Investigating the diversity of Canada’s refugee population and its health implications: does one size fit all?

2017 ◽  
Vol 13 (2) ◽  
pp. 145-156 ◽  
Author(s):  
Bruce Newbold ◽  
Marie McKeary

Purpose Based on a case study in Hamilton, Ontario, Canada, the purpose of this paper is to explore the difficulties faced by local health care providers in the face of constantly evolving refugee policies, programs, and arrivals. In doing so, it illustrates the complications faced by service providers in providing care to refugee arrivals and how the diversity of arrivals challenges health care provision and ultimately the health and well-being of refugees. Design/methodology/approach A series of semi-structured, in-depth interviews with key service professionals in both the social service and health fields in Hamilton, Ontario, Canada, examined both health and health care issues. Findings Beyond challenges for service providers that have been previously flagged in the literature, including language barriers and the limited time that they have with their clients, analysis revealed that health care providers faced other challenges in providing care, with one challenge reflecting the difficulty of providing care and services to a diverse refugee population. A second challenge reflected the lack of knowledge associated with constantly evolving policies and programs. Both challenges potentially limit the abilities of care providers. Research limitations/implications On-going changes to refugee and health care policy, along with the diversity of refugee arrivals, will continue to challenge providers. The challenge, therefore, for health care providers and policy makers alike is how to ensure adequate service provision for new arrivals. Practical implications The Federal government should do a better job in disseminating the impact of policy changes and should streamline programs. This is particularly relevant given limited budgets and resources, tri-partite government funding, short time-frames to prepare for new arrivals, inadequate background information, barriers/challenges or inequitable criteria for access to health and social services, while addressing an increasingly diverse and complex population. Social implications The research reinforces the complexity of the needs and challenges faced by refugees when health is considered, and the difficulty in providing care to this group. Originality/value While there is a large refugee health literature, there is relatively little attention to the challenges and difficulties faced by service providers in addressing the health needs of the diverse refugee population, a topic that is particularly important given limited funding envelopes, shifting policies and programs, and a focus on clients (refugees). It is this latter piece – the challenges faced by providers in providing care to refugees – which this paper explores.

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicole F. Stowell ◽  
Carl Pacini ◽  
Martina K. Schmidt ◽  
Nathan Wadlinger

Purpose This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud. Design/methodology/approach This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws. Findings The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come. Research limitations/implications Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors. Practical implications Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers. Originality/value This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.


2018 ◽  
Vol 33 (4) ◽  
pp. 368-374 ◽  
Author(s):  
Olga Anikeeva ◽  
Paul Arbon ◽  
Kathryn Zeitz ◽  
Murk Bottema ◽  
Adam Lund ◽  
...  

AbstractIntroductionMass gatherings are complex events that present a unique set of challenges to attendees’ health and well-being. There are numerous factors that influence the number and type of injuries and illnesses that occur at these events, including weather, event and venue type, and crowd demographics and behavior.ProblemWhile the impact of some factors, such as weather conditions and the availability of alcohol, on patient presentations at mass gatherings have been described previously, the influence of many other variables, including crowd demographics, crowd behavior, and event type, is poorly understood. Furthermore, a large number of studies reporting on the influence of these variables on patient presentations are based on anecdotal evidence at a single mass-gathering event.MethodsData were collected by trained fieldworkers at 15 mass gatherings in South Australia and included event characteristics, crowd demographics, and weather. De-identified patient records were obtained from on-site health care providers. Data analysis included the calculation of patient proportions in each variable category, as well as the total number of patient presentations per event and the patient presentation rate (PPR).ResultsThe total number of expected attendees at the 15 mass gatherings was 303,500, of which 146 presented to on-site health care services. The majority of patient presentations occurred at events with a mean temperature between 20°C and 25°C. The PPR was more than double at events with a predominantly male crowd compared to events with a more equal sex distribution. Almost 90.0% of patient presentations occurred at events where alcohol was available.Conclusion:The results of the study suggest that several weather, crowd, and event variables influence the type and number of patient presentations observed at mass-gathering events. Given that the study sample size did not allow for these interactions to be quantified, further research is warranted to investigate the relationships between alcohol availability, crowd demographics, crowd mobility, venue design, and injuries and illnesses.Anikeeva O, Arbon P, Zeitz K, Bottema M, Lund A, Turris S, Steenkamp M. Patient presentation trends at 15 mass-gathering events in South Australia. Prehosp Disaster Med. 2018;33(4):368–374.


