scholarly journals Toxic Stress in a Mid-Sized Urban Community: An Initial Needs Assessment of Families with Children in Maywood, IL

2021 ◽  
Vol 12 ◽  
pp. 215013272110301
Author(s):  
Erin McCune ◽  
Jennifer Wojtowicz ◽  
William Adams ◽  
Garry Sigman ◽  
Collette Williams ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Needs Assessment ◽  
Medical Center ◽  
Health Resources ◽  
Community Organizations ◽  
Social Needs ◽  
Toxic Stress ◽  
Adverse Health Outcomes ◽  
Point Increase ◽  
Survey Responses

Background Loyola Medical Center is located in Maywood, IL, a community that faces high rates of poverty, violence, and barriers to healthcare. These factors can contribute to toxic stress, which has been shown to negatively impact children’s health. Objectives The goal of this project was to partner with community organizations to obtain a baseline needs assessment from families in Maywood regarding sources of toxic stress and to identify interventions of interest. Methods In total, 75 anonymous surveys were collected from the Loyola Outpatient Center Pediatric Clinic and a Maywood community center. Survey responses were statistically analyzed in order to determine toxic stressors most commonly impacting families in Maywood as well as interventions of most interest to the community. Results There were 78 respondents for a response rate of approximately 71%. The most common stressors were smoking in the home (33.3%), food insecurity (29.5%), and exposure to violence (26.9%). In this sample, Black respondents were 11.5 times more likely than non-Black respondents to report that their child was exposed to violence in the community – even after controlling for concern about their child’s behavior which served as a surrogate measure of the child’s exposure to toxic stress (P = 0.001). Further, those living with food insecurity were 7.40 times more likely to report that access to food and transportation vouchers were important ( P < .001). For every 1-point increase in the total toxic stress score, respondents were 1.35 times more likely to report that increasing access to mental health resources was important to them, though this was not significant ( P = .10). Conclusion The data demonstrate that toxic stressors, health risks and unmet social needs are prevalent in the Maywood community, which puts local children at risk for future adverse health outcomes. With this information, pediatricians at Loyola Medical Center can work with community organizations to allocate resources to address toxic stressors in Maywood.

scholarly journals A Participatory Study of the Health and Social Impact of a Community Food Centre in Ottawa, Canada

2020 ◽  
Vol 7 (1) ◽  
pp. 88-106
Author(s):  
Aganeta Enns ◽  
Myddryn Ellis ◽  
Tracey O’Sullivan ◽  
Peter Milley ◽  
Elizabeth Kristjansson
Keyword(s):  
Food Insecurity ◽  
Social Impact ◽  
Health Resources ◽  
Positive Influence ◽  
Social Needs ◽  
Food Assistance ◽  
Food Banks ◽  
Structured Interviews ◽  
Additional Food ◽  
Assistance Program

Food insecurity is a pervasive and persistent issue across Canada, where a growing number of people are accessing food banks. Conventional food banks may offer relief for immediate needs but typically have limited capacity to address longer-term food insecurity. This paper focuses on the Parkdale Food Centre in Ottawa, ON, which provides food assistance alongside a range of programs and initiatives designed to address food insecurity and related needs in its community. This qualitative study aims to examine how participation in the programs at the Parkdale Food Centre influences the physical, mental, and social health of people who access the food centre. Semi-structured interviews and a participatory photovoice project were conducted with people who access the food centre. The results indicate that people who access the food centre perceived a positive influence of the programs on their food, health, and social needs, particularly with respect to improved access to fresh foods, connections to social and health resources, and reduced stigma. Incorporating additional food, health, and social programming into an existing food assistance program may help ameliorate elements of food insecurity and associated negative outcomes within communities impacted by this issue.

scholarly journals Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder
Keyword(s):  
Older Adults ◽  
New York ◽  
Health System ◽  
Medical Center ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
New York University ◽  
The Us ◽  
Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

scholarly journals The Impact of the Coronavirus Disease (COVID-19) on the Health and Social Needs of Sex Workers in Singapore

2021 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Vanessa Ho ◽  
Sherry Sherqueshaa ◽  
Wany Dee ◽  
Jane Mingjie Lim ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Sex Work ◽  
Sex Workers ◽  
Social Needs ◽  
Medical Services ◽  
Substantial Impact ◽  
Sex Worker ◽  
Permanent Resident ◽  
The Impact ◽  
Depth Interviews

