scholarly journals The role of unjust treatment for experienced unmet need for health care among Finnish Roma

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Kuusio ◽  
R Lämsä ◽  
M Laalo ◽  
A Castaneda
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Care ◽  
Public Services ◽  
Unmet Need ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Structured Interview ◽  
Vulnerable Groups ◽  
Health Examination

Abstract Background Finland is currently undergoing a major reform of social and health care, one aim of which, is to reduce inequalities between different population groups in access to care. Previous studies showed that Finnish Roma minority are more likely to experience unjust treatment in health services and other public services in comparison to other minorities in Finland. Unjust treatment may influence health behaviors, including the use of health services, by decreasing trust towards health professionals as well as decreasing social, emotional, and physical resources. This study examined the association between experienced unjust treatment in public services and self-assessed unmet need for health care among Roma in Finland. Methods We used data from the Roma health and wellbeing study (Roosa), conducted in Finland (2017-2018). The data was collected by the snowball method in different areas of Finland including a health examination and a structured interview. It covers 365 adults, and of those 223 (61.1%) were women. The outcome measure for unmet health care need was based on the question: “Do you feel that you have adequately received primary care services during the past 12 months?” Logistic regression was used to test the association between unjust treatment and unmet need for health care. Potential confounders were gender, age, marital status, education, employment and self-estimated health. Results The prevalence of unmet need for health care was 37.8 percent among men and 43.7 percent among women. Those who experienced unjust treatment in public services had higher odds (OR = 6.23; p < 0,001) for unmet need for health care than those who felt treated just. This association remained after adjustments for the confounders. Conclusions Over every third of the Finnish Roma experienced unmet need for health care. Unjust treatment seems to be a significant risk factor in access to care among Finnish Roma and its role needs further studies. Key messages Unjust treatment in public services is an indirect indicator of systematic and/or institutional discrimination. It is important to study the extent, nature and consequences of unjust treatment and discrimination to allow vulnerable groups to be taken into account better when renewing health services.

scholarly journals The association between obesity and depression in adults: a meta-review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S267-S267
Author(s):  
Abdi Malik Musa ◽  
Samuele Cortese ◽  
Olivia Bloodworth
Keyword(s):  
Depressive Disorders ◽  
Data Extraction ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Structured Interview ◽  
Future Research ◽  
Odds Ratios ◽  
Medical File ◽  
Depressed Adolescent ◽  
Meta Review

AimsObesity and depression are increasing in prevalence and have become key issues in the public health of the modern day. We performed a meta-review to summarise the association between obesity and depression in adults.MethodA systematic literature search was undertaken on MEDLINE, PsychINFO, EMBASE and Web of Science for systematic reviews (SRs) with or without meta-analyses (MA) on the association between obesity and depression in adults (>18 years) published before 18 September 2018. Any approach to define depressive disorders (e.g. via structured interview or code in medical file) was accepted. Likewise, any method to assess obesity was accepted. Screening, data extraction and quality assessment was completed by two reviewers independently, with a third reviewer to arbitrate any disagreement. AMSTAR 2 tool was used to assess the methodological quality and risk of bias of the pertinent SRs/MAs.ResultAfter duplicate removal, we identified 6007 potentially pertinent citations. Following, title, abstract and full-text screening, 10 studies were included in the review; nine SRs with MAs and one SR. A statistically significant association between obesity and depression was reported in all nine SRs with MAs, with odds ratios ranging from 1.18 (95% CI = 1.11-1.26) to 1.57 (95% CI = 1.53-2.01). Increased severity of obesity (body mass index over 40) was associated with a greater odds of becoming depressed. Odds of developing depression were greater for obese females, compared to obese males, but this difference was not statistically significant. Depression was shown to be a significant risk factor for future obesity in all four relevant MAs with odds ratios ranging from 1.18 (95% CI = 1.13-1.23) to 1.40 (95% CI = 1.14-1.71) . Depressed adolescent females had the highest odds of becoming obese, significantly more so than depressed adolescent males and depressed adults. The quality of the included studies were mixed with five scoring moderate quality, three low quality and two critically low quality.ConclusionThe findings suggest a reciprocal association between depression and obesity, which may be modulated by age and gender. Future research should assess the potential effect of obesity and depression severity more carefully while also exploring the underlying mechanisms. These results warrant the investigation of the effect of obesity or depression intervention on the outcomes of the other.FUNDINGThis research received no financial sponsorship.

