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  Subjects -> SOCIAL SERVICES AND WELFARE (Total: 224 journals)
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Journal of Health Care for the Poor and Underserved
Journal Prestige (SJR): 0.649
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ISSN (Print) 1049-2089 - ISSN (Online) 1548-6869
Published by Project MUSE Homepage  [305 journals]
  • E-consults and Feminist Analyses of the Gig Economy

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      Abstract: The papers in the present issue range in topic from the effects of Medicaid expansion on cardiovascular disease disparities all the way to the overlooked medical needs of siblings of children with special health care needs. Here, I will delve into just a few of the issue's papers, several with feminist analyses of the informal work sector and two concerning the growing practice of e-consults.Informal workers constitute a growing segment of the labor market in the U.S. Sometimes known as independent workers, contract workers, contingent workers, ondemand workers, or gig workers, the category includes domestic workers as well as sex workers, drug dealers, and episodic employees. In some of these sub-groups, women ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Immigrants: Enriching America

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      Abstract: In March 2021, the Administration for Children and Family Services, Office of Refugee Resettlement, sent out a request for federal employee volunteers to work with migrant children in facilities along the Southwest U.S. border. I participated in this mission with a strong desire to help reunite these children with their families in the U.S. Often fleeing violence in their home countries, the children had undertaken difficult and very hazardous journeys traveling through Mexico to the U.S. They arrived as strangers in a strange land, ranging from four to 17 years of age.These children joined a larger, growing, and important demographic. Approximately 45 million—or 14% of the current U.S. population—are immigrants ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • The Impact of Medicaid Expansion on Black-White Disparities in
           Cardiovascular Disease Mortality

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      Abstract: Despite a steady decline in cardiovascular disease (CVD) mortality over the past several decades, it remains a leading cause of death among U.S. adults,1 especially those in lower socioeconomic status (SES)2 and uninsured groups.3 Not surprisingly, non-Hispanic Black adults, who are overrepresented in these at-risk populations, are disproportionately burdened by poor cardiovascular health,4,5 higher CVD mortality,1,5,6 and more CVD-related years of life lost.7 Medicaid expansion has been explored as a potential policy lever to address racial/ethnic health disparities by expanding Medicaid eligibility to nonelderly, single adults who meet certain income thresholds.8 In addition to improved insurance coverage9 and ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Improving Health Outcomes in Vulnerable Populations: The Medical-Legal
           Partnership—Colorado's Experience

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      Abstract: Social determinants of health (SDOH) may have a greater effect on health outcomes than medical interventions, yet health care providers often do not feel adequately equipped to address the health-related social needs (HRSN) of their patients.1,2 Medical-legal partnerships (MLPs) add legal professionals, trained specifically to tackle these issues, to the health care team. First created in the early 1990s and led by the National Center for Medical-Legal Partnerships, MLPs have expanded across the nation, with programs in 450 health centers and hospitals (an increase of over 100 locations from 2019).3–5 Medical-legal partnerships provide a range of legal services; several MLPs guide their service scope by the acronym ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Mexican Americans Participate in Research More than Expected while
           non-Hispanic Whites Participate Less than Expected

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      Abstract: At a time of heightened awareness regarding biases directed toward racial/ethnic minority groups, it is important to reflect upon current research inclusion practices. For the last two decades, the National Institutes of Health (NIH) has required researchers to include members of racial/ethnic minority groups in their projects when possible.1,2 However, the impact of the policy remains to be demonstrated for the Hispanic/Latinx population.1,2 According to the 2018 NIH Inclusion Data by Research, Condition, and Disease Category Report, the approximate median percentage of Hispanic/Latinx participants is 7% compared with 90% of non-Hispanic/Latinx participants.3 Considering that Hispanic/Latinx constitute 18% of the ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Directory Accuracy and Timely Access in Maryland's Medicaid Managed Care
           Program

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      Abstract: The Medicaid program provides public insurance coverage to almost 80 million Americans.1 Since its inception in the 1960s, Medicaid has seen dramatic growth in enrollment as well as significant transformations as a program. Today, states rely on managed care organizations (MCOs) to provide insurance coverage to more than two-thirds of the nation's Medicaid beneficiaries, and MCOs account for almost 50% of Medicaid spending—with $604 billion in fiscal year 2019 going to MCOs.1,2 The premise of managed care is a simple one: states enter contractual relationships with these MCOs and pay the MCOs for access to medical care networks for Medicaid beneficiaries. Although managed care seems to be simple, its implementation ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Cultural Mistrust, Ethnic Discrimination, and Depressive Symptoms among
           Hispanic Emerging Adults

