Joseph W Thompson

University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Are you Joseph W Thompson?

Claim your profile

Publications (32)156.77 Total impact

  • 2014 International Indian Statistical Association Conference On Research Innovations in Statistics for Health, Education, Technology, and Society, Riverside, CA, USA.; 07/2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Graduated driver licensing (GDL) requirements aim to reduce the incidence of motor vehicle crashes and crash-related fatalities for novice drivers by limiting their exposure to the most risky driving situations. These programs vary across states in their scope, intensity, and impact. The purpose of this study was to evaluate the short-term impact of the 2009 Arkansas GDL on reducing teen crashes and fatal crashes. METHODS: Arkansas motor vehicle crash data for 2008 and 2010 were compared. Changes in rates per 10,000 licensed drivers were calculated by age, during the night restriction, and for drivers with passengers. χ analyses were used to test significant differences in rates between pre- and post-GDL years for each age group. RESULTS: Significant decreases in crash rates were found for each age group younger than 19 years, with the largest change evident for 16-year-olds (reduction of 22%). Similar decreases were not found for adults 19 years and older. Rates of fatal crashes for 14- to 18-year-olds were reduced 59%. Nighttime crashes and crashes in vehicles driven by teens with more than one unrelated passenger also demonstrated reductions. CONCLUSION: This study provides evidence of a short-term impact of GDL restrictions on reducing teen driver crashes and fatal crashes in Arkansas. Findings for teen drivers were significantly different from those of adult drivers during the same time frame, further strengthening the results as a function of GDL restrictions as compared with alternative explanations. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level V.
    05/2013; DOI:10.1097/TA.0b013e31828f9967
  • Joseph W. Thompson
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity rates have increased sharply in the United States over the past 30 years, and today nearly one-third of children and adolescents are overweight or obese. Local health officials can play an important role in partnering with local organizations to advocate for and implement policy and environmental changes that will help build healthy communities. The Robert Wood Johnson Foundation Center to Prevent Childhood Obesity is working with multiple partners across the United States to help reverse the childhood obesity epidemic by changing public policies and creating healthier environments in schools and communities - especially those most impacted by this epidemic. Among these partners is the National Association for County and City Health Official's Big Cities Chronic Disease Prevention Community of Practice made up of local health officials that represent the 50 largest metropolitan areas in the United States working to collectively develop and implement policy and environmental change to promote healthy living nationwide. The purpose of this interactive session is to: Highlight the role of public health departments in working with community organizations to improve local nutrition and physical activity environments through policy and environmental changes. Describe the process of building multi-sectoral partnerships and collaboration. Provide examples of promising practices for improving community wellness. Demonstrate the link between federal policy decisions and local implementation. Distinguish between the processes for advocating for institutional or legislative policy changes. Offer evidence and examples supporting the impact of policy and environmental change initiatives on improving health outcomes.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
  • Joseph W. Thompson
    [Show abstract] [Hide abstract]
    ABSTRACT: In 2005, Arkansas Governor Mike Huckabee (R), in a merger of the Departments of Health and Human Services, formed a position of Chief Health Officer to serve as a public advocate for health. In 2007, Governor Mike Beebe (D) requested a legislative demerger of the departments through which the position was modified in name to Surgeon General and in function to explicitly serve as the cabinet level health advisor to the governor developing strategy for health policy alongside the cabinet level directors of the Departments of Health and Human Services. With legislative sanction, the position has evolved to enable strategic planning, support policy development, and provide trusted leadership for the executive branch with both the legislature and public. Serving originally as the Chief Health Officer and now as the Surgeon General, Joe Thompson, MD MPH has led state policy initiatives with successes in tobacco control, childhood obesity prevention, and expanded health insurance coverage. Currently based in an academic health policy center, the Arkansas Surgeon General draws upon the resources of the university and has become a catalyst using empirical information to advance the health agenda of the state. As a model for other states, the organization, function, and operational experience of the office may provide opportunities to advance public health.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
  • Joseph W Thompson · Paula Card-Higginson
    [Show abstract] [Hide abstract]
    ABSTRACT: Parents, clinicians, public health officials, and policy makers need readily available information on the extent of the childhood obesity epidemic. As in any epidemic, the strategies and tools used to combat the imminent threat are frequently based on scientific rationale and experience but applied in areas in which we lack complete understanding. The urgent need for information requires execution of decisions that are not risk-free--such is the case of BMI screening obesity. Use of BMI percentiles to classify weight status among youth and quantify the epidemic can inform and engage parents and other key stakeholders. Arkansas has completed its sixth year of BMI screenings for public school students. Through a groundbreaking legislative mandate that requires BMI assessments in public schools, the state has achieved both enhanced awareness among parents and their children and increased engagement by school, clinical, public health, and community leaders in response to the epidemic. External evaluations conducted since institution of BMI assessments have revealed none of the initially feared negative consequences of BMI measurements such as teasing, use of diet pills, or excessive concerns about weight. In the face of this epidemic, the risks of using BMI assessments in clinical or school-based settings must be recognized but can be managed. Arkansas' Act 1220 and BMI-reporting efforts have not only afforded parents detailed information about their children's health but also provided longitudinal data needed to fully understand the scope of childhood and adolescent obesity in the state and to track progress made in combating this epidemic.
