Placement: Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School
Mentor: Frank Wharam, MB, BCh., BAO, M.P.H. (Director, Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Medical School)
Co-mentor: Roberta Goldman, Ph.D., M.A. (Clinical Professor of Family Medicine, Alpert Medical School, Brown University; Adjunct Professor, Harvard T.H. Chan School of Public Health)
Project: Driving Leadership and Priority for Prevention and Population Health: Impact and Experiences from Health Policy and Organizational Models in the United States
Unni Gopinathan, M.D., Ph.D., is a 2018–19 Harkness/Norwegian Institute of Public Health Fellow in Health Care Policy and Practice. He is an Associate Professor in the Department of Community Medicine and Global Health at the Institute of Health and Society, University of Oslo, and a postdoctoral fellow in the Department of Global Health, Division for Health Services, Norwegian Institute of Public Health. His previous health policy work has addressed a broad range of issues including the lack of research and development for neglected diseases, factors impacting the quality, relevance, and legitimacy of advice from the World Health Organization’s scientific advisory committees, and intersectoral collaboration and governance to promote prevention and address social determinants of health at a global level. Gopinathan has supported WHO guidelines through a multi-country case study review of large-scale programs designed to strengthen human resources for health in low- and middle-income countries. He co-authored the Chatham House report “Towards a New Global Business Model for Antibiotics: Delinking Revenues from Sales” and worked for the interim Secretariat of the Coalition for Epidemic Preparedness Innovations during its establishment in 2016. He was a Duke Global Health Fellow in Geneva (2011) and received his M.D. and Ph.D. in medical biochemistry and infectious disease from the University of Oslo.
Project Abstract: To improve population health and reduce health inequalities, policymakers must understand how health care reforms, health insurance designs, and organizational changes are affecting prevention efforts. Broadly, this project will explore the impact of two major developments in the U.S. health care system: (1) high-deductible health plans and (2) health systems responses to social determinants of health.
High-deductible health plans are now the predominant and fastest growing form of commercial health insurance in the U.S. Patients facing high deductibles may delay seek care or receive lower-value care, and therefore face adverse outcomes such as increased emergency department visits and hospitalizations. Low-income patients may be particularly vulnerable to the impacts of these plans. Phase one of this work will use interrupted time series and controlled time-to-event designs to study how high-deductible health plans are affecting outcomes among patients with chronic obstructive pulmonary disease (COPD)—a condition where high deductibles can have an adverse impact on medication adherence, follow-up visits, and clinical outcomes. Phase two of this project will study the implementation of the Accountable Health Communities Model. Review of policy documents and in-depth stakeholder interviews will be conducted to investigate how the model is fostering cross-cutting collaboration between health care organizations, local health departments, community service organizations and other stakeholders to address patients’ health-related social needs. Information on how collaboration can be incentivized and sustained will offer timely lessons for the Norwegian health systems setting.
Career Activity Since Fellowship
- Senior Researcher, Division for Health Services, Norwegian Institute of Public Health
Current Position:
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Senior Advisor, Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health; Associate Professor, Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo