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Health disparity

Audrey L Jones, Susan D Cochran, Arleen Leibowitz, Kenneth B Wells, Gerald Kominski, Vickie M Mays
BACKGROUND: Black and Latino minorities have traditionally had poorer access to primary care than non-Latino Whites, but these patterns could change with the Affordable Care Act (ACA). To guide post-ACA efforts to address mental health service disparities, we used a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. METHODS: Data were obtained from the Medical Expenditures Panel Survey (MEPS), a two-year panel study of healthcare use, satisfaction with care, and costs of services in the United States (US)...
March 22, 2018: Healthcare (Basel, Switzerland)
Francisco Soto Mas, Holly E Jacobson
Health literacy is a priority issue in both medicine and public health, as it refers to the capacity to obtain and understand basic health information and services and to make appropriate health decisions. Health literacy has been associated with a variety of health care and health outcomes such as hospital admissions, use of preventive services, management of chronic conditions, and mortality. There is also evidence of the connection between low health literacy and health disparities. Despite federal and private efforts, improving health literacy has proven to be an enormous challenge...
March 1, 2018: Health Promotion Practice
Wei-Chen Lee, Hani Serag, Robert L Ohsfeldt, Karl Eschbach, Wissam Khalife, Mohamed Morsy, Kenneth D Smith, Ben G Raimer
Heart failure (HF) is one of the leading causes of hospitalization and readmissions. Our study aimed to examine racial disparities in heart failure patients including onset, mortality, length of stay (LOS), direct costs, and readmission rates. This is a secondary data analysis. We analyzed the risk-adjusted inpatient data of all patients admitted with HF to one health academic center. We compared five health outcomes among three racial groups (white, black, and Hispanic). There were 1006 adult patients making 1605 visits from 10/01/2011 to 09/30/2015...
March 21, 2018: Journal of Immigrant and Minority Health
Rajeshwari Sinha, Sanghamitra Pati
The growing epidemic of noncommunicable diseases (NCDs) has impacted the national health systems, policies, and socioeconomic developments, thereby leading to increasing country level disparities. Despite substantial improvements in health indicators made in the past decade, the Indian health-care system continues to contribute disproportionately to the global disease burden, wherein NCDs holds significant prominence. Against this background, the present review analyzes the current NCD landscape from the perspective of India's health system preparedness toward meeting this growing challenge...
October 2017: Journal of Family Medicine and Primary Care
Kelly K Anderson, Ross Norman, Arlene G MacDougall, Jordan Edwards, Lena Palaniyappan, Cindy Lau, Paul Kurdyak
OBJECTIVE: There is a dearth of information on people with first-episode psychosis who do not access specialized early psychosis intervention (EPI) services. We sought to estimate the proportion of incident cases of nonaffective psychosis that do not access these services and to examine factors associated with EPI admission. METHODS: Using health administrative data, we constructed a retrospective cohort of incident cases of nonaffective psychosis in the catchment area of the Prevention and Early Intervention Program for Psychoses (PEPP) in London, Ontario, between 1997 and 2013...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
John T Doyle, Larry Kindness, James Realbird, Margaret J Eggers, Anne K Camper
Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity...
March 21, 2018: International Journal of Environmental Research and Public Health
Dayna A Johnson, Roland J Thorpe, John A McGrath, W Braxton Jackson, Chandra L Jackson
Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U...
March 21, 2018: International Journal of Environmental Research and Public Health
Yi Dong, Kun Fang, Xin Wang, Shengdi Chen, Xueyuan Liu, Yuwu Zhao, Yangtai Guan, Dingfang Cai, Gang Li, Jianmin Liu, Jianren Liu, Jianhua Zhuang, Panshi Wang, Xin Chen, Haipeng Shen, David Z Wang, Ying Xian, Wuwei Feng, Bruce Cv Campbell, Mark Parsons, Qiang Dong
Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Rebecca Udemans, Marie-Louise Stokes, Louise Rigby, Priya Khanna, Jonathan Christiansen
AIM: The Royal Australasian College of Physicians is renewing its specialty training programs and shifting towards competency-based medical education. Our aim is to improve the quality and rigor of training and graduate outcomes, and promote high standards of physician practice to serve the health of patients, families, and communities in a changing healthcare environment. METHODS: We are progressing holistic change and multiple educational innovations in a complex environment...
March 21, 2018: Medical Teacher
Peter F Rebeiro, Tristan D McPherson, Kathryn M Goggins, Megan Turner, Sally S Bebawy, William B Rogers, Lauren Brinkley-Rubinstein, Anna K Person, Timothy R Sterling, Sunil Kripalani, April C Pettit
Studies evaluating the association between human immunodeficiency virus (HIV) infection continuum of care outcomes [antiretroviral (ART) adherence, retention in care, viral suppression] and health literacy have yielded conflicting results. Moreover, studies from the southern United States, a region of the country disproportionately affected by the HIV epidemic and low health literacy, are lacking. We conducted an observational cohort study among 575 people living with HIV (PLWH) at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee)...
