Awareness of Hospice Care Among Rural African-Americans: Findings From Social Determinants of Health Framework

2021 ◽  
pp. 104990912110578
Author(s):  
Hyunjin Noh ◽  
Hee Y. Lee ◽  
Lewis H. Lee ◽  
Yan Luo
Keyword(s):  
Health Literacy ◽  
Social Determinants Of Health ◽  
Social Isolation ◽  
Social Determinants ◽  
Hospice Care ◽  
Demographic Characteristics ◽  
Black Belt ◽  
Determinants Of Health ◽  
Black Belt Region ◽  
Alabama's Black Belt

Background: Despite the need for hospice care as our society ages, adults in the U.S.’s southern rural region have limited awareness of hospice care. Objective: This study aims to assess the rate of awareness of hospice care among rural residents living in Alabama’s Black Belt region and examine social determinants of health (SDH) associated with the awareness. Methods: A cross-sectional survey was conducted among a convenience sample living in Alabama’s Black Belt region (N = 179, age = 18-91). Participants’ awareness of hospice care, demographic characteristics (ie, age and gender), and SDH (ie, financial resources strain, food insecurity, education and health literacy, social isolation, and interpersonal safety) were assessed. Lastly, a binary logistic regression was used to examine the association between SDH and hospice awareness among participants while controlling for demographic characteristics. Results: The majority of participants had heard of hospice care (n = 150, 82.1%), and older participants (50 years old or older) were more likely to report having heard of hospice care ( OR = 7.35, P < 0.05). Participants reporting worries about stable housing (OR = 0.05, P < 0.05) and higher social isolation were less likely to have heard of hospice care ( OR = 0.53, P < 0.05), while participants with higher health literacy had a higher likelihood to have heard of it ( OR = 2.60, P < 0.01). Conclusions: Our study is the first study assessing the status of hospice awareness among residents of Alabama’s Black Belt region. This study highlighted that factors including age and certain SDH (ie, housing status, health literacy, and social isolation) might be considered in the intervention to improve hospice awareness.

scholarly journals Awareness of Hospice Care Among Rural Residents: Findings from Social Determinants of Health Framework

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 775-775
Author(s):  
Yan Luo ◽  
Hyunjin Noh ◽  
Lewis Lee ◽  
Hee Lee
Keyword(s):  
Health Literacy ◽  
Social Determinants Of Health ◽  
Social Isolation ◽  
Social Determinants ◽  
Hospice Care ◽  
Demographic Characteristics ◽  
Black Belt ◽  
Determinants Of Health ◽  
Rural Residents ◽  
Black Belt Region

Abstract Although the demand for hospice care increases as our society ages, the awareness of hospice care among adults in the southern rural region of the US has not been documented. This study aims to assess the rate of hospice care awareness among rural residents living in the Black Belt Region and examine social determinants of health (SDH) associated with the awareness. A cross-sectional survey was conducted among a convenient sample living in rural Alabama (N=182, age=18-91). Participants’ awareness of hospice care, demographic characteristics (i.e., age, gender), and SDH (i.e., financial resources strain, food insecurity, education and health literacy, social isolation, and interpersonal safety) were assessed. Lastly, a binary logistic regression was used to examine the association between SDH and awareness of hospice care among participants while controlling for demographic characteristics. The majority of participants had heard of hospice care (82.4%), and older participants (over 50 years old) were more likely to report having heard of hospice care (OR=7.35, p&lt;0.05). Participants reporting worries about stable housing (OR=0.05, p&lt;0.05) and higher social isolation were less likely to have heard of hospice care (OR=0.53, p&lt;0.05), while participants with higher health literacy had a higher likelihood to have heard of it (OR=2.60, p&lt;0.01). Our study is the first study assessing the status of hospice care awareness among residents living in the Black Belt Region. This study highlighted that factors including age and certain SDH (i.e., housing status, health literacy, and social isolation) might be considered in the intervention to improve hospice care awareness.

scholarly journals Social Determinants of Health as Potential Influencers of a Collaborative Care Intervention for Patients with Hypertension

2021 ◽  
Vol 31 (1) ◽  
pp. 47-56
Author(s):  
Chidinma A. Ibe ◽  
Carmen Alvarez ◽  
Kathryn A. Carson ◽  
Jill A. Marsteller ◽  
Deidra C. Crews ◽  
...  
Keyword(s):  
Health Literacy ◽  
Community Health ◽  
Social Determinants Of Health ◽  
Community Health Workers ◽  
Social Determinants ◽  
Collaborative Care ◽  
Health Workers ◽  
Determinants Of Health ◽  
Nurse Care ◽  
Care Intervention

