| Course | HD420 Social Determinants of Health and Health Behavior |
|---|---|
| Unit | Unit 8 |
| Paper type | Policy influence analysis |
| Length | About 620 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health and Wellness |
| Updated | October 2026 |
Free sample paper for HD420 Unit 8
Twelve Trips a Year Instead of Four: A Unit 8 Policy Influence Analysis of a Thirty-Day Supply Rule for Blood Pressure Medicine
[Student Name]
Purdue University Global
HD420: Social Determinants of Health and Health Behavior
Unit 8 Policy Influence Analysis
[Instructor Name]
[Date]
The state, its rule and every figure are composite; the study of days' supply in Medicaid, the access framework and the social determinants review cited are real.
The Policy
The composite state's Medicaid program pays for maintenance medicines, such as blood pressure and cholesterol drugs, only in thirty-day supplies, while many commercial plans and Medicare drug plans allow ninety-day fills. The rule was adopted to limit waste when prescriptions change, and it saves the program the cost of medicine that would otherwise be thrown away.
How the Rule Reaches Behavior
A member taking two blood pressure medicines must refill them twelve times a year instead of four. Each refill is a trip to a pharmacy or a wait for mail delivery, and each is a chance for a gap if the trip cannot be made. For members with a car and a pharmacy nearby, the extra trips are a nuisance. For rural members who rely on a neighbor or a county van, every trip is a negotiation.
What the Data Show
Pharmacy claims for adult Medicaid members on blood pressure medicines in the composite state show that [41] percent had at least one gap of more than seven days in a year. Among members in counties classified as rural, the share was [52] percent; in urban counties, [36] percent. Members switched to commercial coverage through a new job, who could then fill ninety-day supplies, had fewer gaps the following year.
A study comparing days' supply among Medicaid patients with chronic conditions found that longer fills were associated with better adherence, with savings in some analyses outweighing the cost of wasted medicine (Taitel et al., 2012).
The rule was written to prevent pills from being wasted, and in doing so it multiplied the moments at which a member could run out, a cost that falls hardest on the members who find a pharmacy trip hardest.
Why Clinicians Blamed Patients
In clinics, a patient whose blood pressure is uncontrolled is often asked whether they are taking their pills, and the honest answer of "I ran out last week" sounds like forgetfulness. The policy is invisible in the exam room. The pattern only appears when refill gaps are viewed across thousands of members and sorted by where they live.
The Determinant Chain
Policy (thirty-day limit) leads to more refill events, which interact with transportation and distance (rural, no car), producing gaps in medicine, which lead to uncontrolled blood pressure, which makes strokes and heart attacks more likely. Each link is a social determinant in the sense the literature uses, a condition in which people live that shapes their health (Braveman & Gottlieb, 2014). The access framework would describe the extra trips as raising the effort a person must spend to reach care (Levesque et al., 2013).
Options
1. Allow ninety-day fills for stable maintenance medicines after the first three months on a drug.
2. Pay pharmacies to synchronize refills so all medicines are filled on one day each month.
3. Cover home delivery from Medicaid-participating pharmacies.
Each option keeps some protection against waste while reducing the number of trips a member must make.
Who Would Need to Act
The state Medicaid agency sets the rule and would need to change it, ideally after a cost analysis that counts avoided hospitalizations as well as wasted pills. Pharmacies would need to adopt refill synchronization. Clinicians could help by asking about refill gaps rather than adherence alone.
References
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It's time to consider the causes of the causes. Public Health Reports, 129(Suppl. 2), 19-31. https://doi.org/10.1177/00333549141291S206
Levesque, J.-F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12, 18. https://doi.org/10.1186/1475-9276-12-18
Taitel, M., Fensterheim, L., Kirkham, H., Sekula, R., & Duncan, I. (2012). Medication days' supply, adherence, wastage, and cost among chronic patients in Medicaid. Medicare & Medicaid Research Review, 2(3). https://doi.org/10.5600/mmrr.002.03.a04
The Purdue Global HD420 Unit 8 instructions
Unit 8 usually asks you to analyze how a policy, often one not written as health policy, influences health behavior and outcomes in a population. Several pages is normal. Good analyses contain the policy described accurately with its intended purpose, a clear mechanism linking the rule to behavior, data showing the pattern, recognition of who bears the effects, and options that preserve the policy's legitimate goals while reducing harm. Many sections reward explaining why the effect was missed. Avoid claiming proof of causation; show timing, mechanism and pattern instead. Cite evidence on the mechanism and a framework that places the policy among the determinants.