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      Abstract: In the United States, emerging adults (ages 18–25) report the highest prevalence of elevated depressive symptoms (15.2%) in comparison with adolescents and all other adult age groups.1 It has been proposed that emerging adults experience higher depressive symptomatology because this developmental period is marked by transitional life changes, high levels of instability, and taking on new and challenging developmental tasks.2,3 In addition to normative developmental risk factors, Hispanic emerging adults are disproportionately exposed to chronic sociocultural stressors (e.g., ethnic discrimination) that place them at an elevated risk of experiencing depressive symptoms.4 Hispanics report a higher prevalence of mild ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • A Preliminary Study of Clinical Psychology Doctoral Students' Training in
           Food Insecurity Assessment and Resource Provision

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      Abstract: Food insecurity (FI), or lack of access to a sufficient amount of nutritious food, is associated with poor health outcomes,1,2 and has increased dramatically in the United States during the COVID-19 pandemic.3–5 People with mental health challenges have elevated rates of FI compared with the general population, and FI is especially prevalent among those with serious mental illness6 and mood disorders.7 Food insecurity is associated with poor mental health outcomes8 and with increased risk for mental illness (specifically, mood disorders).9–12 Further, having an anxiety or mood disorder is associated with an increased risk for FI,13 indicating a bidirectional relationship between mental health and FI.14Given that FI ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Perceptions of Practitioner Support for Patient Autonomy are Associated
           with Delayed Health Care Seeking among Haitian Immigrant Women in South
           Florida

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      Abstract: Florida is home to more than half a million individuals of Haitian descent, the majority of whom reside in the southern region of the state.1 The Haitian community in South Florida experiences a high burden of preventable health conditions that are detectable through routine screening and treatable at early stages of disease progression, including cervical cancer, endometrial cancer, and human immunodeficiency virus.2–5 However, prior research indicates that Haitian immigrants have low utilization of preventive health services and often delay seeking clinical care for symptomatic disease.6–11 Understanding factors that adversely affect timely engagement with the formal health care system is critical for reducing ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Peer-reviewed Nutrition-Affiliated Journals from Sub-Saharan Africa: A
           Regional Snapshot

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      Abstract: Africa is a continent with high incidence of different forms of malnutrition, mostly in sub-Saharan African (SSA) countries.1 These countries are undergoing important changes at demographic, economic, and ecologic levels.2,3 Although governments express continuous commitment to public health solutions, their capacity to achieve the United Nations' Sustainable Development Goals is very low, as seen in the fact that less than 20% of SSA countries are on track.4 Indeed, the 2015 United Nations report5 reported that the prevalence of malnutrition among children under five years of age in SSA accounted for one third of all undernourished children globally. The World Health Organization indicated that the rates of ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Non-Migrant Paid Domestic Workers and Depressive Symptoms: A Mixed-Methods
           Systematic Review

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      Abstract: Paid domestic work (PDW) is mostly an informal type of job in which approximately 76 million individuals participate worldwide; 76% of them are women. Paid domestic work accounts for almost 5% of the global employees and 9% of the female wage and salaried workforce.1 Eighty-five percent (64.5 million) of all paid domestic workers (PDWs) are non-migrant workers living in low, lower-middle, and upper-middle income countries (LLMUMIC).2 Besides housekeeping, PDW activities include caregiving tasks (e.g., children, elderly) that play a crucial role in the reproduction of domestic units and frequently supersede functions of the formal health and welfare systems.3Paid domestic work is considered one of the most ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • The Association of Traumatic Brain Injury with Neurologic and Psychiatric
           Illnesses among Individuals Experiencing Homelessness: A Systematic Review
           and Meta-analysis

