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Policy Reports

We are the University of Maryland’s School of Public Health (the SPH for the state's flagship university) and we are committed to leading research that can be applied to improve the lives of Marylanders. 

We play a unique role by partnering with local and state agencies to provide the data and analysis needed to inform health-promoting policies, programs and interventions. 

The following reports reflect our work commissioned by agencies including the Maryland Department of Health, the Maryland Health Care Commission, the Maryland Department of the Environment and others to fill in the gaps in information needed for decision makers to take needed action to protect and promote the health of our state's diverse population. 

School of Public Health faculty, staff and students wrote a report analyzing risk factors for infant mortality in Maryland for the Maryland General Assembly, as part of a contract with the Maryland Health Care Commission.  

The 17-member team from the Department of Family Science and the Maryland Center for Health Equity was given the task to determine why infant mortality rates in Maryland are highest for African American and rural infants, and to make recommendations to reduce them.

The team submitted the written report to the Senate Finance Committee and House Health and Government Operation Committee of the Maryland General Assembly on Friday, November 1, 2019. 

The Maryland General Assembly passed a bill in April 2018 mandating that the Maryland Health Care Commission produce the study—the first state analysis of infant mortality since 2011. Significant changes have occurred in the health care environment in Maryland since then, but as of 2017, no progress had been made in reducing Black infant mortality rates—and the rural infant mortality rate appeared to be worsening. 

Read the Study of Mortality Rates of African American Infants and Infants in Rural Areas Report To the Senate Finance Committee and the House Health and Government Operations Committee

From housing policies to minimum wage laws, all policies can affect the health of our communities—especially for the most vulnerable among us.

That’s the basis of the “Health in All Policies” model developed by the World Health Organization. The model evaluates the health implications of every policy, integrates health considerations into policymaking and recognizes that health is influenced by a multitude of factors beyond healthcare and at times, beyond the scope of traditional public health activities.

The University of Maryland School of Public Health’s Center for Health Equity (M-CHE), in partnership with a group of Maryland lawmakers, introduced a bill that engaged M-CHE in advising state lawmakers on healthy public policy. The bill, SB 340, was sponsored by Maryland State Senator Shirley Nathan-Pulliam and Delegate Robbyn Lewis and signed into law by Governor Larry Hogan in 2017. 

The law directed M-CHE to convene a workgroup to make recommendations to and inform state and local legislators on laws and policies that promote health equity and have a positive impact on the lives of Maryland’s residents. 

Read the 2019 report on Recommendations for Health in All Policies submitted to Maryland Governor Larry Hogan and the Maryland General Assembly.


November 2017

The five-county Mid-Shore region of Maryland, comprised of Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties, faces unique health challenges similar to many rural communities, such as higher rates of poverty and people living with chronic diseases. To help better meet health care needs in the Mid-Shore region and provide recommendations that could be applied to other Maryland rural areas, the Maryland Health Care Commission (MHCC) and the Department of Health established a workgroup on rural health care delivery to oversee a study, hold public hearings and recommend policy options. At MHCC’s request, the University of Maryland School of Public Health and the Walsh Center for Rural Health Analysis at NORC at the University of Chicago partnered to conduct the study and to work in collaboration with the workgroup. "Health Matters: Navigating an Enhanced Rural Health Model for Maryland, Lessons Learned from the Mid-Shore Counties" is the executive summary and report detailing the findings of the group's studies. The executive summary presents high level themes, considerations and recommendations for addressing the health needs of residents and improving the health care delivery system in Maryland’s five-county Mid-Shore region, and potentially could be applied to other rural Maryland communities.

Read the November 3, 2017 news release: 
Rural Health Report Will Inform Strategies To Improve Health in Five MD Counties

Download the Executive Summary of Health Matters: Navigating an Enhanced Rural Health Model for Maryland (8 pages)

Download Health Matters: Navigating an Enhanced Rural Health Model for Maryland Report (52 pages)

The technical reports document the researchers’ methods and complete findings. We also include copies of the study instruments, where appropriate. 

Technical Report 1: Residents' Views
Research by Lori Simon-Rusinowitz, Connie Raab, Aita Amaize

Technical Report 2: Community Leaders' Perspectives
Research by Luisa Franzini, Dushanka Kleinman

Technical Report 3: Rural Health Landscape
Research by Alana Knudson, Rebecca Oran

Technical Report 4: Visit Patterns by Mid-Shore Residents
Research by Luisa Franzini, Jie Chen, Robin Bloodworth, Deanna Barath

Technical Report 5: Health Care Workforce
Research by Min Qi Wang

Technical Report 6: Mid-Shore Region Characteristics
Research by Deanna Barath, Aita Amaize

Developed by the University of Maryland School of Public Health’s Maryland Institute for Applied Environmental Health in collaboration with the Maryland Department of Health and Mental Hygiene, the report examines the relationship between exposure to extreme weather events and risk of selected health outcomes including food and waterborne illnesses (caused by Salmonella and Campylobacter), hospitalization for heart attacks and asthma, and motor vehicle accidents. Using historical climate data along with health data, researchers were able to describe relationships between exposure to extreme events and risk of these selected diseases. These data, along with the climate projections, were used to calculate health burdens among Marylanders in future decades.

