scholarly journals Influence of Social Determinants on Self-Rated Health in Three Countries of East Asia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 485-485
Author(s):  
Takeshi Nakagawa ◽  
Dannii Yeung ◽  
Jinmyoung Cho
Keyword(s):  
Health Care ◽  
Cultural Values ◽  
Social Determinants ◽  
Health Care Access ◽  
Social Engagement ◽  
Medical Center ◽  
Economic Status ◽  
Community Context ◽  
Self Rated Health ◽  
Education Levels

Abstract This study aims to compare five domains of social determinants and their associations with self-rated health (SRH) among older adults in China, Japan, and Korea, where they share some cultural values but the development and conditions of economic status, health care system, and education system vary. A total of 10,111 participants aged 65 years and older were included from three harmonized datasets at baseline CHARLS, KLoSA, and JSTAR. Guided by the Healthy People 2020 Framework, five domains of social determinants were included: education levels, economic stability (total income, working for pay), social and community context (social engagement, living with children), health care access (medical center utilization), and neighborhood (rural vs. urban). Regression models showed that working for pay, social engagement, and medical center utilization were significant predictors for SRH in three countries. However, unique predictors have also been observed in China and Korea, which will be discussed in the presentation.

Racial Disparities in Incidence of Legionnaires’ Disease and Social Determinants of Health: A Narrative Review

2021 ◽  
pp. 003335492110267
Author(s):  
Candis M. Hunter ◽  
Simone W. Salandy ◽  
Jessica C. Smith ◽  
Chris Edens ◽  
Brian Hubbard
Keyword(s):  
Health Care ◽  
Built Environment ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Narrative Review ◽  
Economic Stability ◽  
Care Access ◽  
Legionnaires Disease ◽  
Access And Quality

Objectives Racial and socioeconomic disparities in the incidence of Legionnaires’ disease have been documented for the past 2 decades; however, the social determinants of health (SDH) that contribute to these disparities are not well studied. The objective of this narrative review was to characterize SDH to inform efforts to reduce disparities in the incidence of Legionnaires’ disease. Methods We conducted a narrative review of articles published from January 1979 through October 2019 that focused on disparities in the incidence of Legionnaires’ disease and pneumonia (inclusive of bacterial pneumonia and/or community-acquired pneumonia) among adults and children (excluding articles that were limited to people aged <18 years). We identified 220 articles, of which 19 met our criteria: original research, published in English, and examined Legionnaires’ disease or pneumonia, health disparities, and SDH. We organized findings using the Healthy People 2030 SDH domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment. Results Of the 19 articles reviewed, multiple articles examined disparities in incidence of Legionnaires’ disease and pneumonia related to economic stability/income (n = 13) and comorbidities (n = 10), and fewer articles incorporated SDH variables related to education (n = 3), social support (none), health care access (n = 1), and neighborhood and built environment (n = 6) in their analyses. Conclusions Neighborhood and built-environment factors such as housing, drinking water infrastructure, and pollutant exposures represent critical partnership and research opportunities. More research that incorporates SDH and multilevel, cross-sector interventions is needed to address disparities in Legionnaires’ disease incidence.

scholarly journals Self-Rated Health and Health Care Access Associated With African American Men’s Health Self-Efficacy

2015 ◽  
Vol 11 (5) ◽  
pp. 1385-1387 ◽  
Author(s):  
Terry Thompson ◽  
Jamie A. Mitchell ◽  
Vicki Johnson-Lawrence ◽  
Daphne C. Watkins ◽  
Charles S. Modlin
Keyword(s):  
Health Care ◽  
African American ◽  
Health Insurance ◽  
Health Care Access ◽  
Self Efficacy ◽  
African American Men ◽  
Good Care ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Care Access

Health self-efficacy, a measure of one’s self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, “Overall, how confident are you in your ability to take good care of your health?” Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.

scholarly journals Medical Students Screen for Social Determinants of Health: A Service Learning Model to Improve Health Equity

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Lucy Bickerton ◽  
Nicolle Siegart ◽  
Crystal Marquez
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Service Learning ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Social Needs ◽  
Community Resources ◽  
Care Access ◽  
Improve Health

Introduction: Medical schools are now required to address health disparities within their curriculum, with a recent emphasis on social determinants of health (SDOH). However, there is scant evidence that incorporating educational experiences around SDOH impacts health equity for patients. The COVID-19 pandemic provided a unique setting to engage students to address SDOH directly with patients. Methods: The authors designed a service-learning experience in which medical students conducted a patient needs assessment survey by phone to assess SDOH in the domains of health care access, economic stability, and social cohesion. We drew descriptive statistics from a deidentified Excel database of call outcomes to quantify health care interactions and community resource referrals generated by callers. Results: The call outcomes revealed unmet health and social needs among the patient population and generated a substantial number of actions to improve health care access and awareness of community resources. Conclusion: The results of this project show that employing medical students to engage with SDOH through action-oriented service learning positively impacts health care access and referrals to community resources. This initiative provides a flexible model to engage medical trainees in addressing health-related social needs that can be applied to a range of clinical settings and learner levels.