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      Abstract: Homelessness is a chronic public health problem that has been notoriously difficult to treat,1 with recent estimates suggesting that over six million individuals are homeless in the United States and European Union today.2,3 Homeless and marginally housed individuals experience myriad mental and physical health problems associated with their lack of stable housing,4 which are compounded and sometimes caused by inadequate access to regular primary and specialty health care.5,6Traumatic brain injury (TBI) among the homeless constitutes a silent epidemic.7 Traumatic brain injury is "caused by a bump, blow, or jolt to the head, or penetrating head injury."8[para.1] Importantly, not all head strikes result in TBI. The ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Siblings of Children with Medical Complexity—A Vulnerable Population
           in the Medical Home

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      Abstract: Children with medical complexity (CMC) are a small but significant and growing population within pediatric health care. Defined as children that have one or more chronic conditions, functional impairment, substantial needs that create a significant impact on the family, and high health care resource utilization,1 CMC are increasingly recognized as needing their own research agenda. Recent analyses have highlighted areas for further research, including quality outcomes, care models, health care utilization, social determinants of health, family resilience, and transitions to adult medicine.1–3There is a growing body of evidence on primary care models for CMC, including some that shows the medical home model ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Discrimination Exposure Based on Race, Gender, and Sexual Orientation of
           Veterans Affairs Health Administration Patients

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      Abstract: Identity-based discrimination within the U.S. health care system is well documented across a number of social identities (e.g., race/ethnicity, gender, sexual orientation).1–4 For example, reported prevalence rates of identity-based health care discrimination in the U.S. range between 4.2% and 52.0% among various racial/ethnic minoritized groups,5 between 10% and 39% among cisgender women,6,7 and between 2% and 41.8% among sexual and gender minoritized (SGM) individuals.8* Risk for identity-based discrimination in health care contexts is compounded among individuals who hold multiple marginalized identities, as evidenced by relatively higher prevalence rates among racial/ethnic minoritized women (versus men) and ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • In Our Own Voices: The Lived Experience of Sex Workers in Philadelphia who
           Identify as Women

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      Abstract: Lack of knowledge among health care providers of the lived experience of sex workers is a public health problem. The lived experiences of sex workers are intertwined with their health. When health care providers and public health officials lack understanding regarding how exactly these lived experiences affect the health, health encounter preferences, and health care utilization of sex workers, then providers are not equipped to adequately address the health care needs of this population. At present, research expanding such knowledge is lacking.Sex workers who identify as women have multiple health risk factors that include unstable housing, unemployment, incarceration, mental illness, emotional/physical/sexual ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Supplemental Nutrition Assistance Program Participation is Associated with
           Lower Health Care Spending among Working Age Adults without Dependents

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      Abstract: Achieving consistent access to food is a struggle for Americans living in poverty. According to the USDA, an estimated 35 million Americans experienced some form of food insufficiency1 for an average of seven months2 in 2019 primarily due to lack of money,1 and recent estimates suggest that the pandemic-induced economic downturn has increased the incidence of food insecurity.3 Worry about the next meal, lack of access to nutritious foods, as well as unmet health care needs due to buying food instead of medications or medical care can have long-term health consequences for individuals living with food insecurity.4–8Research shows that participation in the federal Supplemental Nutrition Assistance Program (SNAP) ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Factors Associated with Diabetes Outcomes among Rural African Americans

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      Abstract: Diabetes is a public health problem and a major contributory risk factor of cardiovascular disease (CVD), the leading cause of death in the United States that affects approximately half of the population.1,2 People who self-identify as African American bear a disproportionate burden of diabetes that is directly linked with adverse cardiovascular health outcomes.2–11 African American men and women have higher rates of diabetes (12.2% and 13.2%, respectively) than non-Hispanic White men and women (8.1% and 6.8%, respectively).2,12–15 Prediabetes is a precursor of diabetes that also affects a larger percentage of African Americans (36.9%) than non-Hispanic Whites (33.9%).16 Further, African Americans are more likely ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Expanding Access to Psychiatric Care: Implementation of Psychiatric
           e-Consultation and Tele-consultation for Primary Care in a Safety-net
           Health System

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      Abstract: A substantial portion of mental health care in the United States is provided by primary care providers (PCPs).1,2 Critical factors underlying this phenomenon include the fact that up to 45% of primary care patients meet criteria for a mental health disorder3,4 and the limited availability of specialty mental health services in many communities.5 In particular, access to specialty mental health services may be disproportionately limited for impoverished, racial and ethnic minority, and rural populations.6Telehealth has been seen as one tool to promote access to psychiatric care.7 Although telehealth often entails the direct provision of care to a patient via a video connection, specialty telehealth can refer to a ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • The Impact of eConsults on Access to Specialty Care for the Uninsured in
           Rural Texas