Author(s):  
Dennis Myers ◽  
Terry A. Wolfer ◽  
Maria L. Hogan

A complex web of attitudinal, cultural, economic, and structural variables condition the decision to respond to communications promoting healthy behavior and participation in risk reduction initiatives. A wide array of governmental, corporate, and voluntary sector health-related organizations focus on effective messaging and health care options, increasing the likelihood of choices that generate and sustain wellness. Researchers also recognize the significant and multifaceted ways that religious congregations contribute to awareness and adoption of health-promoting behaviors. These religiously based organizations are credible disseminators of health education information and accessible providers of venues that facilitate wellness among congregants and community members. The religious beliefs, spirituality, and faith practices at the core of congregational cultural life explain the trustworthiness of their messaging, the health of their adherents, and the intention of their care provision. Considerable inquiry into the impact of religion and spirituality on health reveals substantive correlations with positive psychological factors known to sustain physical and psychological health—optimism, meaning and purpose, hope, well-being, self-esteem, gratefulness, social support, and marital stability. However, the beliefs and practices that create receptivity to health-related communications, care practices, and service provision can also be a deterrent to message impact and participation in healthy behaviors. When a productive relationship between spirituality and health exists, congregational membership offers rituals (e.g., worship, education, mission) and relationships that promote spiritual well-being. Research demonstrates increased life satisfaction and meaning in life, with health risk reduction associated with a sense of belonging, enriched social interactions, and shared experiences. Congregations communicate their commitment to wellness of congregants and community members alike through offering a variety of congregationally based and collaborative wellness and risk reduction programs. These expressions of investment in individual and community health range across all age, gender, and ethnic demographics and address most of the prominent diagnostic categories. These programs are ordered along three dimensions: primary prevention (health care messaging and education), secondary prevention (risk education), and tertiary prevention (treatment). Applying the dimensions of sponsorship, goal/mission, focus, services, staffing, and intended outcome highlights the similarities and differences among them. Several unique facets of congregational life energize the effectiveness of these programs. Inherent trust and credibility empower adherence, and participation decisions and financial investment provide service availability. These assets serve as attractive contributions in collaborations among congregations and between private and public health care providers. Current research has not yet documented the best practices associated with program viability. However, practice wisdom in the planning, implementation, and evaluation of congregationally based and collaborative health-related programs suggests guidelines for future investigation. Congregational leaders and health care professionals emphasize well-designed needs assessment. Effective congregational health promotion and risk reduction may be linked to the availability and expertise of professionals and volunteers enacting the roles of planner/program developer, facilitator, convener/mediator, care manager/advocate, health educator, and direct health care service provider.


2019 ◽  
Vol 68 (2) ◽  
pp. 81-91
Author(s):  
Huiru Tong ◽  
Xiaoming Li ◽  
Shan Qiao ◽  
Yuejiao Zhou ◽  
Zhiyong Shen ◽  
...  

Work-related stress can negatively impact health care providers’ (HCPs) ability to provide care. We examined the sources of work-related stress experienced by HCPs who provided medical care for people living with HIV/AIDS and the impact of the stress on HCPs’ well-being and work performance. We conducted in-depth interviews with 46 HIV/AIDS HCPs in Guangxi, China. The interviews were audio-recorded, transcribed, and imported into NVivo V.11 for data management and data analysis using a thematic approach. We found that the key sources of stress at work included general work-related sources and HIV/AIDS-related sources. All stress was seen to have a substantial impact on the HCPs’ individual well-being, family and social life, and quality of care they provided. We recommended that government and health care facilities should take measures to improve institutional culture and professional development for HIV/AIDS HCPs. More professional training schemes should be provided to strengthen HCPs’ competence, improve universal protection from occupational exposure, and reduce the stigma toward HIV/AIDS patients and their care providers.


