scholarly journals Racial Bias Correlates with States Having Fewer Health Professional Shortage Areas and Fewer Federally Qualified Community Health Center Sites

Author(s):  
Lonnie R. Snowden ◽  
Eli Michaels

Abstract Federally Qualified Community Health Centers (FQHCs), serving Health Professional Shortage Areas (HPSAs), are fixtures of the healthcare safety net and are central to healthcare delivery for African Americans and other marginalized Americans. Anti-African American bias, tied to anti- “welfare” sentiment and to a belief in African Americans’ supposed safety net dependency, can suppress states’ willingness to identify HPSAs and to apply for and operate FQHCs. Drawing on data from n = 1,084,553 non-Hispanic White Project Implicit respondents from 2013–2018, we investigated associations between state-level implicit and explicit racial bias and availability of FQHCs and with HPSA designations. After controlling for states’ sociopolitical conservatism, wealth, health status, and acceptance of the Affordable Care Act’s Medicaid expansion, greater racial bias was correlated with fewer FQHC delivery sites and fewer HPSA designations. White’s bias against African Americans is associated with fewer FQHC opportunities for care and fewer identifications of treatment need for African Americans and other low-income people lacking healthcare options, reflecting bias-influenced neglect.

2016 ◽  
Vol 44 (4) ◽  
pp. 585-588
Author(s):  
Peter Shin ◽  
Marsha Regenstein

Two major safety net providers – community health centers and public hospitals – continue to play a key role in the health care system even in the wake of coverage reform. This article examines the gains and threats they face under the Affordable Care Act.


2019 ◽  
Vol 7 (1) ◽  
pp. 1-8
Author(s):  
Andy Asmara

The daily facts indicated that an individual is the key factor to achieve organization’s success. Every organization with its best performance is always related to its human resources’ balanced competency. The midwife has role, function, and competencies to provide maternal services for women. The midwife’s role is not only a doer, but also an organizer, an educator, and a researcher. Therefore, the midwife is expected to focus on prevention and health promotion aspect with basis of partnership, and community empowerment collaboration with other health workers in order to be readily prepare the health services for anyone who is in need.This was qualitative research method with case study approach. The informant was the midwives of Tambakrejo Community Health Center of Surabaya. According to the data of antenatal care attendance, trained birth attendance, and perinatal care, there were 859 pregnant women, 581 persons on phase of K1 (67.64%), and 551 persons on phase of K4 (64.14%). The birth attendances by trained birth attendants are 513 people (62.56%), while perinatal care recorded 570 people attending the health service (69.51%). The data indicated the performance by the midwives of Tambakrejo Community Health Center categorized in the lowest position among 63 community health centers in Surabaya. The result showed poor soft skill competency and poor hard skill competency on midwives. In conclusion, poor soft skill competency including personal competence and social competence should be trained and developed by obstetrics and gynecology specialist of Soewandhi Public Hospital of Surabaya. The study suggested Surabaya District Health Office needs to conduct training of technology information and computer in order to increase the service quality and to solved the problem related to hard skill competencies on technology and computer skill. 


2019 ◽  
Author(s):  
Stephanie Loo ◽  
Chris Grasso ◽  
Jessica Glushkina ◽  
Justin McReynolds ◽  
William Lober ◽  
...  

BACKGROUND Electronic patient-reported outcome (ePRO) systems can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation. OBJECTIVE This study aimed to implement an ePRO system that administers key health questionnaires in an urban community health center in Boston, Massachusetts. METHODS An ePRO system that administers key health questionnaires was implemented in an urban community health center in Boston, Massachusetts. The system was integrated with the electronic health record so that medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated rollout process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit. RESULTS Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in terms of applying technological innovation to streamline clinical processes and improve patient care. CONCLUSIONS Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model for application of technological innovation to streamline clinical processes and improve patient care.


Author(s):  
David Hartzband ◽  
Feygele Jacobs

To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA). An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis using the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration.  In addition, interviews with health center leadership and staff were completed to understand the context for the findings.The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting of a number of diagnoses, specifically obesity and heart disease, was also evident in the results of the data quality exercise, for both the EHR-derived and stack analytic results.Data awareness, that is, an appreciation of the importance of data integrity, data hygiene and the potential uses of data, needs to be prioritized and developed by health centers and other healthcare organizations if analytics are to be used in an effective manner to support strategic objectives. While this analysis was conducted exclusively with community health center organizations, its conclusions and recommendations may be more broadly applicable. 


2017 ◽  
Vol 48 (1) ◽  
pp. 78-89 ◽  
Author(s):  
Sean J. Haley ◽  
Susan Moscou ◽  
Sharifa Murray ◽  
Traci Rieckmann ◽  
Kameron Wells

Adolescent experimentation with alcohol, tobacco, or other drugs is commonplace, and limited access to screening and treatment services poses a significant public health risk. This study identified alcohol, tobacco, and other drug services available for adolescents at community health center sites in New York. A survey was distributed to medical and behavioral health directors across 54 community health center organizations serving 255 primary care adolescent sites. One third of sites required adolescent screening for substance use disorders (SUDs). Twenty-eight percent of sites said all/nearly all (80%-100%) and 12% said most (60%-79%) adolescents actually were screened. On-site tobacco cessation treatment and substance abuse counseling were offered at 53% and 14% of sites, respectively. Multilevel models suggested that community health center organizations positively influenced sites’ adolescent SUD screening and tobacco treatment. Additional investment in adolescent behavioral health screening and treatment is needed to reduce alcohol, illicit drug, or tobacco use among the underserved.


2019 ◽  
Vol 12 (1) ◽  
pp. 96-101
Author(s):  
Keila Brown ◽  
Loretta T. Lee ◽  
Cynthia Selleck

BackgroundDiabetes self-management education (DSME) programs utilize a multidisciplinary, skills-based approach allowing participants to make self-management choices and follow a comprehensive plan of care, improving their glycemic control.ObjectiveThe purpose of this quality improvement project was to evaluate the effectiveness of DSME on the reduction of hemoglobin A1c (HgbA1c) and body mass index (BMI) in overweight/obese community health center patients.MethodsThe free program met 2 hours weekly for 6 consecutive weeks. A retrospective chart review was conducted to compare baseline to post-session HgbA1c and BMI 12 weeks after completion of the program. Pre- and post-session surveys were also conducted to assess improved diabetes knowledge and confidence.ResultsMean HgbA1c decreased by 1.6% (p = .003) 12 weeks after completion of the program; however, BMI remained unchanged (p = .582). Diabetes knowledge and confidence also improved significantly following DSME (p = .000 and p = .001, respectively).ConclusionsThe study demonstrated that a reduction in HgbA1c levels and an increase in diabetes knowledge and confidence can occur in low income, community health center patients following participation in DSME.Implications for NursingCommunity health center patients who have access to free DSME can improve their health, self-efficacy, and diabetes self-management practices.


2005 ◽  
Vol 28 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Suzanne Cashman ◽  
Judith Savageau ◽  
Maureen McMullen ◽  
Rebecca Kinney ◽  
Celeste Lemay ◽  
...  

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