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Abstract: Hospital length of stay (LOS), or the number of days a patient is admitted to the hospital, is a widely used metric reflecting care provided. Increased LOS is associated with increased rates of hospital-associated infections, pressure wounds, falls, and other important complications.1 Hospital length of stay is used to determine individual costs per patient and as a trend to determine overall reimbursement rates for hospitals.Hospital LOS varies not only with medical diagnoses and treatment, but with social determinants of health (SDOH). Studies of patients admitted for trauma, cancer, and chronic illnesses such as heart failure have shown insurance coverage, race, poverty, and ZIP Code have all been associated ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Individuals living in or near poverty face a number of challenges in securing access to public assistance.1,2 While these challenges are nuanced and complex, systematic program barriers are major sources of incomplete program take-up and maintenance.3–10 At the same time, not all public programs face the same barriers; barriers are closely connected to the social construction of target populations as either deserving or undeserving.11–13 Importantly, the behaviors and characteristics of target populations, such as reciprocity, compliance with dominant social norms, or need,14–16 as well as the race and ethnicity of beneficiaries, play an important role in shaping perceptions of programs and beneficiaries.17–20One ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Since 2014, there has been an increasing focus on the well-being of the health care workforce, an effort that was brought into the spotlight during the COVID-19 pandemic. Improving health care workforce well-being (and decreasing burnout), introduced as the quadruple aim by Bodenheimer and Sinsky, is a prerequisite for improving health care quality and outcomes.1 Burnout—characterized by a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment1—is prevalent in health care. Factors driving burnout among health care professionals include work process inefficiencies (including increased clerical burden), organizational climate, deterioration of meaning in work, and poor ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: In the United States, minoritized populations including Black, Latinx, and Asian people experienced a disproportionate share of infection, hospitalization, and mortality due to COVID-19.1 This was not unexpected. These and other health inequities have been linked to a range of social factors that affect individuals but are driven by structural issues operating at the community and policy levels.2,3 Long-standing policies such as redlining have resulted in entire communities experiencing lack of jobs, limited transportation access, inadequate housing, poorly performing schools, and high incarceration rates.4 This is starkly on display in the Chicago metropolitan region where publicly available data show drastic ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: According to the Kaiser Family Foundation, social determinants of health are defined as "the conditions in which people are born, grow, live, work and age that shape health."1[p.1] The U.S. model of health care, typified by a fee-for-service structure, is ill-suited to address these upstream causes of chronic illness.2 Therefore, early nonmedical intervention against certain social and environmental factors that affect health can provide a high value in reduced health care costs and improved population health.As a complement to skilled medical care, the role of the community health worker (CHW), as defined by the Meharry-Vanderbilt Community Health Worker Collaborative, is to "assist individuals and communities to ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: There are 38.4 million people in the United States living with diabetes,1 a condition that poses a significant physical, economic, and psychological burdens. Diabetes broadly refers to a chronic condition defined by elevated glucose levels. The two most common types are type 1 diabetes, which accounts for 5–10% of cases and is characterized by immune destruction of the insulin producing cells in the pancreas, and type 2 diabetes, which accounts for 90–95% of cases and is characterized by insulin resistance. Decades of research have revealed stark disparities in diabetes prevalence and outcomes, with a disproportionate share of the disease and its complications borne by racially marginalized and low-income ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Nearly 19% of American children live in rural areas, and the lives of these children are markedly different from those of their urban peers.1 Importantly, rural children are more likely to live in poverty than urban children; more than 80% of counties with persistent child poverty are rural, and in 2019, 21.1% of rural children were poor, compared with 16.1% of urban children.2,3 Rural children also experience worse health outcomes, with mortality rates higher than those of urban children.4 Rural children are more likely to have their oral health reported as fair or poor and are less likely to have received fluoride treatment or dental sealants compared with urban children.5Rural children are more likely than urban ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Addressing disparities in the uptake of the COVID-19 vaccine emerged as a key priority of the public health response to COVID-19. Early reports of vaccination coverage identified that rates of vaccination were lower in counties with greater levels of social vulnerability, especially in terms of socioeconomic status, household composition, and disability.1,2 Additionally, vaccination coverage has been reported to be lower in counties where a greater proportion of the population is uninsured, lacks computer or internet access, and