    PEDIATRICS 09/2009; 124 Suppl 1:S73-82. DOI:10.1542/peds.2008-3586J · 5.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the test performance of specific body mass index (BMI) percentile cutoffs for detecting children/adolescents with hypercholesterolemia. Cross-sectional analysis. National Health and Nutrition Examination Survey 1999-2004. Population-based sample of children (aged 3-18 years) with nonfasting total cholesterol (TC) and high-density lipoprotein (HDL) cholesterol levels and adolescents (aged 12-18 years) with fasting low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. Individuals were classified as having hypercholesterolemia if they had a TC level greater than 200 mg/dL, HDL cholesterol level less than 35 mg/dL, LDL cholesterol level greater than 130 mg/dL, or TG level greater than 150 mg/dL, and sensitivity, specificity, and likelihood ratios were calculated for specific BMI percentiles. Receiver operating characteristic curves were constructed and area under the curve (AUC) was calculated. Receiver operating characteristic curves using BMI percentiles to predict abnormal levels of TC and LDL cholesterol had AUC values (0.60 for TC level and 0.63 for LDL cholesterol level) that were less than the threshold of acceptable discrimination (between 0.7-0.8). Body mass index percentiles provided better discrimination for detecting children with abnormal HDL cholesterol and TG levels, with AUC values approaching levels of acceptable discrimination (0.69 and 0.72, respectively), although there are no specific guidelines regarding management of children with these abnormalities. According to the American Academy of Pediatrics guidelines, abnormal levels of LDL cholesterol are used to determine which children require nutritional and pharmacologic therapy. Because BMI percentiles did not adequately identify children and adolescents with abnormal TC and LDL cholesterol levels, the new recommendations for targeted screening of obese children and adolescents may require further consideration.
    JAMA Pediatrics 09/2009; 163(8):716-23. DOI:10.1001/archpediatrics.2009.109 · 4.25 Impact Factor
  • Source
    New England Journal of Medicine 09/2009; 361(16):1599-605. DOI:10.1056/NEJMhpr0905723 · 54.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Studies of private sector employee populations have shown an association between health-risk factors and healthcare costs. Few studies have been conducted on large, public sector employee populations. The objective of the current study was to quantify health plan costs associated with individual tobacco, obesity, and physical inactivity risks in Arkansas's state employee plan. De-identified medical and pharmacy claim costs incurred October 1, 2004-February 28, 2006 were linked with results from self-reported health-risk assessments (HRA) completed August 1, 2006-October 31, 2006. High- and no-risk groups were defined on the basis of cigarette use, BMI, and days/week of moderate physical activity. Annualized costs were compared between groups and across ages. Data were analyzed in September 2007. Of the eligible adults (n=77,774), 56% (n=43,461) voluntarily accessed and completed an Internet-based HRA and had claims data-linked for analyses. Average annual costs across the eligible population totaled $3205. Respondents with high risks incurred greater annual costs ($4432) than those with no risks ($2382). Costs were greater among those with one or more risks, compared with no risks, and increased with age. The greatest average annual cost was for people aged 55-64 years in the high-risk group, who had a 2.2-fold higher cost than those aged 55-64 years in the no-risk group ($7233 versus $3266). Healthcare costs increased with age and were differentially higher for those who used tobacco, were obese, or were physically inactive. The financial viability of the healthcare system is at risk, particularly in plans with a high proportion of adults with health-risk factors.