How the HD 420 Unit 8 example is put together
The analysis states the rule and why it was adopted. A section explains how it reaches behavior through the number of refill events and the effort each one costs, especially for rural members. Data show refill gaps overall and by rural and urban counties, with a comparison for members who moved to commercial coverage, and a published Medicaid study on days' supply; the highlighted sentence names the unintended effect and who bears it. A section explains why clinicians blamed patients. The determinant chain links policy to stroke risk, citing two frameworks. Three options follow, and a section names who would need to act. Throughout, figures are presented as composite but internally consistent, so the arithmetic can be checked.
Where the points sit in the HD420 Unit 8 rubric
Policy influence analyses are usually judged on accuracy about the policy, clarity of the mechanism, strength of the evidence, attention to distribution of effects and quality of options. The mechanism and the evidence typically weigh most, because the unit is about showing how a rule becomes a behavior. Accuracy rewards stating the policy's purpose fairly. Distribution earns credit when the analysis shows who is affected most and why. Options are rewarded when they keep the policy's legitimate aim while reducing harm. Naming who has authority to act adds a practical dimension. Avoiding claims of proven causation, while still making a strong case, is part of the expected care.
Common HD420 Unit 8 mistakes, and how to avoid them
A frequent error is criticizing a policy without acknowledging why it exists, which makes the analysis easy to dismiss. Another is asserting that the rule caused poor outcomes without showing a mechanism or a pattern. Some students describe effects on the whole population and miss who bears them most. Others propose scrapping the rule entirely rather than adjusting it. Leaving out who has authority to change the rule makes recommendations hard to act on. If you are analyzing another rule, perhaps school start times or zoning, describe its purpose and the behavior you think it shapes, and the chain can be traced from there. Using only statewide averages hides the rural and urban difference that makes the case.
Get an HD420 Unit 8 example written to your instructions
Point us to the rule your HD420 Unit 8 analysis examines, whether a benefit schedule, a zoning code or an eligibility requirement, and add the prompt and rubric. The first custom sample is free, back in 24-48h, and follows that rule through the behavior it produces to the health effect, with each link sourced. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More HD420 papers and BS in Health and Wellness samples
- HD420 Unit 1: Social Determinants Discussion Post
- HD420 Unit 2: Determinants Analysis
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- HD420 Unit 5: Access Barrier Study
- HD420 Unit 6: Seminar Reflection on Uninsurance
- HD420 Unit 7: Health Equity Paper on Disability
- HD420 Unit 9: Intervention Level Proposal
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HD420 Unit 8 questions, answered
Does the policy have to be a health policy?
No, and often the stronger analyses examine rules written for other purposes. Zoning, school start times, benefit schedules, wage laws and transit routing all shape health behavior without mentioning health. Choosing such a rule lets you show the course's central idea directly: conditions set by policy narrow the choices people realistically have.
How do I show a policy caused a behavior?
Usually you cannot prove it, and the paper should not claim to. Show the timing, the mechanism and the pattern, then cite research that compares places or periods with and without the rule. Natural comparisons, such as states that stagger benefits against those that do not, are the strongest evidence most undergraduate papers can use.
Should the analysis recommend changing the rule?
Many prompts ask for a recommendation, and it should follow from the analysis. Name who has authority to change the rule, what the change would cost and who might object. A recommendation that ignores tradeoffs, such as the administrative burden of staggering benefits, reads as advocacy rather than analysis, and graders in this course tend to notice.
Where can I find a free HD420 Unit 8 sample paper?
You can read the complete Unit 8 analysis here, tracing a thirty-day medication supply rule to refill gaps among rural Medicaid members.
Can a policy not written for health still be a determinant of health?
Yes. Rules about benefits, zoning, schooling or pharmacy fills shape daily conditions and behavior, and through them health.