AbstractWe evaluated the impact of the coronavirus disease (COVID-19) on the sex work industry and assessed how it has impacted the health and social conditions of sex workers in Singapore. We conducted a sequential exploratory mixed methods study amidst the COVID-19 pandemic from April to October 2020, including in-depth interviews with 24 stakeholders from the sex work industry and surveyor-administered structured surveys with 171 sex workers. COVID-19 had a substantial impact on sex workers' income. The illegality of sex work, stigma, and the lack of work documentation were cited as exclusionary factors for access to alternative jobs or government relief. Sex workers had experienced an increase in food insecurity (57.3%), housing insecurity (32.8%), and sexual compromise (8.2%), as well as a decrease in access to medical services (16.4%). Being transgender female was positively associated with increased food insecurity (aPR = 1.23, 95% CI [1.08, 1.41]), housing insecurity (aPR = 1.28, 95% CI [1.03, 1.60]), and decreased access to medical services (aPR = 1.74, 95% CI [1.23, 2.46]); being a venue-based sex worker was positively associated with increased food insecurity (aPR = 1.46, 95% CI [1.00, 2.13]), and being a non-Singaporean citizen or permanent resident was positively associated with increased housing insecurity (aPR = 2.59, 95% CI [1.73, 3.85]). Our findings suggest that COVID-19 has led to a loss of income for sex workers, greater food and housing insecurity, increased sexual compromise, and reduced access to medical services for sex workers. A lack of access to government relief among sex workers exacerbated such conditions. Efforts to address such population health inequities should be implemented.

scholarly journals Mitigating Childhood Food Insecurity during COVID-19: A Qualitative Study of how School Districts in California’s San Joaquin Valley Responded to Growing Needs

2021 ◽  
pp. 1-26
Author(s):  
Ashley H. Jowell ◽  
Janine S. Bruce ◽  
Gabriela V. Escobar ◽  
Valeria M. Ordonez ◽  
Christina A. Hecht ◽  
...  
Keyword(s):  
School District ◽  
School Districts ◽  
Food Insecurity ◽  
Focus Groups ◽  
Low Income ◽  
Distribution Systems ◽  
Community Organizations ◽  
San Joaquin Valley ◽  
School Meal ◽  
Fresh Foods

Abstract Objectives: To explore best practices and challenges in providing school meals during COVID-19 in a low-income, predominantly Latino, urban-rural region. Design: Semi structured interviews with school district stakeholders and focus groups with parents were conducted to explore school meal provision during COVID-19 from June to August 2020. Data was coded and themes were identified to guide analysis. Community organizations were involved in all aspects of study design, recruitment, data collection, and analysis. Setting: Six school districts in California’s San Joaquin Valley. Participants: School district stakeholders (n=11) included food service directors, school superintendents, and community partners (e.g., funders, food co-operative). Focus groups (n=6) were comprised of parents (n=29) of children participating in school meal programs. Results: COVID-19-related challenges for districts included developing safe meal distribution systems, boosting low participation, covering COVID-19-related costs, and staying informed of policy changes. Barriers for families included transportation difficulties, safety concerns, and a lack of fresh foods. Innovative strategies to address obstacles included pandemic-EBT, bus-stop delivery, community pick-up locations, batched meals, and leveraging partner resources. Conclusions: A focus on fresher, more appealing meals and greater communication between school officials and parents could boost participation. Districts that leveraged external partnerships were better equipped to provide meals during pandemic conditions. In addition, policies increasing access to fresh foods and capitalizing on USDA waivers could boost school meal participation. Finally, partnering with community organizations and acting upon parent feedback could improve school meal systems, and in combination with pandemic-EBT, address childhood food insecurity.

scholarly journals OpenAthens odyssey: challenges of implementing federated authentication for a multi-institutional user population

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Joanne Romano ◽  
Nha Huynh
Keyword(s):  
Case Report ◽  
Medical Center ◽  
Health Resources ◽  
Health Sciences ◽  
Online Resources ◽  
Preparation Methods ◽  
Texas Medical ◽  
Single Sign On ◽  
Active User ◽  
Authentication System