    American journal of preventive medicine 07/2009; 36(6):468-74. DOI:10.1016/j.amepre.2009.01.034 · 4.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The rise in obesity levels in the U.S. in the past several decades has been dramatic, with serious implications for public health and the economy. Experiences in tobacco control and other public health initiatives have shown that public policy may be a powerful tool to effect structural change to alter population-level behavior. In 2007, the National Cancer Institute convened a meeting to discuss priorities for a research agenda to inform obesity policy. Issues considered were how to define obesity policy research, key challenges and key partners in formulating and implementing an obesity policy research agenda, criteria by which to set research priorities, and specific research needs and questions. Themes that emerged were: (1) the embryonic nature of obesity policy research, (2) the need to study "natural experiments" resulting from policy-based efforts to address the obesity epidemic, (3) the importance of research focused beyond individual-level behavior change, (4) the need for economic research across several relevant policy areas, and (5) the overall urgency of taking action in the policy arena. Moving forward, timely evaluation of natural experiments is of especially high priority. A variety of policies intended to promote healthy weight in children and adults are being implemented in communities and at the state and national levels. Although some of these policies are supported by the findings of intervention research, additional research is needed to evaluate the implementation and quantify the impact of new policies designed to address obesity.
    American journal of preventive medicine 03/2009; 36(4):351-7. DOI:10.1016/j.amepre.2008.11.017 · 4.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Arkansas was among the first states to pass comprehensive legislation to combat childhood obesity, with Arkansas Act 1220 of 2003. Two distinct but complementary evaluations of the process, impact, and outcomes of Act 1220 are being conducted: first, surveillance of the weight status of Arkansas children and adolescents, using the statewide data amassed from the required measurements of students' body mass indexes (BMIs); and second, an independent evaluation of the process, impact, and outcomes associated with Act 1220. Various stakeholder groups initially expressed concerns about the Act, specifically concerns related to negative social and emotional consequences for students and an excessive demand on health care. Evaluation data, however, suggest that few adverse effects have occurred either in these areas of concern or in other concerns which have emerged over time. Schools are changing environments and implementing policies and programs to promote healthy behaviors and BMI levels have not increased since the implementation of Act 1220 in 2004. The Arkansas experience to date may serve to inform the efforts of other states to adopt policies to address the epidemic of childhood obesity.
    Journal of Public Health Policy 01/2009; 30 Suppl 1:S124-40. DOI:10.1057/jphp.2008.54 · 1.75 Impact Factor
  • Kevin W Ryan · Paula Card-Higginson · Joseph W Thompson
    Journal of health and human services administration 02/2008; 31(1):124-33.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Crash data from 2001-2005 was linked to hospital discharge data to determine the impact of safety restraint use on crashed-related hospital charges and use for 4013 hospitalizations. Safety restraint use, year of hospitalization and age group affected the hospital charges and length of stay after a crash. Mean hospital charges were 44% greater for unrestrained patients ($44,736 versus $30,990); mean length of stay was 23% longer for the unrestrained (9.2 days versus 7.5 days). Lack of safety restraint use was associated with greater use of hospital resources. Prevention efforts should focus on increasing compliance.
    The Journal of the Arkansas Medical Society 02/2008; 104(7):161-4.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although incidence of vaccine-preventable diseases has decreased, states' school immunization requirements are increasingly challenged. Subsequent to a federal court ruling affecting religious immunization exemptions to school requirements, new legislation made philosophical immunization exemptions available in Arkansas in 2003-2004. This retrospective study conducted in 2006 describes the impact of philosophical exemption legislation in Arkansas. Arkansas Division of Health data on immunization exemptions granted were linked to Department of Education data for all school attendees (grades K through 12) during 2 school years before the legislation (2001-2002 and 2002-2003 [Years 1 and 2, respectively]) and 2 years after philosophical exemptions were available (2003-2004 and 2004-2005 [Years 3 and 4, respectively]). Changes in numbers, types, and geographic distribution of exemptions granted are described. The total number of exemptions granted increased by 23% (529 to 651) from Year 1 to 2; by 17% (total 764) from Year 2 to 3 after philosophical exemptions were allowed; and by another 50% from Year 3 to 4 (total 1145). Nonmedical exemptions accounted for 79% of exemptions granted in Years 1 and 2, 92% in Year 3, and 95% in Year 4. Importantly, nonmedical exemptions clustered geographically, suggesting concentrated risks for vaccine-preventable diseases in Arkansas communities. Legislation allowing philosophical exemptions from school immunization requirements was linked to increased numbers of parents claiming nonmedical exemptions, potentially causing an increase in risk for vaccine-preventable diseases. Continued education and dialogue are needed to explore the balance between individual rights and the public's health.
