Diana R Silver
Diana R Silver
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Vice Dean of Faculty Affairs
Professor of Public Health Policy and Management
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Professional overview
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Dr. Diana Silver's research explores the impact of variation in the implementation, adoption and repeal of state and local public health policies on health outcomes, particularly alcohol consumption, motor vehicle crashes, tobacco use, and food safety. Some of her other work has examined variation in access to publicly funded services such as clinics, after-school programs, parks and playgrounds. Her work has been funded by the National Institutes of Health, the Robert Wood Johnson Foundation, the New York City Department of Health and Mental Hygiene, and several other funders.
Dr. Silver's work has been published in a variety of prominent journals, including the American Journal of Public Health, the American Journal of Health Promotion, Public Health, Tobacco Control, Journal of Safety Research, Social Science and Medicine, the American Journal of Evaluation, PLoS One, Journal of Community Health, Journal of Immigrant and Minority Health, International Journal of Equity in Health, Globalization and Health, Youth and Society, Public Administration Review and Policy Studies Journal. She is an associate editor for the American Journal of Health Promotion, and serves on the New York City Department of Health’s Health Advisory Committee. She began her career focused on the developing policies and programs that could address the epidemics of AIDS, substance abuse and violence in New York City, in such settings as schools, workplaces, jails, and homeless shelters.
Dr. Silver teaches undergraduate and master’s level courses at the School of Global Health, and trains doctoral students. In 2015, Dr. Silver received NYU’s Distinguished Teaching Award, the university’s highest honor for teaching excellence.
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Education
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BA, History, Bates College, Lewiston, MEMPH, Health Education, Hunter College, New York City, NYPhD, Public Administration, New York University, New York City, NY
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Honors and awards
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Distinguished Teaching Award, New York University (2015)Steinhardt Goddard Award (2011)Annual Award for Outstanding Evaluation, American Evaluation Association (2010)Public Affairs Resident Scholar, The Rockefeller Foundation (2007)
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Areas of research and study
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Access to HealthcareAlcohol, Tobacco and Driving PoliciesFood Safety PoliciesImplementation and Impact of Public Health RegulationsInjury PreventionNew York Department of Health and Mental HygienePublic Health LawPublic Health Policy
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Publications
Publications
Stakeholder Perspectives on Data-Driven Solutions to Address Cardiovascular Disease and Health Equity in New York City
AbstractLindenfeld, Z., Pagán, J. A., Silver, D. R., McNeill, E., Mostafa, L., Zein, D., & Chang, J. E. (n.d.).Publication year
2023Journal title
AJPM FocusVolume
2Issue
3AbstractIntroduction: There is growing recognition of the importance of addressing the social determinants of health in efforts to improve health equity. In dense urban environments such as New York City, disparities in chronic health conditions (e.g., cardiovascular disease) closely mimic inequities in social factors such as income, education, and housing. Although there is a wealth of data on these social factors in New York City, little is known about how to rapidly use available data sources to address health disparities. Methods: Semistructured interviews were conducted with key stakeholders (N=11) from across the public health landscape in New York City (health departments, healthcare delivery systems, and community-based organizations) to assess perspectives on how social determinants of health data can be used to address cardiovascular disease and health equity, what data-driven tools would be useful, and challenges to using these data sources and developing tools. A matrix analysis approach was used to analyze the interview data. Results: Stakeholders were optimistic about using social determinants of health data to address health equity by delivering holistic care, connecting people with additional resources, and increasing investments in under-resourced communities. However, interviewees noted challenges related to the quality and timeliness of social determinants of health data, interoperability between data systems, and lack of consistent metrics related to cardiovascular disease and health equity. Conclusions: Future research on this topic should focus on mitigating the barriers to using social determinants of health data, which includes incorporating social determinants of health data from other sectors. There is also a need to assess how data-driven solutions can be implemented within and across communities and organizations.The Diffusion of Punitive Firearm Preemption Laws Across U.S. States
