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Health care inequality

Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira, Jacqueline Alves Torres, Mariza Theme-Filha, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Maria Elizabeth Moreira, Silvana Granado Gama
BACKGROUND: The rate of preterm birth has been increasing worldwide, including in Brazil. This constitutes a significant public health challenge because of the higher levels of morbidity and mortality and long-term health effects associated with preterm birth. This study describes and quantifies factors affecting spontaneous and provider-initiated preterm birth in Brazil. METHODS: Data are from the 2011-2012 "Birth in Brazil" study, which used a national population-based sample of 23,940 women...
October 17, 2016: Reproductive Health
Sonia Duarte de Azevedo Bittencourt, Rosa Maria Soares Madeira Domingues, Lenice Gnocchi da Costa Reis, Márcia Melo Ramos, Maria do Carmo Leal
BACKGROUND: In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. METHODS: Nationwide cross-sectional hospital-based study "Birth in Brazil: national survey into labor and birth" conducted in 2011-2012...
October 17, 2016: Reproductive Health
Folkert de Groot, Stefano Capri, Jean-Claude Castanier, David Cunningham, Bruno Flamion, Mathias Flume, Harald Herholz, Lars-Åke Levin, Oriol Solà-Morales, Christoph J Rupprecht, Natalie Shalet, Andrew Walker, Olivier Wong
With finite resources, healthcare payers must make difficult choices regarding spending and the ethical distribution of funds. Here, we describe some of the ethical issues surrounding inequity in healthcare in nine major European countries, using cancer care as an example. To identify relevant studies, we conducted a systematic literature search. The results of the literature review suggest that although prevention, access to early diagnosis, and radiotherapy are key factors associated with good outcomes in oncology, public and political attention often focusses on the availability of pharmacological treatments...
October 21, 2016: Applied Health Economics and Health Policy
Rahmatollah Moradzadeh, Haidar Nadrian, Farzaneh Golboni, Mohammad Hasan Kazemi-Galougahi, Nasrin Moghimi
Background: Considering the renewed emphasis on women's health, attention to the new aspects of their health, such as equity, among different groups is warranted. The aim of this study was to investigate the economic inequalities among women with osteoporosis-related bone fractures (ORBFs) in Sanandaj, Iran. Methods: In this cross-sectional study, convenient sampling was employed to recruit 220 women with osteoporosis referring to the only rheumatology clinic in Sanandaj (the center of Kurdistan province in Iran) from January to April 2013...
2016: Health Promotion Perspectives
Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Sheena Asthana, Graham Moon, Alex Gibson, Trevor Bailey, Paul Hewson, Chris Dibben
There is a general understanding that socioeconomically disadvantaged people are also disadvantaged with respect to their access to NHS care. Insofar as considerable NHS funding has been targeted at deprived areas, it is important to better understand whether and why socioeconomic variations in access and utilisation exist. Exploring this question with reference to cardiovascular care, our aims were to synthesise and evaluate evidence relating to access to and/or use of English NHS services around (i) different points on the care pathway (i...
October 16, 2016: Health & Social Care in the Community
Antonio Pino, María Albán, Alejandra Rivas, Erika Rodríguez
Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC). Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC's website...
August 19, 2016: Journal of Public Health Research
Raj Chetty, David Cutler, Michael Stepner
Earlier this year, the three of us, along with several colleagues, published new research on the relationship between income and life expectancy in the United States, drawing on population-level data drawn from tax and Social Security records.(1) As part of that research, we created new, publicly available data sets with estimates of (1) life expectancy at age 40 years by gender, area (county and commuting zone), income level, and year (2001-2014); and (2) estimates of mortality rates by age (≥ 40 years), gender, area, income level, and year...
October 13, 2016: American Journal of Public Health
Christopher Hartmann
Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models...
October 13, 2016: American Journal of Public Health
Oluwasola Banke-Thomas, Aduragbemi Banke-Thomas, Charles Anawo Ameh
BACKGROUND: Many Kenyan adolescents die following pregnancy and childbirth complications. Maternal health services (MHS) utilisation is key to averting such poor outcomes. Our objectives were to understand the characteristics of adolescent mothers in Kenya, describe their MHS utilisation pattern and explore factors that influence this pattern. METHODS: We collected demographic and MHS utilisation data of all 301 adolescent mothers aged 15-19 years included in the Kenya Demographic Health Survey 2008/2009 (KDHS)...
