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
The effects of state regulations and alcohol consumption on traffic fatalities 1980-2010
Silver, D., Bae, J., Jimenez, G., Paul, M., & Mancinko, J. (n.d.).Publication year
2013Journal title
Public HealthVolume
127Page(s)
1117-1125Variation in U.S. traffic safety policy environments and motor vehicle fatalities 1980-2010
AbstractSilver, D., Macinko, J., Bae, J. Y., Jimenez, G., & Paul, M. (n.d.).Publication year
2013Journal title
Public HealthVolume
127Issue
12Page(s)
1117-1125AbstractObjective: To examine the impact of variation in state laws governing traffic safety on motor vehicle fatalities. Study design: Repeated cross sectional time series design. Methods: Fixed effects regression models estimate the relationship between state motor vehicle fatality rates and the strength of the state law environment for 50 states, 1980-2010. The strength of the state policy environment is measured by calculating the proportion of a set of 27 evidence-based laws in place each year. The effect of alcohol consumption on motor vehicle fatalities is estimated using a subset of alcohol laws as instrumental variables. Results: Once other risk factors are controlled in statistical models, states with stronger regulation of safer driving and driver/passenger protections had significantly lower motor vehicle fatality rates for all ages. Alcohol consumption was strongly associated with higher MVC death rates, as were state unemployment rates. Conclusions: Encouraging laggard states to adopt the full range of available laws could significantly reduce preventable traffic-related deaths in the U.S. - especially those among younger individuals. Estimating the relationship between different policy environments and health outcomes can quantify the result of policy gaps.How residential mobility and school choice challenge assumptions of neighborhood place-based interventions
AbstractSilver, D., Weitzman, B. C., Mijanovich, T., & Holleman, M. (n.d.).Publication year
2012Journal title
American Journal of Health PromotionVolume
26Issue
3Page(s)
180-183AbstractPurpose: Explore the importance of residential mobility and use of services outside neighborhoods when interventions targeting low-income families are planned and implemented. Design: Analysis of cross-sectional telephone household survey data on childhood mobility and school enrollment in four large distressed cities. Setting: Baltimore, Maryland; Detroit, Michigan; Philadelphia, Pennsylvania; and Richmond, Virginia. Subjects: Total of 1723 teens aged 10 to 18 years and their parents. Measures: Continuous self-report of the number of years parents lived in the neighborhood of residence and city; self-report of whether the child attends school in their neighborhood; and categorical self report of parents' marital status, mother's education, parent race, family income, child's age, and child's sex. Analysis: Chi-square and multivariate logistic regression. Results: In this sample, 85.2% of teens reported living in the city where they were born. However, only 44.4% of black teens lived in neighborhoods where they were born, compared with 59.2% of white teens. Although 50.3% of black teens attended schools outside of their current neighborhoods, only 31.4% of whites did. Residential mobility was more common among black than white children (odds ratio = 1.82; p <.001), and black teens had 43% lesser odds of attending school in their home communities. Conclusions: Mobility among low-income and minority families challenges some assumptions of neighborhood interventions premised on years of exposure to enriched services and changes in the built environment.Improving state health policy assessment: An agenda for measurement and analysis
AbstractMacinko, J., & Silver, D. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
9Page(s)
1697-1705AbstractWe examine the scope of inquiry into the measurement and assessment of the state public health policy environment. We argue that there are gains to be made by looking systematically at policies both within and across health domains. We draw from the public health and public policy literature to develop the concepts of interdomain and intradomain policy comprehensiveness and illustrate how these concepts can be used to enhance surveillance of the current public health policy environment, improve understanding of the adoption of new policies, and enhance evaluations of the impact of such policies on health outcomes.Transportation to clinic: Findings from a pilot clinic-based survey of low-income suburbanites
AbstractSilver, D., Blustein, J., & Weitzman, B. C. (n.d.).Publication year
2012Journal title
Journal of Immigrant and Minority HealthVolume
14Issue
2Page(s)
