The Socioeconomic Determinants of Health and Their Impact on African American Healthcare Delivery

African American (AA) women have high prevalence of Type 2 diabetes mellitus (T2DM) and complications. No studies have been conducted about how social determinants of health and health care delivery affect their T2DM self-management. The purpose was to describe how social determinants of health and healthcare delivery may influence AA women’s T2DM self-management using qualitative descriptive methodology ( N = 10). Ten participants were interviewed. Participants’ geographical location, education, level of income, health literacy, and systemic racism, that is, healthcare delivery services, for example, inadequate healthcare services, providers’ assumptions about the patient’s knowledge of diabetes, providers’ attitudes toward patients, and stigma related to diabetes as a disease were identified. Understanding the role of social determinants of health and the health care delivery system in influencing T2DM self-management is a powerful tool for providers and practitioners for improving practice and health care policies to decrease health disparities and improve health outcomes among AA women with T2DM.

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Social determinants of health affecting treatment of pediatric brain tumors

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.4.peds18594 ◽

2019 ◽

Vol 24 (2) ◽

pp. 159-165

Author(s):

Jillian M. Berkman ◽

Jonathan Dallas ◽

Jaims Lim ◽

Ritwik Bhatia ◽

Amber Gaulden ◽

...

Keyword(s):

African American ◽

Health Disparities ◽

Brain Tumors ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Cns Tumor ◽

Initial Symptoms ◽

Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

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Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18095018 ◽

2021 ◽

Vol 18 (9) ◽

pp. 5018

Author(s):

Ik-Whan G. Kwon ◽

Sung-Ho Kim ◽

David Martin

Keyword(s):

Precision Medicine ◽

Social Determinants Of Health ◽

Population Health ◽

Social Determinants ◽

Information Technologies ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Determinants Of Health ◽

Collaborative Tools ◽

High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

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Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-043584 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043584 ◽

Cited By ~ 1

Author(s):

Joseph E Ebinger ◽

Gregory J Botwin ◽

Christine M Albert ◽

Mona Alotaibi ◽

Moshe Arditi ◽

...

Keyword(s):

African American ◽

Los Angeles ◽

Delivery System ◽

Healthcare Workers ◽

Los Angeles County ◽

Healthcare Delivery ◽

Healthcare Delivery System ◽

Hispanic Ethnicity ◽

Factors Associated ◽

African American Race

ObjectiveWe sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.DesignObservational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.SettingsA multisite healthcare delivery system located in Los Angeles County.ParticipantsA diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomesUsing Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.ResultsWe observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevanceThe demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

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The association of demographic and socioeconomic determinants and self-perceived health

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1202077j ◽

2012 ◽

Vol 140 (1-2) ◽

pp. 77-83 ◽

Cited By ~ 2

Author(s):

Janko Jankovic ◽

Snezana Simic

Keyword(s):

Public Health ◽

Odds Ratio ◽

Wealth Index ◽

Perceived Health ◽

The Elderly ◽

National Health Survey ◽

Determinants Of Health ◽

Public Health Issue ◽

Socioeconomic Determinants ◽

Level Of Significance

Introduction. Inequalities in health are evident in the whole world and present an important and consistent public health issue. The highest contribution to the inequality in heath is attributable to the demographic and socioeconomic determinants of health. Objective. The aim of this study was to analyze the association between the demographic (gender, age, marital status and type of settlement) and socioeconomic determinants of health (education and Wealth Index), and self-perceived health. Methods. In the study the data from 2006 National Health Survey of the population of Serbia were used. The interview involved 14,522 adults aged ?20 years. The association between the demographic and socioeconomic determinants of health as independent variables, and self-perceived health as dependent variable were examined using bivariate and multivariate logistic regression analyses. The minimum level of significance was p<0.05. Results. According to our study, the elderly and females significantly more often perceived their health as poor. Respondents living in rural settings were less likely to perceive their health as poor compared to those living in urban settings (odds ratio was 0.82 in males and 0.75 in females). Males with low education were three times more likely to perceive their health as poor (odds ratio was 3.46) in relation to males with high education. This association was more pronounced in females (odds ratio was 5.37). The same pattern was observed for Wealth Index. Conclusion. This study showed that demographic and socioeconomic inequalities in self-perceived health are present in Serbia. Comprehensive public health policies and interventions for reducing these inequalities are urgently needed with the primarily focus on the most disadvantaged socioeconomic groups.

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Am I My Brother’s Keeper? African American Men’s Health Within the Context of Equity and Policy

American Journal of Men s Health ◽

10.1177/1557988314559242 ◽

2014 ◽

Vol 10 (1) ◽

pp. 73-81 ◽

Cited By ~ 1

Author(s):

Okechuku Kelechi Enyia ◽

Yashika J. Watkins ◽

Quintin Williams

Keyword(s):

African American ◽

Social Determinants Of Health ◽

Health Equity ◽

Social Determinants ◽

African American Men ◽

Men’S Health ◽

Policy Implications ◽

Determinants Of Health ◽

Critical Examination ◽

Men's Health

African American men’s health has at times been regarded as irrelevant to the health and well-being of the communities where they are born, grow, live, work, and age. The uniqueness of being male and of African descent calls for a critical examination and deeper understanding of the psycho-socio-historical context in which African American men have lived. There is a critical need for scholarship that better contextualizes African American Male Theory and cultural humility in terms of public health. Furthermore, the focus of much of the social determinants of health and health equity policy literature has been on advocacy, but few researchers have examined why health-related public policies have not been adopted and implemented from a political and theoretical policy analysis perspective. The purpose of this article will be to examine African American men’s health within the context of social determinants of health status, health behavior, and health inequalities—elucidating policy implications for system change and providing recommendations from the vantage point of health equity.

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