Needs assessment and policy development: Native Hawaiians as Native Americans.

1988 ◽  
Vol 43 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Ormond W. Hammond
Keyword(s):  
Native Americans ◽  
Needs Assessment ◽  
Policy Development ◽  
Native Hawaiians

Poor Survival for US Pacific Islander Cancer Patients: Evidence From the Surveillance, Epidemiology, and End Results Database: 1991 to 2004

2007 ◽  
Vol 25 (36) ◽  
pp. 5738-5741 ◽  
Author(s):  
William B. Goggins ◽  
Grace K.C. Wong
Keyword(s):  
United States ◽  
African Americans ◽  
Native Americans ◽  
Cancer Survival ◽  
The United States ◽  
Native Hawaiians ◽  
Targeted Interventions ◽  
Female Breast ◽  
Cause Specific Survival ◽  
End Results

Purpose Although racial and ethnic differences in cancer survival in the United States have been studied extensively, little is known about cancer survival in US Pacific Islanders (PIs), a fast-growing and economically disadvantaged minority group. Methods Using data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries, we compared cause-specific and all-cause survival for female breast, prostate, lung, colorectal, stomach and liver cancer for Native Hawaiians, Samoans, other PIs (including Tongans, Guamanians, and others), African Americans, and Native Americans with non-Hispanic whites using Cox proportional hazards models. Separate models were fitted adjusting for demographic factors only and demographic and disease severity variables. Results Among all groups, Samoans were the most likely to present with advanced disease and had the worst cause-specific survival for all sites considered. Samoans had particularly poor results (adjusted for demographic variables only) for female breast (relative risk [RR] = 3.05; 95% CI, 2.31 to 4.02), colorectal (RR = 1.82; 95% CI, 1.37 to 2.41) and prostate (RR = 4.82; 95% CI, 3.38 to 6.88) cancers. Native Hawaiians and other PIs also had significantly worse cause-specific survival than did non-Hispanic whites for most sites, but generally had better survival than African Americans or Native Americans. Conclusion Much of the survival disadvantage for PI groups appears to be a result of late diagnosis, and thus targeted interventions have much potential to reduce cancer mortality in this group. More research is needed to find explanations for the particularly poor cancer survival for Samoans in the United States.

scholarly journals Ethnic Differences in Breast Cancer Survival: Status and Determinants

2011 ◽  
Vol 7 (6) ◽  
pp. 677-687 ◽  
Author(s):  
Gertraud Maskarinec ◽  
Cherisse Sen ◽  
Karin Koga ◽  
Shannon M Conroy
Keyword(s):  
Breast Cancer ◽  
African Americans ◽  
Native Americans ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Cancer Survival ◽  
Breast Cancer Survival ◽  
Native Hawaiians ◽  
Tumor Type ◽  
American Women

Ethnic differences in breast cancer survival have been a long-standing concern. The objective of this article is to present relevant studies for all major US racial/ethnic groups including African–Americans, Latinos, Native Americans, Japanese–Americans and Native Hawaiians, and to discuss underlying causes of disparity, In comparison to Caucasian women, African–American women continue to experience the poorest breast cancer–specific survival of all ethnic groups in the USA. The prognosis for Latinos, Native Hawaiians and Native Americans is intermediate, better than for African–Americans but not as good as for Caucasians, whereas Japanese–American women tend to have better outcomes. The following possible contributors to the observed differences are discussed in detail: unfavorable distribution of stage at diagnosis due to low screening rates, limited access to care and treatment, tumor type, comorbidities, socioeconomic status, obesity and physical activity.

Social Provision before the Twentieth Century

2013 ◽  
Author(s):  
Laura S. Jensen
Keyword(s):  
Native Americans ◽  
Policy Development ◽  
National Level ◽  
The Elderly ◽  
The United States ◽  
Colonial Era ◽  
Welfare Benefits ◽  
Social Provision ◽  
The Disabled ◽  
Federal Land

This chapter traces the evolution of social provision in the United States from the colonial era forward, chronicling the local, state, and national-level policy developments that constituted the foundation on which the American welfare state would be built. Specific social welfare benefits discussed include local poor relief; institutional approaches to social provision, such as the poorhouse and the workhouse; state and federal veterans’ pensions and land grants; and federal land entitlements for nonveterans. The essay also considers the legacy of the English Poor Law; the social construction of citizen deservingness; the establishment of programmatic entitlement as a policy practice; the influence of federalism and of illiberal hierarchies of gender, race, ethnicity, and class on early social policy development; and the special challenges faced by women, the elderly, the disabled, slaves, free blacks, and Native Americans in seventeenth-, eighteenth-, and nineteenth-century America.

scholarly journals A Needs Assessment for Postgraduate Training in Selected Public Health Disciplines: Evidence from Health Services Organisations in Lusaka, Zambia