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      Abstract: Limited access to specialty care for the uninsured is a large and growing problem, and a significant contributor to health inequality in the U.S.1 While the national network of federally qualified health centers (FQHCs) and other safety-net clinics helps ensure access to primary care, lack of insurance is a major limiting factor for patients in need of specialty care.2 Limited access to specialists can result in delayed or deferred care for potentially serious problems, leading to poorer health outcomes and higher downstream costs.2,3One solution to help address limited access to specialty care is the use of eConsults. An eConsult allows primary care providers (PCPs) and specialists to communicate electronically ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Experiences of United States Graduates at the Latin American Medical
           School in Cuba: A Road Less Traveled

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      Abstract: Goal 3 of the United Nation's 2030 Agenda for Sustainable Development calls for member nations to "ensure healthy lives and promote well-being for all,"1[p.14] with a specific focus on achieving equitable access to and delivery of health care.1 Among other challenges, barriers to equitable health care include the maldistribution or shortage of health care providers and inadequate training for health care providers working in low-resource settings.2 Data show that academic primary care medical education programs, where they are supported, are associated with decreased health disparities by country.3 Primary care is defined as first-contact, continuous, comprehensive, and coordinated care, undifferentiated by disease ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Interest in Receiving HIV PrEP Among Biological Male Latinx Migrants at
           High-Risk of HIV Living in Mexico

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      Abstract: In Tijuana, Mexico, which borders California in the United States, HIV prevalence rates exceed the Mexican average,1 suggesting a localized epidemic. HIV transmission is tied to multiple factors including the city's location on drug trafficking/production routes, associated injection drug use, and sex tourism that is tied to a quasi-legal red light district.2 Significantly, Tijuana also experiences high volumes of domestic and international migration, including from Central Americans and Mexican migrants deported from the United States.3 Deported and transnational migrants (i.e., from another country to Mexico) are vulnerable to discrimination, homelessness, police victimization and incarceration due to their ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • California's Central Valley: Teaching Social Determinants of Health and
           Cultural Humility Through an Interprofessional, Overnight Road Trip

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      Abstract: Universities across the country have committed to providing students more active learning opportunities.1–4 This move away from the student as passive recipient of knowledge has also reached health professions education in the form of games and simulations,5,6 service learning,7 reflective writing,8 small group learning,9,10 and collaborative clinical case analysis.11Academic health campuses and training programs also face mandates to engage meaningfully with their surrounding communities. The elimination of health inequities will likely be realized only in partnership with community members, including in community-based participatory research approaches.12 Interprofessional approaches to the elimination of health ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Effectiveness of Home Gardening in Improving Food Security and Health in
           Chacraseca, Nicaragua: A Pilot Study

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      Abstract: Nicaragua is a low-income country that presents with high levels of low nutrient intake along with increasing levels of excessive calorie intake.1 Excessive calorie intake usually results in overweight and/or obesity. Overweight is defined as having a body mass index (BMI) 25.0 to < 30 and obesity BMI >= 30 and in Nicaragua, the incidence of overweight and obesity in the general population have been found to be 46% and 15%, respectively.2 On the other hand, the level of low nutrient intake was reported to be 17% in 2015.3 Although the level of undernourishment in Nicaragua has been declining over the years, it is now accompanied by rising levels of over nutrition.4 The existence of low nutrient intake together with ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Rhode Island's Response for COVID-Positive Individuals Experiencing
           Homelessness and Housing Insecurity: A Qualitative Process Evaluation

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      Abstract: The COVID-19 pandemic and resounding public health calls to stay at home present clear and urgent challenges for those experiencing homelessness and housing insecurity. People experiencing homelessness may live in environments more hospitable to COVID transmission, such as congregate shelter settings with transient resident populations or encampments where access to basic hygiene supplies may be limited.1 Several recent studies have already documented high rates of transmission within congregate shelters.2–5 In response to these challenges, states across the U.S. have turned to utilizing hotels and motels to temporarily shelter people, reduce congregate shelter populations, and/or isolate COVID-positive individuals ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Assessing the Health Status and Needs of Informal Workers at Texas Truck
           Stops