350-355AbstractHealth care policymakers have cited transportation barriers as key obstacles to providing health care to low-income suburbanites, particularly because suburbs have become home to a growing number of recent immigrants who are less likely to own cars than their neighbors. In a suburb of New York City,we conducted a pilot survey of low income, largely immigrant clients in four public clinics, to find out how much transportation difficulties limit their access to primary care. Clients were receptive to the opportunity to participate in the survey (response rate = 94%). Nearly one-quarter reported having transportation problems that had caused them to miss or reschedule a clinic appointment in the past. Difficulties included limited and unreliable local bus service, and a tenuous connection to a car. Our pilot work suggests that this population is willing to participate in a survey on this topic. Further, since even among those attending clinic there was significant evidence of past transportation problems, it suggests that a populationbased survey would yield information about substantial transportation barriers to health care.Lifting boatswithout closing gaps: Child health outcomes in distressed us cities from 1992-2002
AbstractSilver, D., Mijanovich, T., Uyei, J., Kapadia, F., & Weitzman, B. C. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
2Page(s)
278-284AbstractObjectives. We compared cause-specific mortality and birth rates for children and youths aged younger than 18 years in 100 US cities from 1992 through 2002. Methods. We used 5 census indicators to categorize the 100 most populous US cities in 1990 as economically distressed or nondistressed. We used Poisson regression to calculate rate ratios for cause-specific mortality and birth rates, comparing distressed cities to nondistressed cities overall and by race/ethnicity from 1992 through 2002. We also calculated rates of change in these variables within each city over this period. Results. Despite improvements in health for the study population in all cities, disparities between city groups held steady or widened over the study period. Gaps in outcomes between Whites and Blacks persisted across all cities. Living in a distressed city compounded the disparities in poor outcomes for Black children and youths. Conclusions. A strong national economy during the study period may have facilitated improvements in health outcomes for children and youths in US cities, but these benefits did not close gaps between distressed and nondistressed cities.People versus place, tackling urban poverty: Guest blog for Media Matters
Silver, D. (n.d.).Publication year
2010Understanding the political context of "new" policy issues: The use of the advocacy coalition framework in the case of expanded after-school programs
AbstractBrecher, C., Brazill, C., Weitzman, B. C., & Silver, D. (n.d.).Publication year
2010Journal title
Journal of Public Administration Research and TheoryVolume
20Issue
2Page(s)
335-355AbstractThis article uses the Advocacy Coalition Framework to identify the stakeholders and their coalitions in the arena of after-school policy, which drew much new attention beginning in the early 1990s in many American cities. Using evidence from case studies in five cities, we show how the framework can be extended beyond stakeholder analysis to include identification of core and secondary value conflicts and of opportunities for policy analysis to help strengthen coalitions and pressures for change. Coalitions in each of the cities differ over core values relating to the purposes of after-school programs (academics versus "fun"), but policy analysts can promote common goals by developing options to deal with the secondary conflicts over the relative importance of facilities versus program content, the modes of collaboration between public schools and community based organizations, and the incentives for public school teachers to engage in staffing after-school programs.Finding the impact in a messy intervention: Using an integrated design to evaluate a comprehensive citywide health initiative
AbstractWeitzman, B. C., Mijanovich, T., Silver, D., & Brecher, C. (n.d.).Publication year
2009Journal title
American Journal of EvaluationVolume
30Issue
4Page(s)
495-514AbstractThis article uses the evaluation of the Robert Wood Johnson Foundation's (RWJF) Urban Health Initiative (UHI), a 10-year effort to improve health and safety outcomes in distressed cities, to demonstrate the strength of an evaluation design that integrates theory of change and quasi-experimental approaches, including the use of comparison cities. This paper focuses on the later stages of implementation and, especially, our methods for estimating program impacts. While the theory of change was used to make preliminary identification of intended outcomes, we used the sites' plans and early implementation to refine this list and revisit our strategy for estimating impacts. Using our integrated design, differences between program and comparison cities are considered impacts only if they were predicted by program theory, local plans for action, and early implementation. We find small, measurable changes in areas of greatest programmatic effort. We discuss the importance of the integrated design in identifying impacts.The pros and cons of comprehensive community Initiatives at the city level: The case of the urban health Initiative