2018 ◽  
Vol 31 (8) ◽  
pp. 878-887
Author(s):  
Marie Nagy ◽  
Mary Chiarella ◽  
Belinda Bennett ◽  
Merrilyn Walton ◽  
Terry Carney

Purpose The “patient journey” technique is one that has been used by health care providers to investigate the strengths and weaknesses of their service delivery. The purpose of this paper is to discuss the experience of adapting this approach for use in an atypical context – the comparison of two systems for managing health care complaints and notifications. It highlights a number of relevant considerations and provides suggestions for similar studies. Design/methodology/approach The design and methods of the study are described, with commentary on the success of key aspects and challenges encountered. To enable comparison between the two systems, this study had a “paired” design, in which examples were selected from each system so that they matched on basic, prescribed, criteria. Data about each matter’s journey were then collected from administrative records. Findings While, overall, the technique provided rich data on the processes of the systems under investigation, the type of data collected (related to administrative/communicative events) and the study’s comparative purpose required consideration and management of a number of issues. These included the implications of using administrative records and the impact of differences between the systems on the paired design. Originality/value This paper describes an attempt to apply the “journey” approach in a context that is uncommon in two ways: first, in its focus on regulatory processes (complaint/notification handling), rather than care provision to an individual patient; and second, in its objective of comparing two different systems. It is hoped this account will assist in further development of this technique.


2021 ◽  
pp. 152715442198999
Author(s):  
Caroline K. Darlington ◽  
Peggy A. Compton ◽  
Sadie P. Hutson

The rising prevalence of opioid use disorder (OUD) among those living in the United States has demanded a collaborative response from health care and policy spheres. Addressing OUD among pregnant women is especially difficult, given the controversies surrounding the medical and ethical balance between meeting maternal versus fetal/newborn needs. Most medical organizations discourage the criminalization of drug use in pregnancy due to the adverse public health outcomes of such an approach. Despite this recommendation, many states continue to use punitive law to address drug use in pregnancy. In 2014, the Fetal Assault Law in Tennessee (TN) became the first law in the United States to directly allow women to be prosecuted for drug use in pregnancy. Since its expiration in 2016, this law has been re-introduced several times to the TN legislature in support of permanent implementation. This article outlines the impact of the initial Fetal Assault Law on maternal/newborn health in TN and provides alternative immediate, short-term, and long-term health policy strategies through which health care providers and legislators can better advocate for the well-being of both mothers with OUD and their infants.


2020 ◽  
Vol 6 (1) ◽  
pp. 24-39
Author(s):  
M. Fontana ◽  
L. McCauley ◽  
M. Fitzgerald ◽  
G.J. Eckert ◽  
E. Yanca ◽  
...  

COVID-19 poses a threat to health and well-being. Objectives: 1) To compare the impact of COVID-19 on the life experiences of essential workers attending a COVID-19 antibody testing clinic at a dental school. 2) To compare responses of dental, non–dental health care, and non–health care essential workers. 3) To assess acceptability/satisfaction of testing done in a dental setting. Method: A total of 984 participants completed a self-administered online questionnaire. Results: Over 90% were healthy (i.e., not in a high-risk health-related group for COVID-19), did not have COVID-19 symptoms within 30 d, and always/frequently engaged in preventive measures. Fifty-eight percent thought that they had a 0% to 25% chance of having immunity/antibodies to COVID-19. Non–dental health care workers thought that their chance was significantly higher (P < 0.05) than others. Over 70% were sometimes, frequently, or always worried about their friends and loved ones getting COVID-19 and of resulting financial problems. Dental workers were significantly less afraid than non–dental health care and non–health care providers. For all groups, more than half of the respondents stated that the pandemic had a negative (somewhat worse or worse) impact on daily life (59%), interactions with others (65%), stress levels (66%), and enjoyment of life (56%). There were significant differences among all 3 groups regarding the percentage of individuals with a negative impact on job security (dental, 47%; non–dental health care, 34%; non–health care, 31%). However, more than half of the respondents stated that the pandemic had a positive impact (same, somewhat better, or much better) on caring about one another, self-care, and exercise. Knowing the results of an antibody test would decrease the level of stress and anxiety in 67% of respondents. Over 80% found a COVID-19 test received in a dental setting acceptable, were “definitely” satisfied, and would “definitely” recommend it to a friend, family, or coworker. Conclusions: These findings support that dental workers are as vulnerable as other essential workers to threats and psychological impacts of COVID-19. They also support the acceptability and satisfaction of testing for a pandemic done in a dental setting. Knowledge Transfer Statement: The results of this study highlight the impact that pandemics such as COVID-19 can have on life experiences of essential workers, including dentists. It also highlights a role that dentistry can play within the broader health care system, during and beyond the current pandemic, to help with surveillance efforts of community health. Testing may also help alleviate stress and anxiety associated with these pandemics.