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      Abstract: Informal workers, who make up 50% of the global workforce, are underpaid, work long hours, and work in hazardous settings.1 While figures vary, it is reported that approximately 37% of nonretired adults in the U.S. are engaged in informal work.2 Informal workers (also commonly known as independent workers, contract workers, contingent workers, on-demand workers, and gig workers) participate in nonstandard work arrangements that deviate from traditional arrangements between employee and employers.2 Informal workers are not considered part of the U.S. labor force, and often do not have an established salary, employment benefits, a regular work schedule, or long-term employment contracts.2Truck stops across North ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Location, Location, Location: The Affordable Care Act's Impact on Free
           Clinics Depends on What State They're In

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      Abstract: The Affordable Care Act (ACA) has significantly increased the availability of health insurance coverage to low-income people. An estimated 20 million Americans have gained coverage since the law's enactment.1 Yet, significant gaps in coverage, affordability, and access remain—and are projected to remain far into the future. Today, there are an estimated 30 million uninsured2 and 44 million underinsured.3 Low-income Black and Latinx adults are at greatest risk of being uninsured and underinsured.4 Their risk of being uninsured is heightened in the 12 states that have not adopted the Medicaid expansion.5,6Against this backdrop, safety-net organizations such as public hospitals, community health centers, health ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Facilitators and Barriers to the Use of Sexual and Reproductive Health
           Services among Adolescents in a Rural Ghanaian District

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      Abstract: Universal access to sexual and reproductive health (S&RH) services is the seventh target of the United Nations' Sustainable Development Goal three, which aims at ensuring healthy lives and promoting well-being for all at all ages.1 There is, however, a global risk of missing target seven of Sustainable Development Goal three if drastic steps are not taken to ensure equitable access to S&RH services among adolescents.1 This need for keen policy interest in adolescent-focused S&RH services is necessitated by the high risk of S&RH problems among adolescents due to their rapidly changing psychosocial and physiological characteristics.2,3 These changing psychosocial and physiological characteristics of adolescents often ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Association of Urban-Rural Residence and Concurrent HIV Infection and
           Opioid Use Disorder Among Medicare Beneficiaries—United States, 2020

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      Abstract: Although effective interventions have resulted in a decrease in new HIV infections during recent years, an estimated 34,800 new HIV infections still occurred during 2019 because of ongoing barriers to receiving effective HIV prevention and care among vulnerable U.S. residents.1 Multiple risk factors are associated with HIV transmission among disproportionately affected populations in selected geographic locations. Injection drug use is a serious obstacle to ending the HIV epidemic.2,3 Previous analyses of national surveillance and survey data in the United States indicate that mortality and morbidity vary greatly across the geographic continuum between urban and rural areas.4–6 Place of residence is a major factor ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Latent Tuberculosis Infection Cascade of Care among Asylum Seekers in
           Verona, Italy

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      Abstract: Tuberculosis (TB) is the 10th leading cause of death worldwide.1 Among the estimated 10.4 million incident cases of TB occurring globally in 2016, the largest proportions were seen in Asia (45%) and Africa (25%), while the World Health Organization (WHO) European Region accounted for only a very small proportion of cases (3%).2 In 2016, there were 58,994 cases of TB reported in the 30 countries of the EU/EEA (European Union and European Economic Area), accounting for a low TB incidence rate (<10 per 100,000 population), which mainly affected vulnerable populations such as migrants.3 Italy has a low incidence of TB (6.6/100,000), with 4,032 new cases identified in 2016, of which 62% involved foreigners.4Though the ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Applying the Health Stigma and Discrimination Framework to Assess HIV
           Stigma among Health Care Professionals: A Mixed Methods, Community-Based
           Participatory Research Study

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      Abstract: Stigma, understood as "an attribute that is deeply discrediting within a particular social interaction,"1[p.3] affects health and quality of life. Specifically, stigma contributes to poor mental health, increased substance use, social marginalization, and lower quality of life,2–5 and is particularly detrimental to care engagement when encountered within health care.6–9 The Health Stigma and Discrimination Framework (HSD),10 a global, crosscutting framework informed by theory, research, and practice delineates the stigmatization process in the context of health. According to the HSD framework, drivers of stigma are inherently negative (e.g., fear of infection, lack of awareness) and tend to occur at more ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Colorectal Cancer Screening with Mailed Fecal Immunochemical Tests and
           Telephone Outreach at a Community Health Center during the COVID-19
           Pandemic

