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2. The Journey to Achieve Health Care Equity: The New Joint Commission Accreditation Standard and Call for Papers.
- Author
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Baker DW
- Subjects
- Humans, United States, Joint Commission on Accreditation of Healthcare Organizations, Accreditation, Health Equity
- Published
- 2022
- Full Text
- View/download PDF
3. Defining the social determinants of health for nursing action to achieve health equity: A consensus paper from the American Academy of Nursing.
- Author
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Kuehnert P, Fawcett J, DePriest K, Chinn P, Cousin L, Ervin N, Flanagan J, Fry-Bowers E, Killion C, Maliski S, Maughan ED, Meade C, Murray T, Schenk B, and Waite R
- Subjects
- Humans, Population Health, United States, Consensus, Health Equity, Health Policy, Nursing Care, Social Determinants of Health, Societies, Nursing
- Abstract
Background: The 2019-2020 American Academy of Nursing (Academy, 2019) policy priorities document states that "they have a clear and distinct focus on social determinants of health and uses this lens to advance policies and solutions within each of the three overarching priorities" PURPOSE: This consensus paper seeks to establish conceptual clarity and consensus for what social determinants of health mean for nursing, with emphasis on examples of health policies that advance planetary health equity and improve planetary health-related quality of life., Methods: Volunteers from five Expert Panels of the Academy met via videoconference to determine roles and refine the focus of the paper. After the initial discussion, the first draft of the conceptual framework was written by the first three authors of the paper and, after discussion via videoconference with all the co-authors, successive drafts were developed and circulated for feedback. Consensus was reached when all authors indicated acceptance of what became the final version of the conceptual framework., Findings: A conceptual framework was developed that describes how the social determinants of health can be addressed through nursing roles and actions at the individual, family, and population levels with a particular focus on the role of health policy. The paper provides a specific health policy example for each of the six key areas of the social determinants of health to illustrate how nurses can act to improve population health., Discussion: Nursing actions can support timely health policy changes that focus on upstream factors in the six key areas of the social determinants of health and thus improve population health. The urgent need to eliminate systematic and structural racism must be central to such policy change if equity in planetary health-related quality of life is to be attained., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
4. Reconfiguring a One-Way Street: A Position Paper on Why and How to Improve Equity in Global Physician Training.
- Author
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Hudspeth JC, Rabin TL, Dreifuss BA, Schaaf M, Lipnick MS, Russ CM, Autry AM, Pitt MB, and Rowthorn V
- Subjects
- Education, Medical methods, Education, Medical standards, Emigrants and Immigrants legislation & jurisprudence, Foreign Medical Graduates supply & distribution, Foreign Medical Graduates trends, Global Health trends, Humans, Licensure legislation & jurisprudence, Licensure trends, United States, Foreign Medical Graduates legislation & jurisprudence, Global Health education, Health Equity trends
- Abstract
Large numbers of U.S. physicians and medical trainees engage in hands-on clinical global health experiences abroad, where they gain skills working across cultures with limited resources. Increasingly, these experiences are becoming bidirectional, with providers from low- and middle-income countries traveling to experience health care in the United States, yet the same hands-on experiences afforded stateside physicians are rarely available for foreign medical graduates or postgraduate trainees when they arrive. These physicians are typically limited to observership experiences where they cannot interact with patients in most U.S. institutions. In this article, the authors discuss this inequity in global medical education, highlighting the shortcomings of the observership training model and the legal and regulatory barriers prohibiting foreign physicians from engaging in short-term clinical training experiences. They provide concrete recommendations on regulatory modifications that would allow meaningful short-term clinical training experiences for foreign medical graduates, including the creation of a new visa category, the designation of a specific temporary licensure category by state medical boards, and guidance for U.S. host institutions supporting such experiences. By proposing this framework, the authors hope to improve equity in global health partnerships via improved access to meaningful and productive educational experiences, particularly for foreign medical graduates with commitment to using their new knowledge and training upon return to their home countries.
- Published
- 2019
- Full Text
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5. Addressing Social Determinants to Improve Patient Care and Promote Health Equity: An American College of Physicians Position Paper.
- Author
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Daniel H, Bornstein SS, Kane GC, Carney JK, Gantzer HE, Henry TL, Lenchus JD, Li JM, McCandless BM, Nalitt BR, Viswanathan L, Murphy CJ, Azah AM, and Marks L
- Subjects
- Humans, Societies, Medical, United States, Health Equity, Health Policy, Health Promotion, Quality Improvement, Social Determinants of Health
- Abstract
Social determinants of health are nonmedical factors that can affect a person's overall health and health outcomes. Where a person is born and the social conditions they are born into can affect their risk factors for premature death and their life expectancy. In this position paper, the American College of Physicians acknowledges the role of social determinants in health, examines the complexities associated with them, and offers recommendations on better integration of social determinants into the health care system while highlighting the need to address systemic issues hindering health equity.
- Published
- 2018
- Full Text
- View/download PDF
6. Using incident reports to diagnose communication challenges for precision intervention in learning health systems: A methods paper.
- Author
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Clark, Rebecca R. S., Klaiman, Tamar, Sliwinski, Kathy, Hamm, Rebecca F., and Flores, Emilia
- Subjects
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MEDICAL incident reports , *WOMEN'S health services , *RACE , *INSTRUCTIONAL systems - Abstract
Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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7. Disparities in Overdose Deaths: Looking Back at Larochelle and Colleagues' 2021 Paper.
- Author
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Volkow, Nora D., Han, Beth, and Chandler, Redonna K.
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SUBSTANCE abuse treatment , *DRUG overdose , *RISK assessment , *HEALTH services accessibility , *MEDICAL quality control , *OPIOID abuse , *OPIOID analgesics , *HEALTH equity , *NALOXONE - Abstract
The article discusses an article by M. R. Larochelle and colleagues about disparities in overdose deaths. Topics include reason that the opioid overdose crisis most heavily affected non-Hispanic White people, major events that could not have been predicted at the time the article by Larochelle and colleagues was written, and lessons learned about the need for timely data on drug use patterns and overdoses to guide interventions.
- Published
- 2024
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8. How often do US-based schizophrenia papers published in high-impact psychiatric journals report on race and ethnicity?: A 20-year update of Lewine and Caudle (1999).
- Author
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Nagendra, Arundati, Orleans-Pobee, Maku, Spahnn, Rachel, Monette, Mahogany, Sosoo, Effua E., Pinkham, Amy E., and Penn, David L.
- Subjects
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SCHIZOPHRENIA risk factors , *PSYCHOSES , *RACE , *ELECTRONIC publishing , *RISK assessment , *SEVERITY of illness index , *DESCRIPTIVE statistics , *ETHNIC groups , *HEALTH equity - Abstract
Racial and ethnic disparities have been clearly documented in schizophrenia studies, but it is unclear how much research attention they receive among US-based studies published in high-impact journals. The current paper updates Lewine and Caudle's (1999) and Chakraborty and Steinhauer's (2010) works, which quantified how frequently schizophrenia studies included information on race and ethnicity in their analyses. We examined all US-based papers on schizophrenia-spectrum, first-episode psychosis, and clinical high-risk groups, published between 2014 to 2016 in four major psychiatric journals: American Journal of Psychiatry, Journal of the American Medical Association – Psychiatry, Schizophrenia Bulletin, and Schizophrenia Research. Of 474 US-based studies, 62% (n = 295) reported analyses by race or ethnicity as compared to 20% in Lewine and Caudle's (1999) study. The majority of papers (59%) reported sample descriptions, a 42% increase from Lewine and Caudle's (1999) study. Additionally, 47% matched or compared the racial/ethnic composition of primary study groups and 12% adjusted for race (e.g., as a covariate). However, only 9% directly analyzed racial and/or ethnic identity in relation to the primary topic of the paper. While schizophrenia studies report analyses by race and ethnicity more frequently than 20 years ago, there remains a strong need for systematic, nuanced research on this topic. The authors offer recommendations for how to conceptualize and report upon race and ethnicity in schizophrenia research. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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9. Principles for Ending Human Immunodeficiency Virus as an Epidemic in the United States: A Policy Paper of the Infectious Diseases Society of America and the HIV Medical Association.
