“Healing Alone?”: Social Capital, Racial Diversity and Health Care Inequality in the American States

2017 ◽  
Vol 45 (6) ◽  
pp. 1059-1087 ◽  
Author(s):  
Ling Zhu
Keyword(s):  
Health Care ◽  
Social Capital ◽  
Health Care Access ◽  
Racial Diversity ◽  
Care Access ◽  
American States ◽  
The Social ◽  
High Level ◽  
Domain I ◽  
The Impact

There is an influential tradition in political science that social capital, defined as mutual trust and civic engagement, is linked to better substantive outcomes for citizens in democracies. Recently, scholars who link social capital to race and inequality have challenged this favorable picture of social capital. This study draws from the scholarly discussion on how social capital affects inequality in diverse societies. Focusing on the health care domain, I use a new dynamic measure of social capital to evaluate the “social capital thesis” and “racial diversity thesis” of inequality. Moreover, I explore how these two political forces are intertwined with each other in shaping the unequal health care access across American states. Key empirical findings confirm that social capital and racial diversity are counterbalancing forces shaping health care inequality. Despite it reduces health care inequality, the impact of social capital is tempered with high level of racial diversity.

scholarly journals Social Capital and Health Care Access

2009 ◽  
Vol 66 (3) ◽  
pp. 272-306 ◽  
Author(s):  
Kathryn Pitkin Derose ◽  
Danielle M. Varda
Keyword(s):  
Health Care ◽  
Social Capital ◽  
Health Care Access ◽  
Care Access

scholarly journals 482. Impact of COVID-19 Pandemic on Psychosocial and Clinical Factors among people with and without HIV living in Miami

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Patricia RaccamarichClaudia S Uribe ◽  
Ana S Salazar Zetina ◽  
Emily K Montgomerie ◽  
Douglas Salguero ◽  
Alejandro M Mantero ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People Living With Hiv ◽  
Coping With Stress ◽  
Care Access ◽  
Significant Difference ◽  
Physical Consequences ◽  
The Impact ◽  
Hiv Negative

Abstract Background As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIV-negative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%); there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH; OR 0.40, p=0.03). Conclusion The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care. Disclosures All Authors: No reported disclosures

scholarly journals The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China

2021 ◽  
Vol 18 (18) ◽  
pp. 9623
Author(s):  
Haochuan Xu ◽  
Han Yang ◽  
Hui Wang ◽  
Xuefeng Li
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Access ◽  
Migrant Workers ◽  
Health Care Services ◽  
Public Health Care ◽  
Chinese Government ◽  
Care Access ◽  
Care Services ◽  
The Impact

Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.

Social capital and health care access among the older adults in Bangladesh

2019 ◽  
Vol 23 (1) ◽  
pp. 54-63
Author(s):  
Md. Shahidul Islam
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Social Capital ◽  
Logistic Regression ◽  
Older People ◽  
Health Care Access ◽  
Economic Hardship ◽  
Content Type ◽  
Care Access ◽  
Access Problem

Purpose The purpose of this paper is to investigate the association between social capital (SC) and health care access problem among the older people in Bangladesh. Design/methodology/approach This study applied a random sampling method to select 310 older adults (all aged 60 years) in Bangladesh. Exploratory factor analysis was employed to extract SC dimensions. Logistic regression was applied to measure the association of SC dimensions and access. Findings The logistic regression result shows that with a one-unit increase in social network, norms of reciprocity, and civic participation, health care access problem will be decreased by OR= 0.732 (95% CI =0.529–1.014); OR=0.641 (95% CI = 0.447–0.919); and OR=0.748 (95% CI = 0.556–1.006) units. Respondents who have economic hardship were 3.211 (OR=3.211, CI = 0.84–5.59) times more likely to say that they had health care access problem compared with who had no economic hardship. Research limitations/implications The study showed that the lower level of SC and presence of economic hardship increased the probability to health care access problem among the older people. Improving SC may be helpful in reducing health care access problem. However, economic hardship reductions are also important to reduce the health care access problem. Improving SC and reducing economic hardship thus should be implemented at the same time. Practical implications The study showed that low SC and economic hardship increased the probability to health care access problem. Improving SC may be helpful in reducing health inequity. However, economic hardship reductions also important to health care access. Therefore, improving SC and reducing economic hardship should be implemented at the same time. Originality/value This study has a great policy importance in regard to reducing health care access problem among the older adult in Bangladesh as SC has a potential to bring about a concomitant improvement in the condition of the health care access.