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      Abstract: In the United States, colorectal cancer (CRC) ranks as third in incidence and third in mortality among cancers.1 In addition, non-Hispanic Black (hereafter Black) patients have the second highest CRC incidence and mortality rates behind Alaska Natives when compared with patients of all other ethnicities and races.2 Lower rates of CRC screening in Black patients appear to be primarily responsible for the higher incidence and mortality.3 Furthermore, the screening disparity primarily stems from a combination of socioeconomic factors, including lack of equitable access to health care and mistrust of medical systems due to the historic mistreatment of Black patients.3,4 This has led many patients to be skeptical of the ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Association of Inadequate Provider Networks with Unmet Need for Health
           Services and Self-Employment among People with Disabilities

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      Abstract: More than a quarter of all Americans are living with at least one disability, making people with disabilities (PWD) a key demographic group for improving health care in the United States.1 People with disabilities are known to be at a higher risk of having both physical and mental health complications in addition to facing greater economic disadvantages than people without disabilities.1–4 As a result, a diverse array of health care professionals are often required in order to meet the needs of PWD. While the majority of PWD qualify for insurance coverage through Medicaid or Medicare, 36.1% of all PWD have private insurance, typically through an employer-sponsored or a marketplace plan.5 Given the health care needs ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • The Association between Health Professional Shortage Area (HPSA) Status,
           Work Environment, and Nurse Practitioner Burnout and Job Dissatisfaction

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      Abstract: A shortage of primary care providers has significant implications for patients, communities, and the United States (U.S.). Currently eighty-three million Americans live in areas without adequate numbers of health care providers,1 which is a matter for concern as insufficient primary care provider supply is associated with negative outcomes, including higher rates of hospitalization, lower patient-rated health quality, and even higher mortality.2–6 Access to primary care is key to the prevention and management of chronic and acute health conditions, and thus improved populationlevel health.7 Despite the well-demonstrated importance of primary care in improving the health of populations and decreasing health ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Perceptions and Understanding of Patients with Cardiovascular Disease and
           Non-Licensed Caregivers about Patient-Centered Care: An Exploratory Study
           in Central Appalachia

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      Abstract: Cardiovascular diseases (CVDs) remain the leading cause of death in the United States (U.S.), accounting for one in three deaths annually.1–3 Disparities in CVD outcomes and risk factors exist across demographic groups, socioeconomic strata, and geographic areas2–4 with places such as Central Appalachia having disproportionately high burdens.4,5 One national public health goal is to reduce/eliminate these disparities at both individual and population levels.6 Patient-centered care (PCC) is a model of health care delivery for improving both physician/patient outcomes and quality of care that has been heavily promoted over the past decades because of the potential to contribute to these efforts to reduce/eliminate ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Inconsistent Medicaid Coverage is Associated with Negative Health Events
           for People with Epilepsy

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      Abstract: Medicaid—a state-administered health insurance program for pregnant women, people with disabilities, some low-income people, some families and children, and some elderly—covers over 70 million individuals in the United States each year.1,2 While the program is federally coordinated, eligibility/enrollment criteria and processes vary widely because it is administered by the states. Although policies vary across states, an individual often must renew their Medicaid every 12 months, but changes in income or employment or not having the support to help with renewal can result in disruptions in coverage.3,4 Given these complexities, there has long been attention to gaps in Medicaid coverage, often referred to as ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Rethinking the Digital Divide: Using an Internet Survey in a Flint Water
           Crisis Medicaid Population

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      Abstract: Studies suggest low-income populations have limited access to use the internet compared with higher-income populations.1–2 In 2019, the Kaiser Family Foundation reported that 7% of Americans did not have internet access at home and 42% were on Medicaid or uninsured and the larger share were African American and Hispanic.3 With regard to income, 18% of people 100% below the federal poverty level (FPL) had no internet access at home compared with 3% of people earning 400% or more of FPL.4 Further, a 2019 study shows that 97% of adults earning over $100,000 owned a smart phone compared with 71% of those earning $30,000 or less.5 Computer literacy, unaffordable internet services, and lack of access to internet-ready ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Using A Customized SMS Program to Promote Colonoscopy Adherence and
           Support Bowel Cleanliness for Spanish-speaking Patients