October 12, 2016: International Journal of Adolescent Medicine and Health
Yin Zhou, Gary A Abel, Willie Hamilton, Kathy Pritchard-Jones, Cary P Gross, Fiona M Walter, Cristina Renzi, Sam Johnson, Sean McPhail, Lucy Elliss-Brookes, Georgios Lyratzopoulos
Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore, desirable; however, the optimal means of achieving this aim are uncertain owing to the involvement of different tumour, patient and health-care factors, often in combination. Most relevant evidence relates to patients with colorectal or lung cancer in a few economically developed countries, and defines emergency presentations contextually (that is, whether patients presented to emergency health-care services and/or received emergency treatment shortly before their diagnosis) as opposed to clinically (whether patients presented with life-threatening manifestations of their cancer)...
October 11, 2016: Nature Reviews. Clinical Oncology
Heesoo Yoon, Minsung Sohn, Minsoo Jung
Communication related to health not only substantially affects perceptions and behaviors related to health but is also positively associated with the extent of health-information seeking and the practice of preventive behavior. Despite the fact that the number of cancer survivors has increased dramatically, there are few studies of the lack of health information, factors which act as barriers, and the difficulties in follow-up care experienced by cancer survivors. Therefore, we reviewed media utilization and the types of media used by cancer survivors with regard to risk communication and suggested appropriate strategies for cancer communication...
September 2016: Journal of Cancer Prevention
O T Alade, O A Arikawe, F B Lawal, J O Taiwo
BACKGROUND: Access to dental services improves oral health and thereby, overall general health. For people with limited or no access to oral health care services, outreach dental services may be used to reduce oral health inequality. There is however paucity of information on the economic analysis of outreach dental services in sub Saharan Africa. OBJECTIVE: To report a cost minimization analysis of an outreach dental service as compared with a primary oral health clinic...
June 2016: Annals of Ibadan Postgraduate Medicine
David S Younger
The South African health care system is embedded in a background of racial subordination and sexual violence against girls and women and of hierarchical male authority from youth to adulthood. Low wages, unemployment, urban overcrowding, inadequate sanitation, malnutrition, crime, and violence have contributed to economic and health inequality. With more health-insured whites than blacks and the proportion of gross national product spent on health care slowly increasing, two-thirds of health expenditures have been consumed by the private sector at a time when the cost of health insurance has risen to more than 3 times the rate of the consumer price index...
November 2016: Neurologic Clinics
Adam Fusheini, John Eyles
BACKGROUND: Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy...
October 7, 2016: BMC Health Services Research
Annette J Browne, Colleen Varcoe, Josée Lavoie, Victoria Smye, Sabrina T Wong, Murry Krause, David Tu, Olive Godwin, Koushambhi Khan, Alycia Fridkin
BACKGROUND: Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery...
October 4, 2016: BMC Health Services Research
Wenjing Tao, Janne Agerholm, Bo Burström
BACKGROUND: Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, utilization and quality of primary care. METHODS: A systematic search was performed in Web of Science and PubMed for English language studies published between 1980 and 2013, supplemented by reference tracking. Articles were selected based on inclusion criteria, and data extraction and critical appraisal were performed by two authors independently...
October 4, 2016: BMC Health Services Research
Anastasia J Gage, Onyebuchi Ilombu, Akanni Ibukun Akinyemi
BACKGROUND: Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. METHODS: Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines...
October 6, 2016: BMC Pregnancy and Childbirth
A K Lofters, M Slater, M Vahabi
Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice...
October 6, 2016: Journal of Immigrant and Minority Health
Andrew M Subica, Cheryl T Grills, Sandra Villanueva, Jason A Douglas
INTRODUCTION: Childhood obesity is disproportionately prevalent in communities of color, partially because of structural inequities in the social and built environment (e.g., poverty, food insecurity, pollution) that restrict healthy eating and active living. Community organizing is an underexamined, grassroots health promotion approach that empowers and mobilizes community residents to advocate for, and achieve, environmental and policy changes to rectify these structural inequities...
October 3, 2016: American Journal of Preventive Medicine
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