Bobby Milstein

Learn More
Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and(More)
One of the key elements in qualitative data analysis is the systematic coding of text (Strauss and Corbin 1990:57%60; Miles and Huberman 1994:56). Codes are the building blocks for theory or model building and the foundation on which the analyst’s arguments rest. Implicitly or explicitly, they embody the assumptions underlying the analysis. Given the(More)
OBJECTIVES Awareness of and support for systems thinking and modeling in the public health field are growing, yet there are many practical challenges to implementation. We sought to identify and describe these challenges from the perspectives of practicing public health professionals. METHODS A systems-based methodology, concept mapping, was used in a(More)
Health planners in the Division of Diabetes Translation and others from the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention used system dynamics simulation modeling to gain a better understanding of diabetes population dynamics and to explore implications for public health strategy. A(More)
The Hawaii Department of Health (HDOH) used concept mapping techniques to engage local stakeholders and national subject area experts in defining the community and system factors that affect individuals' behaviors related to tobacco, nutrition, and physical activity. Over eight working days, project participants brainstormed 496 statements (edited to a(More)
INTRODUCTION Healthy People 2010 (HP 2010) objectives call for a 38% reduction in the prevalence of diagnosed diabetes mellitus, type 1 and type 2, by the year 2010. The process for setting this objective, however, did not focus on the achievability or the compatibility of this objective with other national public health objectives. We used a dynamic(More)
We used a dynamic simulation model of the US health system to test three proposed strategies to reduce deaths and improve the cost-effectiveness of interventions: expanding health insurance coverage, delivering better preventive and chronic care, and protecting health by enabling healthier behavior and improving environmental conditions. We found that each(More)
Numerous local interventions for cardiovascular disease are available, but resources to deliver them are limited. Identifying the most effective interventions is challenging because cardiovascular risks develop through causal pathways and gradual accumulations that defy simple calculation. We created a simulation model for evaluating multiple approaches to(More)