AbstractMacinko, J. A., Silver, D. R., Clark, D. A., & Pomeranz, J. L. (n.d.).Publication year
2023Journal title
American journal of preventive medicineAbstractIntroduction: Firearm violence is a public health crisis. Most states prohibit local firearm laws, but some states have laws that allow for lawsuits and other penalties against local governments and lawmakers who pass firearm laws deemed preempted. These punitive firearm preemptive laws may reduce firearm policy innovation, discussion, and adoption beyond preemption alone. Yet, it is unknown how these laws spread from state to state. Methods: In 2022, using an event history analysis framework with state dyads, logistic regression models estimate the factors associated with adoption and diffusion of firearm punitive preemption laws, including state-level demographic, economic, legal, political, population, and state-neighbor factors. Results: As of 2021, 15 states had punitive firearm preemption laws. Higher numbers of background checks (AOR=1.50; 95% CI=1.15, 2.04), more conservative government ideology (AOR=7.79; 95% CI=2.05, 35.02), lower per capita income (AOR=0.16; 95% CI=0.05, 0.44), a higher number of permissive state firearm laws (AOR=2.75; 95% CI=1.57, 5.30), and neighboring state passage of the law (AOR=3.97; 95% CI=1.52, 11.51) were associated with law adoption. Conclusions: Both internal and external state factors predict the adoption of punitive firearm preemption. This study may provide insight into which states are susceptible to adoption in the future. Advocates, especially in neighboring states without such laws, may want to focus their firearm safety policy efforts on opposing the passage of punitive firearm preemption.Uses of Social Determinants of Health Data to Address Cardiovascular Disease and Health Equity : A Scoping Review
AbstractMcNeill, E., Lindenfeld, Z., Mostafa, L., Zein, D., Silver, D. R., Pagán, J., Weeks, W. B., Aerts, A., Rosiers, S. D., Boch, J., & Chang, J. E. (n.d.).Publication year
2023Journal title
Journal of the American Heart AssociationVolume
12Issue
21AbstractBACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Prior research suggests that social determinants of health have a compounding effect on health and are associated with cardiovascular disease. This scoping review explores what and how social determinants of health data are being used to address cardiovascular disease and improve health equity. METHODS AND RESULTS: After removing duplicate citations, the initial search yielded 4110 articles for screening, and 50 studies were identified for data extraction. Most studies relied on similar data sources for social determinants of health, including geo-coded electronic health record data, national survey responses, and census data, and largely focused on health care access and quality, and the neighborhood and built environment. Most focused on developing interventions to improve health care access and quality or characterizing neighborhood risk and individual risk. CONCLUSIONS: Given that few interventions addressed economic stability, education access and quality, or community context and social risk, the potential for harnessing social determinants of health data to reduce the burden of cardiovascular disease remains unrealized.Uses of Social Determinants of Health Data to Address Cardiovascular disease and health equity: A scoping review
AbstractMcNeill, E., Lindenfeld, Z., Stein, D., Silver, D. R., Pagan, J., Weeks, W., Des Rosiers, S., Boch, J., & Chang, J. (n.d.).Publication year
2023Journal title
Journal of the American Health AssociationVolume
12AbstractAbstract Background Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Prior research suggests that social determinants of health have a compounding effect on health and are associated with cardiovascular disease. This scoping review explores what and how social determinants of health data are being used to address cardiovascular disease and improve health equity. Methods and Results After removing duplicate citations, the initial search yielded 4110 articles for screening, and 50 studies were identified for data extraction. Most studies relied on similar data sources for social determinants of health, including geocoded electronic health record data, national survey responses, and census data, and largely focused on health care access and quality, and the neighborhood and built environment. Most focused on developing interventions to improve health care access and quality or characterizing neighborhood risk and individual risk. Conclusions Given that few interventions addressed economic stability, education access and quality, or community context and social risk, the potential for harnessing social determinants of health data to reduce the burden of cardiovascular disease remains unrealized.Variance of US Hospital Characteristics by Safety-Net Definition