Background: The Texas Medical Center (TMC) is home to one of the world’s largest cohorts of faculty, students, researchers, and clinicians who rely on seamless and immediate access to digital biomedical and health resources. This group is served by the TMC Library, with a collection that includes over 380,000 ebooks and 59,000 ejournals. In 2018, the TMC Library implemented OpenAthens, a federated authentication system to replace a locally hosted instance of EZproxy.Case Presentation: The TMC Library is unique in its multi-institutional user population, which presents distinct challenges in adopting a single sign-on authentication system. Our project involved OpenAthens technical support, information technology teams from six academic institutions, and over thirty publishers. Implementation included the creation of an OpenAthens parent account, an active user directory, a resource catalog, and installation of our OpenAthens credentials at each publisher site. Because the TMC Library serves multiple institutions, OpenAthens built a custom login page and a portal to support both single sign-on and a generic username and password option. This case report discusses the reasons why OpenAthens was chosen, the preparation methods for implementation, the various challenges encountered and resolved, and recommendations for other health sciences libraries considering this system.Conclusions: The OpenAthens system provides important benefits: granular usage reports, single sign-on access, and data to negotiate reduced pricing for online resources. With prior knowledge and preparation, health sciences libraries can successfully implement OpenAthens with customizations tailored to their specific resources and user population.

Hunger: A Missed Opportunity for Screening in the Pediatric Emergency Department

2018 ◽  
Vol 57 (11) ◽  
pp. 1318-1325 ◽  
Author(s):  
Tamar Robinson ◽  
Leah Bryan ◽  
Veda Johnson ◽  
Terri McFadden ◽  
Sarah Lazarus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Emergency Department ◽  
Food Insecurity ◽  
Hospital Staff ◽  
Social Needs ◽  
Social Risk ◽  
Care Hospital ◽  
Social Risk Factors ◽  
Primary Care Hospital

Background. The American Academy of Pediatrics and pediatric community recognize the importance of addressing social determinants of health. There are limited data on the prevalence of food insecurity or literature establishing protocols assessing food insecurity in the emergency department (ED). Methods. Two anonymous surveys were administered, one to families during their ED visit and another to ED staff to assess perceptions on the ED’s role in providing social support. Results. Thirty-three of 214 respondents (15.4%) reported food insecurity and are associated with economic risk factors ( P < .0001) and a lack of primary care ( P = .008). Overall, 83.2% of the ED staff believed knowing information about families’ social risk factors would help patient care and 77.6% believed that the ED staff should address families’ social needs. Conclusions. Food insecurity affects a significant portion of ED families across income ranges. Screening for food insecurity in the ED is important given association with lack of primary care. Hospital staff supports screening and intervention.

Perinatal Outcomes among Women Identified by a Community Health Needs Assessment

2021 ◽  
Author(s):  
Elaine L. Duryea ◽  
Robert Martin ◽  
Donald McIntire ◽  
Catherine Y. Spong ◽  
David B. Nelson
Keyword(s):  
Health Disparities ◽  
Needs Assessment ◽  
Community Health ◽  
Perinatal Outcomes ◽  
Social Needs ◽  
Health Needs ◽  
Target Area ◽  
Health Needs Assessment ◽  
Community Health Needs Assessment ◽  
Adverse Perinatal Outcomes

Objective The aim of the study is to compare perinatal outcomes for women with greater social needs, as identified by the Community Health Needs Assessment, to those of women living in other areas of the county. Study Design This was a retrospective cohort study of pregnant women delivering at a large inner-city county hospital. Perinatal outcomes were analyzed for women living within a target area with substantial health disparities and social needs, and compared with those women living outside the target area. Statistical analysis included student's t-test, Chi square, and logistic regression. Results Between January 2015 and July 2020, 66,936 women delivered at Parkland hospital. Of these, 7,585 (11%) resided within the target area. These women were younger (26.8 ± 6.5 vs. 27.9 ± 6.4 years, p < 0.001), more likely to be black (37 vs. 13%, p < 0.001), and had a higher body mass index or BMI (33.3 ± 7.0 vs. 32.6 ± 6.4 kg/m2, p < 0.001). All women were likely to access prenatal care, with 7,320 (96.5%) in the target area and 57,677 (97.2%) outside the area attending at least one visit. Adverse perinatal outcomes were increased for women living within the target area, which persisted after adjustment for age, race, and BMI. This included an increased risk of preeclampsia (adjusted risk ratio [aRR] 1.1, 95% confidence interval or CI [1.03, 1.2]) and abruption (aRR 1.3, 95% CI [1.1, 1.7]), as well as preterm birth before both 34 weeks (aRR 1.3, 95% CI [1.2, 1.5]) and 28 weeks (aRR 1.3, 95% CI [1.02,1.7]). It follows that neonatal ICU admission (aRR 2.1, 95% CI [1.3, 3.4]) and neonatal death (aRR 1.2, 95% CI [1.1, 1.3]) were increased within the target area. Interestingly, rate of postpartum visit attendance was higher in the target area (57 vs. 48%), p < 0.001. Conclusion Even among vulnerable populations, women in areas with worse health disparities and social needs are at greater risk of adverse perinatal outcomes. Efforts to achieve health equity will need to address social disparities. Key Points