- Author
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Person, Anna K, Armstrong, Wendy S, Evans, Tyler, Fangman, John J W, Goldstein, Robert H, Haddad, Marwan, Jain, Mamta K, Keeshin, Susana, Tookes, Hansel E, Weddle, Andrea L, and Feinberg, Judith
- Subjects
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HIV infection epidemiology , *HIV prevention , *HEALTH services accessibility , *MEDICAL care , *HEALTH care reform , *QUALITY of life , *MEDICAL societies - Abstract
While we have the tools to achieve this goal, the persistent barriers to healthcare services experienced by too many individuals will need to be addressed to make significant progress and improve the health and quality of life of all people with human immunodeficiency virus (HIV). The necessary structural changes require actions by federal, state, and local policymakers and range from ensuring universal access to healthcare services to optimizing care delivery to ensuring a robust and diverse infectious diseases and HIV workforce. In this article, we outlines 10 key principles for policy reforms that, if advanced, would make ending the HIV epidemic in the United States possible and could have much more far-reaching effects in improving the health of our nation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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10. Efforts by critical access hospitals to increase health equity through greater engagement with social determinants of health.
- Author
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Lemont B, Puro N, Franz B, and Cronin CE
- Subjects
- Humans, United States, Health Services Accessibility, Social Determinants of Health, Surveys and Questionnaires, Hospitals, Rural, Health Equity
- Abstract
Purpose: Greater health care engagement with social determinants of health (SDOH) is critical to improving health equity. However, no national studies have compared programs to address patient social needs among critical access hospitals (CAHs), which are lifelines for rural communities. CAHs generally have fewer resources and receive governmental support to maintain operations. This study considers the extent to which CAHs engage in community health improvement, particularly upstream SDOH, and whether organizational or community factors predict involvement., Methods: Using descriptive statistics and Poisson regression, we compared 3 types of programs (screening, in-house strategies, and external partnerships) to address the patient social needs between CAHs and non-CAHs, independent of key organizational, county, and state factors., Findings: CAHs were less likely than non-CAHs to have programs to screen patients for social needs, address unmet social needs of patients, and enact community partnerships to address SDOH. When we stratified hospitals according to whether they endorsed an equity-focused approach as an organization, CAHs matched their non-CAH counterparts on all 3 types of programs., Conclusions: CAHs lag relative to their urban and non-CAH counterparts in their ability to address nonmedical needs of their patients and broader communities. While the Flex Program has shown success in offering technical assistance to rural hospitals, this program has mainly focused on traditional hospital services to address patients' acute health care needs. Our findings suggest that organizational and policy efforts surrounding health equity could bring CAHs in line with other hospitals in terms of their ability to support rural population health., (© 2023 The Authors. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.)
- Published
- 2023
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11. Partnerships to improve social determinants of health, health equity, and health outcomes: An SNRS whitepaper.
- Author
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Ahn H, Butts B, Cottrell DB, Kesey J, McNeill CC, Mumba MN, O'Brien T, Reifsnider E, and Reilly CM
- Subjects
- Humans, United States, Health Equity, Public-Private Sector Partnerships, Social Determinants of Health
- Published
- 2022
- Full Text
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12. Perspectives on Disparities and Equity in Cancer Outcomes: A Call to Action.
- Author
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Odunsi K
- Subjects
- Humans, United States epidemiology, Health Services Accessibility, Trust, Ethnicity, Healthcare Disparities, Health Equity, Neoplasms diagnosis, Neoplasms epidemiology, Neoplasms therapy
- Abstract
Despite remarkable progress in cancer prevention, treatment, and survivorship in the United States over the past 3 decades, there remain considerable disparities in cancer incidence and mortality among various groups based on race, ethnicity, and other social determinants of health. For most cancer types, African Americans have the highest mortality rate and lowest survival rate of any racial and ethnic group. Here the author highlights some of the factors responsible for cancer health disparities and proposes that cancer health equity is a fundamental human right. These factors include inadequate health insurance coverage, medical mistrust, lack of diversity in the workforce, and social and economic exclusion. Recognizing that health disparities do not exist in isolation but are part of a complex set of problems associated with education, housing, employment, health insurance, and community structures, the author contends that the challenge cannot be solved by public health measures alone but would require a multifaced and coordinated approach involving several sectors of the economy-business, schools, financial institutions, agriculture, and urban planning. Several immediate and medium-term action items are proposed to set the foundation for sustained efforts that would have an impact in the long term. These include developing culturally tailored interventions through community engagement to enhance uptake of cancer screening and clinical trials among racial and ethnic minorities and other medically underserved patients, expanding access to equitable and affordable quality health care by increasing access to health insurance, and prioritizing investment in early-career cancer researchers to enhance diversity and improve equity in the workforce., (Copyright © 2023 by the Association of American Medical Colleges.)
- Published
- 2023
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13. Dental Therapists in the United States: Health Equity, Advancing.
- Author
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Mertz E, Kottek A, Werts M, Langelier M, Surdu S, and Moore J
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- Dental Care methods, Dental Care trends, Evaluation Studies as Topic, Humans, United States, Dental Care psychology, Dental Health Services supply & distribution, Health Equity trends, Patient Acceptance of Health Care psychology, Stakeholder Participation psychology
- Abstract
Background: Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations., Objectives: The objective of this study is to qualitatively examine the drivers and outcomes of the US dental therapy movement through a health equity lens, including community engagement, implementation and dissemination, and access to oral health care., Methods: The study compiled a comprehensive document library on the dental therapy movement including literature, grant documents, media and press, and gray literature. Key stakeholder interviews were conducted across the spectrum of engagement in the movement. Dedoose software was used for qualitative coding. Themes were assessed within a holistic model of oral health equity., Findings: Health equity is a driving force for dental therapy adoption. Community engagement has been evident in diverse statewide coalitions. National accreditation standards for education programs that can be deployed in 3 years without an advanced degree reduces educational barriers for improving workforce diversity. Safe, high-quality care, improvements in access, and patient acceptability have been well documented for DTs in practice., Conclusion: Having firmly taken root politically, the impact of the dental therapy movement in the US, and the long-term health impacts, will depend on the path of implementation and a sustained commitment to the health equity principle., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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14. Improving Postpartum and Long-Term Health After an Adverse Pregnancy Outcome: Examining Interventions From a Health Equity Perspective.
