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Abstract: This quarter, as classes resume at Meharry Medical College, we are publishing our regular issue and a supplemental issue sponsored by the Office of Minority Health (OMH). The open-access OMH supplement represents work supported by the office in the form of grants. Topics range from sickle cell disease to programs for Black and Latine youth to interpretation programs for people speaking minority languages. Papers were selected after blind peer review. (Initially, 90 abstracts were submitted and underwent review by OMH and JHCPU. Based on that review, we invited 56 authors to submit papers for peer review. The 18 published papers are the ones that did best in the blind peer review process.)The bulk of the regular ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Diet is a key modifiable risk factor for many diseases plaguing low-income communities including obesity, diabetes, and heart disease.1 Although the United States Department of Agriculture (USDA) and other organizations offer dietary guidelines, adherence to such recommendations among the U.S. population is low.2,3 Populations that are medically underserved and economically disadvantaged are at disproportionately high risk for poor diet4–6 and diet-attributable disease.7–10 These individuals often seek primary care in federally qualified health center (FQHC) settings, which serve underserved areas or populations and offer sliding scale fees.Promoting diet quality in FQHC settings is critical to supporting healthy ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: The United States (U.S.) criminal legal system is massive in both size and churn. In 2019 alone, over 722,000 youth had contact with the juvenile justice system,1 and nearly 6.3 million adults were incarcerated (jail or prison) or placed on probation or parole.2 Over 10 million jail and 600,000 prison admissions occur each year.3 In fact, the U.S. incarcerates more people than any other developed nation,4 and over half of those incarcerated are parents of young children.5,6 In turn, about one in every 14 U.S. youths have had a parent incarcerated.7,8 Well-documented racial and economic disparities exist in who is more likely to live in hyper-policed communities and to be arrested, sentenced, and incarcerated.9–12 ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Increasingly, health care systems provide support to families experiencing unmet social needs.1–3 Some examples of programs health care systems may facilitate include screening patients for issues such as food insecurity, housing instability, and transportation problems; distributing housing vouchers to patients at risk for homelessness; and navigating access to social services through case management for patients with complex social needs. In such programs, housing is generally treated as a social determinant of health, yet housing is also a physical determinant of health. Mitigating housing insecurity, reducing the housing cost-burden, and increasing access to social services and opportunities that support good ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Prior to the Affordable Care Act (ACA), Medicaid provided health coverage to limited groups of nonelderly adults: poor parents, low-income pregnant women, adults with disabilities meeting strict medical standards, and poor childless adults in some states. The ACA expanded the role of Medicaid, encouraging states to increase eligibility for lower-income adults irrespective of their parental, pregnancy, or disability status. As a result, Medicaid enrollment increased from 54.5 million in 2010 to 73.9 million in 2019.1Under the ACA, the federal government pays a higher percentage (90%) of the costs for newly eligible Medicaid beneficiaries compared with those eligible based on each state's eligibility rules in place ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: In Jamaica, a British Commonwealth country in the Caribbean, archaic laws prohibiting anal intercourse (known as the buggery law), however enforced, reinforce stigma and discrimination against lesbian, gay, bisexual, and trans people by the wider society. While an increasing number of Jamaicans hold progressive or more open-minded views toward LGBTQ people and same-sex partnerships,1 19th-century colonial laws remain embedded in the Jamaican legal code as relics of pre-independent Jamaica ruled by Great Britain. In 2011, these laws became enshrined in the Jamaican constitution through "savings law" clauses included in the Jamaican Charter of Fundamental Rights and Freedoms (also known as the Jamaican constitution) ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: HIV and justice-involvement disproportionately affect African American and Latinx male youth who make up 32% of the 18–24-year-old population1 yet account for 68% of HIV infections2 and 58% of those incarcerated.3 Justiceinvolved young adults (JIYA) have higher rates of HIV risk behaviors including early sexual debut, sex with multiple sexual partners, inconsistent or no condom use, substance use in the context of sexual activity,4,5,6 and high rates of STIs (ranging from 4–48%).7National policies to reduce HIV emphasize the importance of testing as a tool to identify HIV infection in all individuals who are positive and facilitate linkage to and retention in HIV care.10,11 However, only a limited number of studies ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Transition-aged youth experiencing homelessness (TAYEH) report higher rates of substance use compared with stably housed transition-aged youth (TAY)1 (roughly ages 15–262) and are more likely to report recent drug use and substance use disorder than other youth.3–8 Transition-aged youth experiencing homelessness may be influenced to use substances through their social networks, which are largely constituted of other TAYEH who also engage in substance use.9,10 Their networks are also less likely than the networks of other TAY to provide tangible and emotional support to help them successfully transition to more stable circumstances.10,11 Effective programs are needed to assist TAYEH in reducing substance use and ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Type 2 diabetes is a prevalent chronic condition that is associated with cardiovascular and renal disease in the U.S.1–2 These cardiovascular and renal diseases are the leading comorbidities in diabetes, significantly affecting morbidity and mortality.3 Newer agents such as sodium-glucose transporter 2 inhibitors (SGLT2i) offer cardiorenal benefits and improved glucose control while reducing the risk of atherosclerotic cardiovascular disease (ASCVD) events and slowing chronic kidney disease (CKD) progression.3–5 Additionally, SGLT2i has been shown to decrease the incidences of heart failure and hospitalizations for heart failure.6 Following the benefits of SGLT2i, the American Diabetes Association (ADA) guidelines ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Homelessness, poverty, and multiple negative health outcomes are disproportionately high in Arkansas, particularly in Little Rock (the county seat of Pulaski County and Arkansas's capital and largest city).1,2 Homelessness is both a cause and effect of health disparities in the state, and this bi-directional relationship is especially burdensome among women and children. Given the strong pathway