David Grembowski, Ph.D.

April 1, 2008

On the faculty at the University of Washington since 1981, David Grembowski, Ph.D., is professor of health services in the School of Public Health and Community Medicine's Department of Health Services. Additionally, he is an adjunct sociology professor in the College of Arts and Sciences, and a professor of dental public health sciences in the School of Dentistry. He is the associate director of the Ph.D. program in Health Services, director of the Social and Behavioral Sciences M.P.H. Program, and is affiliated with the Extended M.P.H. and M.H.A. programs. Dr. Grembowski's research domains cover the design and performance of health care systems, prevention, and technology diffusion. His methodologic interests are program evaluation and survey research.

Dr. Grembowski holds a Ph.D. from his current institution, the University of Washington, in urban planning with a focus on evaluation methods. He holds an M.A. and a B.A. in sociology from Washington State University.

Little is known about public health financing in the Unites States, particularly the degree to which funding for local public health agencies influences the health of local communities. Thus, research into whether local public health spending is related to disparities in health outcomes is also sparse. As health care costs increase overall, it would be useful to know whether resources should be allocated to the public health system's investments in disparity reduction, or whether those resources would be best spent in the medical care arena or perhaps in addressing the social determinants of health. In 2007, Dr. Grembowski was awarded a HCFO grant under the second special topic solicitation in Public Health Systems Research (PHSR) to address this topic. His study, Public Health Funding and Population Health, seeks to estimate whether per capita expenditures of local health departments are associated inversely with local disparities in mortality rates for Black and White racial/ethnic groups, and to estimate whether changes in expenditures are associated with changes in those disparities over time. Early findings reveal changes in local health expenditures may not affect changes in racial/ethnic disparities in age-adjusted, all-cause mortality rates. "We also are examining whether the organization and services of local health departments are related to racial/ethnic disparities in mortality, which may offer a more robust estimate of public health's effect on disparities in mortality," Dr. Grembowski said. "Our research is contributing to the growing body of evidence around public health spending and disparity reduction. Together, this work should contribute to the nascent field of PHSR, which supports evidence-based decision making in public health."

Dr. Grembowski's other work has examined efforts to improve quality by increasing access to care in integrated delivery systems; managed care and physician referrals; managed care and patient-physician relationships; cost-effectiveness of preventive services for older adults; fluoridation effects on oral health and dental demand; financial incentives and dentist adoption of preventive technologies; effects of dental insurance on dental demand, and the link between mother and child access to dental care. In another HCFO project funded in 2004, Improving Access to Improve Quality: Evaluation of an Organizational Innovation, he sought to better understand the impact of new information technology (IT) and payment incentives on patient and provider health care decisions and utilization.

For more information about Dr. Grembowski and his research, please visit http://depts.washington.edu/hserv/faculty/Grembowski_David