- Author
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Ditosto JD, Roytman MV, Dolan BM, Khan SS, Niznik CM, and Yee LM
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- Pregnancy, Female, United States epidemiology, Humans, Pregnancy Outcome, Postpartum Period, Health Equity, Diabetes, Gestational therapy, Hypertension therapy
- Abstract
Gestational diabetes mellitus and hypertensive disorders in pregnancy are adverse pregnancy outcomes (APOs) that affect 15% of pregnancies in the United States. These APOs have long-term health implications, with greater risks of future cardiovascular and chronic disease later in life. In this manuscript, we review the importance of timely postpartum follow-up and transition to primary care after APOs for future disease prevention. We also discuss interventions to improve postpartum follow-up and long-term health after an APO. In recognizing racial and ethnic disparities in APOs and chronic disease, we review important considerations of these interventions through a health equity lens., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
15. Reproductive Health Care for Incarcerated People: Advancing Health Equity in Unequitable Settings.
- Author
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Rajagopal K, Landis-Lewis D, Haven K, and Sufrin C
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- Female, Humans, United States, Reproductive Health, Delivery of Health Care, Health Status Disparities, Health Equity, Prisoners
- Abstract
There are over 150,000 incarcerated females in the United States. Structural inequities, including racism, adversely affect the reproductive health outcomes, autonomy, and access to care that people in custody face. This article reviews the status of reproductive health and health care among incarcerated women and describes ways that community OB/GYNs can address health inequities by providing comprehensive, compassionate care to incarcerated people, especially when they come to community settings for care while they are in custody. To address reproductive health disparities and inequities that adversely affect incarcerated individuals, community providers can implement these recommendations and also engage in advocacy., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
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16. The Importance of Structural Interventions for Advancing Sexual Health and Health Equity in the United States: A Review of the Evidence and Recommendations for Action on Sexually Transmitted Infections.
- Author
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Agénor M, Geller AB, Crowley JS, and Boyer CB
- Subjects
- United States epidemiology, Humans, Sexual Health, Health Equity, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Competing Interests: Conflict of Interest and Sources of Funding: None declared.
- Published
- 2023
- Full Text
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17. The Public Health National Center for Innovations: An Initial Qualitative Evaluation.
- Author
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Siegfried AL, Kennedy M, Gonick SA, and Liotta M
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- Accreditation, Humans, Leadership, Qualitative Research, United States, Health Equity, Public Health
- Abstract
Context: The Public Health National Center for Innovations (PHNCI) was launched in 2015 as a division of the Public Health Accreditation Board (PHAB) to serve as a hub for fostering public health innovation and transformation., Objectives: We explored perspectives of key informants to assess PHNCI's work in its first 5 years, including implementation of activities, outputs, accomplishments, and opportunities., Design: This qualitative study involved a Web site review; secondary document review; 15 interviews with 17 key informants purposively sampled from 2 groups-PHNCI and PHAB staff and leadership (PHNCI respondents), and external partners and collaborators (external respondents); and thematic analysis of qualitative data., Setting: United States., Results: PHNCI implemented its planned activities over the past 5 years-including grant programs and learning communities; large-scale public health initiatives; conferences, events, and convenings; webinar trainings; and resources, tools, and materials-resulting in more than 150 outputs. According to key informants, PHNCI's major accomplishments were as follows: contributed to an increased understanding and awareness of innovation in the public health field; provided grants and learning communities to support innovation; developed and disseminated materials to help practitioners innovate; established partnerships and promoted cross-sector collaboration; supported systems transformation; incorporated innovation into public health accreditation; and focused efforts to advance health equity., Conclusions: Going forward, PHNCI should continue to prioritize its core activities that support public health innovation and transformation; expand its work by addressing innovation in new public health topic areas; strengthen and expand its cross-sector work, partnerships, and activities to advance health equity and antiracism; and increase its visibility and reach, particularly within other sectors. Continued commitment and leadership are important for strengthening the capacity of the public health system to innovate, respond to ongoing and emerging public health threats and challenges, and advance health equity., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
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18. Latina Women in the U.S. Physician Workforce: Opportunities in the Pursuit of Health Equity.
- Author
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Balderas-Medina Anaya Y, Hsu P, Martínez LE, Hernandez S, and Hayes-Bautista DE
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- Ethnicity, Female, Hispanic or Latino, Humans, Male, United States, Workforce, Health Equity, Physicians
- Abstract
Purpose: Some progress has been made in gender diversity in undergraduate medical education and the physician workforce, but much remains to be done to improve workforce disparities for women, particularly women from underrepresented populations, such as Latinas. This study examines the current level of representation and demographic characteristics of Latina physicians, including age, language use, nativity, and citizenship status., Method: The authors used data from the 2014-2018 U.S. Census Bureau's American Community Survey (ACS) 5-year estimates for their analyses. During the time period covered by this analysis, ACS response rates ranged from 92.0% to 96.7%. The authors included in this study individuals who self-reported their occupation as physician and who self-identified their race/ethnicity as either non-Hispanic White (NHW) or Hispanic/Latino, regardless of race. The authors used person-level sampling weights provided by the ACS to convert the original 1% sample to a 100% enumeration of the population., Results: According to the ACS 2014-2018 5-year estimates, NHW physicians make up 65.8% (660,031/1,002,527) of physicians in the United States. Women comprise 36.1% (361,442) of the total U.S. physician population; however, Hispanic/Latina women comprise only 2.4% (24,411). The female physician population is younger than the male physician population, and Hispanic female physicians are the youngest. Latina physicians are far more likely to speak Spanish at home than NHW physicians. Immigrants make up 40.1% (9,782/24,411) of the Hispanic female physician population, and 12.3% (3,012/24,411) of Hispanic female physicians are not U.S. citizens., Conclusions: This study suggests that Latina physicians in the United States are younger, more likely to be bilingual and speak Spanish at home, and very underrepresented, compared with NHW female and male physicians. Increasing their share of the U.S. physician workforce would benefit the pursuit of health equity for an ever more diverse population., (Copyright © 2021 by the Association of American Medical Colleges.)
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- 2022
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19. Promoting Health and Well-being in Healthy People 2030.
- Author
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Pronk N, Kleinman DV, Goekler SF, Ochiai E, Blakey C, and Brewer KH
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- Health Status, Humans, Social Environment, Societies, United States, Health Equity
- Abstract
Healthy People 2030 describes a vision and offers benchmarks that can be used to track progress toward the goal of all people in the United States achieving their full potential for health and well-being across the life span. This vision can be realized through evidence-based interventions and policies that address the economic, physical, and social environments in which people live, learn, work, and play. Securing health and well-being for all will benefit society as a whole. Gaining such benefits requires eliminating health disparities, achieving health equity, attaining health literacy, and strengthening the physical, social, and economic environments. Implementation of Healthy People 2030 will by strengthened by engaging users from many sectors and ensuring the effective use and alignment of resources. Promoting the nation's health and well-being is a shared responsibility-at the national, state, territorial, tribal, and community levels. It requires involving the public, private, and not-for-profit sectors., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
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20. Addressing Health Equity and Social Determinants of Health Through Healthy People 2030.
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Gómez CA, Kleinman DV, Pronk N, Wrenn Gordon GL, Ochiai E, Blakey C, Johnson A, and Brewer KH
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- Health Status Disparities, Humans, Pandemics, SARS-CoV-2, United States, COVID-19, Health Equity, Healthy People Programs, Social Determinants of Health
- Abstract
The evolution of Healthy People reflects growing awareness of health inequities over the life course. Each decade, the initiative has gained understanding of how the nation can achieve health and well-being. To inform Healthy People 2030's visionary goal of achieving health equity in the coming decade, the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (Secretary's Advisory Committee) provided the US Department of Health and Human Services with guidance on key terms, frameworks, and measurement for health equity. Conditions in the environments in which people are born, live, learn, work, play, worship, and age influence health and well-being outcomes, functioning, and quality-of-life outcomes and risks and are mostly responsible for health inequities. No single individual, organization, community, or sector has sole ownership, accountability, or capacity to sustain the health and well-being of an entire population. The COVID-19 pandemic in the United States highlights underlying inequities and disparities in health and health care across segments of the population. Contributing factors that were known prior to the pandemic have led to major discrepancies in rates of infection and death. To reduce health disparities and advance health equity, systems approaches-designed to shift interconnected aspects of public health problems-are needed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
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21. Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians.