Objectives: The use of collaborative care teams, comprising nurse care managers and community health workers, has emerged as a promising strategy to tackle hyperten­sion disparities by addressing patients’ social determinants of health. We sought to identify which social determinants of health are associated with a patient’s likelihood of engaging with collaborative care team members and with the nurse care manager’s likelihood of enlisting community health workers (CHW) to provide additional sup­port to patients.Methods: We conducted a within-group longitudinal analysis of patients assigned to receive a collaborative care intervention in a pragmatic, cluster randomized trial that aims to reduce disparities in hypertension control (N=888). Generalized estimating equations were used to identify which social deter­minants of health, reported on the study’s baseline survey, were associated with the odds of patients engaging with the col­laborative care intervention, and of nurses deploying community health workers.Results: Patients who were unable to work and those with higher health literacy were less likely to engage with the collaborative care team than those who were employed full time or had lower health literacy, respectively. Patients had a greater likeli­hood of being referred to a community health worker by their care manager if they reported higher health literacy, perceived stress, or food insecurity, while those report­ing higher numeracy had lower odds of receiving a CHW referral.Implications/Conclusions: A patient’s social determinants of health influence the extent of engagement in a collaborative care intervention and nurse care manager appraisals of the need for supplementary support provided by community health workers.Ethn Dis. 2021;31(1):47-56; doi:10.18865/ed.31.1.47

scholarly journals Social determinants of health associated with hemodialysis non-adherence and emergency department utilization: a pilot observational study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kamna S. Balhara ◽  
Lori Fisher ◽  
Naya El Hage ◽  
Rosemarie G. Ramos ◽  
Bernard G. Jaar
Keyword(s):  
Risk Factors ◽  
Health Literacy ◽  
Observational Study ◽  
Social Determinants Of Health ◽  
Resource Utilization ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Emergency Department Utilization ◽  
Convenience Sample ◽  
Physical Limitations

Abstract Background Dialysis patients who miss treatments are twice as likely to visit emergency departments (EDs) compared to adherent patients; however, prospective studies assessing ED use after missed treatments are limited. This interdisciplinary pilot study aimed to identify social determinants of health (SDOH) associated with missing hemodialysis (HD) and presenting to the ED, and describe resource utilization associated with such visits. Methods We conducted a prospective observational study with a convenience sample of patients presenting to the ED after missing HD (cases); patients at local dialysis centers identified as HD-compliant by their nephrologists served as matched controls. Patients were interviewed with validated instruments capturing associated risk factors, including SDOH. ED resource utilization by cases was determined by chart review. Chi-square tests and ANOVA were used to detect statistically significant group differences. Results All cases visiting the ED had laboratory and radiographic studies; 40% needed physician-performed procedures. Mean ED length of stay (LOS) for cases was 17 h; 76% of patients were admitted with average LOS of 6 days. Comparing 25 cases and 24 controls, we found no difference in economic stability, educational attainment, health literacy, family support, or satisfaction with nephrology care. However, cases were more dependent on public transport for dialysis (p = 0.03). Despite comparable comorbidity burdens, cases were more likely to have impaired mobility, physical limitations, and higher severity of pain and depression. (p < 0.05). Conclusions ED visits after missed HD resulted in elevated LOS and admission rates. Frequently-cited SDOH such as health literacy did not confer significant risk for missing HD. However, pain, physical limitations, and depression were higher among cases. Community-specific collaborations between EDs and dialysis centers would be valuable in identifying risk factors specific to missed HD and ED use, to develop strategies to improve treatment adherence and reduce unnecessary ED utilization.

Opioid Literacy of Korean Americans in Rural Alabama: Addressing the Role of Social Determinants of Health

2021 ◽  
pp. 104365962199590
Author(s):  
Hee Yun Lee ◽  
Eun Young Choi ◽  
Cho Rong Won ◽  
Jieun Song ◽  
Jamie M. Gajos ◽  
...  
Keyword(s):  
Health Literacy ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Contact ◽  
Korean Americans ◽  
Determinants Of Health ◽  
Opioid Overdose ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Rural Alabama

Introduction: Opioid crisis has disproportionately affected Alabamians with the highest opioid prescription rate, and it is subjected to affect Korean Americans (KA) negatively based on common predictors of opioid misuse that KA possess. Method: Cross-sectional data of KA in rural Alabama ( N = 230) were analyzed. Opioid literacy was assessed by the Brief Opioid Overdose Knowledge survey. Six social determinants of health factors were considered: financial status, educational attainment, English proficiency, household food insecurity, health literacy, and social contact. Results: Participants had limited opioid literacy ( M = 3.56, SD = 3.06). After adjusting for demographics and health covariates, higher levels of overall opioid literacy were associated with higher household income ( B = .48, p < .01), higher levels of health literacy ( B = .71, p < .01), and less frequent social contact ( B = −.40, p < .01). Significant social determinants of health predictors varied across subdomains of opioid literacy. Discussion: The findings suggest that culturally competent and community-level interventions are needed to increase opioid literacy in KA in rural Alabama.

scholarly journals Health Literacy: A Key Component of Controlling Social Determinants of Health

2018 ◽  
Vol 5 (1) ◽  
pp. 1-3
Author(s):  
Rahman Panahi ◽  
Gholamreza Ebrahimi ◽  
Ali Ahmadi ◽  
◽  
◽  
...  
Keyword(s):  
Health Literacy ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health
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