scholarly journals Place-based Inequality in “Energetic” Pain: The Price of Residence in Rural America

2018 ◽  
Vol 4 ◽  
pp. 237802311880303 ◽  
Author(s):  
Lazarus Adua ◽  
Ashley Beaird
Keyword(s):  
Access To Health Care ◽  
Rural Households ◽  
Well Being ◽  
Rural America ◽  
Residential Energy ◽  
The Past ◽  
Rural And Urban ◽  
Access To Health ◽  
Urban Places ◽  
Lower Educational Attainment

Despite the tendency for some to view rural life or living close to nature with nostalgia, the unpalatable truth is that rural America is beset with many problems, including lower incomes, higher poverty rates, limited access to well-paying jobs, higher morbidity and mortality rates, inadequate access to health care, and lower educational attainment. In this study, we question whether this palpable rural disadvantage extends to residential energy costs, a subject with serious implications for the well-being of households. Analyses of data spanning two decades show that rural households consistently spend more on residential energy than urban households, although they generally use less. This finding, which indicates the existence of energy cost inequality between rural and urban places, represents a kind of rural tax. Any sustained spikes in costs, which has happened in the past and would likely happen in the future, could portend significant access risks to rural households.

scholarly journals Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

2009 ◽  
Vol 1 (2) ◽  
pp. 304-309 ◽  
Author(s):  
Edward Paul ◽  
Danya Fortess Fullerton ◽  
Ellen Cohen ◽  
Ellen Lawton ◽  
Anne Ryan ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Well Being ◽  
Public Programs ◽  
Skill Sets ◽  
Legal Professionals ◽  
Access To Health ◽  
Patient Health ◽  
Access To Food ◽  
Attending Physicians

Abstract Background Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. Intervention This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Discussion Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced.

scholarly journals Health Care Access Among Essential Critical Infrastructure Workers, 31 States, 2017-2018

2021 ◽  
pp. 003335492199668
Author(s):  
Winifred L. Boal ◽  
Jia Li ◽  
Sharon R. Silver
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Personal Health ◽  
The Past ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Objectives Essential workers in the United States need access to health care services for preventive care and for diagnosis and treatment of illnesses (coronavirus disease 2019 [COVID-19] or other infectious or chronic diseases) to remain healthy and continue working during a pandemic. This study evaluated access to health care services among selected essential workers. Methods We used the most recent data from the Behavioral Risk Factor Surveillance System, 2017-2018, to estimate the prevalence of 4 measures of health care access (having health insurance, being able to afford to see a doctor when needed, having a personal health care provider, and having a routine checkup in the past year) by broad and detailed occupation group among 189 208 adults aged 18-64. Results Of all occupations studied, workers in farming, fishing, and forestry occupations were most likely to have no health insurance (46.4%). Personal care aides were most likely to have been unable to see a doctor when needed because of cost (29.3%). Construction laborers were most likely to lack a personal health care provider (51.1%) and to have not had a routine physical checkup in the past year (50.6%). Compared with workers in general, workers in 3 broad occupation groups—food preparation and serving; building and grounds cleaning and maintenance; and construction trades—had significantly lower levels of health care access for all 4 measures. Conclusion Lack of health insurance and underinsurance were common among subsets of essential workers. Limited access to health care might decrease essential workers’ access to medical testing and needed care and hinder their ability to address underlying conditions, thereby increasing their risk of severe outcomes from some infectious diseases, such as COVID-19. Improving access to health care for all workers, including essential workers, is critical to ensure workers’ health and workforce stability.

Inequalities in health care and social work intervention: The case of Iran

2010 ◽  
Vol 53 (4) ◽  
pp. 556-567 ◽  
Author(s):  
Taghi Doostgharin
Keyword(s):  
Health Care ◽  
Social Work ◽  
Access To Health Care ◽  
Well Being ◽  
Health Care Facilities ◽  
Inequalities In Health ◽  
Stress Symptoms ◽  
Access To Health ◽  
Work Intervention ◽  
Social Work Interventions

This article examines the role of social workers in tackling inequalities in health care. The aim of such social work interventions is to empower service users, increase their well-being and reduce stress symptoms, mainly by advocacy and facilitating their access to health-care facilities and promoting social change.