AbstractMcneill, E., Cronin, C., Puro, N., Franz, B., Silver, D. R., & Chang, J. E. (n.d.).Publication year
2023Journal title
JAMA network openVolume
6Issue
9Page(s)
E2332392Abstract~Association between COVID-19 vaccine hesitancy and trust in the medical profession and public health officials
AbstractSilver, D. R., Kim, Y., McNeill, E., Piltch-Loeb, R., Wang, V., & Abramson, D. (n.d.).Publication year
2022Journal title
Preventive MedicineVolume
164AbstractOne's personal physician, national and state or local public health officials, and the broader medical profession play important roles in encouraging vaccine uptake for COVID-19. However, the relationship between trust in these experts and vaccine hesitancy has been underexplored, particularly among racial/minority groups where historic medical mistrust may reduce uptake. Using an April 2021 online sample of US adults (n = 3041) that explored vaccine hesitancy, regression models estimate levels of trust in each of these types of experts and between trust in each of these experts and the odds of being COVID-19 vaccine takers vs refusers or hesitaters. Interaction terms assess how levels of trust in the medical profession by race/ethnicity are associated with vaccine hesitancy. Trust in each expert is positively associated with trust in other experts, except for trust in the medical profession. Only trust in one's own doctor was associated with trust in the medical profession, as measured by factor scores derived from a validated scale. Lower levels of trust in experts were significantly associated with being either a hesitater or a refuser compared to being a taker. Black respondents had higher odds of being either a hesitater or a refuser compared to white respondents but the interaction with trust was insignificant. For Hispanic respondents only, the odds of being a hesitater declined significantly when trust in the medical profession rose. Mistrust in the medical profession, one's doctor and national experts contributes to vaccine hesitancy. Mobilizing personal physicians to speak to their own patients may help.Determinants of the COVID-19 vaccine hesitancy spectrum
AbstractPiltch-Loeb, R., Silver, D. R., Kim, Y., Norris, H., McNeill, E., & Abramson, D. M. (n.d.).Publication year
2022Journal title
PloS oneVolume
17Issue
6 JuneAbstractVaccine hesitancy remains an issue in the United States. This study conducted an online survey [N = 3,013] using the Social Science Research Solution [SSRS] Opinion Panel web panelists, representative of U.S. adults age 18 and older who use the internet, with an over-sample of rural-dwelling and minority populations between April 8 and April 22, 2021- as vaccine eligibility opened to the country. We examined the relationship between COVID-19 exposure and socio-demographics with vaccine intentions [eager-to-take, wait-and-see, undecided, refuse] among the unvaccinated using multinomial logistic regressions [ref: fully/ partially vaccinated]. Results showed vaccine intentions varied by demographic characteristics and COVID-19 experience during the period that eligibility for the vaccine was extended to all adults. At the time of the survey approximately 40% of respondents were unvaccinated; 41% knew someone who had died of COVID-19, and 38% had experienced financial hardship as a result of the pandemic. The vaccinated were more likely to be highly educated, older adults, consistent with the United States initial eligibility criteria. Political affiliation and financial hardship experienced during the pandemic were the two most salient factors associated with being undecided or unwilling to take the vaccine.Do alcohol policies affect everyone equally? An assessment of the effects of state policies on education-related patterns of alcohol use, 2011–2019
AbstractSilver, D. R., Bae, J. Y., McNeill, E., & Macinko, J. A. (n.d.).Publication year
2022Journal title
Drug and alcohol dependenceVolume
239AbstractBackground: Public policies are a powerful tool to change behaviors that may harm population health, but little is known about how state alcohol policies affect different population groups. This study assesses the effects of a comprehensive measure of the state alcohol regulatory environment (the State Alcohol Policy Score or SAPS) on heavy drinking—a risk factor for premature death—on different population groups, defined by levels of educational attainment, then by race/ethnicity, and sex. Methods: We pool each state's Behavioral Risk Factor Surveillance Survey (BRFSS) 2011–2019 and use robust Poisson regression analyses that control for individual-level factors, state-level factors (1 year lagged SAPS score for each state, state fixed effects), and year fixed effects to assess the relationship between SAPS and heavy drinking behaviors by education group. Interaction terms test whether education moderates the relationship by race/ethnicity and gender. Results: SAPS scores increased 2010–2018, but substantial gaps persist between states. A 10 % increase in a state's alcohol policy score is associated with a 2 % lower prevalence in current drinking (APR=0.97, 95 % CI=0.97–0.97, p < 0.0011) although not for those with a high school education or less. A 10 % increase in the SAPS was associated with a 3 % lower prevalence of heavy drinking; interaction terms in models reveal that a 10 % increase in the SAPS was associated with a lower prevalence of heavy drinking among those with less than a college education. Conclusion: Narrowing gaps in alcohol policies between states may reduce heavy drinking among those with lower educational attainment.Federal Paid Sick Leave Is Needed to Support Prevention and Public Health and Address Inequities