In addition, the report recommends actions that individuals, families and communities can take to minimize the negative health burdens. It describes how the negative health burdens are not equally distributed across race/ethnicity or geographical areas of Maryland. The report concludes that local and state level strategies to build healthy and resilient communities must take into account these differential burdens.

Key findings of the Maryland Climate and Health Profile report include:

  • Extreme weather is on the rise: Summertime extreme heat events more than doubled in Maryland during the 1980s, 1990s, and 2000s compared to the 1960s and 1970s.
  • Extreme weather increases risk of foodborne illnesses: Both extreme heat and extreme precipitation events significantly increase the risk of Salmonella infections in Maryland. The increases in risk associated with extreme weather events is considerably higher among coastal communities compared to more inland communities.
  • Extreme heat raises heart attack risk: Exposure to summertime extreme heat events increases the risk of hospitalization for heart attack in Maryland. Non-Hispanic blacks have a much higher risk compared to non-Hispanic whites.
  • Extreme heat and precipitation raise severe asthma attack risk: Exposure to summertime extreme heat and precipitation events increase the risk of hospitalization for asthma in Maryland.  
  • Extreme precipitation raises accident risk: Exposure to extreme precipitation events increases the risk of motor vehicle accidents, particularly during the fall and summer months.

According to the report, the increases in frequency of extreme weather events during summer months in the future (2040) are projected to result in higher rates of asthma and heart attack hospitalization as well as Salmonella infections. The magnitude of these increases will likely vary considerably across the 24 counties in Maryland.

Download the Maryland Climate and Health Profile Report

Highlights from the Maryland Climate and Health Profile Report

Climate Change and Public Health Resources on the Maryland Department of Health and Mental Hygiene website

The Maryland Climate and Health Profile report is based on and developed in conjunction with the DHMH Maryland Public Health Strategy for Climate Change project, funded by the U.S. Centers for Disease Control and Prevention (CDC) as part of its Climate-Ready States and Cities Initiative. Research studies led by Dr. Amir Sapkota in the UMD School of Public Health informed many of the report’s key findings. This Climate and Health Profile report summarizes a collaborative effort between the DHMH, local health departments, and the University of Maryland School of Public Health’s Maryland Institute for Applied Environmental Health. The report utilized the CDC’s Building Resilience Against Climate Effects (BRACE) framework to identify vulnerable populations and use this data to inform interventions and increase resilience.

Commissioned by the Maryland Department of Health and Mental Hygiene and the Maryland Department of the Environment, the report on the potential public health impacts if fracking was allowed in Maryland, was produced by UMD public health and environmental justice experts, with input from residents of Maryland’s Garrett and Allegany counties, which hold the untapped natural gas reserves, and a variety of other stakeholders. It was the first report of its kind to be used in guiding state policy decisions about whether and how unconventional natural gas development (UNGD) should take place and found that significant potential hazards to air quality, social determinants of health, water quality, occupational health and healthcare infrastructure. Maryland was the first state with gas reserves to pass a ban through legislative action in 2017, according to a report by The Washington Post

August 19, 2014 Press Release: UMD Public Health Study To Inform MD Decision on “Fracking” 
October 2, 2014: Public Health Study of Fracking To Inform MD Policy Decisions
March 28, 2017: Public Health Advocates Celebrate Maryland Fracking Ban 

Commissioned by Prince George's County, the Maryland Department of Health and Mental Hygiene (DHMH), the University of Maryland Medical System and Dimensions Healthcare System, the Public Health Impact Study of Prince George's County was conducted by a team of senior researchers at the University of Maryland School of Public Health. "Transforming Health in Prince George's County, Maryland: A Public Health Impact Study" is the summary report detailing the findings of this unique group of studies that will inform the design of a new system to improve health and health care in Prince George's County. Click on the report cover image below to download the PDF summary report document.

July 24, 2012 news release: Transforming Health in Prince George's County: UMD Study To Inform Health Care System Redesign

Download a PDF of the complete Public Health Impact Study, including Section I (the summary report) and Section II (the detailed technical reports).