Professional Oral Health Care Reduces the Number of Oropharyngeal Bacteria

2008 ◽  
Vol 87 (6) ◽  
pp. 594-598 ◽  
Author(s):  
A. Ishikawa ◽  
T. Yoneyama ◽  
K. Hirota ◽  
Y. Miyake ◽  
K. Miyatake
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Cavity ◽  
Oral Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Oral Health Care ◽  
Silent Aspiration ◽  
Professional Oral Health Care ◽  
Dependent Elderly

Silent aspiration of oropharyngeal pathogenic organisms is a significant risk factor causing pneumonia in the elderly. We hypothesized that regular oral hygiene care will affect the presence of oropharyngeal bacteria. Professional cleaning of the oral cavity and/or the gargling of a disinfectant liquid solution was performed over a five-month period in three facilities for the dependent elderly. Total oropharyngeal bacteria, streptococci, staphylococci, Candida, Pseudomonas, and black-pigmented Bacteroides species were monitored. The levels of these oropharyngeal bacteria decreased or disappeared after weekly professional oral health care, i.e., cleaning of teeth, dentures, tongue, and oral mucous membrane by dental hygienists. After lunch, gargling with povidone iodine was shown to be less effective than professional oral care. These findings indicate that weekly professional mechanical cleaning of the oral cavity, rather than a daily chemical disinfection of the mouth, can be an important strategy to prevent aspiration pneumonia in the dependent elderly.

scholarly journals Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya

2018 ◽  
Author(s):  
Racheal Omukhulu Makokha
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Public Services ◽  
Published Data ◽  
County Governments ◽  
Care Services ◽  
Access To Health ◽  
The Impact

The last five decades have seen uncountable debates on the impact of decentralization on provision of public services. While it has evidently improved public service delivery in some countries, it has worsened it in others. Kenya implemented devolution in 2013 in the hope of bringing public services nearer to the people. Health was one of the services identified. Yet, the local media has reported negative impact of devolution on provision of health services since 2013. This study sought to look at the actual effect of devolution on access to health care services by analysing secondary quantitative data from the government published data, official statistics, international development agencies’ surveys and reports. Two county governments; Kisumu and Makueni were chosen to represent the urban and rural populations respectively. Contrary to the wider literature on health decentralization, this study found out that devolution did not worsen access to health care services in Kenya. The study attributed this to the nature of devolution adopted in the country where the county governments have considerable authority, decision-making power and responsibility over their counties.

Can Digitization of Health Care Help Low-Resourced Countries Provide Better Community-Based Rehabilitation Services?

2019 ◽  
Author(s):  
Joseph Kimuli Balikuddembe ◽  
Jan D Reinhardt
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Workers ◽  
Information Access ◽  
Vulnerable Groups ◽  
Community Based ◽  
Full Spectrum ◽  
Community Based Rehabilitation ◽  
Rural And Remote Areas ◽  
Traditional Health Care

Abstract In the wake of globalization, proliferation of digital technologies (DTs) is rapidly changing many activities across sectors, including health to “go digital”. Harnessing opportunities of DTs can be a pathway for delivery of health services such as community-based rehabilitation to the vulnerable groups of populations, particularly those in the low resourced countries where the health systems are still weak and experiencing a deficit of trained health workers to effectively deliver a full spectrum of health services. This perspective explored how some DTs can be leveraged in delivery of CBR services in the rural and remote areas of low resourced countries. This is described based on information access and exchange, social satisfaction, shortages of rehabilitation workforce, professional development and capacity building. However, a caution is made since seizing such advantages of DTs can inevitably be associated with spillovers and limitations among others including needs prioritization, skills and language limitations, internet addiction and censorship, professionalism and ethical dilemma and sustainability if proper remedies are not taken. Moreover, as DTs are revolutionizing various activities across sectors, including health; this is not meant to substitute the traditional health care activities including those delivered through CBR but rather to augment their delivery in low resourced settings and elsewhere.