AbstractPomeranz, J. L., Pagán, J. A., & Silver, D. R. (n.d.).Publication year
2022Journal title
American journal of preventive medicineVolume
63Issue
2Page(s)
e75Abstract~Generational differences in beliefs about COVID-19 vaccines
AbstractWang, V. H., Silver, D. R., & Pagán, J. A. (n.d.).Publication year
2022Journal title
Preventive MedicineVolume
157AbstractVaccine uptake variation across demographic groups remains a public health barrier to overcome the coronavirus pandemic despite substantial evidence demonstrating the effectiveness of COVID-19 vaccines against severe illness and death. Generational cohorts differ in their experience with historical and public health events, which may contribute to variation in beliefs about COVID-19 vaccines. Nationally representative longitudinal data (December 20, 2020 to July 23, 2021) from the Understanding America Study (UAS) COVID-19 tracking survey (N = 7279) and multilevel logistic regression were used to investigate whether generational cohorts differ in COVID-19 vaccine beliefs. Regression models adjusted for wave, socioeconomic and demographic characteristics, political affiliation, and trusted source of information about COVID-19. Birth-year cutoffs define the generational cohorts: Silent (1945 and earlier), Boomer (1946–1964), Gen X (1965–1980), Millennial (1981–1996), and Gen Z (1997–2012). Compared to Boomers, Silents had a lower likelihood of believing that COVID-19 vaccines have many known harmful side effects (OR = 0.52, 95%CI = 0.35–0.74) and that they may lead to illness and death (OR = 0.53, 95%CI = 0.37–0.77). Compared to Boomers, Silents had a higher likelihood of believing that the vaccines provide important benefits to society (OR = 2.27, 95%CI = 1.34–3.86) and that they are useful and effective (OR = 1.97, 95%CI = 1.17–3.30). Results for Gen Z are similar to those reported for Silents. Beliefs about COVID-19 vaccines markedly differ across generations. This is consistent with the idea of generational imprinting—the idea that some beliefs may be resistant to change through adulthood. Policy strategies other than vaccine education may be needed to overcome this pandemic and future public health challenges.How Patient-Centered Medical Homes Integrate Dental Services Into Primary Care : A Scoping Review
AbstractGupta, A., Akiya, K., Glickman, R. S., Silver, D. R., & Pagán, J. A. (n.d.).Publication year
2022Journal title
Medical Care Research and ReviewVolume
79Issue
4Page(s)
487-499AbstractIntegrated care delivery is at the core of patient-centered medical homes (PCMHs). The extent of integration of dental services in PCMHs for adults is largely unknown. We first identified dental–medical integrating processes from the literature and then conducted a scoping review using PRISMA guidelines to evaluate their implementation among PCMHs. Processes were categorized into workforce, information-sharing, evidence-based care, and measuring and monitoring. After screening, 16 articles describing 21 PCMHs fulfilled the inclusion criteria. Overall, the implementation of integrating processes was limited. Less than half of the PCMHs reported processes for information exchange across medical and dental teams, referral tracking, and standardized protocols for oral health assessments by medical providers. Results highlight significant gaps in current implementation of adult dental integration in PCMHs, despite an increasing policy-level recognition of and support for dental-medical integration in primary care. Understanding and addressing associated barriers is important to achieve comprehensive patient-centered primary care.State Paid Sick Leave and Paid Sick-Leave Preemption Laws Across 50 U.S. States, 2009–2020
AbstractPomeranz, J. L., Silver, D. R., Lieff, S. A., & Pagán, J. A. (n.d.).Publication year
2022Journal title
American journal of preventive medicineVolume
62Issue
5Page(s)