- Author
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Daniel, Hilary and Butkus, Renee
- Subjects
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HEALTH equity , *LGBTQ+ people , *HEALTH of LGBTQ+ people , *HEALTH policy , *PHYSICIANS' attitudes , *WELL-being , *MEDICAL care - Abstract
In this position paper, the American College of Physicians examines the health disparities experienced by the lesbian, gay, bisexual, and transgender (LGBT) community and makes a series of recommendations to achieve equity for LGBT individuals in the health care system. These recommendations include enhancing physician understanding of how to provide culturally and clinically competent care for LGBT individuals, addressing environmental and social factors that can affect their mental and physical well-being, and supporting further research into understanding their unique health needs. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
22. Advancing health equity: The Association of Black Gastroenterologists and Hepatologists.
- Author
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White PM, Iroku U, Carr RM, and May FP
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- Black or African American, Gastroenterology trends, Health Equity statistics & numerical data, Health Equity trends, Humans, Internationality, Societies, Medical, United States epidemiology, Digestive System Diseases diagnosis, Digestive System Diseases epidemiology, Digestive System Diseases therapy, Gastroenterology standards, Health Equity standards, Healthcare Disparities statistics & numerical data
- Published
- 2021
- Full Text
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23. Women's Health Policy in the United States: An American College of Physicians Position Paper.
- Author
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Daniel, Hilary, Erickson, Shari M., Bornstein, Sue S., Health and Public Policy Committee of the American College of Physicians, Kane, Gregory C, Gantzer, Heather E, Henry, Tracey L, Lenchus, Joshua D, Li, Joseph M, McCandless, Bridget M, Nalitt, Beth R, Viswanathan, Lavanya, Murphy, Caleb J, Azah, Ayeetin M, and Marks, Lianne
- Subjects
- *
WOMEN'S health , *HEALTH policy , *HEALTH equity , *MEDICAL care , *AGE distribution , *CONTRACEPTION , *DECISION making , *DOMESTIC violence , *LEAVE of absence , *MANAGEMENT , *MEDICAL needs assessment , *MEDICAL societies , *SEX crimes , *FAMILY planning - Abstract
In this position paper, the American College of Physicians (ACP) examines the challenges women face in the U.S. health care system across their lifespans, including access to care; sex- and gender-specific health issues; variation in health outcomes compared with men; underrepresentation in research studies; and public policies that affect women, their families, and society. ACP puts forward several recommendations focused on policies that will improve the health outcomes of women and ensure a health care system that supports the needs of women and their families over the course of their lifespans. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
24. Cardiovascular Risk Factors Among Asian Americans: Perspectives on the Role of Acculturation in Cardiovascular Diseases Health Disparities.
- Author
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Vo, Victoria, Lopez, Glydel, Malay, Shravani, and Roman, Youssef M.
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CARDIOVASCULAR disease related mortality ,RISK assessment ,IMMIGRANTS ,HEALTH literacy ,ASIAN Americans ,ACCULTURATION ,SOCIOECONOMIC factors ,CARDIOVASCULAR diseases risk factors ,RACE ,RELIGION ,SPIRITUALITY ,FAMILY structure ,HEALTH equity ,MINORITIES - Abstract
The growing prevalence of cardiovascular diseases in the United States (US) has disproportionately affected minority populations more than their white counterparts. A population that is often overlooked is the Asian American population, particularly Southeastern Asian immigrants. Despite having relatively favorable socioeconomic indicators compared to the general US population, Asian Americans, specifically Southeast Asian individuals, face a significant burden of traditional cardiovascular risk factors and are considered a high cardiovascular disease risk group. In addition, most studies have aggregated Asian populations into one major racial group rather than analyzing the different ethnicities among the Asian categorization. While some studies suggest that the acculturation process has some degree of impact on cardiovascular health, there has not been a widely-used tool to measure or ascertain the totality of acculturation. Instead, multiple proxies have been used to measure acculturation, and prior studies have argued for more culturally-tailored acculturation proxies. This paper aims to assess the implications of different acculturation measures on cardiovascular health among Asian Americans, particularly Southeastern Asian immigrants. The following proxies were expanded on in this paper: English spoken at home, length of stay in the US, religiosity and spirituality, and admixed family structures. Previous studies showed that as the length of stay in the US increases, the burden of cardiovascular risk factors increases. However, the impact of English spoken at home, religiosity, and admixed family structure are still inconclusive given the extent of current studies. While most studies suggest that an increase in acculturation increases the risk of cardiovascular disease, it is critical to note that acculturation is a multifaceted process. Therefore, more studies are necessary to appropriately examine the implications of various acculturation processes on cardiovascular risk factors in Asians, specifically Southeastern Asian individuals in the US. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
25. The Future Physician Workforce Needed to Advance Health Equity for Children of Immigrant Families.
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Acosta DA
- Subjects
- Humans, Child, United States, Physicians supply & distribution, Pediatrics, Health Workforce, Emigrants and Immigrants, Health Equity
- Abstract
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This article was published as part of a supplement sponsored by the Robert Wood Johnson Foundation.
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- 2024
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26. Children in Immigrant Families: Advancing Health Equity Introduction and Executive Summary.
- Author
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Falusi O, Linton JM, and Fortuna LR
- Subjects
- Humans, Child, United States, Emigrants and Immigrants, Health Equity
- Abstract
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Published
- 2024
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27. Equity and justice in health.
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Murray TA
- Subjects
- Humans, United States, Healthcare Disparities, Health Status Disparities, Social Justice, Health Equity
- Abstract
Background: While justice is promised to all U.S. citizens, the truth is that the pathway to equity and justice in health is riddled with obstacles for many marginalized and minoritized groups. The United States ranks lower on crucial health measures than its high-income peer countries, reflecting differences in health outcomes for marginalized and minoritized populations., Purpose: Promoting equity and justice in health is vital as health shapes the daily experiences of individuals and communities, specifically those from marginalized and minoritized backgrounds., Method: This paper highlights the health care system and sociopolitical factors contributing to the longstanding structural barriers that impede health and the need for structural competence, advocacy, and activism in the nursing workforce., Discussion: Understanding systemic issues underlying health inequities provides an opportunity to develop targeted strategies to eliminate practices perpetuating inequities and pave the way for everyone to have a fair and just opportunity to be as healthy as possible., Conclusion: Specific education, practice, research, and policy recommendations can advance equity and justice in health., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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28. Cross Cultural Empathetic Behavior in Health Care Providers: A Review of 3 Countries.
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Sullivan-Detheridge, Julie H., Reifsnider, Elizabeth, Mengsteab, Mesele, Merie, Kassaw, Staller, Judit, and Allen, Angela M.
- Subjects
EVALUATION of medical care ,IMPLICIT bias ,RACISM ,EMPATHY ,TRANSCULTURAL medical care ,RACE ,CULTURAL competence ,ETHNOCENTRISM ,HEALTH equity ,RURAL health - Abstract
This paper examines empathetic behavior in the United States, a strongly individualistic country, as contrasted with Hungary and Ethiopia, which are moderately individualistic and strongly collectivistic respectively. It suggests that empathy may have a wider than originally perceived application in diverse settings to combat factors of ethnic bias and discrimination that adversely impact health. Models that distinctly focus on the development of healthcare provider empathic care are needed to enable the needs of resource scarce regions of the world to be met, including pockets of the U.S. More investigation is warranted on how empathic behavior can positively impact health outcomes and disparities. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Society of American Gastrointestinal and Endoscopic Surgeons guidelines development: health equity update to standard operating procedure.