scholarly journals Ethical Justification of Conducting Research Trials in Lower and Middle Income Countries Including Pakistan: The Responsibilities of Research Enterprises

2016 ◽  
Vol 6 (3) ◽  
pp. 25-29
Author(s):  
Zoheb Rafique
Keyword(s):  
Health Care ◽  
Population Size ◽  
Cultural Values ◽  
Health Care Cost ◽  
Academic Research ◽  
Asian Country ◽  
Middle Income ◽  
Education Levels ◽  
Drug Regulations ◽  
Conducting Research

Asia is the most diverse continent in the world in terms of culture, religion, population size, finance, education, health care, academic research, general population skills, and governmental drug regulations. Each Asian country has its own unique qualities when it comes to attracting industry sponsored clinical trials. Factors that influence selecting location of a study site for a sponsored trial are mainly population size, infrastructure, education levels, and quality of health care, cost and drug regulatory platform.   Conducting research in traditional countries like Pakistan adds another dimension to the problems in assuring that research conducted in an ethical manner. The indigenous layer of the cultural values makes it even more difficult task, but this is the task that we are morally and ethically bound to shoulder.

scholarly journals The Impact Of A Whole Health Model Of Care On Patient Outcomes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 838-838
Author(s):  
Anna Faul ◽  
Pamela Yankeelov ◽  
Joseph D'Ambrosio ◽  
Sam Cotton ◽  
Barbara Gordon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Social Determinants ◽  
Health Care Access ◽  
Determinants Of Health ◽  
Education Attainment ◽  
Psychological Determinants ◽  
Care Access ◽  
The Impact ◽  
Over Time

Abstract The FlourishCare Model (FCM) transforms primary care sites by addressing all determinants of health and focusing on helping patients to flourish. The FlourishCare Index (FCI) is a clinical measure to assess the effectiveness of the FCM to address all determinants of health. We will present data on the effectiveness of the FCM serving 159 older adults with MCCs. The sample was mostly female (77%), White (64%), retired (54%), married (30%) or widowed (20%) and living in urban areas (64%). The mean age was 69 (SD=15), with 13 years education (SD=3). Patients changed significantly over time on total FCI scores (57%-72%;□=3.80,SE=0.63). Results show significant growth over time for individual health behaviors (58%-67%;□=2.14,SE=0.84), health care access (71%-89%;□=4.43,SE=1.00) and social determinants (62%-85%;□=5.54,SE=1.02) with psychological determinants (54%-61%;□=1.74,SE=0.95) and environmental determinants (70%-81%;□=2.81,SE=1.62) showing a trend to significance. Interaction effects with time show that the FCM supported patients with lower education attainment to improve at a higher rate than those with higher education attainment, for the total FCI score (□=-0.59,SE=0.24) and health care access (□=-0.94,SE=0.38). Receiving mental health counseling resulted in more improvement in psychological determinants than those who did not receive counseling (□=3.43,SE=2.04). The FCM was able to support rural patients at a higher rate than urban patients to gain access to health care (□=4.13,SE=2.02). The FCM supported Hispanic patients the most in improving social determinants of health (□=8.40,SE=3.93). This study showed the importance of a systems approach to care using measures that focus on what matters most to older adults who value quality-of-life outcomes.

scholarly journals Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255226
Author(s):  
I. Jimeno ◽  
N. Mendoza ◽  
F. Zapana ◽  
L. de la Torre ◽  
F. Torrico ◽  
...  
Keyword(s):  
Health Care ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Social Determinants ◽  
Community Involvement ◽  
Health Care Access ◽  
Access To Health Care ◽  
Qualitative Content Analysis ◽  
Three Dimensions ◽  
Research Subjects