688-695AbstractIntroduction: Paid sick leave is associated with lower mortality risks and increased use of health services. Yet, the U.S. lacks a national law, and not all employers offer paid leave, especially to low-wage workers. States have enacted paid sick-leave laws or preemption laws that prohibit local governments from enacting paid sick-leave requirements. Methods: In 2019 and 2021, state paid sick-leave laws and preemption laws in effect in 2009–2020 were retrieved from Lexis+, coded, and analyzed for coverage and other features. Data from the U.S. Bureau of Economic Analysis were used to estimate the jobs covered by state paid sick-leave laws in 2009–2019. Results: In 2009, no state had a paid sick-leave law, and 1 state had preemption. By 2020, a total of 12 states had paid sick-leave laws, with a form of preemption (n=9) or no preemption (n=3), and 18 additional states solely preempted local laws without requiring coverage, creating a regulatory vacuum in those states. Although all state paid sick-leave laws covered private employers and required care for children and spouses, some laws exempted small or public employers or did not cover additional family members. The percentage of U.S. jobs covered by state-required paid sick leave grew from 0% in 2009 to 27.6% in 2019. Conclusions: Variation in state paid sick-leave laws, preemption, and lack of employer provision of paid sick leave to low-wage workers creates substantial inequities nationally. The federal government should enact a national paid sick-leave law.By the Letter of Law? The Effects of Administrative Adjudication for Resolving Disputes in NYC’s Restaurant Grading Initiative
AbstractSilver, D. R., Rothbart, M. W., & Bae, J. Y. (n.d.).Publication year
2021Journal title
American Review of Public AdministrationVolume
51Issue
8Page(s)
619-635AbstractAdministrative adjudication can serve as a quasi-judicial forum for resolving disputes resulting from government regulations. New York City recently required restaurants to post letter grades reflecting their compliance with food safety regulations and incorporated an easily accessible administrative adjudication system into its policy design. This study examines the implementation of this feature of the policy by using a regression discontinuity framework to explore the effects of the grading policy on adjudication processes and regulatory outcomes. Quantitative data included 222,527 food safety inspection records (2007–2014); qualitative data included interviews, observations, and document review. Restaurants were more likely to have violations reduced and grades improved at adjudication when grades were at stake. Moreover, adjudication outcomes were highly sensitive to score differences near grade cut-points. Professional representatives helped restaurants to negotiate the interpretation of rules in the quasi-judicial proceedings, softening rigidity of regulations. Representatives’ expertise was consistent with being “repeat players,” which may distort the use of such forums to ensure justice and fairness. This study illuminates the ramifications of including alternative dispute resolution systems in the implementation of regulatory policies.State Gun-Control, Gun-Rights, and Preemptive Firearm-Related Laws Across 50 US States for 2009–2018
AbstractPomeranz, J. L., Silver, D. R., & Lieff, S. A. (n.d.).Publication year
2021Journal title
American journal of public healthVolume
111Issue
7Page(s)
1273-1280AbstractObjectives. To assess state policy environments and the relationship between state gun-control, gun-rights, and preemptive firearm-related laws in the United States. Methods. In 2019 through 2020, we evaluated substantive firearm laws and preemptive firearm laws across 50 US states for 2009 through 2018. For each state, we compared substantive measures with preemptive measures on the same policy topic for 2018. Results. The presence of state firearm-related laws varied across states, but with the exception of “punitive preemption” the number of gun-control, gun-rights, and preemptive measures remained unchanged in most states from 2009 through 2018. As of 2018, a majority of states had preemptive measures on almost all gun-control policy topics without enacting substantive gun-control measures. Several states had a combination of gun-control and preemptive measures. Only a small number of states had gun-control measures with few to no preemptive measures. Conclusions. Even where state legislators were unable to pass statewide gun-rights measures, they succeeded in passing preemption, preserving state authority over a wide range of gun-control and gun-rights policy topics. The majority of states used preemption as a tool to support policy frameworks favoring gun rights.24-Year trends in educational inequalities in adult smoking prevalence in the context of a national tobacco control program : The case of Brazil
AbstractBandi, P., Chang, V. W., Sherman, S. E., & Silver, D. R. (n.d.).Publication year
2020Journal title
Preventive MedicineVolume