2020 ◽  
Author(s):  
Maio Bulawayo ◽  
Adam Silumbwe ◽  
Margarate Nzala Munakampe ◽  
Nawa Mukumbuta ◽  
Juliet Musabula ◽  
...  
Keyword(s):  
Public Health ◽  
Health Economics ◽  
Health Services ◽  
Needs Assessment ◽  
Policy Development ◽  
Postgraduate Training ◽  
Training Needs ◽  
Healthcare Management ◽  
Health Coverage ◽  
Public Health Training

Abstract Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on the needs assessment conducted to understand postgraduate training needs for three selected public health disciplines – Health Policy and Systems, Health Economics, and Healthcare Management and Planning – at the University of Zambia. Methods: The study adopted a cross-sectional design, comprising qualitative and quantitative components. Data were collected through semi-structured interviews administered to 32 participants, identified through a comprehensive stakeholder mapping process, holding selected management positions in public and private health service organisations across Zambia. The organisations included regulatory authorities, research institutions, government ministries, insurance firms, multilateral and health services organisations. Results: Overall (n=22), more than 68% of the stakeholders reported that they had no employees that were formally trained in the three disciplines. More than 90% of the stakeholders opined that training in these disciplines would be beneficial in providing competencies to strengthen service provision. The horizontal skills mismatch for health economics, and health services management and planning were found to be 93% and 100%, respectively. Among the key public health training needs were: policy development and analysis, economic evaluation, and strategic management. Conclusions: This study confirms that introducing post graduate training in the proposed public health disciplines will not only benefit Zambian health services organisations, but also help strengthen the health systems in general. For other empirical contexts, the findings imply the need for the introduction of academic programmes which respond to ever-changing public health skills demanded; and should be matched with local priorities and service delivery.

People of Color

2019 ◽  
pp. 45-74
Author(s):  
Carol Easley Allen ◽  
Cheryl E. Easley
Keyword(s):  
United States ◽  
Native Americans ◽  
African American Women ◽  
Minority Groups ◽  
Maternal Mortality Ratio ◽  
Geographical Location ◽  
The United States ◽  
Native Hawaiians ◽  
Health Issues ◽  
Mortality Ratio

This chapter, which focuses mainly on the United States, describes and provides many examples of how discrimination against members of racial and ethnic minority groups adversely affects their health. The chapter focuses on African Americans and non-American blacks in the United States, Latinos, Native Hawaiians and other Pacific Islanders, and Native Americans and Alaska Natives. The chapter discusses the roots and underlying issues of social injustice experienced by racial and ethnic minorities, including racial discrimination, poverty, social exclusion, geographical location and residence patterns, employment status and occupational health issues, and health literacy. The chapter also discusses what needs to be done. Three text boxes address racial/ethnic definitions in the U.S. Census, the high maternal mortality ratio among African American women, and cultural competence/transcultural nursing.

scholarly journals A Needs Assessment for Postgraduate Training in Selected Public Health Disciplines: Evidence from Health Services Organisations in Lusaka, Zambia

2020 ◽  
Author(s):  
Maio Bulawayo ◽  
Adam Silumbwe ◽  
Margarate Nzala Munakampe ◽  
Nawa Mukumbuta ◽  
Juliet Musabula ◽  
...  
Keyword(s):  
Public Health ◽  
Health Economics ◽  
Health Services ◽  
Needs Assessment ◽  
Policy Development ◽  
Postgraduate Training ◽  
Training Needs ◽  
Healthcare Management ◽  
Health Coverage ◽  
Public Health Training

Abstract Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and service gaps for selected public health disciplines – Health Policy and Systems, Health Economics, and Healthcare Management and Planning – at the University of Zambia. Methods: The study adopted a cross-sectional design, comprising qualitative and quantitative components. Data were collected using semi-structured questionnaires administered to 32 representatives of purposively sampled public and private health service organisations based in Lusaka Zambia. The health services organisations included regulatory authorities, research institutions, government ministries, insurance firms and other cooperating partners. Results: Overall (n=22), more than 68% of the stakeholders reported that they had no employees that were formally trained in the three disciplines. More than 90% of the stakeholders opined that training in these disciplines would be beneficial in providing competencies to strengthen service provision. The horizontal skills mismatch for health economics, and health services management and planning were found to be 93% and 100%, respectively. Among the critical public health training needs were: policy development and analysis, economic evaluation, and strategic management. Conclusions: This study confirms that introducing post-graduate training in the proposed public health disciplines will not only benefit Zambian health services organisations but also help strengthen the health systems in general. For other empirical contexts, the findings imply the need for the introduction of academic programmes which respond to ever-changing public health skills demanded. They should be matched with local priorities and service delivery.

