scholarly journals Achieving Healthcare Equity: Disparities in Diagnosis, Quality of Care, and Outcomes Among People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 665-666
Author(s):  
Maricruz Rivera-Hernandez ◽  
Amit Kumar ◽  
Amit Kumar

Abstract Alzheimer’s disease and Related Dementia (ADRD) is a significant public health problem and improving the quality and efficiency of care for older adults with ADRD is a national priority. Approximately five million older adults in the United States, including 50% of nursing home residents and 20% of community-dwelling elderly, have ADRD or probable dementia. Although, the number of minorities affected by ADRD growing at an alarming rate, the diagnosis of ADRD and supportive care for this condition are more likely to be delayed among racial/ethnic minority groups. Given the need to ensure equity of care among racial and ethnic groups, there is a pressing need to understand disparities in diagnosis, access and quality of care among racial and ethnic groups with ADRD, specifically using nationally representative data. This symposium will feature four presentations that provide novel insight regarding racial disparities among people with ADRD in the community-, institution-based post-acute, and long-term settings. Individual presentations will describe 1) racial and ethnic differences in risk and protective factors of dementia and cognitive impairment without dementia; 2) racial and ethnic disparities in high-quality home health use among persons with dementia; 3) Within- and between-nursing homes racial and ethnic disparities in resident’s outcomes for people with ADRD; and 4) racial differences in transition to post-acute care and rehab utilization following hip fracture related hospitalization in patients with ADRD. Finally, there will be a discussion regarding policy and clinical implications, as well directions for future research.

Pain Medicine ◽  
2020 ◽  
Author(s):  
Mary E Morales ◽  
R Jason Yong

Abstract Objective To summarize the current literature on disparities in the treatment of chronic pain. Methods We focused on studies conducted in the United States and published from 2000 and onward. Studies of cross-sectional, longitudinal, and interventional designs were included. Results A review of the current literature revealed that an adverse association between non-White race and treatment of chronic pain is well supported. Studies have also shown that racial differences exist in the long-term monitoring for opioid misuse among patients suffering from chronic pain. In addition, a patient’s sociodemographic profile appears to influence the relationship between chronic pain and quality of life. Results from interventional studies were mixed. Conclusions Disparities exist within the treatment of chronic pain. Currently, it is unclear how to best combat these disparities. Further work is needed to understand why disparities exist and to identify points in patients’ treatment when they are most vulnerable to unequal care. Such work will help guide the development and implementation of effective interventions.


2021 ◽  
Vol 13 (2) ◽  
pp. 23
Author(s):  
Kusum Singh

This study examines the extent and reasons for differences in occupational distributions by race and ethnicity in the U.S. labor market from 2007 to 2018. Using IPUMS data, the study found that racial differences in occupational distributions were lower than ethnic disparities in occupational distributions. Racial disparity in occupational distributions increased slightly, while the ethnic disparity in occupational distributions decreased from 2007 to 2018. Most importantly, racial and ethnic disparities in occupational distributions were found to be not only due to observed socio-demographic variables of workers but also due to other unexplained factors. The effect of unexplained variables had more pronounced effects on the racial differences in occupational distributions than on the ethnic differences in occupational distributions. 


2010 ◽  
Vol 19 (8) ◽  
pp. 834-842 ◽  
Author(s):  
Dima M. Qato ◽  
Stacy Tessler Lindau ◽  
Rena M. Conti ◽  
L. Philip Schumm ◽  
G. Caleb Alexander

PEDIATRICS ◽  
2021 ◽  
pp. e2020024091
Author(s):  
Kimberly B. Glazer ◽  
Jennifer Zeitlin ◽  
Natalia N. Egorova ◽  
Teresa Janevic ◽  
Amy Balbierz ◽  
...  

Author(s):  
Daniel S. Gardner ◽  
Caroline Rosenthal Gelman

Minority and immigrant elders constitute a greater proportion of the population than ever before and are the fastest growing segment of the older population. Within these racial and ethnic groups there is considerable variation with regard to age, gender, country of origin, language, religion, education, income, duration of U.S. residency, immigration status, living arrangements, social capital, and access to resources. The authors summarize research on older adults regarding racial and ethnic disparities, barriers to health and social service utilization, and dynamics of family caregiving. Implications are offered for social-work practice, policy, and research.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 604-604
Author(s):  
Katherine Ornstein ◽  
Natalie Plick ◽  
Claire Ankuda

Abstract We used the Health and Retirement Study, a large nationally representative study of U.S. older adults from 2002-2015, to identify decedents and assess quality of EOL care by availability of kin. 7.9% of participants were kinless at EOL (no adult children or spouses), reflecting national estimates of 1,027,600 older adults. Those who were kinless at EOL were more likely to be female (61.2% vs 51.5%), from the lowest wealth quartile (53.6% vs 35.6%), and less likely to be white and non-Hispanic (75.6% vs 81.8%). Among the community-dwelling population, individuals with kin received 2.4 times as much hours of help from informal caregivers per month, compared to those without kin. We did not observe differences in rates of hospital death by kin status in adjusted models. More work is needed to assess any unmet needs in the EOL period for kinless older adults, especially as healthcare moves towards increased in-home supports.


2020 ◽  
Author(s):  
Ting-Yu Lu ◽  
Jen-Hao Chen ◽  
Je-Kan Du ◽  
Ying-Chun Lin ◽  
Pei-Shan Ho ◽  
...  

Abstract Background: The adverse impact of poor oral conditions in older adults on their quality of life is a public health problem. This study assessed the mediating effects of dental status, occlusal condition, dysphagia and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) in the older population. Methods: A total of 1100 representative community-dwelling adults aged 65 years and older were recruited from a large-scale survey conducted in Kaohsiung, Taiwan. Dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, and dysphagia was collected using face-to-face interview. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using Geriatric Oral Health Assessment Index. Results: Comparing with non-xerostomia, participants with xerostomia had a 0.20 decrease in the level of OHRQoL (p< .001), and the direct effect was accounted for 83.3% of the total effect. The dysphagia and the masticatory performance were found to have a significant mediating effect on the association between xerostomia and OHRQoL (βs = 0.20 and −0.13, respectively; βs = 0.05 and −0.08, respectively) and 10.8% of the effect was attributed to dysphagia mediation. Furthermore, the functional teeth and occlusal condition had a significant mediating effect on the association between xerostomia and masticatory performance , and the functional teeth was accounted for 43.6% of the effect. Conclusions: Xerostomia had the greatest effect on OHRQoL. The mediating role of dysphagia and masticatory performance on the association between xerostomia and OHRQoL was significant and deserves further attention. Older adults could improve their OHRQoL through a community-based oral function intervention. Our results further suggest that early screening for swallowing and masticatory function is essential to prevent or delay the onset of complications.


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