131AbstractBrazil was a low and middle-income country (LMIC) in the late-1980s when it implemented a robust national tobacco-control program (NTCP) amidst rapid gains in national incomes and gender equality. We assessed changes in smoking prevalence between 1989 and 2013 by education level and related these changes to trends in educational inequalities in smoking. Data were from four nationally representative cross-sectional surveys (1989, n = 25,298; 2003 n = 3845; 2008 n = 28,938; 2013 n = 47,440, ages 25–69 years). We estimated absolute (slope index of inequality, SII) and relative (relative index of inequality, RII) educational inequalities in smoking prevalence, separately for males and females. Additional analyses stratified by birth-cohort to assess generational differences. Smoking declined significantly between 1989 and 2013 in all education groups but declines among females were steeper in higher-educated groups. Consequently, both absolute and relative educational inequalities in female smoking widened threefold between 1989 and 2013 (RII: 1.31 to 3.60, SII: 5.3 to 15.0), but absolute inequalities in female smoking widened mainly until 2003 (SII: 15.8). Conversely, among males, declines were steeper in higher-educated groups only in relative terms. Thus, relative educational inequalities in male smoking widened between 1989 and 2013 (RII: 1.58 to 3.19) but mainly until 2008 (3.22), whereas absolute equalities in male smoking were unchanged over the 24-year period (1989: 21.1 vs. 2013: 23.2). Younger-cohorts (born ≥1965) had wider relative inequalities in smoking vs. older-cohorts at comparable ages, particularly in the youngest female-cohorts (born 1979–1988). Our results suggest that younger lower-SES groups, especially females, may be particularly vulnerable to differentially higher smoking uptake in LMICs that implement population tobacco-control efforts amidst rapid societal gains.Dental radiographs for age estimation in us asylum seekers : Methodological, ethical, and health issues
AbstractKapadia, F., Stevens, J., & Silver, D. R. (n.d.).Publication year
2020Journal title
American journal of public healthVolume
110Issue
12Page(s)
1786-1789AbstractUnaccompanied migrant children seeking asylum status in the United States are often forced to undergo dental radiographs, or x-rays, to verify that they are younger than 18 years. The application of third molar dental radiographs is methodologically flawed and should not be employed as a determinant of chronological age. Furthermore, the use of such tests without obtaining informed consent from either the youth or an objective advocate is unethical. Finally, the legal and health consequences of these inappropriately applied tests are severe and jeopardize the safety and security of these vulnerable minors.Have Health Reforms in Brazil Reduced Inequities in Access to Cancer Screenings for Women?
AbstractMullachery, P., MacInko, J. A., & Silver, D. R. (n.d.).Publication year
2020Journal title
Journal of Ambulatory Care ManagementVolume
43Issue
3Page(s)
257-266AbstractWe measured asset-based and education-based inequity in utilization of 2 cancer screening tests, Pap tests and mammograms, using nationally representative surveys conducted in 2003, 2008, and 2013. Utilization of Pap tests (ages 25-59 years) and mammograms (ages 50-69 years) increased over time. Asset-based and education-based inequities declined significantly for both screening tests, particularly among women who reported a doctor visit in the previous year. This decline coincided with increases in the coverage of primary health care in Brazil. However, barriers persisted; in 2013, college-educated women were still 2.27 times more likely to have a mammogram than those who were illiterate.State Legislative Strategies to Pass, Enhance, and Obscure Preemption of Local Public Health Policy-Making
AbstractPomeranz, J. L., & Silver, D. R. (n.d.).Publication year
2020Journal title
American journal of preventive medicineVolume
59Issue
3Page(s)
333-342AbstractIntroduction: Local governments are often innovators of public health policy-making, yet states are increasingly preempting or prohibiting local control over public health issues. Previous research identified examples of strategies used by state legislatures to pass preemption in ways that may obscure public discussion about preemption or the topics preempted or enhance the strength of a previously passed preemptive law. Methods: To systematically identify strategies to pass, obscure, or enhance preemption, in 2019, the authors conducted a content analysis of the full text of the bills from which preemptive laws in 5 policy areas (tobacco control, firearms, paid sick leave, food and nutrition, and civil rights) passed over a 5-year period (2014–2018) for preemptive laws that remained in effect as of January 2019. Results: This research identified 5 methods state legislators used during the 5-year period to pass and support preemption: (1) pass preemptive bills quickly (11 laws); (2) obscure preemption by adding it to pre-existing bills on nonrelevant substantive topics (4 bills), bundling preemption of multiple nonrelated topics (4 bills), or titling bills in a way that does not reflect the substance of the bill (1 bill); (3) repeal and replace preemption (2 laws); (4) preempt litigation (1 law); and (5) enact punitive preemption (7 laws). Conclusions: Strategies employed to pass preemption obscure public debate about preemption and the underlying public health and social justice issues at stake while minimizing the ability of local governments to protect their populations and the nation to learn from local policy successes.Presence of Counterfeit Marlboro Gold Packs in Licensed Retail Stores in New York City : Evidence from Test Purchases
AbstractKurti, M., He, Y., Silver, D. R., Giorgio, M. M., Von Lampe, K., MacInko, J. A., Ye, H., Tan, F., & Mei, V. (n.d.).Publication year