Introduction Chagas disease is caused by the Trypanosoma cruzi infection. It is a neglected tropical disease with considerable impact on the physical, psychological, familiar, and social spheres. The Valle Alto of Cochabamba is a hyperendemic region of Bolivia where efforts to control the transmission of the disease have progressed over the years. However, many challenges remain, above all, timely detection and health-care access. Methods Following the Science Shop process, this bottom-up research emerged with the participation of the civil society from Valle Alto and representatives of the Association of Corazones Unidos por el Chagas from Cochabamba. The aim of this study is to explore the social determinants in the living realities of those affected by Chagas disease or the silent infection and how families in the Valle Alto of Cochabamba cope with it. An interdisciplinary research team conducted a case study of the life stories of three families using information from in-depth interviews and performed a descriptive qualitative content analysis and triangulation processes. Findings Findings provide insights into social circumstances of the research subjects’ lives; particularly, on how exposure to Trypanosoma cruzi infection affects their daily lives in terms of seeking comprehensive health care. Research subjects revealed needs and shared their experiences, thus providing an understanding of the complexity of Chagas disease from the socioeconomic, sociocultural, political, and biomedical perspectives. Results enlighten on three dimensions: structural, psychosocial, and plural health system. The diverse perceptions and attitudes toward Chagas within families, including the denial of its existence, are remarkable as gender and ethnocultural aspects. Findings support recommendations to various stakeholders and translation materials. Conclusions Intersectional disease management and community involvement are essential for deciding the most appropriate and effective actions. Education, detection, health care, and social programs engaging family units ought to be the pillars of a promising approach.

scholarly journals Social Determinants of Health for People With Serious Mental Illness After Transitioning to the Community

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 32-33
Author(s):  
Kathy Kellett ◽  
Kaleigh Ligus ◽  
Kristin Baker ◽  
Julie Robison
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Determinants ◽  
Community Context ◽  
Improve Quality ◽  
Social Community

Abstract Approximately 10 million, or 6 percent, of the U.S. population experience serious mental illness (SMI) (NAMI, 2019). Social determinants of health (SDOH) associated with this population can provide important information for targeted innovations with the potential to reduce disease burden and improve quality of life. Using secondary data from Connecticut’s Money Follows the Person Rebalancing Demonstration, this research compares people age 50+ who transitioned out of an institution onto the Medicaid HCBS Mental Health Waiver (MHW) (n= 271) to those receiving Mental Health services through the Medicaid State Plan (MHSP) (n=278). Analyses examine SDOH in both groups and are organized around five broad domains: Finances; education; social/community context, health/health care, and neighborhood/built environment. MHSP participants were significantly more likely to report not having enough money at the end of the month at 6 (42% vs. 21%), 12 (37% vs. 20%), and 24 (37% vs. 17%) months. Significantly more MHSP than MHW participants did not like where they lived at 6 (12% vs. 1%) and 24 (24% vs. 5%) months. Significantly more MHSP than MHW participants were unhappy with the help they received in the community at 6 (22% vs. 8%), 12 (23% vs. 7%), and 24 (19% vs. 5%) months. Groups did not differ by education, social/community context, health/health care, feelings of safety where they live, or on post-transition hospitalizations, ED use or reinstitutionalization. To improve quality of life in the community, MHSP participants could benefit from greater assistance with finances, housing, and community services.

scholarly journals Factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia: a Secondary data analysis of 2016 Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
koku Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Economic Status ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Perceived Barriers ◽  
Reproductive Age ◽  
Factors Associated ◽  
Care Access ◽  
Reproductive Age Women

Abstract Background: Health care access is the timely use of personal health services to achieve the best health outcomes. Difficulties to access health care among reproductive-age women may lead to different negative health outcomes like death and disability. Therefore, this study aimed to assess factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia. Method: This study was based on the 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of health care perceived barriers were created from four questions used to rate health care access perceived barriers among reproductive-age women. The Generalized Estimating Equation (GEE) model was fitted to identify factors associated with health care perceived barriers. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between independent and outcome variables. Result: This study revealed that the perceived barrier of health care access among reproductive age women found to be 69.9% with 95%CI (69.3 to 70.7) to at least one or more of the four reasons. Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), divorced/separated (AOR= 1.34, 95%CI: 1.17 to 1.54), had no health insurance coverage (AOR=1.19, 95%CI: 1.01 to 1.45), poor (AOR=2.09,95%CI: 1.86 to 2.35) and middle wealth (AOR=1.57,95%CI:1.38 to 1.79), no education (AOR=2.30, 95%CI:1.95 to 2.72), primary education (AOR= 1.84, 95%CI :1.58 to 2.15) and secondary education (AOR= 1.31, 95%CI: 1.13 to 1.51) were factors associated with perceived barriers of health care access. Conclusion: Significant proportion of reproductive-age women faced barriers of health care access, of which, money and distance were the common perceived barriers. Divorced/separated marital status, old age, rural dwelling, no health insurance coverage, low economic status and level of education were factors associated with perceived barriers of health care access. This findings suggests that further strengthening and improvement of health care access to those with low socio-economic status for the realization of universal health coverage and equity of service provision.

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