- Author
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Kumar SS, Collings AT, Collins C, Colvin J, Sylla P, and Slater BJ
- Subjects
- Humans, United States, Societies, Medical, Healthcare Disparities, Practice Guidelines as Topic, Health Equity standards
- Abstract
Introduction: The SAGES Guidelines Committee creates evidence-based clinical practice guidelines. Due to existing health disparities, recommendations made in these guidelines may have different impacts on different populations. The updates to our standard operating procedure described herein will allow us to produce well-designed guidelines that take these disparities into account and potentially reduce health inequities., Methods: This paper outlines updates to the SAGES Guidelines Committee Standard Operating Procedure in order to incorporate issues of heath equity into our guideline development process with the goal of minimizing downstream health disparities., Results: SAGES has developed an evidence-based, standardized approach to consider issues of health equity throughout the guideline development process to allow physicians to better counsel patients and make research recommendations to better address disparities., Conclusion: Societies that promote guidelines within their organization must make an intentional effort to prevent the widening of health disparities as a result of their recommendations. The updates to the Guidelines Committee Standard Operating Procedure will hopefully lead to increased attention to these disparities and provide specific recommendations to reduce them., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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30. Discussion of federal policies affecting broadband expansion and telehealth in Appalachia.
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Kirkland, Deborah A. and Lindley, Lisa C.
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- *
INTERNET access , *HEALTH services accessibility , *MEDICAL quality control , *HEALTH policy , *NURSING , *TELEMEDICINE , *RURAL health services , *ADVANCED practice registered nurses , *RURAL conditions , *PUBLIC health , *TELENURSING , *QUALITY assurance , *HEALTH equity , *COVID-19 pandemic ,FEDERAL government of the United States - Abstract
There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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31. Wasted Potential: Decoding the Trifecta of Donor Kidney Shortage, Underutilization, and Rising Discard Rates.
- Author
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McKenney, Ceilidh, Torabi, Julia, Todd, Rachel, Akhtar, M. Zeeshan, Tedla, Fasika M., Shapiro, Ron, Florman, Sander S., Holzner, Matthew L., and van Leeuwen, L. Leonie
- Subjects
KIDNEY transplantation ,PATIENTS ,TRANSPLANTATION of organs, tissues, etc. ,RECEIVER operating characteristic curves ,BODY mass index ,ORGAN donor registries ,LOGISTIC regression analysis ,ORGAN donation ,CHI-squared test ,DESCRIPTIVE statistics ,ODDS ratio ,HEALTH equity ,DATA analysis software ,CONFIDENCE intervals - Abstract
Kidney transplantation is a life-saving intervention for end-stage renal disease; yet, the persistent gap between organ demand and supply remains a significant challenge. This paper explores the escalating discard rates of deceased donor kidneys in the United States to assess trends, discard reasons, demographical differences, and preservation techniques. Data from the Scientific Registry of Transplant Recipients from 2010 to 2021 was analyzed using chi-squared tests for trend significance and logistic regression to estimate odds ratios for kidney discard. Over the last decade, discard rates have risen to 25% in 2021. Most discarded kidneys came from extended criteria donor (ECD) donors and elevated kidney donor profile index (KDPI) scores. Kidney biopsy status was a significant factor and predictor of discard. Discard rates varied greatly between Organ Procurement and Transplantation Network regions. Of reasons for discard, "no recipient located" reached a high of 60%. Additionally, there has been a twofold increase in hypothermic machine perfusion (HMP) since 2010, with transportation difficulties being the main reason for the discard of perfused kidneys. Our findings suggest a need to recalibrate organ utilization strategies, optimize the use of lower-quality kidneys through advanced preservation methods, and address the evolving landscape of organ allocation policies to reduce kidney discard rates. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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32. Influence of geographic access and socioeconomic characteristics on breast cancer outcomes: A systematic review.
- Author
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Conti, Benoit, Bochaton, Audrey, Charreire, Hélène, Kitzis-Bonsang, Hélène, Desprès, Caroline, Baffert, Sandrine, and Ngô, Charlotte
- Subjects
BREAST cancer ,HEALTH facilities ,CANCER prognosis ,HEALTH equity ,HEALTH services accessibility - Abstract
Socio-economic and geographical inequalities in breast cancer mortality have been widely described in European countries and the United States. To investigate the combined effects of geographic access and socio-economic characteristics on breast cancer outcomes, a systematic review was conducted exploring the relationships between: (i) geographic access to healthcare facilities (oncology services, mammography screening), defined as travel time and/or travel distance; (ii) breast cancer-related outcomes (mammography screening, stage of cancer at diagnosis, type of treatment and rate of mortality); (iii) socioeconomic status (SES) at individuals and residential context levels. In total, n = 25 studies (29 relationships tested) were included in our systematic review. The four main results are: The statistical significance of the relationship between geographic access and breast cancer-related outcomes is heterogeneous: 15 were identified as significant and 14 as non-significant. Women with better geographic access to healthcare facilities had a statistically significant fewer mastectomy (n = 4/6) than women with poorer geographic access. The relationship with the stage of the cancer is more balanced (n = 8/17) and the relationship with cancer screening rate is not observed (n = 1/4). The type of measures of geographic access (distance, time or geographical capacity) does not seem to have any influence on the results. For example, studies which compared two different measures (travel distance and travel time) of geographic access obtained similar results. The relationship between SES characteristics and breast cancer-related outcomes is significant for several variables: at individual level, age and health insurance status; at contextual level, poverty rate and deprivation index. Of the 25 papers included in the review, the large majority (n = 24) tested the independent effect of geographic access. Only one study explored the combined effect of geographic access to breast cancer facilities and SES characteristics by developing stratified models. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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33. Complex identities, intersectionality and research approaches in millennial family caregivers in the United States.
- Author
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Aaron, Siobhan P., Waters, Austin, Tolentino, Anthony, Rascon, Aliria, Phan, Cuong, Chen, Emma, Travers, Jasmine, Jones, Miranda G., Kent‐Marvick, Jacqueline, and Thomas Hebdon, Megan
- Subjects
CAREGIVER attitudes ,WELL-being ,ATTITUDE (Psychology) ,FAMILIES ,GROUP identity ,PSYCHOLOGY of caregivers ,INTERSECTIONALITY ,NURSING research ,HEALTH equity ,MEDICAL needs assessment - Abstract
Aims: A discussion of the personal and social contexts for Millennial family caregivers and the value of including complex identity and intersectionality in Millennial family caregiving research with practical application. Design: Discussion paper. Data sources This discussion paper is based on our own experiences and supported by literature and theory. Implications for Nursing: Millennial family caregivers have distinct generational, historical and developmental experiences that contribute to the care they provide as well as their own well‐being. Complex identity, the integration of multiple identities, and intersectionality, systems and structures that disempower and oppress individuals with multiple identities, need to be addressed in nursing research so intervention tailoring and health equity can be better supported in this population. From research conceptualization and design to data analysis, data must be used intentionally to promote equity and reduce bias. The inclusion of diverse Millennial caregivers throughout all stages of the research process and having a diverse nursing research workforce will support these efforts. Conclusion: Millennial family caregivers comprise one‐quarter of the family caregiving population in the United States, and they are more diverse than previous family caregiving generational cohorts. Their needs will be more fully supported by nursing scientists with the adoption of methods and techniques that address complex identity and intersectionality. Impact: Nursing researchers can use the following research approaches to address complex identity and intersectionality in Millennial caregivers: inclusion of qualitative demographic data collection (participants can self‐describe); data disaggregation; data visualization techniques to augment or replace frequencies and descriptive statistics for demographic reporting; use of researcher reflexivity throughout the research process; advanced statistical modelling techniques that can handle complex demographic data and test for interactions and differential effects of health outcomes; and qualitative approaches such as phenomenology that centre the stories and experiences of individuals within the population of interest. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. Policy solutions to eliminate racial and ethnic child health disparities in the USA.