    American Journal of Preventive Medicine 04/2007; 32(3):194-201. DOI:10.1016/j.amepre.2006.10.014 · 4.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: National recommendations to address the emerging obesity epidemic include increased awareness, individual interventions, and environmental changes. However, guidance for translating public health and clinical evidence into meaningful policies has been limited. Arkansas formulated and passed simple yet powerful legislation to combat childhood obesity through actions in public schools. Specific legislative requirements were straightforward. Importantly, the act included an independent mechanism to identify, examine, debate, and develop further action steps. Based on our experience, we present a framework for developing a cross-sector approach to translating science into policy and practice, and we offer this guide to other states facing similar health threats.
    Health Affairs 07/2006; 25(4):992-1004. DOI:10.1377/hlthaff.25.4.992 · 4.64 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Compulsory vaccination has contributed to the enormous success of US immunization programs. Movements to introduce broad "philosophical/personal beliefs" exemptions administered without adequate public health oversight threaten this success. Health professionals and child welfare advocates must address these developments in order to maintain the effectiveness of the nation's mandatory school vaccination programs. We review recent events regarding mandatory immunization in Arkansas and discuss a proposed nonmedical exemption designed to allow constitutionally permissible, reasonable, health-oriented administrative control over exemptions. The proposal may be useful in political environments that preclude the use of only medical exemptions. Our observations may assist states whose current nonmedical exemption provisions are constitutionally suspect as well as states lacking legally appropriate administrative controls on existing, broad non-medical exemptions.
    American Journal of Public Health 06/2005; 95(5):778-83. DOI:10.2105/AJPH.2004.046193 · 4.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Children are frequently perceived to be healthy, low-risk individuals with a majority of clinical services devoted to health maintenance and preventive clinical services. However, a subset of children have unique needs that require specialized care to achieve optimal health outcomes. The purpose of this research was to use survey tools that have been developed to identify children with special health care needs (CSHCN) to measure prevalence and resource needs of these children in the military health system (MHS). The US Department of Defense manages the MHS, which is one of the largest integrated health care systems in the world and provides care to almost 2,000000 children. We incorporated the CSHCN survey screener and assessment questions into the annual health care survey of beneficiaries who are eligible for benefits within the MHS. In addition, we used claims information available from inpatient and outpatient services. We used parent reports from the survey to estimate the prevalence of CSHCN. Incorporating claims data and restricting our analyses to those who were enrolled continuously in a military health maintenance organization (TRICARE Prime), we described utilization of different types of health care resources and compared CSHCN with their healthy counterparts. Finally, we examined alternative types of special needs and performed regression analyses to identify the major determinants of health needs and resource utilization to guide system management and policy development. CSHCN compose 23% of the TRICARE Prime enrollees who are younger than 18 years and whose parents responded to the survey. The needs of a majority of these children consist of prescription medications and services targeting medical, mental health, and educational needs. CSHCN experience 5 times as many admissions and 10 times as many days in hospitals compared with children without special needs. CSHCN are responsible for nearly half of outpatient visits for enrolled children and more than three quarters of inpatient days. Service utilization varies dramatically by type of special need and other demographic variables. CSHCN represent a major challenge to organized systems of care and our society. Because they represent a group of children who are particularly at risk with potential for improved health outcomes, efforts to improve quality, coordinate care, and optimize efficiency should focus on this target population.
    PEDIATRICS 09/2004; 114(2):384-93. DOI:10.1542/peds.114.2.384 · 5.30 Impact Factor
  • Joseph W Thompson · Kevin W Ryan · Shirley Tyson · Chiquita Munir
    [Show abstract] [Hide abstract]
    ABSTRACT: The 1998 Tobacco Master Settlement Agreement (MSA) resulted in a singular and unanticipated revenue stream flowing to state governments from U.S. tobacco companies. In response, public health leaders were challenged with an opportunity to secure funding for much needed health programs. However, state leaders have chosen to utilize these new funds for a wide variety of purposes; in many instances, expenditures totally unrelated to health or health care. In contrast, Arkansas is unique among all states in choosing to utilize MSA funds solely to establish new health-related programs. Examination of the educational and developmental process through which Arkansas designed its expenditure plan, secured political support, and initiated new health programs in a time of budgetary constraints will inform public health officials to more effectively engage policy makers at local, state, and federal levels.
