Introduction to Access to Healthcare

Author(s):  
André den Exter ◽  
Mark A. Hall ◽  
Allison K. Hoffman ◽  
Keith Syrett

This chapter demonstrates how the comparison between Europe and the United States reveals two very different approaches to dealing with the fundamental question of access to healthcare. Here, ‘access to care’ consists of both availability and affordability. Affordability is determined by how a country helps people to pay for care, including by means of healthcare coverage that entitles or enables a patient to access affordable care. Coverage is commonly provided by some type of insurance that pays for the costs of treatment. But care can be arranged and paid for more directly, without insurance, through a program that simply operates facilities or clinics serving an eligible population, as in the United Kingdom. Typically, these direct-access programs are run by government, but they may also be privately operated, as for instance the free clinics and ‘safety net’ hospitals that serve the uninsured in the United States.

2020 ◽  
Vol 25 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Amaia Del Campo ◽  
Marisalva Fávero

Abstract. During the last decades, several studies have been conducted on the effectiveness of sexual abuse prevention programs implemented in different countries. In this article, we present a review of 70 studies (1981–2017) evaluating prevention programs, conducted mostly in the United States and Canada, although with a considerable presence also in other countries, such as New Zealand and the United Kingdom. The results of these studies, in general, are very promising and encourage us to continue this type of intervention, almost unanimously confirming its effectiveness. Prevention programs encourage children and adolescents to report the abuse experienced and they may help to reduce the trauma of sexual abuse if there are victims among the participants. We also found that some evaluations have not considered the possible negative effects of this type of programs in the event that they are applied inappropriately. Finally, we present some methodological considerations as critical analysis to this type of evaluations.


2020 ◽  
Vol 119 (820) ◽  
pp. 303-309
Author(s):  
J. Nicholas Ziegler

Comparing the virus responses in Germany, the United Kingdom, and the United States shows that in order for scientific expertise to result in effective policy, rational political leadership is required. Each of these three countries is known for advanced biomedical research, yet their experiences in the COVID-19 pandemic diverged widely. Germany’s political leadership carefully followed scientific advice and organized public–private partnerships to scale up testing, resulting in relatively low infection levels. The UK and US political responses were far more erratic and less informed by scientific advice—and proved much less effective.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meredith T. Niles ◽  
Kristen Brassard Wirkkala ◽  
Emily H. Belarmino ◽  
Farryl Bertmann

Abstract Background Home food procurement (HFP) (i.e. gardening, fishing, foraging, hunting, backyard livestock and canning) have historically been important ways that people obtain food. Recently, some HFP activities have grown (e.g. gardening), while other activities (e.g. hunting) have become less common in the United States. Anecdotally, COVID-19 has sparked an increase in HFP evidenced by increased hunting licenses and shortages in seeds and canning supplies. HFP may have positive benefits for food security and diet quality, though research beyond gardening is especially limited in high-income countries. Methods We examine HFP activities since the COVID-19 pandemic began, and their relationship to food security and dietary quality using multivariable logit models and matching analysis with a statewide representative survey (n = 600) of residents of Vermont, United States. Results We find 29% of respondent households classified as food insecure since COVID-19, and higher prevalence of food insecurity among those experiencing a negative job change since COVID-19, households earning less than $50,000 annually, Hispanic and multi-race respondents. Nearly 35% of respondents engaged in HFP activities since the COVID-19 pandemic began; the majority of those gardened, and more than half pursued HFP activities more intensely than before the pandemic or for the first time. Food insecure households were more likely to pursue HFP more intensely, including more gardening, fishing, foraging, and hunting. Respondents who were food insecure, Black, Indigenous, People of Color, those with a negative job disruption, and larger households all had greater odds of increased intensity of HFP during the COVID-19 pandemic. HFP was significantly associated with eating greater amounts of fruits and vegetables; however, this effect was only significant for food secure households. Conclusion Overall, these results suggest that HFP activities have increased since the start of the COVID-19 pandemic, and may be an important safety net for food insecure households. However, HFP for food insecure households does not translate into the same higher fruit and vegetable intake as found among food secure HFP households, suggesting this population may be trying to maintain intake, or that they may have potential important resource or technical assistance needs. Long-term, HFP activities may have important food security and diet quality impacts, as well as conservation implications, which should be more thoroughly explored. Regardless, the increased interest and intensity of HFP demonstrates opportunities for educational and outreach efforts.


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