Food Insecurity in an Urban Pregnancy Cohort

2021 ◽  
Author(s):  
Kirby Sullivan ◽  
Meghan St John ◽  
Emily DeFranco ◽  
Elizabeth Kelly
Keyword(s):  
Food Insecurity ◽  
Linear Models ◽  
Medical Center ◽  
Adjusted Relative Risk ◽  
Annual Household Income ◽  
Department Of Agriculture ◽  
Maternal Characteristics ◽  
Key Points ◽  
Study Population ◽  
The University

Objective Food insecurity is a prominent problem and has been implicated in adverse maternal and neonatal outcomes. This study aims to describe the food insecure population in an urban academic health center perinatal cohort. Study Design We enrolled 451 postpartum inpatients at the University of Cincinnati Medical Center who completed a questionnaire and were then categorized as food insecure based on U.S. Department of Agriculture standardized survey questions. Generalized linear models estimated the relative influence of maternal characteristics on food insecurity. Results Among the study population (n = 426), 18.6% (95% confidence interval: 15.2–22.4%) were classified as food insecure. Factors with increased adjusted relative risk on food insecurity include annual household income <$40,000, obesity, and smoking. Food insecure women also reported lower levels of love, satisfaction, and joy, and higher levels of despair. Conclusion We recommend the use of a validated screening tool on all pregnant women with the associated psychosocial stressors and social determinants of health. Key Points

An Israeli Model of a Hospital Emergency Information Center

1999 ◽  
Vol 14 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Margalit Drory ◽  
Jennie Posen ◽  
Doron Vilner ◽  
Karni Ginzburg ◽  
Bianca Lederman
Keyword(s):  
Crisis Intervention ◽  
Medical Staff ◽  
Medical Center ◽  
Community Organizations ◽  
Mass Casualties ◽  
Hospital Emergency ◽  
The Public ◽  
Tel Aviv ◽  
The Social ◽  
Information Center

AbstractThe Emergency Information Center model developed by the social work department of Tel Aviv Sourasky Medical Center is activated in cases of mass casualties following disasters. It aims to provide reliable information to help the public cope with confusion and uncertainty, and to enable the medical staff to concentrate on treating the casualties. The Information Center is comprised of several interrelated units within the hospital, and maintains contact with a range of community organizations. The article describes the structure and activities of the various units, and discusses a number of aspects relevant to personnel organization in crisis intervention.

scholarly journals Universal Screening of Social Determinants of Health at a Large US Academic Medical Center, 2018

2020 ◽  
Vol 110 (S2) ◽  
pp. S219-S221
Author(s):  
Dodi Meyer ◽  
Eva Lerner ◽  
Alex Phillips ◽  
Katarina Zumwalt
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Universal Screening ◽  
Medical Center ◽  
Academic Medical Center ◽  
Social Needs ◽  
Determinants Of Health ◽  
System Level ◽  
Presbyterian Hospital ◽  
Academic Medical

Universal screenings for social determinants of health (SDOH) are feasible at the health system level and enable institutions to identify unmet social needs that would otherwise go undiscovered. NewYork-Presbyterian Hospital implemented SDOH screenings together with clinical screenings in four outpatient primary care sites. Aligning SDOH screening with clinical screening was crucial for establishing provider buy-in and ensuring sustainability of screening for SDOH. Despite some challenges, universal screening for SDOH has allowed NewYork-Presbyterian Hospital to identify unmet needs to improve population health.

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