in social capital predicted lower levels of risky behavior as well as lower health care expenditures. CONCLUSIONS: This information is important in terms of policy efforts at providing health care for this vulnerable group of individuals, as well as in developing prevention and intervention programs that can be delivered through the health care system and via links to community supports.
PURPOSE: To examine a nested model that predicts adolescent risky behavior, health care use, and health care expenditures from individual characteristics, such as age and gender, and community characteristics such as social capital and community-level risky behavior rates. METHODS: Claims and encounter data were used to classify adolescents enrolled in Florida's Healthy Kids Program into two groups: those who engaged in risky behavior (ARB) and those who did not (NRB). Hierarchical linear modeling techniques were used to predict the odds of risky behavior, the odds of health care use, and health care expenditures based on individual and community characteristics. RESULTS: ARB consumed significantly more health care services than NRB, and their higher use and charges were attributable not only to individual level factors (i.e., age, gender, presence of special health care need, metropolitan residence status), but also to community level factors (i.e., social capital, risky behavior rates, violence, and ethnic/racial composition) as well. In particular, community investment in social capital predicted lower levels of risky behavior as well as lower health care expenditures. CONCLUSIONS: This information is important in terms of policy efforts at providing health care for this vulnerable group of individuals, as well as in developing prevention and intervention programs that can be delivered through the health care system and via links to community supports.
Authors: Sheri A Lippman; Hannah H Leslie; Torsten B Neilands; Rhian Twine; Jessica S Grignon; Catherine MacPhail; Jessica Morris; Dumisani Rebombo; Malebo Sesane; Alison M El Ayadi; Audrey Pettifor; Kathleen Kahn Journal: Health Place Date: 2018-02-03 Impact factor: 4.078
Authors: Marie C D Stoner; Torsten B Neilands; Kathleen Kahn; James P Hughes; F Xavier Gómez-Olivé; Rhian Twine; Stephen Tollman; Oliver Laeyendecker; Catherine MacPhail; Jennifer Ahern; Sheri A Lippman; Audrey Pettifor Journal: J Adolesc Health Date: 2019-09-11 Impact factor: 5.012
Authors: Sheri A Lippman; Anna M Leddy; Torsten B Neilands; Jennifer Ahern; Catherine MacPhail; Ryan G Wagner; Dean Peacock; Rhian Twine; Dana E Goin; F Xavier Gómez-Olivé; Amanda Selin; Stephen M Tollman; Kathleen Kahn; Audrey Pettifor Journal: J Int AIDS Soc Date: 2018-10 Impact factor: 5.396