2016 ◽  
Vol 26 (2) ◽  
pp. 179-202 ◽  
Author(s):  
Qiuying Zheng ◽  
Tang Yao ◽  
Xiucheng Fan

Purpose – The purpose of this paper is to explore the dynamics of online health care communities and the impact of two-way online social support on customers’ well-being and patients’ quality of life, at different social exclusion levels. Design/methodology/approach – An online survey in China’s Anti-Hepatitis B Online Community includes 326 respondents. A combined hierarchical regression analysis and structural equation model test the hypotheses. Findings – Both receiving and giving online social support, as reciprocal altruism behaviors, enhance patients’ well-being. Receiving online social support influences psychological well-being most; giving has the largest impact on existential domains. Social exclusion boosts the benefits of giving online social support but attenuates the benefits of receiving it. Research limitations/implications – This research focusses on the effects of online social support among socially excluded patients. Extensions could rely on objective instead of subjective measures and alternative methodologies to test the underlying processes. Additional insights could derive from a bidirectional perspective. Practical implications – Medical treatment institutions should leverage customer resources; health care providers should prioritize patients who feel socially excluded as effective online support providers. Health care community administrators can use several means to convince patients to contribute to communities. Originality/value – Social support in online health care communities is a collaborative service that uses customers as service resources. This study explains the collaborative service and how customers feel about their bidirectional roles. It also extends reciprocal altruism research to a health information technology realm by systematically exploring how giving, vs receiving, online social support affects customers’ well-being.


2020 ◽  
pp. 15-17
Author(s):  
Alan H Rosenstein

Healthcare is a complex multidimensional system that depends upon effective communication and collaboration amongst all members of the health care team as the key ingredient for best patient care. In the current health care environment all health care providers are feeling the growing pressures on care delivery and the changing health dynamics which in many instances has negatively impacted their attitudes and behaviors toward medical care. Nursing is a key part of this process. In order to provide best patient care, affiliated organizations need to recognize how important staff satisfaction and engagement is to care continuity and provide the necessary resources and support to maintain staff physical, emotional, and behavioral well- being. The aim of the article is to review key literature findings to help organizations recognize the causes and consequences of stress and burnout and the importance of providing the appropriate support and resources to help nurses succeed.


Author(s):  
Michelle Rydback ◽  
Akmal S. Hyder

Purpose Focusing on customization, this paper aims to examine how service providers market health care in emerging markets through medical tourism. Design/methodology/approach Using a qualitative method, researchers conducted 18 semi-structured interviews with managers from five health-care providers and supporting organizations in the Philippines. For analysis, data from the service providers are compared. Findings Customization is found to play crucial role in offering health-care services. The customization takes place by adapting to emotional, social and cultural needs; alleviating knowledge asymmetry; and moderating the negative impact of the unfamiliar context experienced by international patients. Research/limitations implications The empirically grounded theoretical framework needs to be tested in different contexts for generalization. Practical implications The study focuses on understanding and responding to the needs of international patients, also demonstrating that health-care marketing must be developed through a joint effort by both the medical and business sides of health-care providers. Social implications The paper acknowledges the need for health-care marketing and the novel role of health-care providers. Originality/value Using a marketing lens, this study sheds light on the underexplored industry of medical tourism.


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