between health and housing,3 it is not surprising that Arkansas has some of the worst maternal and child health rankings in the U.S. As of 2023, Arkansas has the highest maternal mortality rate among the 50 states,4 and infant mortality in Arkansas is the third highest at 7.38 infant deaths per 1,000 live births in 2020.5 ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: The World Health Organization defines social determinants of health (SDOH) as non-medical factors that influence health outcomes, including socioeconomic and other social factors in which people are born, grow, work, live, and age.1 Social determinants of health have been posited as potential drivers of ethnoracial differences in mental health status.2 According to the differential exposure hypothesis, ethnoracial minoritized groups have worse health outcomes due to greater stress exposure.3 When individuals are exposed to traumatic stress, including sudden, severe illness or injury, SDOH may influence their responses and recovery.4 A recent review links SDOH, including financial strain and discrimination, to poor ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: During 2010–2019, the U.S. population who identified as two or more races (i.e., Multiracial) increased by 30%.1 The increasing diversity of the U.S. is especially notable among those under age 18 years: the population identifying as Multiracial increased from 2.1% in 2010 to 8.8% in 2020 among adults 18 years and over, but increased from 5.6% to 15.1% during this time among children under age 18 years.2 These trends call for a better understanding of the experiences and health needs of Multiracial youth so that relevant health-related policies and practices can be implemented to address those needs.Some studies suggest that those identifying with more than one racial or ethnic group are more likely to experience ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Social determinants of health (SDOH) such as food insecurity, housing instability, and economic deprivation are strongly associated with numerous adverse health outcomes in Medicaid-eligible populations.1–3 Unmet social needs in turn contribute to increased health care utilization, including emergency department (ED) visits and extended hospital stays.4–8 Social determinants of health are also a documented driver of ongoing health disparities and health inequity, disproportionately affecting lowincome communities and communities of color.9,10 Accordingly, health systems have taken increased interest in SDOH-focused interventions, spending nearly $2.5 billion on SDOH programming between 2017 and 2019.11 Despite ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: According to the U.S. Census Bureau, roughly four out of every 10 Americans in 2019 was a Black, Indigenous, or other Person of Color (BIPOC) individual—including Latinx respondents who represent various racial identities, including White, but report a Hispanic ethnicity.1 Over the last several decades, researchers have highlighted the significant and persistent health inequities that exist in BIPOC communities throughout the United States.2–4 While the extent and nature of the problem of racial health inequity is still being explored by practitioners, patients, and policymakers, evidence of its effect on the health status of Americans is consistent across many sources.5Increasing provider cultural ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Health disparities, which are defined as systematic and unjust differences in the health status of different population groups, are a global concern.1 Health disparities are rooted in the historical and current unequal distribution of environmental, social, political, and economic resources. For example, living in rural and remote regions is strongly associated with a lower life expectancy and a poor health status.1,2 People who live in remote regions often encounter economic and social disadvantages, geographic and spatial barriers, and shortages of sufficient health care.1,2 These factors have been well described as social determinants of health,3 which influence life expectancy4 and mortality and/or morbidity ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Despite progress in reducing new HIV infections in the United States (U.S.), publicly available data suggest that new HIV infections continue to occur at an alarming rate.1 The project described here, Ending the HIV Epidemic (EHE) in the U.S.: A Plan for America and the National HIV/AIDS Strategy 2022–2025, has a goal of reducing new HIV infections in the U.S. by 75% by 2025 and 90% by 2030.2 It focuses on four strategies that together can end the HIV epidemic: diagnose, treat, prevent, and respond.3 In 2030, EHE's success will be measured primarily against the declared target of fewer than 3,000 new HIV infections a year.2 The goal is far off: the latest estimates in 2021 reported 36,136 new HIV diagnoses occurred ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: Health planners in African countries have in recent times embarked on system-design changes to improve the effectiveness and efficiency of public-sector management of health-commodity inventory including medicines, vaccines, testing kits, and medical devices. Of these changes, reconfiguring the multitier or multi-echelon hubandspoke arrangements commonly seen in public-sector supply logistics has gained a lot of attention. Interest in reconfiguration has grown because the traditional three-tier design can significantly undermine efforts to ensure ready and uninterrupted supplies of essential medicines and vaccines needed for routine care provision, national immunization programs, or donor-supported projects in ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: The Future of Nursing Report 2020–2030: Charting a Path to Achieve Health Equity presents a recommendation that nursing curricula prepare students to understand health equity.1 This report defines health equity as the state in which "everyone has a fair and just opportunity to be as healthy as possible."1[p.127] An important component of understanding health equity is mitigation of social determinants of health (SDOH), and an important way to accomplish this is through advocacy and political engagement. Professional nursing organizations and accrediting bodies for nursing have identified the importance of a curriculum that addresses how to engage in health policy, which may inspire advanced practice nurses (APNs) ... Read More PubDate: 2024-08-07T00:00:00-05:00
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Abstract: In August of 2009, a dedicated group of faculty and medical students from Texas Tech University Health Sciences Center (TTUHSC) School of Medicine came together to address the pressing need for affordable health care access in Lubbock, Texas (TX) and the surrounding western Texas region. Their collaborative effort led to the establishment of the Free Clinic at Lubbock Impact. This initiative was born with a clear mission: to bridge the critical gap in health care accessibility in the area, focusing specifically on uninsured, low-income individuals aged 18 to 65 years old.Searching for ways to expand and better serve the patient population, Ophthalmology Nights, also known as Ophtho Nights, were established at the ... Read More PubDate: 2024-08-07T00:00:00-05:00
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