Raising Awareness of Postnatal Depression

1997 ◽  
Vol 3 (4) ◽  
pp. 100
Author(s):  
Kerrie Puts
Keyword(s):  
Health Promotion ◽  
Needs Assessment ◽  
Support Group ◽  
Postnatal Depression ◽  
Policy Development ◽  
Ad Hoc ◽  
Reference Group ◽  
Community Action ◽  
Intersectoral Collaboration ◽  
Raising Awareness

Berwickwide Community Health Service (BCHS) conducted a project during National Mothering Week that set out to raise community awareness of Postnatal Depression (PND) and to assess the need for establishing a PND support group in Northern Casey, Victoria. Target groups included mothers of young children, general practitioners (CPs) and the general community. A reference group consisting of professional and community representatives was involved in the planning, implementation and evaluation of all strategies. Approaches used included health education, professional development, information development, creating supportive environments, supporting community action, intersectoral collaboration and policy development. The project highlighted the need for a PND support group in Northern Casey and was successful in terms of raising awareness of PND, information development and dissemination, and needs assessment of mothers in Northern Casey. Mothering Week provided an ideal opportunity to give a relatively small project a larger, more attractive profile and provided an ideal vehicle to introduce the 'heavy' issue of PND in a forum that celebrated and raised the status of motherhood. Although as health promotion practitioners we are not encouraged to run ad hoc events and to strive instead for sustainable outcomes, this project showed that applying health promotion principles to one-off events such as Mothering Week can be very useful in needs assessment and in determining characteristics particular to the target group. The increase in knowledge and skills and the sense of ownership that participants can experience through participation in such a project can also foster a sense of community spirit that lays the groundwork for more sustainable, future projects.

Abstract P341: Community Environment Associated with Cardiovascular Disease Hospitalization Rates in Denver, Colorado

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Ronica N Rooks ◽  
Kathryn DeYoung ◽  
Emery Shekiro ◽  
Edward Havranek ◽  
Arthur Davidson
Keyword(s):  
Cardiovascular Disease ◽  
Land Use ◽  
Native Americans ◽  
Policy Development ◽  
Hispanic Americans ◽  
City Government ◽  
Poverty Level ◽  
Community Environment ◽  
Hospitalization Rates ◽  
Chi Square Analysis

Introduction: Hospitalization rates for acute myocardial infarction (AMI), coronary heart disease (CHD), and stroke have decreased over time, although trends are debatable for heart failure (HF). These trends are unequally distributed. There is a growing literature documenting the relationship between social and economic characteristics of people’s communities and cardiovascular disease (CVD). Based on a social ecological model of health through the life course, we descriptively examined associations between CVD hospitalization rates and patient characteristics and census tract (CT)-level community environment. Hypothesis: CVD hospitalization rates will be higher in community environments with higher percentages of individuals living below the federal poverty level, racial/ethnic minority groups, and non-residential (i.e., commercial/office, industrial, open space, public/civic, vacant, and miscellaneous space) vs. residential land use. Methods: Colorado Hospital Association (2009-2013) data were used to measure ICD-9 coded hospitalization rates (per 1,000) for Denver, Colorado residents ≥20 years. Data were merged with American Community Survey (2009-2013) and Denver County land use (2010) data. Using chi-square analysis, we examined associations between age-adjusted CVD hospitalization rates (N=15,521) and CT-level community environment (in quartiles) (N=144). Results: Denver’s annual CVD hospitalization rate was 6.6. Patient-level AMI (1.7), CHD (2.8), and HF (2.2) rates were higher among men. Women had higher stroke-related rates (2.4). Across CVD types, rates for those ≥65 years (6.5-13.5) were higher than middle-aged groups (2.1-3.4). Average annual age-adjusted AMI hospitalization rates were higher in CTs with the highest quartile of Hispanic Americans (2.0), Native Americans (1.9), and individuals below poverty (1.9). CHD rates were higher in CTs with higher percentages of Hispanic Americans (3.1), individuals below poverty (3.1), and Native Americans (3.1). HF rates were higher in CTs with higher percentages of industrial/office land use (3.5), individuals below poverty (3.3), and Hispanic Americans (3.2). Stroke rates were higher in CTs with higher percentages of Native Americans (3.0), industrial/office land use (3.0), and African Americans (3.0). The largest disparities for rate ratios comparing the highest to the lowest quartiles for each exposure by CVD outcome were the percentage of individuals below poverty (AMI 2.2; CHD 2.1; HF 2.4; Stroke 1.7), non-Hispanic Whites (AMI 0.7; CHD 0.7; HF 0.7; Stroke 0.7), Hispanic Americans (AMI 1.5; CHD 1.5; HF 1.5), and Native Americans (Stroke 1.30). Conclusions: In conclusion, associations exist between community environment and CVD hospitalization rates, suggesting opportunities for health policy development in Denver’s city government, council districts, and neighborhoods .

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