    Health Promotion Practice 08/2004; 5(3 Suppl):57S-63S. DOI:10.1177/1524839904264593 · 0.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Analyses of expenditures from the historic tobacco Master Settlement Agreement (MSA) demonstrate the difficulties in achieving support for long-term disease prevention and health promotion initiatives. We report as a policy case study the successful development, political execution, and program deployment of new state health programs funded by Arkansas' MSA funds. Arkansas' success demonstrates the need for political leadership, the development and insertion of empirical health information into the policy deliberations, in-depth knowledge of the political process, and a broad-based coalition committed to improving health.
    Health Affairs 01/2004; 23(1):177-85. DOI:10.1377/hlthaff.23.1.177 · 4.32 Impact Factor
  • Source
    Joseph W Thompson · Kevin W Ryan · Sathiska D Pinidiya · James E Bost
    [Show abstract] [Hide abstract]
    ABSTRACT: Many states have turned to commercial health plans to serve Medicaid beneficiaries and to achieve cost-containment goals. Assumptions that the quality of care provided to Medicaid beneficiaries through these programs is acceptable have not been tested. To compare the quality of care provided to children and adolescents in commercial and Medicaid managed care in the United States. Using 1999 data collected through the Health Plan Employer Data and Information Set, we examined reported quality-of-care indicators for children and adolescents. Results from 423 commercial and 169 Medicaid plans were compared. Matched pairs analyses were performed using data from each of the 81 companies serving both populations to control for corporate differences. Correlation coefficients and regression procedures were used to examine observed variations in health plan performance. Quality indicators including prenatal care, childhood immunizations, well-child visits, adolescent immunizations, and myringotomy and tonsillectomy rates. Using standard indicators of clinical performance, children and adolescents enrolled in Medicaid received worse care compared with their commercial counterparts. For most of the 81 health plans serving both populations, Medicaid enrollees had statistically significantly (P<.001) lower rates than commercial plans for clinical quality indicators (eg, childhood immunization rates of 69% vs 54%); for clinical access indicators (eg, well-child visits in the first 15 months of life, 53% vs 31%); and for common procedures (eg, myringotomies for children aged 0-4 years, 35 vs 2 per 1000 members). Conversely, some plans demonstrated equal and high-quality care for both populations. Regression models failed to identify consistent plan characteristics that explained the observed differences in quality of care. Most commercial health plans do not deliver high-quality care on a number of performance indicators for children enrolled in Medicaid. Policy makers and the public need plan-specific quality information to inform purchasing decisions.
    JAMA The Journal of the American Medical Association 09/2003; 290(11):1486-93. DOI:10.1001/jama.290.11.1486 · 30.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most health services in the United States are delivered by managed care organizations (MCOs). Publicly available, plan-specific performance information is required to adequately assess healthcare quality provided. Using women's health indicators, we compared performance results for MCOs and evaluated whether those MCOs that publicly report quality-of-care (QOC) results demonstrate better QOC than those plans that restrict public access to data. Data from the Health Plan Employer Data and Information Set (HEDIS) for commercial MCOs in 1998 were analyzed for women's QOC indicators. Plan-specific, regional, and national performances were analyzed and results compared to established benchmarks. Public-reporting plans were compared to plans that restrict access to QOC information. Linear regression was used to identify determinants of health plan performance including public release of information. Commercial MCOs had wide variations in QOC indicators and, on average, failed to attain national health goals for most women's health indicators analyzed. Plans that restricted public access to QOC information had poorer performance than those that did not (p<0.05). Results suggest that whether a plan publicly releases its performance information is highly associated with health plan performance even after taking into account other factors. The voluntary aspect of reporting and the ability of health plans to restrict public access is allowing poorer performing health plans to escape public scrutiny. Variations in QOC have clinical significance and, if publicly available, would enable individuals to select high-quality healthcare products. The ability of health plans to restrict public information is not consistent with the 1973 Health Maintenance Organization Act requiring public information on health plan quality. A national strategy to ensure that QOC information is available on all healthcare systems is past due.
    American Journal of Preventive Medicine 01/2003; 24(1):62-70. DOI:10.1016/S0749-3797(02)00569-X · 4.28 Impact Factor