Silver, D., & Weitzman, B. (n.d.).Publication year
2009Journal title
The Foundation ReviewVolume
1Issue
1Page(s)
85-95If you build it, will they come?: Estimating unmet demand for after-school programs in america's distressed cities
AbstractWeitzman, B. C., Mijanovich, T., Silver, D., & Brazill, C. (n.d.).Publication year
2008Journal title
Youth and SocietyVolume
40Issue
1Page(s)
3-34AbstractTelephone-survey data were gathered from parents and youth in five of America's largest and most distressed cities to estimate unmet demand for after-school programs. Unmet demand was conceptualized as a function of low utilization and dissatisfaction with one's current arrangement; furthermore, the authors argue that dissatisfaction must stem from something that can be addressed through changes in policy or programs. Large numbers of parents of children who infrequently use after-school programs were found to indicate that they would increase utilization if there were improvements in the quality, access, or types of programming. However, large numbers of parents whose children do not participate or participate infrequently in after-school programs were also found to express satisfaction with their arrangement and indicated that they do not wish to change it. Expanding services with the assumption that children from these families will participate may be misguided.Efforts to improve public policy and programs through data practice: Experiences in 15 distressed American cities
AbstractWeitzman, B. C., Silver, D., & Brazill, C. (n.d.).Publication year
2006Journal title
Public Administration ReviewVolume
66Issue
3Page(s)
386-399AbstractPhilanthropies and government agencies interested in children's issues are encouraging localities to improve the process of collecting, linking, and sharing microdata and aggregated summary statistics. An implicit assumption of these efforts is that outcomes will improve as a result of the new approaches. However, there has been little systematic study of these efforts. In this article, we examine efforts to improve data practice in 15 distressed American cities. Interviews conducted in these cities revealed variation in the types of information collected, dissemination, and intended audiences. We identify significant challenges to these efforts, including adequate resources, turf battles, technical problems, access to information sources, inconsistent leadership, and absence of political will. We find that little is known about the impact of these initiatives on decision making. Assumptions that improved data practice will lead to improved policy making have not yet been realized in these cities.Following the money: Using expenditure analysis as an evaluation tool
AbstractBrecher, C., Silver, D., Searcy, C., & Weitzman, B. C. (n.d.).Publication year
2005Journal title
American Journal of EvaluationVolume
26Issue
2Page(s)
166-188AbstractThis article describes the nature and utility of fiscal analysis in evaluating complex community interventions. Using New York University's evaluation of the Robert Wood Johnson Foundation's Urban Health Initiative as an example, the authors describe issues arising in defining and operationalizing constructs for fiscal analysis. The approach's utility is demonstrated in the use of interim findings to help redefine the program's goals for resource allocation, to modify its theory of change to include greater emphasis on state-level action, and to emphasize the importance of local public schools as resource centers and intervention targets. The fiscal analysis also provides new insights into the limitations of "preventive" versus "corrective" spending categories and helps make goals for such functional reallocation more realistic. The authors discuss limitations of fiscal analysis due to available data quality, the extent of cooperation needed from public officials to collect relevant data, and the level of expertise needed to interpret the data.Integrating a comparison group design into a theory of change evalutation
Weitzman, B., Silver, D., & Dillman, K. N. (n.d.). In E. Stern (Ed.), Evaluation research methods: The case of the urban health initiative (1–).Publication year
2005Integrating a comparison group design into a theory of change evaluation: The case of the urban health initiative
AbstractWeitzman, B. C., Silver, D., & Dillman, K. N. (n.d.).Publication year
2002Journal title
American Journal of EvaluationVolume
23Issue
4Page(s)
