Health Equity

INTRODUCTION: The COVID-19 pandemic has significantly impacted Thailand, including urban centers like Bangkok and surrounding areas, highlighting a critical need for effective management within densely populated communities to mitigate its effects. METHODS: This qualitative study sought to explore community management strategies developed in Khlong Toei, a large, congested urban community in Bangkok, Thailand. Seven in-depth interviews ( n =7), six focus groups ( n =23), and two brainstorming sessions ( n =12) were conducted for this study...

INTRODUCTION: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as "hang ups, let downs, bad breaks, setbacks" that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. METHODS: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U...

INTRODUCTION: In the United States, sickle cell disease (SCD)-the homozygous inheritance of a point mutation within the beta-globin chain of hemoglobin-affects between 80,000 and 100,000 people. Adequate nutrition can influence the pathophysiology of SCD, and individuals with SCD who are undernourished are more likely to have impaired immune function and disease exacerbation. Undernourishment is often caused by food insecurity (FI), which is defined as "a household-level economic and social condition of limited or uncertain access to adequate food" by the USDA...

BACKGROUND: Limited availability and poor quality of data in medical records and trauma registries impede progress to achieve injury-related health equity across the lifespan. METHODS: We used a Nominal Group Technique (NGT) in-person workgroup and a national web-based Delphi process to identify common data elements (CDE) that should be collected. RESULTS: The 12 participants in the NGT workgroup and 23 participants in the national Delphi process identified 10 equity-related CDE and guiding lessons for research on collection of these data...

Inclusive language is a cornerstone for inclusive, just, and equitable health care. While the American Medical Association released inclusive language guidance in 2021, it was unclear the extent to which physician practice organizations and their affiliated journals have adopted and promoted inclusive language. In our analysis, we found a lack of inclusive language resources across many physician practice organizations and their affiliated journals. Moreover, when guidance was provided by such entities, it was sometimes limited or not reflective of the American Medical Association recommendations...

PROBLEM: Cultural safety is an approach to patient care designed to facilitate respect of patients' cultural needs and address inequities in care in culturally diverse situations. BACKGROUND: Much literature considers culturally safe care during the perinatal period, yet little is known about how patients experience and understand cultural safety. This is despite patient-defined care being one of the definitions of cultural safety. QUESTION HYPOTHESIS OR AIM: This scoping review investigates what is known from existing qualitative literature about patients' experience of cultural safety frameworks in perinatal interventions...

BACKGROUND: The study aims to examine the risk of multiple chronic condition (MCC)-related emergency department (ED) visits, MCC-related hospitalization following the ED visit, and mortality after MCC-related ED visits among adults with intellectual and developmental disabilities (IDD), adults compared with nondisabled adults by race and ethnicity, using the 2020 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. METHODS: We identified IDD adults using ICD-10-CM codes, extracting 296,394 nondisabled adults and 99,538 IDD adults, of which 67,771 are white, 19,164 are black, 10,667 are Latinx, and 1936 are other race or multiple race...

INTRODUCTION: In 2017, Chile decriminalized abortion on three grounds: (i) if the pregnant person's life is at risk, (ii) fetal nonviability, and (iii) rape or incest. This multicase study explores the experiences of pregnant people legally entitled to but denied access to legal abortion in Chile. METHODS: Through a snowball sampling approach, we recruited adult Chilean residents who sought, were eligible for, and were denied a legal abortion after September 2017...

BACKGROUND: Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood. PURPOSE: The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States...

No abstract text is available yet for this article.

INTRODUCTION: Student health services are associated with improved health outcomes and academic success, particularly among under-resourced college populations. This study compared student health services at Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs) and identified factors associated with the availability of comprehensive health services (CHS). METHODS: We conducted a secondary analysis of 2022 data from the Integrated Postsecondary Education Data System (IPEDS), the Minority Serving Institutions (MSIs) Directory, and the websites of HBCUs and PBIs ( n =167)...

Motor vehicle crashes are a leading cause of death in the United States, and disproportionately impact communities of color. Replacing human control with automated vehicles (AVs) holds the potential to reduce crashes and save lives. The benefits of AVs, including automated shuttles, buses, or cars could extend beyond safety to include improvements in congestion, reductions in emissions, and increased access to mobility, particularly for vulnerable populations. However, AVs have not attained the level of public trust that has been expected, given their potential to save lives and increase access to mobility...

INTRODUCTION: The lack of disability-accessible medical diagnostic equipment (MDE) in primary care impedes the receipt of quality medical care by people with mobility impairments. Cross-sectional surveys and observational studies have found <40% of medical offices have disability-accessible examination tables or weight scales. Although government agencies and advocates recommend primary care acquisition of the accessible MDE, the rate of acquisition is unknown. METHODS: Using panel data, the research examined if primary care offices audited for disability accessibility increased accessible examination table and scale presence between the first and second audit...

BACKGROUND: Health inequalities in African American communities have been further exacerbated by COVID-19. Public health departments and other safety-net providers across the United States have partnered with community-based organizations to address barriers to COVID-19 testing in disproportionately impacted communities. This narrative review summarizes lessons learned from published examples of these community-based COVID-19 testing efforts. METHODS: We searched online databases for peer-reviewed articles on community-based COVID-19 testing interventions in the United States aimed at increasing COVID-19 testing among African American populations...

INTRODUCTION: Under-represented minority patients (URM) enroll in cancer clinical trials (CCT) at low rates. To gain insight into barriers and facilitators to CCT enrollment, we conducted a mixed method study of URM patients who were successfully treated on a therapeutic CCT from 2018-2021 at all institutional sites. METHODS: A retrospective chart review of 270 minority patients was conducted to identify patient demographics and characteristics. All living URM patients were requested to participate in a survey and qualitative interview using a photo elicitation technique...

For decades, health professional organizations have recommended increased diversity in the workforce and education. To address persistent inequities in health care, the racial composition of the nursing workforce needs be congruent with the U.S. population. Without first addressing structural inequity in nursing education programs, the nursing profession cannot begin to address structural racism in health care. The lack of nursing student diversity is reflective of barriers in program admissions. This article is a call to nursing accreditation bodies to operationalize anti-racism to improve U...

BACKGROUND: The current approach to increasing diversity in medical education fails to consider local community demographics when determining medical school matriculation. PURPOSE: We propose that medical schools better reflect their surrounding community, both because racially/ethnically concordant physicians have been shown to provide better care and to repair the historical and current racist impacts of these institutions that have criminalized, displaced, and excluded local Black and Brown communities...

PURPOSE: Inaccurate beliefs about medication abortion (MA) are common. This study evaluated pilot data from a community-led media intervention designed to increase MA knowledge among Black and Latinx women in Georgia. METHODS: Participants ( N =855) viewed the intervention video and completed pre-post surveys. Data were analyzed using linear and logistic regression. RESULTS: Knowledge scores significantly increased from 3.88/5.00 to 4.47/5...

No abstract text is available yet for this article.

Diabetes mellitus (DM) confers unique risks during the perinatal period, contributing to maternal, fetal, and neonatal morbidity and mortality. Integrating DM education and management services with obstetrical care offers key advantages for birthing individuals. The purpose of this study is to describe the development and implementation of a perinatal DM program at a large ambulatory practice serving a diverse population. Understanding this approach and program workflow may facilitate adoption of similar services in other care settings...