scholarly journals Low Rates of Vasectomy Among Minorities: A Result of Differential Receipt of Counseling?

2009 ◽  
Vol 4 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Sonya Borrero ◽  
Charity G. Moore ◽  
Mitchell D. Creinin ◽  
Said A. Ibrahim
Keyword(s):  
Access To Health Care ◽  
White Men ◽  
Unintended Birth ◽  
Access To Health ◽  
History Of ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Male Sterilization ◽  
Effective Contraceptive Method ◽  
Effective Contraceptive

Male sterilization is a highly effective contraceptive method that is underused especially among minorities. This analysis examined the association between race/ethnicity and receipt of sterilization counseling. This study used data collected by the 2002 National Survey of Family Growth. The analysis included men 15 to 44 years old who had not undergone sterilization. The outcome was receipt of sterilization counseling in the 12 months prior to interview, and the primary predictor was race/ethnicity. Sociodemographic characteristics, history of fathering an unintended birth, intention for more children, and access to health care were examined as confounders. Sixty-one (1.7%) men reported receiving sterilization counseling. Although counseling was reported more commonly by Black and Hispanic men compared with White men, the rates were not significantly different (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 0.8-7.1 and OR = 1.9, 95% CI = 0.9-4.1, respectively). In this nationally representative sample of men aged 15 to 44 years, there were exceedingly low rates of sterilization counseling for all men regardless of race/ethnicity.

Barriers to Health Care Among Adults With Minoritized Identities in the United States, 2013–2017

2020 ◽  
Vol 110 (6) ◽  
pp. 857-862
Author(s):  
Stephanie M. Hernandez ◽  
P. Johnelle Sparks
Keyword(s):  
United States ◽  
Health Care ◽  
Access To Health Care ◽  
The United States ◽  
Barriers To Health Care ◽  
Access To Health ◽  
Interview Survey ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Barriers To Health

Objectives. To examine the relationship between minoritized identity and barriers to health care in the United States. Methods. Nationally representative data collected from the 2013 to 2017 waves of the National Health Interview Survey were used to conduct descriptive and logistic regression analyses. Men and women were placed in 1 of 4 categories: no minoritized identities, minoritized identities of race/ethnicity (MIoRE), minoritized identities of sexuality (MIoS), or minoritized identities of both race/ethnicity and sexuality (MIoRES). Five barriers to health care were considered. Results. Relative to heterosexual White adults and after controlling for socioeconomic status, adults with MIoRE were less likely to report barriers, adults with MIoS were more likely to report barriers, and adults with MIoRES were more likely to report barriers across 2 of the study measures. Conclusions. Barriers to care varied according to gender, minoritized identity, and the measure of access to health care itself. Public Health Implications. Approaching health disparities research using an intersectional lens moves the discussion from examining individual differences to examining the role of social structures such as the health care system in maintaining and reproducing inequality.

Telemedicine Basics

2021 ◽  
pp. 3-11
Author(s):  
Guenevere Burke ◽  
Jared Lucas
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Access To Health Care ◽  
Electronic Information ◽  
Remote Areas ◽  
Access To Health ◽  
History Of ◽  
Key Terms ◽  
Improve Access

Telemedicine is a rapidly growing field in health care and emergency medicine. Telemedicine, telehealth, and virtual health refer to the use of telecommunications technology and electronic information to support health and provide care over distance. It has been used to improve access to health care in geographically remote areas for decades, but its use and recognized benefits have expanded considerably over the years, accelerated by the COVID-19 pandemic. This chapter provides a brief overview of the history of telemedicine, introduces key terms, and reviews basic definitions that are foundational to telemedicine practice. Finally, it summarizes a wide array of telehealth applications in emergency medicine, which are detailed further in later chapters.

scholarly journals Prospective study of the link between overweight/obesity and diabetes incidence among Mexican older adults: 2001-2012

2015 ◽  
Vol 57 ◽  
pp. 15 ◽  
Author(s):  
Guido Pinto ◽  
Hiram Beltrán-Sánchez
Keyword(s):  
Older Adults ◽  
Genetic Predisposition ◽  
Access To Health Care ◽  
Diabetes Incidence ◽  
Family History Of Diabetes ◽  
Obesity And Diabetes ◽  
Access To Health ◽  
Aging Study ◽  
History Of

Objective. To prospectively assess the relationship between overweight/obesity and incidence of type 2 diabetes mellitus (T2DM) among Mexicans aged 50+, assessing effects of age, genetic predisposition, education, physical activity, and place of esidence. Materials and methods. The Mexican Health and Aging Study (MHAS) was used to prospectively follow respondents free of diabetes in 2001 who became diabetic by 2012. Multivariate random effects logistic regression was used to assess covariates effects on the incidence of T2DM. Results. Obese or overweight individuals at baseline (2001) were about 3 and 2 times, respectively, significantly more likely to become diabetic by 2012. Genetic predisposition increases the risk of diabetes by about three times compared to those with no family history of diabetes. Conclusion. Overweight/ obesity and genetic predisposition are the primary drivers of diabetes incidence among Mexican older adults. Reducing body weight and having access to health care may ameliorate the disease burden of T2DM.

