scholarly journals Chronic Disease Among Medicaid Beneficiaries Over 50: The Potential Impact of Medicaid Work Requirements

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 361-361
Author(s):  
Rodlescia Sneed ◽  
Graham Gardner ◽  
Alexander Stubblefield ◽  
Briana Mezuk

Abstract Since 2018, several states have proposed requiring work or other community engagement activities as a condition of receiving Medicaid; however, there has been little inquiry into the impact of such policies on Medicaid recipients over 50. Here, we describe the prevalence and burden of chronic disease among Medicaid beneficiaries over 50 who might be impacted by Medicaid work requirements. We used data from the 2016 wave of the Health and Retirement Study, a large-scale population-based study of adults aged >50. Our sample included individuals over 50 who were not Medicare-eligible (<65 years old) and not receiving Social Security Income. We used logistic regression models to compare those working <20 hours per week (the minimal community engagement/work cutoff) to those working >=20 hours per week, adjusting for age, race/ethnicity, sex, education, and marital status. Individuals working <20 hours per week had greater prevalence of chronic health conditions, including greater odds of diabetes (OR: 2.06; 95% CI: 1.37-2.46), hypertension (OR:2.56; 95% CI: 1.69-3.89), arthritis (OR: 2.96; 95% CI: 2.06-4.62, and lung disease (OR: 4.11; 95% CI: 2.31-7.32). Further, among those with chronic health conditions, those working <20 hours per week reported more, medication use, more worsening of their conditions in the past 2 years, and more hospitalization than their counterparts. Taken together, these finding suggest that Medicaid work requirements in this population would have the most impact on the most medically vulnerable individuals. Policymakers should consider this as they propose policies impacting Medicaid coverage in this population.

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 876-878 ◽  
Author(s):  

Chronic health conditions affect many children and adolescents. These conditions are illnesses or impairments that are expected to last for an extended period of time and require medical attention and care that is above and beyond what would normally be expected for a child or adolescent of the same age, extensive hospitalization, or in-home health services.1 These conditions include, among others, juvenile rheumatoid arthritis, asthma, cystic fibrosis, diabetes, spina bifida, hemophilia, seizure disorders, neuromuscular disease, acquired immunodeficiency syndrome, and congenital heart diseases. Although each specific condition may be relatively or extremely rare, when they are considered together, many children and adolescents are affected. Health conditions may be characterized by their duration and their severity. Although these terms are often linked, they refer to different aspects of a health condition. A chronic condition is generally one that has lasted or is expected to last more than a defined period of time, usually 3 months or longer. Conditions vary widely in their onset, course, and duration.2 Severity refers to the impact a condition has on a child's physical, intellectual, psychological, or social functioning.3 This impact may occur as a result of persistent symptoms, required treatments, limitations of activity or mobility, or interference with school, recreation, work, and family activities. Current estimates are that between 10 and 20 million American children and adolescents have some type of chronic health condition or impairment. Most of these conditions are relatively mild and interfere little with the children's ability to participate in usual childhood activities.4 However.


Author(s):  
Alina Morawska

Chronic childhood health conditions are common and significantly affect the child and family. This chapter begins by describing the central role parents play in children’s health outcomes and illness management and the impact the child’s health condition has on parents and the family. Few parenting interventions have been evaluated, and most focus on medical aspects rather than psychosocial factors related to child and family well-being. Existing approaches to parenting support are described, followed by an exploration of the evidence for Triple P interventions. Recent research using Positive Parenting for Healthy Living, a brief parenting intervention for parents with children with chronic health conditions, is showing promising outcomes. Policy and service implications of recent research are summarized.


2017 ◽  
Vol 18 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Scott O’Brien ◽  
Simon Nadel ◽  
Ofran Almossawi ◽  
David P. Inwald

2018 ◽  
Vol 40 (4) ◽  
pp. 318-325
Author(s):  
Megan R. Story ◽  
Benjamin Finlayson ◽  
Lauren Creger ◽  
Elise Bunce

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-336
Author(s):  
Aarti Bhat ◽  
August Jenkins ◽  
David Almeida

