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Health care disparity

Lucinda B Leung, Arturo Vargas-Bustamante, Ana E Martinez, Xiao Chen, Hector P Rodriguez
OBJECTIVE: To conduct a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. STUDY SETTING/DATA COLLECTION: Clinical outcomes (2011) and patient survey data (2012) for Type 2 diabetes adults from 14 CHCs (n = 1,053). STUDY DESIGN: We estimated separate regression models for Latino and Asian patients by English language preference for Clinician & Group-Consumer Assessment of Healthcare Providers and System, Patient Assessment of Chronic Illness Care, hemoglobin A1c, and self-reported hypoglycemic events...
October 21, 2016: Health Services Research
Philip M Massey, Brent A Langellier, Tetine Sentell, Jennifer Manganello
OBJECTIVE: To examine differences in health information seeking between U.S.-born and foreign-born populations in the U.S. DESIGN: Data from 2008 to 2014 from the Health Information National Trends Survey were used in this study (n = 15,249). Bivariate analyses, logistic regression, and predicted probabilities were used to examine health information seeking and sources of health information. RESULTS: Findings demonstrate that 59.3% of the Hispanic foreign-born population reported looking for health information, fewer than other racial/ethnic groups in the sample...
October 21, 2016: Ethnicity & Health
Wanjiku F M Njoroge, Cody A Hostutler, Billie S Schwartz, Jennifer A Mautone
There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home...
December 2016: Current Psychiatry Reports
Patrick J Dillon, Ambar Basu
Over the past decade, scholars and practitioners have called for efforts to reduce disparities in the cost and quality of end-of-life care; a key contributor to these disparities is the underuse of hospice care by African American patients. While previous studies have often relied on interviewing minority individuals who may or may not have been terminally ill, among them only few who were using hospice care services, this essay reports the findings of a grounded theory analysis of interviews with 26 African American hospice patients (n = 10) and lay caregivers (n = 16)...
2016: Journal of Health Care for the Poor and Underserved
Craig N Sawchuk, Emily Van Dyke, Adam Omidpanah, Joan E Russo, Ursula Tsosie, Jack Goldberg, Dedra Buchwald
INTRODUCTION: Cancer is among the leading causes of death in American Indians and Alaska Natives (AI/ANs), with rates increasing over the last two decades. Barriers in accessing cancer screening and treatment likely contribute to this situation. METHODS: We administered structured clinical interviews and conducted descriptive and multiple linear regression analyses of demographic, health, spiritual, and treatment factors associated with self-reported barriers to cancer care among 143 adult AI/AN oncology patients...
2016: Journal of Health Care for the Poor and Underserved
Terrence S Batliner
: American Indians and Alaska Natives (AI/AN) experience significant health disparities relative to the general U.S. POPULATION: In particular, oral diseases affect the majority of the AI/AN population and their prevalence is significantly greater than observed in other demographic sectors of the U.S. POPULATION: The reasons for these disparities are multiple but lack of access to dental care is clearly a contributing factor. The dentist-to-population ratio in many AI/AN communities is less than half the U...
2016: Journal of Health Care for the Poor and Underserved
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
Jeffrey N Siegelman, Courtney Woods, Bisan Salhi, Sheryl Heron
No abstract text is available yet for this article.
November 2016: Medical Education
Sheena Mary McCormack, Veronica Noseda, Jean-Michel Molina
INTRODUCTION: In contrast to the global trend showing a decline in new HIV infections, the number reported in the World Health Organization (WHO) region of Europe is increasing. Health systems are disparate, but even countries with free access to screening and treatment observe continuing high rates of new infections in key populations, notably men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is only available in France. This commentary describes the European epidemics and healthcare settings where PrEP could be delivered, how need might be estimated for MSM and the residual barriers to access...
2016: Journal of the International AIDS Society
Cheryl K Zogg, Fernando Payró Chew, John W Scott, Lindsey L Wolf, Thomas C Tsai, Peter Najjar, Olubode A Olufajo, Eric B Schneider, Elliott R Haut, Adil H Haider, Joseph K Canner
Importance: Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear...
October 19, 2016: JAMA Surgery
Molly Carnes, Paula Johnson, Wendy Klein, Marjorie Jenkins, C Noel Bairey Merz
Gender-based bias and conflation of gender and status are root causes of disparities in women's health care and the slow advancement of women to leadership in academic medicine. More than a quarter of women physicians train in internal medicine and its subspecialties, and women physicians almost exclusively constitute the women's health focus within internal medicine. Thus, internal medicine has considerable opportunity to develop women leaders in academic medicine and promote women's health equity.To probe whether holding an endowed chair-which confers status-in women's health may be an effective way to advance women leaders in academic medicine and women's health, the authors explored the current status of endowed chairs in women's health in internal medicine...