Americans’ View of the Impact of COVID-19: Perspectives on Racial Impacts and Equity

2021 ◽  
Author(s):  
Katherine Carman ◽  
Anita Chandra ◽  
Carolyn Miller ◽  
Christopher Nelson ◽  
Jhacova Williams
Keyword(s):  
Health Care ◽  
African Americans ◽  
Access To Health Care ◽  
The Public ◽  
Equity And Access ◽  
Access To Health ◽  
The Face ◽  
Nationally Representative ◽  
The Impact ◽  
Over Time

Abstract Context: The COVID-19 pandemic has had a disparate effect on African Americans and Latino groups. But it is unknown how aware the public is of these differences, and how the pandemic has changed perceptions of equity and access to health care. Methods: We use panel data from nationally representative surveys fielded to the same respondents in 2018 and 2020 to assess views and changes in views over time. Findings: We found that awareness of inequity is highest among Non-Hispanic Black respondents and higher income and higher educated groups, and that there have been only small changes in perceptions of inequity over time. However, there have been significant changes in views of the government’s obligation ensure access to health care. Conclusions: Even in the face of a deadly pandemic, one that has killed disproportionately more African Americans and Latinos, many in the U.S. continue not to recognize that there are inequities in access to health care and the impact of COVID-19 on certain groups. But policies to address inequity may be shifting. We will continue to follow these respondents to see whether changes in attitudes endure over time or dissipate.

Conclusion

2020 ◽  
pp. 181-202
Author(s):  
Patricia Zavella
Keyword(s):  
Health Care ◽  
Women Of Color ◽  
Access To Health Care ◽  
Reproductive Rights ◽  
Reproductive Justice ◽  
Human Right ◽  
Access To Health ◽  
Poor Women ◽  
History Of ◽  
The Right

This chapter reflects on how the movement for reproductive justice addresses the increased polarization of politics around immigration and reproductive rights in the wake of the election of President Trump. It argues that women of color in the movement for reproductive justice have a history of crafting a politics of inclusion that aims to empower those who are marginalized by intersecting systems of power, with a radical vision of citizenship. These activists insist that poor women of color have the human right to access to health care with dignity as well as the right to healthy lives and wellness.

Transfusion History and Risk of Non-Hodgkin Lymphoma (NHL): an Interlymph Pooled Analysis

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3039-3039
Author(s):  
James R Cerhan ◽  
Silvia de Sanjosé ◽  
Bracci M Paige ◽  
John J. Spinelli ◽  
Claire M Vajdic ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Follicular Lymphoma ◽  
Meta Analysis ◽  
White Men ◽  
Population Based ◽  
Pooled Analysis ◽  
Case Control ◽  
History Of ◽  
Race Ethnicity ◽  
Transfusion History