371-385AbstractThis paper describes how we strengthened the theory of change approach to evaluating a complex social initiative by integrating it with a quasi-experimental, comparison group design. We also demonstrate the plausibility of selecting a credible comparison group through the use of cluster analysis, and describe our work in validating that analysis with additional measures. The integrated evaluation design relies on two points of comparison: (1) program theory to program experience; and (2) program cities to comparison cities. We describe how we are using this integrated design to evaluate the Robert Wood Johnson Foundation's Urban Health Initiative, an effort that aims to improve health and safety outcomes for children and youth in five distressed urban areas through a process of citywide, multi-sector planning and changed public and private systems. We also discuss how the use of two research frameworks and multiple methods can enrich our ability to test underlying assumptions and evaluate overall program effects. Using this integrated approach has provided evidence that the earliest phases of this initiative are unfolding as the theory would predict, and that the comparison cities are not undergoing a similar experience to those in UHI. Despite many remaining limitations, this integrated evaluation can provide greater confidence in assessing whether future changes in health and safety outcomes may have resulted from the Urban Health Initiative (UHI).Setting an agenda for local action: The limits of expert opinion and community voice
AbstractSilver, D., Weitzman, B., & Brecher, C. (n.d.).Publication year
2002Journal title
Policy Studies JournalVolume
30Issue
3Page(s)
362-378AbstractMany social programs, funded by government or philanthropy, begin with efforts to improve local conditions with strategic planning. Mandated by funders, these processes aim to include the views of community residents and those with technical expertise. Program leaders are left to reconcile public and expert opinions in determining how to shape their programs. The experience of the Robert Wood Johnson Foundation's Urban Health Initiative suggests that although consultation with experts and the public failed to reveal a clear assessment of the community's problems or their solutions, it did assist in engaging diverse groups. Despite this engagement, however, core leaders wielded substantial power in selecting the agenda.Health promotion in the city: A structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in US metropolitan areas, 1980-1995
AbstractFreudenberg, N., Silver, D., Carmona, J. M., Kass, D., Lancaster, B., & Speers, M. (n.d.).Publication year
2000Journal title
Journal of Urban HealthVolume
77Issue
3Page(s)
443-457AbstractTo achieve its national public health goals, the US must improve the health of low-income urban populations. To contribute to this process, this study reviewed published reports of health promotion interventions designed to prevent heart disease, HIV infection, substance abuse, and violence in US cities. The study's objectives were to describe the target populations, settings, and program characteristics of these interventions and to assess the extent to which these programs followed accepted principles for health promotion. Investigators searched five computerized databases and references of selected articles for articles published in peer-reviewed journals between 1980 and 1995. Selected articles listed as a main goal primary prevention of one of four index conditions; were carried out within a US city; included sufficient information to characterize the intervention; and organized at least 25% of its activities within a community setting. In general, programs reached a diverse population of low-income city residents in a variety of settings, employed multiple strategies, and recognized at least some of the principles of effective health promotion. Most programs reported a systematic evaluation. However, many programs did not involve participants in planning, intervene to change underlying social causes, last more than a year, or tailor for the subpopulations they targeted, limiting their potential effectiveness. Few programs addressed the unique characteristics of urban communities.Everyday heroes: A review of Something Better for My Children: The History and People of Head Start by Kay Mills
Silver, D. (n.d.).Publication year
1998Journal title
New York Times Book ReviewLetter: A way to cut out crime
Weitzman, B., & Silver, D. (n.d.). In New York Times (1–).Publication year
1997One method for assessing HIV/AIDS peer-education programs
AbstractHaignere, C. S., Freudenberg, N., Silver, D. R., Maslanka, H., & Kelley, J. T. (n.d.).Publication year
1997Journal title
Journal of Adolescent HealthVolume
21Issue
2Page(s)
76-79AbstractThis study offers a new evaluation methodology for peer-education programs. Peer educators' knowledge, self-esteem, peer pressure, and the number of friends, neighbors, and relatives given HIV/AIDS information were compared before and after training using self-administered questionnaires. Significant changes were observed in knowledge, peer pressure, self-efficacy, numbers of people given condoms, number of formal and informal HIV/AIDS presentations, and numbers of HIV/AIDS discussions with friends and neighbors.How black and Latino community organizations respond to the AIDS epidemic: a case study in one New York City neighborhood.
Freudenberg, N., Lee, J., & Silver, D. (n.d.).Publication year
1989Journal title
AIDS education and prevention : official publication of the International Society for AIDS EducationVolume
1Issue
1Page(s)
12-21