2019Journal title
Nicotine and Tobacco ResearchVolume
21Issue
8Page(s)
1131-1134AbstractBackground: There are no independent studies measuring the availability of premium brand counterfeit cigarettes in New York City from licensed retailers. Methods: We forensically analyzed the cigarette packaging of Marlboro Gold (n = 1021) purchased from licensed tobacco retailers in New York City, using ultraviolet irradiation and light microscopy to determine whether they were counterfeit. Results: We find that while only 0.5% (n = 5) of our sample exhibits at least one characteristic synonymous with counterfeit packaging, none of our packs can be conclusively classified as counterfeit. Conclusions: We do not find any counterfeit Marlboro Gold packs purchased at full price from licensed cigarette retailers throughout New York City. Future research using test purchases should include other venues (eg, street and online) and specifically ask for discounts to ascertain the overall presence of counterfeit cigarettes. Implications: This is the first study to independently measure the availability of counterfeit cigarette packs purchased at full price from licensed retailers in New York City. We find that none of the Marlboro Gold packs purchased from licensed cigarette retailers are counterfeit.What a Difference a Grade Makes : Evidence from New York City's Restaurant Grading Policy
AbstractRothbart, M. W., Schwartz, A. E., Calabrese, T. D., Papper, Z., Mijanovich, T., Meltzer, R., & Silver, D. R. (n.d.).Publication year
2019Journal title
Public Administration ReviewVolume
79Issue
5Page(s)
651-665AbstractCan governments use grades to induce businesses to improve their compliance with regulations? Does public disclosure of compliance with food safety regulations matter for restaurants? Ultimately, this depends on whether grades matter for the bottom line. Based on 28 months of data on more than 15,000 restaurants in New York City, this article explores the impact of public restaurant grades on economic activity and public resources using rigorous panel data methods, including fixed-effects models with controls for underlying food safety compliance. Results show that A grades reduce the probability of restaurant closure and increase revenues while increasing sales taxes remitted and decreasing fines relative to B grades. Conversely, C grades increase the probability of restaurant closure and decrease revenues while decreasing sales taxes remitted relative to B grades. These findings suggest that policy makers can incorporate public information into regulations to more strongly incentivize compliance.What Are the Financial Implications of Public Quality Disclosure? Evidence from New York City’s Restaurant Food Safety Grading Policy
AbstractMeltzer, R., Rothbart, M. W., Schwartz, A. E., Calabrese, T. D., Silver, D. R., Mijanovich, T., & Weinstein, M. (n.d.).Publication year
2019Journal title
Public Finance ReviewVolume
47Issue
1Page(s)
170-201AbstractGrading schemes are an increasingly common method of quality disclosure for public services. Restaurant grading makes information about food safety practices more readily available and may reduce the prevalence of foodborne illnesses. However, it may also have meaningful financial repercussions. Using fine-grained administrative data that tracks food safety compliance and sales activity for the universe of graded restaurants in New York City and its bordering counties, we assess the aggregate financial effects from restaurant grading. Results indicate that the grading policy, after an initial period of adjustment, improves restaurants’ food safety compliance and reduces fines. While the average effect on revenues for graded restaurants across the municipality is null, the graded restaurants located geographically closer to an ungraded regime experience slower growth in revenues. There is also evidence of revenue convergence across graded and ungraded restaurants in the long term.Evaluating the relationship between binge drinking rates and a replicable measure of U.S. State alcohol policy environments
AbstractSilver, D. R., Macinko, J. A., Giorgio, M. M., & Bae, J. Y. (n.d.).Publication year
2018Journal title
PloS oneVolume
14Issue
6AbstractExcessive alcohol consumption contributes significantly to premature mortality, injuries and morbidity, and a range of U.S. state policies have been shown to reduce these behaviors. Monitoring state alcohol policy environments is essential, but methodologically challenging given that new laws may be passed (or repealed) each year, resulting in considerable variation across states. Existing measures have not been made public or have only a single year available. We develop a new replicable measure, the state alcohol policy score, for each state and year 2004–2009, that captures the essential features of a state’s evidence-based alcohol policies. We evaluate its similarity to two existing alcohol policy measures and validate it by replicating findings from a previous study that used one of those measures to assess