The dissertation employs Andersen and Newman's conceptual framework of health service utilization to examine continuity of care among homeless people. The research context is the Health Care for the Homeless Program which provides free health and medical care to thousands of homeless people in 19 major U.S. cities. The study examines continuity of care for a common illness episode among homeless people, namely peripheral vascular disease of the lower limbs and related disorders. Continuity is modeled as a function of predisposing individual, illness level, and health service system characteristics. The analysis uses multiple regression statistical methods to assess whether and the extent to which individual and health system determinants have net effects on continuity. The findings suggest two related theoretical implications. First, there are multiple sources of continuity. Second, health service system and individual characteristics affect continuity net of each other. The findings also suggest several practical implications including the importance of full-time outreach staff, verbal instructions to return for care, and more extensive weekly hours at each delivery site, just to name a few.

Recently, subjective wellbeing, or more popularly, happiness and life satisfaction, have received growing interest from social scientists, policy makers, and the public alike. This thesis applies Wellbeing, Self-determination, and Social Cognitive theories, and investigates the role of subjective wellbeing for obesity. The main methodology is multivariate regression with ordinary least square, Logit, and two-stage least square estimators. The data are from the Canadian Community Health Survey, 2010. Results show that subjective wellbeing has negative, independent impact on body mass index (BMI) and on the probability of being obese after controlling for the conventionally studied determinants of obesity like age, gender, income, and education. The study contributes to the literature on obesity and suggests possible policy interventions on obesity from the perspective of subjective wellbeing.

American Cancer Society(ACS) of Greater Boston in partnership with CVS Pharmaceuticals, Mobile Diagnostics and WHDH-TV developed Project:AWARE which offered breast cancer information and free mammograms for over two years in the Greater Boston area. This program was designed to reach low income and/or minority women. In this study the intended audience for Project:AWARE was studied in order to determine if the messages reached them. Forty Hispanic, forty Black and forty Caucasian women thirty-five years of age or older who live in Boston Housing Authority developments were interviewed. An interviewer, using a questionnaire, requested information about the participants' knowledge of breast cancer, knowledge of Project:Aware, and television viewing habits in order to determine if they had seen any part of this extensive television campaign and if it convinced them to get a mammogram. After two documentaries, over 1500 airings of Public Service Announcements(PSA's), ten locally produced programs and numerous ten-second calendar spots, ten-percent of the sample remembered seeing a Project:AWARE message on television while a similar number remembered seeing a poster about Project:AWARE. Only one women reported that seeing information about Project:AWARE convinced her to get a mammogram. Further testing will have to be done by health care professionals in order to insure that health information campaigns are reaching all segments of society. Large audiences for television programs are no indication that everyone in a community is receiving the message. Additional funds will have to be found in order to insure that messages are placed when and where they will be seen by low income and/or minority women of all ethnic backgrounds in order to insure that they have the same opportunities for good health care as other segments of society.

The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The data were examined using Poisson analysis and logistic regression. Results indicated that drills and exercises had no statistically significant impact on public health performance for the 3 performance measures examined; of all predictors, what explained the most variance in reaching performance targets was the number of real emergencies to which a health department had responded in the past. Performing drills and exercises did not predict the likelihood of reaching performance targets. These findings have implications for positive social change for Congressional leaders and other government representatives. Such public servants could use this information to guide their efforts to redirect public health emergency preparedness funds away from drills and exercises and toward other fundamental public health activities. These more focused efforts could facilitate the improvement of public health laboratory capacity, the training of field epidemiologists, and the advancements in technology for enhanced reporting and surveillance.

<b>Background</b>: Evidence-based policy making (EBPM) has become an article of faith. While critiques have begun to emerge, they are predominately based on theory or opinion. This thesis uses the 2008 case study of tobacco control policy making for Indigenous Australians to analyse empirically the concept of EBPM. <b>Research questions</b>: (1) How, if at all, did the Government use evidence in Indigenous tobacco control policy making? (2) What were the facilitators of and barriers to the use of evidence? (3) Does the case study augment or challenge the apparent inviolability of EBPM? <b>Methods</b>: Data were collected through: (1) a review of primary documents largely obtained under the Freedom of Information Act 1982; and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates and academics. <b>Results</b>: Historically, Indigenous smoking was not problematised because Indigenous people faced other urgent health/social problems and smoking was considered a coping mechanism. High prevalence data acquired salience in 2007/08 in the context of a campaign to reduce disparities between Indigenous and non-Indigenous health outcomes. Ensuing policy proposals were based on recommendations from literature reviews, but evidence contained in those reviews was weak; notwithstanding this, the proposals were adopted. Historical experiences led policy makers to give special weight to proposals supported by Indigenous stakeholders. Moreover, the perceived urgency of the problem was cited to justify a trial-and-evaluate approach. <b>Conclusion</b>: While the policies were not based on quality evidence, their formulation/adoption was neither irrational nor reckless. Rather, the process was a justifiable response to a pressing problem affecting a population for which barriers existed to data collection, and historical experiences meant that evidence was not the only determinant of policy success. The thesis proposes a more nuanced appraoch to conceptualising EBPM wherein evidence is neither a necessary nor a sufficient condition for policy. The approach recognises that rigorous evidence is always desirable but that, where circumstances affect the ability of such research being conducted, consideration must be given to acting on the basis of other knowledge (e.g. expert opinion, small-scale studies). Such an approach is justifiable where: (1) inaction is likely to lead to new/continued harm; and (2) there is little/no prospect of the intervention causing additional harm. Under this approach, non-evidentiary considerations (e.g. community acceptability) must be taken into account.

Since its inception in 1989, the private water sector of England and Wales has been enlisted as a centrepiece in debates concerning the merits of privatisation. Advocates point to increased environmental performance and increased investment. Critics note a significant retraction of the early free market aspirations and increasingly prescriptive regulation. However, market mechanisms and liberalisation are once again being emphasised in policy, reigniting the debate surrounding the commoditisation of water. This thesis engages directly and critically with Karen Bakker's 'Uncooperative Commodity' approach to the 'reregulation' of the industry, arguing its tenants must be adapted to accommodate these recent developments. While Bakker's earlier accounts of the reregulation of the water industry placed a great emphasis on the geography and biophysical properties of water, later work by both her and her contemporaries have developed more refined and socialised models of how water and society interact to produce temporary regularities in the material world. This thesis argues that an appropriate means of developing Bakker's original thesis would be a greater focus on socio-historical context when exploring the materiality of water, and hence the degree to which water may be transformed into a private commodity. Bob Jessop's Strategic Relational Approach (Jessop 2008) is deployed as a means of describing and relating: (1) the degree to which research can identify underlying mechanisms which govern the outcomes of attempts to commoditise water under capitalist modes of production, (2) the role of the state and politics in flanking or supporting the commoditisation of water and (3) the role of existing discursive-institutional structures in introducing path-dependencies and uneven power geometries which in turn effect the outcomes of collective action towards the commoditisation of water. The thesis documents historical developments in English and Welsh resource planning, regulation, and policy from 1945 to 2012 in order to explain the current structure of the industry, its response to water scarcity, and the origins of the current reform programme. It then focuses on the conflicts and tensions between actors in the industry generated by the current reform programme and their role in affecting the degree of success of the programme itself.