- Author
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Jindal M, Barnert E, Chomilo N, Gilpin Clark S, Cohen A, Crookes DM, Kershaw KN, Kozhimannil KB, Mistry KB, Shlafer RJ, Slopen N, Suglia SF, Nguemeni Tiako MJ, and Heard-Garris N
- Subjects
- Child, Humans, United States, Health Status Disparities, Policy, Emigration and Immigration, Health Equity, Racism prevention & control
- Abstract
Societal systems act individually and in combination to create and perpetuate structural racism through both policies and practices at the local, state, and federal levels, which, in turn, generate racial and ethnic health disparities. Both current and historical policy approaches across multiple sectors-including housing, employment, health insurance, immigration, and criminal legal-have the potential to affect child health equity. Such policies must be considered with a focus on structural racism to understand which have the potential to eliminate or at least attenuate disparities. Policy efforts that do not directly address structural racism will not achieve equity and instead worsen gaps and existing disparities in access and quality-thereby continuing to perpetuate a two-tier system dictated by racism. In Paper 2 of this Series, we build on Paper 1's summary of existing disparities in health-care delivery and highlight policies within multiple sectors that can be modified and supported to improve health equity, and, in so doing, improve the health of racially and ethnically minoritised children., Competing Interests: Declaration of interests AC has a contract with Organon & Co (previously part of Merck) as a clinical trainer for the Nexplanon contraceptive device. In this role, she provides training and education to resident physicians at her institution in the use of the subdermal implant device. She does not receive payment or any other form of incentive from Organon & Co in this role NH-G is the co-owner of XNY Genes. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
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35. Racial and Ethnic Disparities in Perioperative Health Care Among Patients Undergoing Cardiac Surgery: JACC State-of-the-Art Review.
- Author
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Milam AJ, Ogunniyi MO, Faloye AO, Castellanos LR, Verdiner RE, Stewart JW 2nd, Chukumerije M, Okoh AK, Bradley S, Roswell RO, Douglass PL, Oyetunji SO, Iribarne A, Furr-Holden D, Ramakrishna H, and Hayes SN
- Subjects
- United States epidemiology, Humans, Academies and Institutes, Cardiac Surgical Procedures, Anesthesiology, Cardiologists, Health Equity
- Abstract
There has been little progress in reducing health care disparities since the 2003 landmark Institute of Medicine's report Unequal Treatment. Despite the higher burden of cardiovascular disease in underrepresented racial and ethnic groups, they have less access to cardiologists and cardiothoracic surgeons, and have higher rates of morbidity and mortality with cardiac surgical interventions. This review summarizes existing literature and highlights disparities in cardiovascular perioperative health care. We propose actionable solutions utilizing multidisciplinary perspectives from cardiology, cardiac surgery, cardiothoracic anesthesiology, critical care, medical ethics, and health disparity experts. Applying a health equity lens to multipronged interventions is necessary to eliminate the disparities in perioperative health care among patients undergoing cardiac surgery., Competing Interests: Funding Support and Author Disclosures Dr Ogunniyi has received institutional research grant support from AstraZeneca, Boehringer Ingelheim, Cardurion Pharmaceuticals, and Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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36. Introduction to Special Issue on Advancing Health Equity Among Black Communities.
- Author
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Debnam KJ, Rodgers CRR, and Smith P
- Subjects
- Humans, Systemic Racism, United States, Black or African American, Health Equity
- Abstract
The current paper serves as an introduction to this special issue, Advancing Health Equity among Black Communities, in which we provide an overview of the papers included. Specifically, we summarize the papers covered in the special issue and highlight some of the common themes. The impetus for this special issue originated from a culmination of the COVID-19 pandemic, continued murders of Black people by police officers, and an unsettling political climate (e.g., Galea & Abdalla, 2020). While the impact of individual racism has been studied extensively, the insidious and pervasive impact of structural racism is less understood. Structural racism is a system in which embedded values, practices and policies facilitate and perpetrate the continued differential treatment of people based on race and becomes an almost hidden influence on the way an institution functions. For this special issue, prevention scientists were invited to submit conceptual and empirical research reflecting their understandings of structural racism as it operates in U.S. systems (e.g., education, justice, housing, workforce) and contributes to health inequities in the lives of Black Americans. The submissions also demonstrate how prevention scientists can leverage translational science to impact policies, practices, and procedures to promote equitable and sustainable change for Black communities., (© 2023. Society for Prevention Research.)
- Published
- 2024
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37. Moving from dialogue to demonstration: assessing anti-racist practice in social work education utilizing simulation.
- Author
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Lynch, Brittany
- Subjects
- *
SOCIAL work education , *HEALTH equity , *ANTI-racism , *PANDEMICS , *WHITE supremacy - Abstract
The stark racial health disparities associated with the COVID-19 pandemic coupled with the apparent rise of white supremacy in the United States (U.S.) supports the necessity of anti-racist social work education and practice. Anti-racist practice is particularly salient given the significant numbers of Black, Indigenous, People of Color (BIPOC) served by social workers across the country. This paper highlights ways in which racism continues to permeate the country and the implications for social work practice and education, and how assessment of anti-racist practice has historically and continues to be absent in social work education. After reviewing the coming changes to the Council on Social Work Education's (CSWE) Educational and Policy Accreditation Standards (EPAS) associated with centering anti-racism in social work education, the paper then offers a rationale for utilizing simulation in student assessment of anti-racist practice behaviors. In order to ensure that social work students are meeting the mandate associated with practicing through an anti-racist lens and are ready to effectively collaborate with BIPOC communities, social work students must be adequately assessed while engaged in their educational training. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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38. Mechanisms of Racialization in the U.S. Child Welfare System: How African Immigrant Families become Black.
- Author
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Suleiman, Johara
- Subjects
- *
FAMILIES & psychology , *CHILD welfare , *IMMIGRANTS , *RACIALIZATION , *BLACK people , *RACE , *HEALTH equity - Abstract
This paper applies the concept of racialization to an analysis of research on the child welfare system's racial disparities and its interactions with Black African immigrant families. This conceptual paper makes the argument that Black African immigrants are an important population of focus for U.S. child welfare system research, and that the use of a racialization lens is necessary to interpret the experiences of the increasingly diverse, Black-racialized population with the child welfare system. [ABSTRACT FROM AUTHOR]
- Published
- 2024
39. An examination of the impact of health insurance enrollment in reducing racial health disparities.
- Author
-
Song, In Jung, Ha, Inhyuck "Steve", Lee, Won Fy, and Choi, Minjung
- Subjects
HEALTH insurance ,RACIAL inequality ,HEALTH equity ,PERIODIC health examinations ,RACE discrimination - Abstract
This paper investigates the effects of health insurance enrollment on health disparities among different racial groups in the United States. Two models were constructed and estimated empirically where a health insurance disparity model was nested in the health disparity model. The Blinder-Oaxaca decomposition method was used to measure potential racial discrimination in health status. The racial gap in health disparities was broken down by endowment and treatment effects. The results show that the health status gap can be explained by potential discrimination in health insurance enrollment between Blacks and Whites. Overall, health insurance enrollment plays a critical role in explaining racial disparities and a racial disparity in the healthcare industry explains a nontrivial portion of the differences in health status. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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40. Rural chronic disease research patterns in the United Kingdom, United States, Canada, Australia and New Zealand: a systematic integrative review.
- Author
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Disler, R., Glenister, K., and Wright, J.