October 18, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Kelli DePriest, Arlene Butz
Asthma disproportionately affects children who are non-White and of low socioeconomic status. One innovative approach to address these health disparities is to investigate the child's neighborhood environment and factors influencing asthma symptoms. The purpose of this integrative review is to critique research investigating the relationships between neighborhood-level factors and asthma morbidity in urban children. Three literature databases were searched using the terms "asthma," "child," "neighborhood," and "urban...
October 18, 2016: Journal of School Nursing: the Official Publication of the National Association of School Nurses
J Augustin, J Austermann, S Erasmi
Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example...
October 18, 2016: Das Gesundheitswesen
Deirdre A Caplin, Ken R Smith, Kirsten K Ness, Heidi A Hanson, Stephanie M Smith, Paul C Nathan, Melissa M Hudson, Wendy M Leisenring, Leslie L Robison, Kevin C Oeffinger
PURPOSE: To determine the independent contribution of population socioeconomic and health system factors on childhood cancer survivors' medical care and screening. METHODS: 7899 childhood cancer survivors in the United States and Canada enrolled in the Childhood Cancer Survivor Study (CCSS). Population-level factors were derived from U.S. Area Health Resource File or 201 Canadian Census. Health service utilization and individual-level factors were self-reported...
October 18, 2016: Journal of Adolescent and Young Adult Oncology
Harry Hx Wang, Jia Ji Wang, Kenny D Lawson, Samuel Ys Wong, Martin Cs Wong, Fang Jian Li, Pei Xi Wang, Zhi Heng Zhou, Yao Qun Yeong, Sian M Griffiths, Stewart W Mercer
OBJECTIVE: Multimorbidity (having ≥2 chronic conditions within an individual) is a rapidly increasing problem particularly among hypertensive patients. This study compared the prevalence of hypertension and those with multimorbidity in three study populations. DESIGN AND METHOD: We used cross-sectional data from three self-report surveys in China [N = 162,464], Scotland [N = 36,921], and Hong Kong [N = 29,187]. A consistent methodology was adopted to select representative samples of the household resident population of all ages by multi-stage stratified random sampling in each area...
September 2016: Journal of Hypertension
Kenneth Jamerson
Race and ethnicity provide an important construct that identifies individuals at increased risk for hypertension and related cardiovascular complications. While a significan proportion of health care disparity can be attributed to social, cultural and ecomnomic factors, mapping of the human genome allows for a biological construct of race. A systematic review of the effect of race on the response to antihypertensive therapy was performed in 2007. In this current review, an update of this subject is provided...
September 2016: Journal of Hypertension
Vickie M Mays, Audrey L Jones, Ayesha Delany-Brumsey, Courtney Coles, Susan D Cochran
BACKGROUND: Experiences of discrimination in health care settings may contribute to disparities in mental health outcomes for blacks and Latinos. We investigate whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment. RESEARCH METHODS: We used data from 3 waves of the California Quality of Life Survey, a statewide population-based telephone survey assessing mental health/substance disorders and their treatment...
October 6, 2016: Medical Care
Chris S Ivanoff, Krassimira Yaneva, Diana Luan, Bogomil Andonov, Reena R Kumar, Anirudha Agnihotry, Athena E Ivanoff, Dimitrios Emmanouil, Luiz Evaristo Ricci Volpato, Filip Koneski, Ilijana Muratovska, Huda A Al-Shehri, Sara M Al-Taweel, Michele Daly
BACKGROUND: Training culturally competent graduates who can practice effectively in a multicultural environment is a goal of contemporary dental education. The Global Oral Health Initiative is a network of dental schools seeking to promote global dentistry as a component of cultural competency training. OBJECTIVE: Before initiating international student exchanges, a survey was conducted to assess students' awareness of global dentistry and interest in cross-national clerkships...
October 18, 2016: International Dental Journal
Amanda N Fader, Tim Xu, Brian J Dunkin, Martin A Makary
BACKGROUND: Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. METHODS: This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States...
October 17, 2016: Surgical Endoscopy
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique H Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes prior to pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes in the U.S. are lacking. OBJECTIVE: To estimate changes in the prevalence of overall pregestational diabetes (all types) and pregestational type 1 and type 2 diabetes, and whether changes varied by race-ethnicity between 1996 and 2014. STUDY DESIGN: Cohort study conducted among 655,428 pregnancies at a Northern California integrated health delivery system in 1996-2014...
October 14, 2016: American Journal of Obstetrics and Gynecology
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