Population needs for mental health services. Introduction to the theme

1997 ◽  
Vol 6 (S1) ◽  
pp. 3-12
Author(s):  
Ville Lehtinen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Unmet Need ◽  
Health Resources ◽  
Economic Recession ◽  
Health Care Expenditures ◽  
Public And Private

All over the world large sums of both public and private money are expended on the operation of psychiatric health care services. In most of the European countries mental health care expenditures, as well as the total health care budget, increased quite rapidly during the 80s. But in the 90s the economic recession has forced to cut down costs which has meant a decrease in mental health resources and, evidently, an increase of the unmet need for these services in the population.The problem is that the development of mental health services has been, for the most part, merely accidental and random, usually not clearly planned and based neither on real knowledge of the population needs nor on setting priorities when all needs can not be satisfied. During the period of increasing resources there was no real need for priority setting; somewhat exaggerating one can say that every emerging demand for services could be met by allocating new resources. During the recession, on the other hand, the cutting of costs have been the main goal, leading again to an unplanned development: the cuts of resources have been rather forced and panicky, not based on consideration of true population needs or the consequences of the development.

Understanding the implementation and integration of e-health services

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 36-37 ◽  
Author(s):  
Frances S Mair ◽  
Carl May ◽  
Tracy Finch ◽  
Elizabeth Murray ◽  
George Anderson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Literature Review ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Organizational Factors ◽  
Mixed Methods Study ◽  
Health Examination ◽  
Health Technologies ◽  
Design Factors

We are conducting a multicentre, mixed methods study to examine the attitudes of health professionals to e-health in order to identify strategies to support increased uptake and utilization of e-health services. The first part of the work is a systematic literature review. After searching five electronic databases, a total of 66 review papers were identified which concerned barriers and facilitators to the implementation of e-health. Examination of the main themes from these reviews identified three major types of barriers/facilitators: (1) technology design factors, (2) health professional interactions, and (3) organizational factors. The utilization of e-health technologies by health-care professionals is complex, as demonstrated by the preliminary findings of the literature review.

How accessible is the Serbian health system? Main barriers and challenges ahead

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Hernandez-Quevedo ◽  
V Bjegovic-Mikanovic ◽  
M Vasic ◽  
D Vukovic ◽  
J Jankovic ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Medical Care ◽  
Access To Health Care ◽  
Unmet Need ◽  
Policy Issue ◽  
Vulnerable Groups ◽  
Free Access ◽  
Access To Health ◽  
Underlying Causes

Abstract Background Access to health care is a key health policy issue faced by countries in the WHO European Region and Serbia is not an exception. There is increasing concern that financial and economic crisis may have delay progress regarding the performance of the Serbian health system. While substantial development has been experienced by the Serbian health system since 2000, we analyse whether barriers to health care access exist in the country and the underlying causes. Methods We combine quantitative and qualitative methods to assess the accessibility of the Serbian health system. We use the latest data available both at national (e.g. National Health Survey) and European (EUSILC) level to understand whether barriers to access exist and the underlying causes. On the qualitative side, we analyse the different policies implemented by the Serbian government to improve the accessibility of the health system in the last decade, identifying the challenges ahead for the country. Results We find that, in 2018, 5.8% of the Serbian population reported unmet need for medical care due to costs, travel distances or waiting lists, well above the EU28 average and much higher than in neighbouring countries. Financial constraints are reported to be the main reason for unmet needs for medical care. Long waiting times also impede the accessibility of health services in Serbia. Conclusions Serbia has a comprehensive universal health system with free access to health care, however, some vulnerable groups, such as those living in poverty or Roma people in settlements, have more barriers in accessing health care. It is expected that Serbia will continue to develop policies focused on reducing barriers to accessing health care and improving the efficiency of the health system, supported by international organisations and in the context of the EU accession negotiations. Key messages Some vulnerable groups have more barriers in accessing adequate care in Serbia. National initiatives are in place to increase access to the health system but there is scope for further work.

scholarly journals Insurance Status, Use of Mental Health Services, and Unmet Need for Mental Health Care in the United States

2015 ◽  
Vol 66 (6) ◽  
pp. 578-584 ◽  
Author(s):  
Elizabeth Reisinger Walker ◽  
Janet R. Cummings ◽  
Jason M. Hockenberry ◽  
Benjamin G. Druss
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Unmet Need ◽  
The United States ◽  
Insurance Status
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