Housing instability and food insecurity among low-income children are linked to diminished access to health care

2008 ◽  
Keyword(s):  
Health Care ◽  
Food Insecurity ◽  
Low Income ◽  
Access To Health Care ◽  
Housing Instability ◽  
Low Income Children ◽  
Access To Health

Health Policy in Cambodia: To What Extent Is an Aid-Dependent Country Able to Determine Its Own Policy?

2014 ◽  
Vol 44 (1) ◽  
pp. 171-187 ◽  
Author(s):  
VIRGINIE DIAZ PEDREGAL ◽  
BLANDINE DESTREMAU ◽  
BART CRIEL
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Low Income ◽  
Access To Health Care ◽  
Implementation Process ◽  
Health Care Provision ◽  
Care Provision ◽  
Low Income Country ◽  
Access To Health ◽  
Wide Range

AbstractThis article analyses the design and implementation process of arrangements for health care provision and access to health care in Cambodia. It points to the complexity of shaping a coherent social policy in a low-income country heavily dependent on international aid.At a theoretical level, we confirm that ideas, interests and institutions are all important factors in the construction of Cambodian health care schemes. However, we demonstrate that trying to hierarchically organise these three elements to explain policy making is not fruitful.Regarding the methodology, interviews with forty-eight selected participants produced the qualitative material for this study. A documentary review was also an important source of data and information.The study produces two sets of results. First, Cambodian policy aimed at the development of health care arrangements results from a series of negotiations between a wide range of stakeholders with different objectives and interests. International stakeholders, such as donors and technical organisations, are major players in the policy arena where health policy is constructed. Cambodian civil society, however, is rarely involved in the negotiations.Second, the Cambodian government makes political decisions incrementally. The long-term vision of the Cambodian authorities for improving health care provision and access is quite clear, but, nevertheless, day-to-day decisions and actions are constantly negotiated between stakeholders. As a result, donors and non-government organisations (NGOs) working in the field find it difficult to anticipate policies.To conclude, despite real autonomy in the decision-making process, the Cambodian government still has to prove its capacity to master a number of risks, such as the (so far under-regulated) development of the private health care sector.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

The Obama administration’s vision

2017 ◽  
Author(s):  
Anne Daguerre
Keyword(s):  
Health Care ◽  
Low Income ◽  
Income Tax ◽  
Access To Health Care ◽  
Educational Opportunities ◽  
Social Investment ◽  
Earned Income ◽  
Access To Health ◽  
Antipoverty Programs ◽  
Temporary Assistance

This chapter seeks to define the Obama administration's vision for American social policy. It argues that Obama’s policies were based on a moderate left-leaning modernizing effort through the expansion of existing antipoverty programs, Temporary Assistance for Needy Families (TANF), food stamps, Earned Income Tax Credit and unemployment insurance. The Affordable Care Act (2010) was the most significant antipoverty initiative of the Obama presidency. The administration was committed to a moderate social investment approach centered on expanding educational opportunities and generalizing access to health care, especially for low income Americans.

scholarly journals Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

2017 ◽  
Vol 54 ◽  
pp. 004695801773296
Author(s):  
Edward S. Kielb ◽  
Corwin N. Rhyan ◽  
James A. Lee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Low Income ◽  
Access To Health Care ◽  
Financial Burden ◽  
Access To Health ◽  
Care Costs

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

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