lives below the federal poverty line.3 While mass vaccination campaigns have made the COVID-19 vaccine available to those without insurance coverage, other socioeconomic barriers to ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Over sixteen million Californians speak a language other than English, and 6.4 million report speaking English less than "very well."1 Individuals with limited English proficiency (LEP) often have worse health outcomes, including higher hospital readmission rates within 30 days,2,3 medication errors,4 undiagnosed hypertension,5 and lower breast cancer screening rates6 compared with English-proficient individuals. These disparities in health outcomes result from barriers to clinician-patient communication7 and, therefore, accessing care.8,9 Evidence indicates that support from professional medical interpreters as opposed to ad hoc interpretation by family and friends for LEP patients can reduce miscommunication ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Long COVID is a condition that develops after an initial COVID-19 infection and is characterized by symptoms that persist for at least three months.1 These symptoms can include fatigue, muscle aches, shortness of breath, and headaches, and are usually episodic in nature, varying in presence and intensity from day to day.2 This variability makes it challenging for people with long COVID to engage in tasks such as working and activities of daily living.2Estimates of long COVID's prevalence vary due to differences in how it is defined and differences in the populations studied.3 For example, the Centers for Disease Control and Prevention defines long COVID as symptoms lasting three months or more post-infection and ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: As climate degradation creates increasingly hot summers, the health risks to agricultural workers and other outdoor laborers will intensify. The damaging effects of working in the heat have been demonstrated in multiple studies.1,2,3,4,5,6,7,8,9 Despite the evidence of heat-exposure damage, national worker heat-exposure protections do not exist. Some states have barred cities and counties from enacting local heat-protection regulations. To reduce heat-related morbidity and mortality, health advocacy and regulations to protect our workforce are needed.This study examined working conditions of agricultural workers laboring in the intense Florida summer heat and mild winters, focusing on seasonal patterns of rest ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: In Canada, public housing serves as a vital resource for low-income individuals and families, with hundreds of thousands of Canadians relying on these services across major urban centers.1 In the Province of Quebec, the Mauricie region alone features over 333 public properties, including 2,960 low-rent housing units and various community and affordable housing options.2 Research on the health of public housing residents reveals significant disparities. A study conducted in Quebec using data collected from the Canadian Community Health Survey in 2007–2008 indicated that residents of public housing tend to report poorer overall health than private renters; they are more likely to experience chronic conditions such as ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Mood and anxiety disorders are widely prevalent among new and expectant mothers. Approximately up to 20% of women in the perinatal period experience depression, which can begin during pregnancy and persist up to 12 months postpartum. Additionally, around 16% experience anxiety or related disorders.1–3 However, there is limited research on the prevalence of perinatal depression and anxiety among Latinas in the United States (U.S.). Previous cross-sectional studies indicate that Latinas residing in the U.S. experience perinatal depression at rates as high as 52%4,5 and 59% report elevated anxiety levels.6,7 Without effective support, depression and anxiety can have a negative impact on mothers' psychological ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: As of 2024, over 190,000 women, the majority of whom are between the age of 25 and 49, are incarcerated in prisons and jails across the United States; moreover, these statistics may underestimate all individuals who will require reproductive health care during their period of incarceration given the exclusion of transgender and nonbinary individuals in many publicly available datasets.1,2 Individuals who are incarcerated often hold multiple marginalized identities and have histories of trauma and health conditions that result from multiple forms of structural violence such as racism, classism, and sexism.3 For instance, this structural oppression manifests itself through the disproportionate incarceration of Black ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Appropriate management of dietary behavior is a key approach for effective glycemic control among those with diabetes mellitus.1 Cultural patterns can influence dietary behavior.2 Certain cultural groups have higher diabetes incidence; Hispanic people have a higher incidence of type 2 diabetes mellitus than non-Hispanic White people.3 The role of Hispanic acculturation in the United States (U.S.) has mixed findings for diabetes outcomes.4Patient management of dietary behavior can improve patient health by lowering hemoglobin A1c (HbA1c) levels. Diabetes self-management education and support delivered by certified diabetes educators using the meal-plate method reduced HbA1c levels at six months among those with ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Stroke is a condition that affects the arteries delivering blood to and within the brain. Of all strokes, 82.7% are ischemic, caused by a clot that obstructs blood flow to the brain, while 17.3% are hemorrhagic, caused by a ruptured brain blood vessel.1 Ischemic stroke (IS) is the second leading cause of death and the