its relationship with several binge drinking outcomes. Estimates of the association between one-year lagged state alcohol policy scores and state binge drinking outcomes, obtained from the 2005–2010 Behavioral Risk Factor Surveillance System surveys (n = 440,951, 2010), were produced using Generalized Linear Models that controlled for state and individual-level co-variates, with fixed effects for year and region. We find a 10-percent-age point increase in the state alcohol policy score was associated with a 9% lower odds of binge drinking (aOR = 0.91, 95% CI 0.89, 0.92; N = 1,992,086), a result consistent for men, women and for most age and race subgroups. We find that gender gaps in binge drinking behaviors narrowed in states with higher state alcohol policy scores. These results were nearly identical to those found in other studies using different scores obtained with the aid of expert opinions. We conclude that the score developed here is a valid measure that can be readily updated for monitoring and evaluating the variation and impact of state alcohol policies and make available our state scores for the years of the study.Impact of New York City’s 2014 increased minimum legal purchase age on youth tobacco use
AbstractMacinko, J. A., & Silver, D. R. (n.d.).Publication year
2018Journal title
American journal of public healthVolume
108Issue
5Page(s)
669-675AbstractObjectives. To assess the impact of New York City’s (NYC’s) 2014 increase of the minimum legal purchase age (MLPA) for tobacco and e-cigarettes from 18 to 21 years. Methods. We performed a difference-in-differences analysis comparing NYC to the rest of New York State by using repeated cross-sections of the New York Youth Tobacco Survey (2008-2016) and to 4 Florida cities by using the Youth Risk Behavior Surveys (2007-2015). Results. Adolescent tobacco use declined slightly in NYC after the policy change. However, this rate of change was even larger in control locations. In NYC, e-cigarette use increased and reported purchases of loose cigarettes remained unchanged, suggesting uneven policy implementation, enforcement, or compliance. Conclusions. Increasing the MLPA to 21 years in NYC did not accelerate reductions in youth tobacco use any more rapidly than declines observed in comparison sites. Public Health Implications. Other cities and states currently raising their MLPA for tobacco may need to pay close attention to policy enforcement and conduct enhanced monitoring of retailer compliance to achieve the full benefits of the policy.Planned parenthood is health care, and health care must defend it : A call to action
AbstractSilver, D. R., & Kapadia, F. (n.d.).Publication year
2017Journal title
American journal of public healthVolume
107Issue
7Page(s)
1040-1041Abstract~Changes in health care inequity in Brazil between 2008 and 2013
AbstractMullachery, P., Silver, D. R., & Macinko, J. A. (n.d.).Publication year
2016Journal title
International Journal for Equity in HealthVolume
15Issue
1AbstractBackground: Brazil has made progress towards a more equitable distribution of health care, but gains may be threatened by economic instability resulting from the 2008 global financial crisis. This study measured predictors of health care utilization and changes in horizontal inequity between 2008 and 2013. Method: Data were from two nationally representative surveys that measured a variety of sociodemographic, health behaviors and health care indicators. We used Poisson regression models to estimate adjusted prevalence ratios and the Horizontal Equity Index (HEI) standardized by health needs to measure inequity in the utilization of doctor and dentist visits, hospitalizations and reporting of a usual source of care (USC) for those 18 and older. To estimate the HEI, we ranked the population from the poorest to the richest using a wealth index. We also decomposed the HEI into its different components and assessed changes from 2008 to 2013. Results: The population proportion with doctor and dentist visits in the past year and a USC increased between 2008 and 2013, while hospitalizations declined. In 2013, pro-rich inequity in doctor visits increased significantly while the distribution of hospitalizations shifted from pro-rich in 2008 to neutral in 2013. Dentist visits were highly pro-rich and USC was slightly pro-rich; the distribution of dentist visits and USC did not change over time. Health need was a strong predictor of health care utilization regardless of the type of coverage (public or private). Education, wealth, and private health plans were associated with the pro-rich orientation of doctor and dentist visits. Private health plans contributed to the pro-rich orientation of all outcomes, while the Family Health Strategy contributed to the pro-poor orientation of all outcomes. Conclusion: The results of this study support the claim that Brazil's population continued to see absolute gains in access to care despite recent economic crises. However, gains in equity have slowed and may even decline if investments are not maintained as the country enters deeper financial and political crises.