Search Results
Briefing
Declining access to health care in northern New England
Access to health care is a major concern across the northern New England states?Maine, New Hampshire, and Vermont?where rising operating costs and population loss threaten the stability of hospitals and other medical facilities that serve their surrounding rural communities. New analysis of financial data shows that many rural hospitals are operating at losses that are predictive of financial distress or even closure. Consequently, the communities served by these hospitals may be at risk of losing the benefits they provide to public health and the local economy. Addressing the financial ...
Working Paper
Employment Trajectories among Individuals with Opioid Use Disorder: Can Evidence-Based Treatment Improve Outcomes?
Using administrative records of Medicaid enrollees in Rhode Island that link their health-care information with their payroll employment records, this paper produces new stylized facts concerning the association between opioid use disorder (OUD) and employment and inquires as to whether treatment with FDA-approved medications might boost the job-finding rates of OUD patients. We find that individuals diagnosed with OUD are less likely to be employed compared with other Medicaid enrollees, that their employment tends to be more intermittent, and that they face increased job-separation risk ...
Report
The criminal population in New England: records, convictions, and barriers to employment
The portion of the U.S. population with a criminal record has been receiving mounting attention in recent years. While there is a significant amount of data about the criminal population under supervision, there is very limited linked data identifying how most individuals move through the criminal justice system. By analyzing multiple national and state data sources, this report aims to identify the size of the New England population with a criminal record and to describe the broad demographic characteristics of this population. The report illustrates that the size of the population in the ...
Report
Exploring causes of and responses to the opioid epidemic in New England
The opioid epidemic remains rampant in New England, where, from 2015 through 2017, more than 10,000 people died from opioid overdoses. In 2017, each of the six states experienced an overdose-death rate that was greater than the national average. Beyond causing a high number of deaths, the opioid epidemic is costing New England productive workers. People with the most severe problems stemming from opioid-use disorder tend to be in the 25?44 age group, but no one is immune. The epidemic affects people of every type?all ages and all races, men and women, residents of rural areas and of urban ...
Report
Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?
Since the early 2000s Rhode Island has been among the states hardest hit by the opioid crisis. In response, the state has made it a priority to expand access to medication-assisted treatment (MAT) for opioid use disorder (OUD), which refers to the use of the FDA-approved medications methadone, buprenorphine, and/or naltrexone in conjunction with behavioral therapy. MAT is strongly supported by scientific evidence and endorsed by US public health officials and yet fails to reach many OUD patients. Using administrative data covering medical treatments and selected health outcomes for more than ...
Briefing
The Challenge of Declining K–12 Enrollment in Northern New England
COVID-related public health concerns and declining tax revenues raised or continue to raise important questions throughout the country about when and how to restart schools and how to fund them in the near term. For communities across northern New England, there are also fundamental, longer-term concerns over declines in the student population that will still confront districts well beyond the current academic year. In every county in New Hampshire, Maine, andVermont, the number of young residents has declined over the last two decades. Northern New England is not alone in facing this ...
Briefing
Aging and declining populations in northern New England: is there a role for immigration?
In hundreds of communities across northern New England, the population is aging rapidly and becoming smaller. The entire country is aging, but northern New England stands out: Among the populations of all US states, those of Maine, New Hampshire, and Vermont have the top-three highest median ages, respectively. The situation is even more extreme in northern New England?s rural counties, where the populations of the smallest towns generally are substantially older than those of the rest of the region. These communities also have seen the slowest, or even negative, population growth over the ...
Report
Can Treatment with Medications for Opioid Use Disorder Improve Employment Prospects? Evidence from Rhode Island Medicaid Enrollees
The nation’s long-standing crisis of opioid abuse intensified during the COVID-19 pandemic, with opioid-related deaths rising to nearly 81,000 in 2021, an increase of more than 60 percent from just two years earlier. Also during the pandemic, the labor force participation rate in the United States fell precipitously, and as of September 2022 it remained depressed by more than a full percentage point relative to its February 2020 level despite record numbers of job openings in 2021 and 2022. The unfortunate confluence of labor shortages and record-setting opioid mortality highlights the need ...
Working Paper
Who Gets Medication-assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database
This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a ...
Report
Why is state and local government capital spending lower in the New England states than in other U.S. states?
This report explores several hypotheses as to why state and local governments in New England have been spending less on capital investment than the national average, on a normalized basis. Census data show that state and local capital spending in all six New England states was well below the national average between 2000 and 2012, whether measured on a per capita basis, as a share of personal income, or as a share of state and local government spending. To explore why this is so, this report considers how capital spending has changed over time, how capital spending differs by state and across ...