Roles for Health Educators in a Time of Health Care Cutbacks: Preventive and Ameliorative Approaches

1984 ◽  
Vol 4 (4) ◽  
pp. 293-302 ◽  
Author(s):  
E. Richard Brown
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Access ◽  
Community Organization ◽  
Public Health Care ◽  
Federal State ◽  
Health Educators ◽  
Care Access ◽  
State And Local ◽  
The Impact

Cutbacks in public health care programs at federal, state, and local levels have reduced the health care access of many low-income persons. Based on findings from several California studies, this article suggests several roles for health educators intended to prevent cutbacks or mitigate their impact. Methods of preventing cutbacks rely on community organization methods and coalitions including health education professional groups. When preventive actions are unsuccessful, health educators may ease the impact of cutbacks by developing adequate education interventions for users of affected services and community organization strategies to improve access to remaining services. Specific methods are suggested and discussed.

scholarly journals Measuring Staff Empowerment Regarding Health Care for Clients with Intellectual Disabilities

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Joanne Wilkinson ◽  
Nechama W. Greenwood ◽  
Claire Tienwey Wang ◽  
Laura F. White ◽  
Larry Culpepper
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Intellectual Disabilities ◽  
Health Care Access ◽  
Breast Cancer Mortality ◽  
Care Access ◽  
Direct Support ◽  
Reliable Instrument ◽  
Tool Set ◽  
The Impact

Background. Women with intellectual disabilities (ID) contract breast cancer at the same rate as the general population but have higher breast cancer mortality and lower rates of breast cancer screening. Many women with ID live in group homes or supported residences where they are cared for by direct support workers. While direct support workers are thought to influence client health, this effect is underresearched, and we lack tools for measuring staff empowerment and perceptions regarding client health. Methods. We developed and validated an instrument, the staff empowerment tool (SET), to measure staff empowerment as related to supporting clients in preventive health. Results. The SET was found to be a reliable instrument for measuring staff activation and empowerment in helping clients access mammography screening. Discussion. Quantifying staff empowerment and perspectives is important in studying and reducing disparities among adults with ID, a vulnerable population. Further research to determine the impact of staff empowerment levels on their clients’ health and health care access is suggested. The SET is a valuable tool for measuring the construct of staff empowerment, evaluating interventions, and collecting data regarding variation in staff empowerment.

scholarly journals Access to health care for people with disabilities in rural Malawi what are the barriers?

2019 ◽  
Author(s):  
Josephine Harrison ◽  
Rachael Thomson ◽  
Hastings T. Banda ◽  
Grace B. Mbera ◽  
Stefanie Gregorius ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People With Disabilities ◽  
Randomised Control Trial ◽  
Care Access ◽  
Health Care Accessibility ◽  
Access To Health ◽  
Lung Condition ◽  
The Impact

Abstract Introduction People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside an impairment, on health care accessibility is explored. Method Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Questions, were recruited. People with cognitive impairments were excluded. Each of the selected participants underwent an individual in-depth interview and full recordings of these were then transcribed and translated. Findings and discussion Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Other barriers identified were distance to a facility, which was most hindering for the participants with a chronic lung condition, and unfavourable health seeking behaviour, whilst ‘time’ was found to be a common underlying factor. Attitudinal factors were not found to influence health care accessibility for this cohort. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.

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.

Medicaid's Post-ACA Paradoxes

2020 ◽  
Vol 45 (4) ◽  
pp. 617-632
Author(s):  
Colleen M. Grogan
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Coverage ◽  
Medicaid Program ◽  
Working Adults ◽  
The Past ◽  
Care Access ◽  
American States ◽  
The Us ◽  
Improve Health

Abstract Medicaid's experience one decade after the passage of the Affordable Care Act represents extreme divergence across the American states in health care access and utilization, policy designs that either expand or restrict eligibility, and delivery model reforms. The past decade has also witnessed a growing ideological divide about the very purpose and intent of the Medicaid program and its place within the US health care system. While liberal-leaning states have actively embraced the program and used it to expand health coverage to working adults and families as an effort to improve health and prevent poverty and the insecurity and instability that comes with high medical costs (evictions, bankruptcy), conservative states have actively rejected this expanded idea of Medicaid and argued instead that the program should revert back to its “original” purpose and be used only for the “truly” needy. This article highlights several paradoxes within Medicaid that have led to this growing bifurcation, and it concludes by shedding light on important targets for future reform.

The Impact of Coming Out on Health and Health Care Access

2002 ◽  
Vol 15 (1) ◽  
pp. 1-29 ◽  
Author(s):  
Shari Brotman ◽  
Bill Ryan ◽  
Yves Jalbert ◽  
Bill Rowe
Keyword(s):  
Health Care ◽  
Coming Out ◽  
Health Care Access ◽  
Care Access ◽  
The Impact
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