March 20, 2018: AIDS and Behavior
Paul L Weygandt, Scott M Dresden, Emilie S Powell, Joe Feinglass
Introduction: Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods: We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois...
March 2018: Western Journal of Emergency Medicine
Chandra L Jackson, Symielle A Gaston, Rui Liu, Kenneth Mukamal, Eric B Rimm
In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to 2015, we examined the relationship between alcohol-drinking patterns and sleep duration/quality by race and sex. Using Poisson regression models with robust variance, we estimated sex-specific prevalence ratios for each sleep duration/quality category among blacks compared to whites within categories of alcohol-drinking pattern, adjusting for socioeconomic status and other potential confounders...
March 20, 2018: International Journal of Environmental Research and Public Health
Jyoti Savla, L Rebecca Bivens, Karen A Roberto, Rosemary Blieszner
OBJECTIVE: Despite overall improvements in the U.S. health care, older adults living in rural counties, such as Appalachian Virginia, continue to be underserved. METHOD: Multinomial regression models, including both individual and county data from 503 older adults aged 65+, were used to examine factors associated with informal and formal care use. RESULTS: Older adults with stronger filial beliefs and less positive attitudes toward community services preferred informal help...
March 1, 2018: Journal of Aging and Health
Shearwood McClelland, Jennifer Leberknight, B Ashleigh Guadagnolo, C Norman Coleman, Daniel G Petereit
Introduction: American Indian/Alaska Native (AI/AN) patients with cancer disproportionally present with more advanced stages of disease and have the worst cancer-specific survival rates of any racial/ethnic group in the United States. The presence of disparities in radiation therapy (RT) access for AI/AN patients has rarely been examined. Methods and materials: National Cancer Institute (NCI) initiatives toward addressing AI/AN disparities were examined. Additionally, an extensive PubMed literature search for studies investigating RT access disparities in AI/AN patients was performed...
January 2018: Advances in Radiation Oncology
Maegan V Mazereeuw, Diana R Withrow, E Diane Nishri, Michael Tjepkema, Eduardo Vides, Loraine D Marrett
BACKGROUND: Métis people are 1 of 3 Aboriginal groups recognized by the Canadian constitution. We estimated site-specific incidence rates and survival for the most common cancers among Métis adults in Canada and compared these with rates among non-Aboriginal adults in Canada. METHODS: We examined responses to the 1991 long-form census, including self-reported Métis ancestry linked to national mortality and cancer databases for followup from 1992 to 2009. We estimated age-standardized incidence rates and 5-year relative survival...
March 19, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Douglas Yeung
This viewpoint paper argues that policy interventions can benefit from the continued use of social media analytics, which can serve as an important complement to traditional social science data collection and analysis. Efforts to improve well-being should provide an opportunity to explore these areas more deeply, and encourage the efforts of those conducting national and local data collection on health to incorporate more of these emerging data sources. Social media remains a relatively untapped source of information to catalyze policy action and social change...
March 19, 2018: Journal of Medical Internet Research
Julie A Lynch, Brygida Berse, Merry Rabb, Paul Mosquin, Rob Chew, Suzanne L West, Nicole Coomer, Daniel Becker, John Kautter
BACKGROUND: Tumor testing for mutations in the epidermal growth factor receptor (EGFR) gene is indicated for all newly diagnosed, metastatic lung cancer patients, who may be candidates for first-line treatment with an EGFR tyrosine kinase inhibitor. Few studies have analyzed population-level testing. METHODS: We identified clinical, demographic, and regional predictors of EGFR & KRAS testing among Medicare beneficiaries with a new diagnosis of lung cancer in 2011-2013 claims...
March 20, 2018: BMC Cancer
Arleen F Brown, Li-Jung Liang, Stefanie D Vassar, Jose J Escarce, Sharon Stein Merkin, Eric Cheng, Adam Richards, Teresa Seeman, W T Longstreth
Background: Trends in cardiovascular disparities are poorly understood, even as diversity increases in the United States. Objective: To examine U.S. trends in racial/ethnic and nativity disparities in cardiovascular health. Design: Repeated cross-sectional study. Setting: NHANES (National Health and Nutrition Examination Survey), 1988 to 2014. Participants: Adults aged 25 years or older who did not report cardiovascular disease...
March 20, 2018: Annals of Internal Medicine
George A Mensah
No abstract text is available yet for this article.
March 20, 2018: Annals of Internal Medicine
David Matthew Doyle, Pam Factor-Litvak, Bruce G Link
OBJECTIVE: The aim of the present study was to test a life course model in which racial disparities in physical health between Caucasian and African Americans are driven by disparities in close relationship functioning. This model also examined relative evidence for intergenerational transmission of relationship functioning and ongoing exposure to prejudice and discrimination as two pathways that might shape adult relationship functioning. METHOD: A sample of 523 Caucasian and African American men and women were prospectively tracked from a birth cohort initiated in the 1960s...
February 3, 2018: Social Science & Medicine
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