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      Abstract: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer death in the United States.1 Although CRC-related morbidity and mortality can be reduced through early detection and treatment, almost two-thirds of patients are diagnosed with advanced stage disease. Rates of CRC screening are lower than for other preventable cancers, particularly among ethnic minorities, non-English speakers, and low-income individuals who present at later stages with higher mortality rates than non-Hispanic White, English-speaking, and higher-income patients.2,3 Overall incidence rate of CRC is declining among Hispanic/Latino people. However, Hispanic people aged younger than 50 years are seeing an ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • School-based Stock Inhaler Programs and Neighborhood Disadvantage

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      Abstract: In the United States (U.S.), children spend most of their waking time at school.1 At least 10% of school children have asthma, a chronic respiratory condition that can cause life-threatening symptoms at any time without warning 2,3 During an asthma attack, symptoms can be ameliorated with the prompt administration of rescue medication (albuterol sulfate). Accordingly, all children should have ready access to it while at school—schools should be prepared to administer it at a moments' notice.4 Despite this necessity, few schoolchildren have access to this potentially life-saving medication.5 Youth belonging to racial/ethnic minority and disadvantaged groups have even less access owing to greater difficulties ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Availability, Utilization, and Quality of Basic Emergency Obstetric and
           Newborn Care Services in Farta District, Rural Health Centers, Ethiopia

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      Abstract: The World Health Organization (WHO) estimates that up to 15% of expected births worldwide develop life-threatening complications during pregnancy, delivery, or the postpartum period.1 The heavy burden of maternal and reproductive health problems remains a challenge for sub-Saharan Africa (SSA).2 The health and survival of the newborn are closely linked to the care of the mother before and during pregnancy, childbirth, and the postnatal period.3 The majority of maternal mortality is due to direct obstetric events such as hemorrhage, hypertension, obstructed labor, sepsis, and complications of abortion.4 The high number of maternal deaths in some parts of the world reflects inequalities in access to quality health ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Services and Challenges at a Native American Residential Substance Use
           Disorder Treatment Center during the COVID-19 Pandemic

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      Abstract: An upsurge in overdose deaths in 20201 and reports of possible increases in alcohol consumption2,3 underscore the need to avoid substance use disorder (SUD) treatment service disruptions during the COVID-19 pandemic.4,5 Yet, it can be expected that many residential treatment centers—a critical component of the nation's SUD treatment system—are experiencing challenges regarding the infrastructure and support needed to implement infection control protocols.6 This may be especially so for residential treatment centers serving Native Americans, a population that faces pronounced social and economic inequities,7 has commonly practiced closeness—not social distancing,8 and often lacks access to culturally appropriate ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Developing a Public Health Improvement Consortium in Appalachian Kentucky:
           Harnessing the Power of the Local Collective

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      Abstract: To improve the health of a population is a complex, multi-faceted endeavor. The World Health Organization (WHO) defines public health as "the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society."1[p.1] (Emphasis added by the authors.) Such an organized effort is particularly difficult in an area known for geographic isolation and poor health.2However, within the Appalachian counties of Breathitt, Lee, Leslie, Letcher, Wolfe, Knott, Owsley and Perry of the Kentucky River District Area Development District (KRADD), the area is also known for strong relationships among people who call this area home and the endeavors they spearhead to improve the health ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
  • Beyond Primary Care: Renewing the Community Health Center Vision for
           Today's Health Crisis

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      Abstract: When H. Jack Geiger and John Hatch initiated The Tufts Comprehensive Community Health Action Program and its Tufts-Delta Health Center in Bolivar County, Mississippi in 1966, the aims were not limited to health care. The Program also embraced community development and positive social change. Access to food, housing, clothing, water and sanitation, economic development, job training, education, and transportation were necessary to break cycles of poverty and deprivation. Access to quality comprehensive health care was necessary but not sufficient.1 As we learned from an innovative population health program over a course of several years, rather than evanescing, Geiger and Hatch's vision of population health can ... Read More
      PubDate: 2022-05-11T00:00:00-05:00
       
 
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