- Subjects
HEALTH services accessibility ,RURAL geography ,MEDICAL care of the chronically ill ,HEALTH outcome assessment ,TELEMEDICINE ,RURAL health services ,MEDICAL referrals ,CHRONIC diseases ,SYSTEMATIC reviews ,MEDICAL care research ,PATIENTS' attitudes ,RURAL health ,HEALTH equity ,INDIGENOUS peoples ,RURAL population - Abstract
Background: People living in rural and remote communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. The aim of this paper was to describe the characteristics and outcomes of studies investigating innovative models of care for people living with chronic disease in rural areas of developed countries where a metropolitan comparator was included.Methods: An integrative systematic review was undertaken. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to understand the empirical and theoretical data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom.Results: Literature searching revealed 620 articles published in English between 1st January 2000 and 31st March 2019. One hundred sixty were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations.Conclusions: This integrated review reveals that the published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease. [ABSTRACT FROM AUTHOR]- Published
- 2020
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41. Advancing health equity through nursing research.
- Author
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Still CH, Flores DD, Brooks J, and Santa Maria D
- Subjects
- United States, Humans, Health Status Disparities, Workforce, Health Workforce, Health Equity, Nursing Research
- Abstract
Background: Health inequities are major predictors of poor health and remain a complex and persistent challenge globally and in the United States. Research has documented the underlying causes and mechanisms that give rise to health disparities. However, it lacks adequate attention to the strategies needed to build upon promulgated research to address equity-based challenges to improve health., Purpose: This paper describes how building and supporting diverse research teams can play a central role in increasing the research capacity and participation of diverse populations to improve the health of individuals, families, and communities., Methods: Exemplars from work and discussion of strategies to grow nursing's health equity workforce are presented., Discussion: Actions to build and leverage partnerships to expand capacity, maximize the impact of health equity outcomes, and cultivate a supportive environment to grow the health equity scientific workforce are discussed., Conclusion: Nurse scientists can address health equity through the research process., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
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42. Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States.
- Author
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Pratt S and Hagan-Haynes K
- Subjects
- Humans, United States, Accidents, Traffic, Transportation, Public Policy, Motor Vehicles, Health Equity
- Abstract
Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.
- Published
- 2023
- Full Text
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43. Poverty or Racism? A Re-Analysis of Briggs et al. 2022.
- Author
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Drake, Brett, Jones, Dylan, Chen, Jun-Hong, Font, Sarah, Putnam-Hornstein, Emily, Barth, Richard P., and Jonson-Reid, Melissa
- Subjects
RACISM ,DATA quality ,STATISTICS ,CHILD abuse ,RESEARCH methodology ,FAMILY support ,RACE ,CONTENT mining ,CHILD welfare ,POVERTY ,DATA analysis ,WHITE people ,HEALTH equity ,PUBLIC welfare ,SOCIAL services ,RESEARCH bias ,AFRICAN Americans ,FOSTER home care - Abstract
Purpose: This paper presents a re-analysis of the National Child Abuse and Neglect Data System (NCANDS) data presented by Briggs et al. (2022). Methods: We review five components of that article: The aims, variables, analytic strategy, analysis, and conclusions. Results: We conclude that several of the NCANDS variables used are invalid at the national level, and that this is sufficient to call the research into question. We find concerning issues in analytic strategy and analysis as well, many stemming from a failure to account for the serious underreporting of services in NCANDS, and the wide variability in data quality and consistency across states. We also found what we consider to be issues with their statistical analysis. Discussion: The reanalysis presented in this article shows no pattern of disparate within Child Protective Services (CPS) outcomes by race and, therefore, no support for the Briggs et al. claim of pervasive anti-Black racism within the CPS system. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
44. Global learning: A post-COVID-19 approach to advance health equity.
- Author
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Parke, Dana Marie, Ogbolu, Yolanda, and Rowthorn, Virginia
- Subjects
- *
MIDDLE-income countries , *INTERDISCIPLINARY education , *ENDOWMENTS , *INTERPROFESSIONAL relations , *LEARNING , *WORLD health , *INTERNATIONAL relations , *HEALTH equity , *PUBLIC health , *COMMUNITY services , *COVID-19 pandemic , *WEBINARS , *LOW-income countries - Abstract
The COVID-19 pandemic has accelerated acceptance of learning from other countries, especially for high-income countries to learn from low- and middle-income countries, a practice known as global learning. COVID-19’s rapid disease transmission underscored how connected the globe is as well as revealed stark health inequities which facilitated looking outside of one’s borders for solutions. The Global Learning for Health Equity (GL4HE) Network, supported by Robert Wood Johnson Foundation, held a 3-part webinar series in December 2021 to understand the current state of global learning and explore how global learning can advance health equity in the post-COVID-19 era. This paper reflects on these cutting-edge discussions about the current state of global learning, drawing upon the highlights, perspectives, and conclusions that emerged from these webinars. The paper also comments on best practices for global learning, including adapting for context, addressing biases, funding considerations, ensuring bidirectional partnerships, community engagement, and adopting a multidisciplinary approach. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
45. A scoping review of institutional policies and recommendations for trans inpatient mental health care.
- Author
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Britt‐Thomas, Jessica Y., Kridel, Matthew, Velez, Janina, Kouame, Gail, Tharrington, Shafer, Barrett, Thomas, and Casanova, Tracy
- Subjects
MEDICAL quality control ,ONLINE information services ,CINAHL database ,MEDICAL databases ,PSYCHOLOGY information storage & retrieval systems ,SYSTEMATIC reviews ,GENDER-nonconforming people ,DECISION making ,COMMUNICATION ,HEALTH care teams ,MANAGEMENT ,LITERATURE reviews ,MEDLINE ,HEALTH equity ,RESIDENTIAL patterns ,MENTAL health services - Abstract
Accessible Summary: What is known on the subject?: International guidelines for trans‐and‐gender‐non‐conforming (TGNC) exists in outpatient settings.Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. What does this paper add to existing knowledge?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. What are the implications for practice?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. Introduction: Access to culturally sensitive care is critical for addressing known mental health disparities among trans‐and gender‐non‐conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. Aim: To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. Method: A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. Results: Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. Discussion: The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well‐being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. Implications for practice: To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
46. The global role, impact, and limitations of Community Health Workers (CHWs) in breast cancer screening: a scoping review and recommendations to promote health equity for all.
- Author
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Hand, Taylor, Rosseau, Natalie A., Stiles, Christina E., Sheih, Tianna, Ghandakly, Elizabeth, Oluwasanu, Mojisola, and Olopade, Olufunmilayo I.
- Subjects
BREAST tumor diagnosis ,OCCUPATIONAL roles ,HEALTH policy ,EVALUATION of human services programs ,MIDDLE-income countries ,DEVELOPED countries ,PROFESSIONS ,HEALTH services accessibility ,SYSTEMATIC reviews ,EARLY detection of cancer ,DISEASE incidence ,WORLD health ,PUBLIC health ,LOW-income countries ,CHI-squared test ,COST analysis ,LITERATURE reviews - Abstract
Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area. [ABSTRACT FROM AUTHOR]
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- 2021
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47. 'I just think it's weird': the nature of ethical and substantive non-ethical concerns about infertility treatments among Black and White women in U.S. graduate programmes.