primary cause of disability globally.2 In Colombia, cerebrovascular diseases were responsible for 20.9% of deaths in 2021.3Reperfusion therapies, such as intravenous thrombolysis (IVT) and mechanical thrombectomy (MT), have been a major breakthrough in IS therapy, demonstrating efficacy in reducing the overall burden of disability in well-designed clinical trials.4 Mechanical thrombectomy is an ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Members of racial and ethnic minority groups continue to be underrepresented in the health care workforce. For instance, African Americans and Hispanics constitute only about 4% of the U.S. physician workforce, despite constituting a much larger percentage of the U.S. population.1 This is attributed to many barriers throughout the pre-health journey such as socioeconomic barriers and navigation through a complex, expensive application process.2 In addition, pre-health students face additional expectations of sustaining good grades, adding extracurriculars, and being involved in projects off campus.3 More than ever, pre-health pathway programs play an important role as support systems for socioeconomically ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Many cancer patients are burdened not only by the illness itself, but by the social drivers of health (SDOH) that add to the cumulative weight of the non-medical aspects of their lives co-occurring with cancer. Income insecurity, lack of health insurance, and social isolation are significantly associated with cancer mortality, and patients describe grappling with complex changes in their lives, often linked to the financial hardship caused by cancer.1,2 Some SDOH, such as transportation barriers, can be alleviated through patient navigation or social work interventions. However, a subset of SDOH referred to as health-harming legal needs (HHLN),3 are best resolved through legal intervention. Examples of HHLN include ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: A growing number of observations are consistent with the view that workplace violence (WPV) in the health care sector is on the rise. A 2022 survey of the American College of Emergency Physicians found 85% of respondents to hold that "the rate of violence experienced in emergency departments has increased over the past five years."1 Moreover, two-thirds of the emergency medicine physicians in question reported being assaulted in the past year alone.1 A more recent Press Ganey survey of nursing personnel concluded that "more than two nursing personnel were assaulted every hour" for a total of "57 assaults per day, 1,739 assaults per month, and 5,217 assaults per quarter."2[n.p.] These and other recent observations ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Homelessness in North America is on the rise. In the United States, following a gradual decrease in the number of people experiencing homelessness from 2007–2016, there has been a steady increase in the prevalence rate since 2017 that has reversed the reductions of the previous decade.1 Canada has observed a similar trend, with a 20% increase in the number of people experiencing homelessness from 2018 to 2020–2022.2 As homelessness rates in the United States and Canada rose, the health and social service systems that support people experiencing homelessness were transformed.3 The COVID-19 pandemic resulted in critical shifts in alternative shelter models, such as the temporary use of hotels and motels to prevent ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: Racial and ethnic health inequities persist in the U.S., driven by structural and social factors that disadvantage communities of color. Black individuals live an average of five years less than White individuals, due to differences in poverty levels, exposure to pollution, and access to quality education, employment, and health care, among other factors.1,2 Beyond the toll of increased rates of sickness and premature death among historically marginalized individuals and communities, the financial cost of these inequities has recently been estimated at $451 billion a year and this amount will continue to increase if current trends in morbidity and mortality hold.3Racial and ethnic health inequities have been a ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: A 20-year-old Spanish-speaking woman is the victim of a home invasion and sustains a stab wound to her leg. She calls 911 and is transported to a hospital. Her stab wound is complicated and will require a specialist. She is discharged from the emergency department to follow up as an outpatient, however there are no specialists who accept her insurance—Medicaid—in her area. At home, she becomes intensely afraid. She experiences flashbacks of the home invasion. She is unable to sleep, and her anxiety prevents her from leaving the house. She misses her follow-up appointment due to lack of transportation to the specialist an hour away; she is unable to work due to her injury. Her life seems to be spiraling out of ... Read More PubDate: 2025-05-07T00:00:00-05:00
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Abstract: As cancer is the second leading cause of death in the United States, its prevention is a priority for health care systems. The National Cancer Institute notes that certain underserved populations are at greater risk for cancer mortality than the general population due to factors associated with race, socioeconomic status, geography, education, and gender.1 Routine cancer screenings are thought to help reduce these disparities, and cancer screening programs have been implemented across the country to increase access to these services for the medically underserved.While many health care systems offer cancer screening programs, many battle the issue of adequate uptake by underserved populations. As noted by Young and ... Read More PubDate: 2025-05-07T00:00:00-05:00
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