Abstract Background. A recent meta-analysis of 9 case-control and 5 cohort studies reported a positive association of transfusion history with risk of NHL (RR=1.20; 95% CI 1.07-1.35), which was only evident in cohort (RR=1.25) and not case-control (RR=1.05) studies (Castillo et al., Blood 2010;116:2897-2907). Risk was similar in men and women, and for transfusions before or after 1992. In subset analyses, elevated risk was only apparent for chronic lymphocytic leukemia (CLL) and not diffuse large B-Cell lymphoma (DLBCL) or follicular lymphoma, but power was low. To further investigate these findings, particularly from studies conducted after 1990, better assess confounding, and address heterogeneity by NHL subtypes, we conducted an individual-level, pooled analysis of 13 case-control studies in the InterLymph Consortium (including 11 studies conducted after 1990; 8 studies were not included in the published meta-analysis). Methods. There were a total of 10,805 cases and 14,026 controls with transfusion data from 13 studies conducted in Europe, North America, and Australia. Transfusion history and other risk factors were self-reported in interviewer-administered or self-administered questionnaires. All risk factor data were harmonized centrally, and cases were grouped into NHL subtypes according to the WHO classification using guidelines from the InterLymph Pathology Working Group. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression, adjusted for age, sex, and study center. Results. The median age at diagnosis was 60 years for cases (range, 18-97) and 59 years for controls (range, 16-97). The overall prevalence of a history of any transfusion in controls was 15.5%, was higher in women (18.6%) than men (13.0%), and increased with age, but was not associated with race/ethnicity (Asian, Black, Hispanic, White, other) or geographic region after adjusting for age and sex. Among whites, history of any transfusion was inversely associated with NHL risk among men (OR=0.74; 95% CI 0.65-0.83) but not women (OR=0.92; 95% CI 0.83-1.03); there were no significant results for other race/ethnicity groups, and ORs were highly variable and imprecise due to small sample sizes. Thus analyses were restricted to white men, where there was no trend with the number of transfusions, time since first transfusion, age at first transfusion, or decade of first transfusion. Further adjustment for socioeconomic status, body mass index, smoking, alcohol use or hepatitis C virus (HCV) seropositivity did not alter these results. The associations were stronger in hospital-based (OR=0.56; 95% CI 0.45-0.70) than population-based (OR=0.84; 95% CI 0.72-0.98) studies, and were stronger in studies from Southern Europe (OR=0.53; 95% CI 0.36-0.79) than northern Europe (OR=0.67; 95% CI 0.53-0.83) or North America (OR=0.82; 95% CI 0.70-0.98). For NHL subtypes, statistically significant inverse associations were observed for follicular lymphoma (OR=0.70; 95% CI 0.56-0.88), DLBCL (OR=0.72; 95% CI 0.59-0.87), and CLL/SLL (OR=0.67; 95% CI 0.52-0.87), whereas weaker and non-statistically significant associations were observed for mantle cell (OR=0.81; 95% CI 0.54-1.23), marginal zone (OR=0.78; 95% CI 0.54-1.15), lymphoplasmacytic (OR=0.82; 95% CI 0.47-1.42) and peripheral T-cell (OR=0.83; 95% CI 0.49-1.40) lymphomas. Conclusion. Contrary to earlier results, transfusion history was inversely associated with risk of NHL and the common subtypes of follicular lymphoma, DLBCL and CLL/SLL among white men, whereas associations were null among white women and other racial/ethnic groups. These results were not explained by confounding by lifestyle factors or HCV seropositivity, era of first transfusion, hospital versus population-based study design, or geographic location. Despite dramatic changes in transfusion practice over the past 40 years, results were similar for decade of first transfusion, suggesting secular trends are a less likely explanation. Our results are unexpected and bias cannot be ruled out. Further studies, particularly cohort studies, are needed to clarify the role of transfusion history in NHL risk. Disclosures No relevant conflicts of interest to declare.

scholarly journals Health Disparities: Challenges, Opportunities, and What You Can Do About It

2018 ◽  
Vol 28 (3) ◽  
pp. 223-231 ◽  
Author(s):  
Hani K. Atrash
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
The United States ◽  
Care Providers ◽  
Access To Health ◽  
Race Ethnicity

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.  

Determinants of Health Care Access After Spinal Cord Injury

2013 ◽  
Vol 44 (2) ◽  
pp. 11-17
Author(s):  
Veronica Umeasiegbu
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Access ◽  
Access To Health Care ◽  
Rehabilitation Counseling ◽  
Care Access ◽  
Access To Health ◽  
Cord Injury ◽  
Race Ethnicity

This paper presents a review of the literature examining determinants of access to health care among individuals with spinal cord injury (SCI). The literature shows that health insurance, race-ethnicity, income, age, gender, and residential location (rural/urban) are common themes discussed in the literature as factors that influence access to health care of persons with SCI. This review ends with discussion of implications for rehabilitation counseling research and practice.

Perspectives on Health Policy From People With Disabilities

2020 ◽  
pp. 104420732095667
Author(s):  
Sarah D. Smith ◽  
Jean P. Hall ◽  
Noelle K. Kurth
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Access To Health Care ◽  
Universal Access ◽  
People With Disabilities ◽  
Moral Issue ◽  
Human Right ◽  
Telephone Interviews ◽  
Access To Health ◽  
Nationally Representative

People with disabilities are marginalized and face barriers to participation in society, including political participation and representation. While data indicate that people with disabilities have similar political preferences to the overall American population, little research has been conducted to assess the health policy views of people with disabilities in their own words. This study uses qualitative data collected between 2017 and 2019 via 35 telephone interviews and 484 open-ended responses from a nationally representative survey to analyze what people with disabilities would like policymakers to know about health care and health insurance for people with disabilities. Results reveal that this population’s perceptions of social exclusion and stigma inform what they would like to tell policymakers. In addition, people with disabilities were largely supportive of Affordable Care Act features and framed expanded or universal access to health care as a human right or a moral issue.

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