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Tierney, Katherine and Urban, Amber
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INFERTILITY treatment ,AMERICAN women ,RACISM ,ETHICS ,RESEARCH methodology ,INTERVIEWING ,PATIENTS' attitudes ,RESEARCH funding ,WHITE people ,STUDENT attitudes ,POLICY sciences ,HEALTH equity ,AFRICAN Americans - Abstract
In the United States, Black women's use of infertility treatments is relatively low, despite elevated or similar rates of infertility compared with White women. Ethical concerns about infertility treatments have been identified as a potential sociocultural factor contributing to these treatment-seeking disparities. Despite documented differences, the substance of these ethical concerns is unclear. Clarifying the nature of these concerns contributes to our understanding of the social forces that shape the contexts of infertility care. Using an intersectional and comparative analysis of semi-structured interviews with Black or African American and White women enrolled in U.S. graduate programmes, this paper investigates the nature and substance of ethical concerns about medicalized infertility treatments. Three central themes emerged: (i) ethical concerns were not binary; (ii) ethical concerns varied by modality, but not by race, and focussed primarily on infertility treatments involving third parties; and (iii) substantive non-ethical concerns were concentrated among Black women and were driven by discomfort with or preferences against treatments involving third-parties. The paper concludes with a discussion of the implications of these findings for researchers, providers, and policymakers. [ABSTRACT FROM AUTHOR]
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- 2023
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48. A school‐based health centre partnership: Faculty practice, nursing student learning and wellness in youth, families and community.
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Beierwaltes, Patricia, Bell, Sue Ellen, Cornell, Rhonda, Ostrow, Laurel Gail, Schmitz, Nicole, Verchota, Gwen, Clisbee, David, Houston, Rebecca, and Eggenberger, Sandra K.
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FAMILIES & psychology ,EVALUATION of medical care ,HEALTH education ,SCHOOL health services ,HEALTH services accessibility ,COMMUNITIES ,INTERVIEWING ,MEDICAL teaching personnel ,NURSING education ,LEARNING strategies ,HUMAN services programs ,QUALITATIVE research ,HEALTH ,PHILOSOPHY of education ,RESEARCH funding ,SOCIAL classes ,MEDICAL practice ,NURSING students ,HEALTH equity ,CONTENT analysis ,EDUCATIONAL outcomes ,HEALTH promotion ,SECONDARY analysis - Abstract
Aims and Objectives: This paper describes the development of a SBHC with an innovative model of care that grew out of a partnership between a public‐school district and a university nursing programme in the midwestern region of the United States. Background and Purpose: Persistent barriers to health and health care experienced by youth are well documented. School‐based health centres (SBHCs) can improve educational and health outcomes, positively impacting health equity. Academic systems are positioned to address health care needs of the school‐aged population, yet educators face challenges of accessing quality learning placements for students and faculty practice sites. Methods: A community‐based collaborative methodology guided the planning phases that were driven by priority needs identified by families and stakeholders. With the mission of "partnering with students, families, and communities in the promotion of health and wellness through engagement in practice, education, and research," an ongoing dialogue over a two‐year period led to articulating a vision, designing a plan and implementing a nurse‐managed SBHC. The Standards for Reporting Qualitative Research (SRQR) checklist was considered in the preparation of this paper. Results: In three years, this SBHC has addressed and identified priority needs and served individual youth and families. The SBHC provides opportunities for the faculty to fulfil a practice requirement for certification and accreditation. Nursing students engage with youth and families in health education and health promotion while strengthening their technical and relational skills. Family nurse practitioner students gain valuable clinical experience. Faculty with expertise in family nursing guide family assessments, support family resiliency and direct therapeutic conversations with family units. Conclusion: SBHCs serve youth, families, and community. This academic–practice partnership has the added benefit of providing faculty practice opportunities and nursing student experiential learning. Relevance to Clinical Practice: SHBCs provide practice opportunities that address needs in individuals, families, and communities. Partnerships should be considered at academic nursing programmes to support their needs and fulfil commitments to address health equity gaps. [ABSTRACT FROM AUTHOR]
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- 2023
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49. Rural-Urban disparities in self-reported physical/mental multimorbidity: A cross-sectional study of self-reported mental health and physical health among working age adults in the U.S.
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Rhubart, Danielle, Kowalkowski, Jennifer, and Yerger, Jordan
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HEALTH services accessibility ,SELF-evaluation ,CROSS-sectional method ,MULTIPLE regression analysis ,MENTAL health ,POPULATION geography ,SOCIOECONOMIC factors ,SEX distribution ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,RESEARCH funding ,HEALTH equity ,RURAL health ,URBAN health ,COMORBIDITY ,EVALUATION ,ADULTS - Abstract
Purpose: Self-rated physical health (SRPH) and self-rated mental health (SRMH) are both linked to excess morbidity and premature mortality and can vary across rural and urban contexts. This can be particularly problematic for rural residents who have less access to important health care infrastructure. In this paper, we assess the prevalence of and rural-urban disparities at the intersection of SRPH and SRMH, specifically self-rated physical/mental multimorbidity (SRPMM) overall and across rural-urban contexts. Methods: Using a cross-sectional demographically representative national dataset of over 4000 working age adults in the U.S., we expose rural-urban differences in the prevalence of SRPMM and explore individual-level factors that may explain this disparity. Results: Approximately 15 percent of working age adults reported SRPMM, but rural adults were at higher risk than their urban counterparts. However, this disadvantage disappeared for remote rural working-age adults and was attenuated for metro-adjacent rural working-age adults when we controlled for the fact that rural adults had lower household incomes. Conclusion: Findings reveal a higher risk of SRPMM among rural adults, in part because of lower incomes among this group. This work acts as the foundation for facilitating research on and addressing rural-urban disparities in SRPMM. [ABSTRACT FROM AUTHOR]
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- 2023
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50. Barriers and facilitators to healthcare for people without documentation status: A systematic integrative literature review.
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Clifford, Namuun, Blanco, Nancy, Bang, So Hyeon, Heitkemper, Elizabeth, and Garcia, Alexandra A.
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ONLINE information services ,CINAHL database ,PSYCHOLOGY information storage & retrieval systems ,HEALTH policy ,HEALTH services accessibility ,SYSTEMATIC reviews ,RESEARCH methodology ,COMMUNITY health services ,LANGUAGE & languages ,DOCUMENTATION ,HEALTH literacy ,QUALITY assurance ,HEALTH insurance ,SOCIAL classes ,EMPLOYMENT ,CULTURAL competence ,GOVERNMENT policy ,MEDLINE ,HEALTH equity ,THEMATIC analysis ,PSYCHOLOGICAL resilience - Abstract
Aims: To identify the barriers and facilitators to healthcare for people without documentation status. Design: We conducted a systematic integrative literature review following the Whittemore and Knafl methodology. Methods: Literature search was conducted to identify studies addressing barriers or facilitators to healthcare for people without documentation status in the United States between 2012 and 2022. Studies were critiqued for quality, with results analysed thematically using the social‐ecological model. Data Sources: Searches were conducted in PubMed, PAIS, Web of Science, CINAHL and Psych Info in October 2022. Results: The review incorporated 30 studies (19 qualitative and 11 quantitative). People without documentation status encountered numerous healthcare barriers such as intrapersonal (lack of financial resources and health insurance, fear), interpersonal (language and cultural discrepancies, discrimination), community (bureaucratic requirements, anti‐immigrant rhetoric) and policy‐related barriers. Conversely, linguistically and culturally competent care, empathetic and representative staff, health navigators, safety‐net clinics and supportive federal policies emerged as key facilitators. Conclusion: These findings illuminate the complex healthcare disparities experienced by people without documentation status and underscore facilitators enhancing care accessibility. Future research is needed to explore interventions to increase access to care for this population. Impact: This paper provides a comprehensive examination of the complex barriers and facilitators to healthcare for people without documentation status in the United States. The findings support the value of universal healthcare access, a priority of the World Health Organization, and can inform healthcare policies and practices worldwide. Reporting Method: The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework. Patient or Public Contribution: No patient or public contribution was needed. Trial and Protocol Registration: The study protocol was registered with the PROSPERO database (registration number: CRD42022366289). [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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