Abstract Housing insecurity—or limited and/or unreliable access to quality housing— is a potent on-going stressor that can adversely impact individual well-being. This study extends previous research by investigating the impact of housing insecurity on both the emotional and physical health of aging African American adults using the Midlife in the United States (MIDUS) Refresher oversample of African Americans collected from 2012-2013 (N = 508; M age = 43.02; 57% women). Participants reported on their negative affect, number of chronic health conditions experienced in the last year, and experiences of housing insecurity since the 2008 recession (e.g., homelessness, threatened with foreclosure or eviction, lost home). Negative affect and chronic conditions, respectively, were regressed on housing insecurity, and the potential moderating effect of age was tested. Results showed that housing insecurity was associated with more negative affect (B = 0.05, SE = 0.03, p = .002) and chronic health conditions (B = 0.26, SE = 0.03, p < .001). Additionally, the association between housing insecurity and negative affect was moderated by age (B = -0.11, SE = 0.00, p = .019), such that the effect of housing insecurity on negative affect was stronger for younger adults than for older adults. These results suggest that experiences of insecure housing leave African American adults vulnerable to compromised emotional and physical health, however, the negative effects of housing insecurity may attenuate with age.


2019 ◽  
pp. 216769681988345
Author(s):  
David Allen ◽  
Nerina Scarinci ◽  
Louise Hickson

Patient- and family-centered care has been shown to improve outcomes across a range of health conditions. The purpose of this study was to determine the impact of interventions to improve the patient- and family-centeredness of care (PFCIs) on the effectiveness of care of young adults (16–25) with chronic health conditions. A segregated design mixed-methods systematic review with meta-analysis and meta-synthesis of the literature was conducted. Thirteen quantitative papers and three qualitative papers were identified for inclusion. Random-effects meta-analysis was performed on quantitative findings, and a meta-synthesis was performed on qualitative findings. Preliminary evidence suggests that PFCIs were associated with improvements in the self-efficacy of young people with chronic health conditions. However, there were very few identified studies, and those that were identified were primarily in the field of mental health, requiring ongoing further research.


2013 ◽  
pp. 224-245
Author(s):  
Jennifer Stinson ◽  
Navreet Gill

Chronic health conditions in children and youth are important health problems that seriously affect all aspects of their everyday lives. There is growing recognition of the need to promote disease self-management in youth with chronic health conditions. While there is evidence of the effectiveness of self-management programs to improve health outcomes in pediatric chronic illnesses, there are barriers to youth receiving these services. Internet-based programs offer an innovative approach to improve the availability, accessibility, and acceptability of these programs. This chapter provides an overview of Internet-based chronic disease self-management treatment programs for children and youth. It defines and describes the underlying theories, processes, and content elements of Internet-based self-management programs. Practical tips for program development and evaluation in terms of improved health outcomes are also discussed based on the authors’ experience with developing the “Teens Taking Charge: Managing Arthritis Online” self-management program for adolescents with arthritis. Future directions for theory, research, and clinical practice are also described.


2022 ◽  
pp. 135910532110681
Author(s):  
M Rosie Shrout ◽  
Daniel J Weigel

College students ( N = 125) with concealable chronic health conditions (CCHCs) completed online surveys at the beginning and end of the semester assessing stigma experiences and academic outcomes. Correlations showed stigma, alienation, and lack of campus fit were associated with greater illness-related academic interference ( ps < 0.001), negative academic self-comparison ( ps < 0.001), academic anxiety ( ps < 0.001), academic dissatisfaction ( ps < 0.001), and lower expected grades (except alienation; ps < 0.001–0.03) over time. Hierarchical multiple regressions identified a lack of campus fit as an important predictor across academic outcomes ( ps < 0.001–0.019). Students with CCHCs face health- and stigma-related challenges that can interfere with academic performance.


2021 ◽  
Author(s):  
Adelson Jantsch ◽  
Bo Burström ◽  
Gunnar Nilsson ◽  
Antônio de Leon

Abstract There is a need for evidence that residency training in family medicine (RTFM) can benefit the care of patients in primary care in low- and middle-income countries. We tested the hypothesis that two years of RTFM enables doctors to better detect chronic health conditions (CHC) while requesting fewer laboratory exams and providing more follow-up visits. We performed a retrospective longitudinal observational analysis of medical consultations from 2013 to 2018 in primary care in Rio de Janeiro, comparing doctors without RTFM (Generalists) versus family physicians (FPs). Multivariate multilevel binomial regression models estimated the risks of patients being diagnosed for a list of 31 CHCs, having a follow-up visit for these CHCs, and having laboratory tests ordered from a list of 30 exams. 569.289 patients had 2.908.864 medical consultations performed by 734 generalists and 231 FPs. Patients seen by FPs were at a higher risk of being detected for most of the CHCs, at a lower risk of having any of the 30 LTs requested, and at higher risk of having a follow-up visit in primary care. RTFM can make physicians more skilled to work in primary care. Policymakers must prioritize investments in RTFM to make primary care truly comprehensive.


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