Poverty, Welfare Reform and the "Culture of Wealth"

2007 ◽  
Vol 29 (4) ◽  
pp. 43-45 ◽  
Author(s):  
Merrill Singer
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Partner Violence ◽  
Access To Health Care ◽  
Structural Violence ◽  
Well Being ◽  
Legal Rights ◽  
True Nature ◽  
Care Access ◽  
Access To Health

An important shift has occurred in anthropology over the last 30 years. A notable expression of this change is seen in the contemporary anthropology of poverty. As dramatically contrasted with the anthropology of poverty of an earlier era, when the notion of a "culture of poverty" had currency within the discipline, current thinking has been significantly influenced by a structural approach that seeks to understand poverty and its health consequences in terms of what has been called "structural violence." Structural violence was introduced into the lexicon of anthropology to label relations of inequality that are so grave in their effect that they can be seen as a form of sanctioned violence (like the structuring of access to health care in terms of possession of health insurance or the exclusion from quality housing, or even any housing, on the basis of ethnicity and social class). Unlike street violence or intimate partner violence, both forms of physical harm that are criminalized, structural violence is legal and hence unpunished. Indeed, perpetrators, if they are corporate heads, may be rewarded with stock options and other perks that boost their salaries to obscene levels relative to the prevailing wage system in society generally. Structural violence has been publicly denied its true nature as a direct assault on the health and well-being of the poor and other marginalized populations because access to health care, access to housing, and access to food are not legal rights.

Javanese Muslim with Diabetes in Yogyakarta Managing The Daily Self-Care Activity

2015 ◽  
Vol 4 (4) ◽  
pp. 241
Author(s):  
Muflikh Try Harbiyan
Keyword(s):  
Access To Health Care ◽  
Diabetes Management ◽  
Self Care ◽  
Well Being ◽  
Structured Education ◽  
Peace Of Mind ◽  
Poor Access ◽  
Access To Health ◽  
Care Activity

<p>Self-care, capability in performing certain activity in maintaining well-being in daily life, was regarded important especially among people with long-term condition such as diabetes. Locus of control and self-efficacy are among the self-agency factors that might influence how people engage with daily self-care activity in diabetes management. While, Javanese and Islamic values and norms are other parts of structure that support the effort. This study aimed to seek further into the experiences and perceptions among the Javanese Muslim on how they managed to do self-care in diabetes management. The study was done utilizing a mixed method approach with the usage of the Summary of Diabetes Self-care Activity (SDSCA) questionnaire to measure the level of self-care and followed by further interview to dig deeper into the perception and experiences and what are the opportunity or obstacle in performing daily self-care. A convenient sample of 100 participants has filled the questionnaires, with further 24 interviews. The study identified the moderate self-care practices as a separate notion, instead of an integrated and comprehensive concept amid the unavailability of a structured education program. Five themes were generated from the interviews, those are: education and knowledge, being in or out of control, Javanese way – sensitivity and surrender, peace of mind and role of Allah or God, and poor access to health care.</p>

Outcome of African-American (AA) Multiple Myeloma (MM) Patients after Autologous Stem Cell Transplantation (ASCT): A Single-Center Experience.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3327-3327
Author(s):  
Yin Wu ◽  
Olga Goloubeva ◽  
Kathleen Ruehle ◽  
Saul Yanovich ◽  
Aaron P. Rapoport ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Access To Health Care ◽  
Cox Regression ◽  
The Past ◽  
Single Center Experience ◽  
Time Period ◽  
Younger Age ◽  
Access To Health ◽  
Significant Difference ◽  
Caucasian Patients

Abstract The incidence of MM in African-Americans is more than double that in Caucasians. Historically AAs have had a higher mortality rate than Caucasians; but over the past 10 yrs, the age-adjusted mortality rate has been on the decline for AAs while it has been stable for Caucasians as a result of ASCT and novel agents. Previous studies (n=74 AA patients) suggested that response to ASCT is similar, if not better, for AA patients (Verma et al 2008, Saraf et al 2006). We retrospectively analyzed the clinical presentation of a large cohort of AA patients (n=103) who underwent ASCT at our center between 1998 and 2008 and compared their outcome to that of Caucasians patients (n=183) transplanted in the same time period. AA patients were significantly younger than Caucasian patients at diagnosis with median age 53 (range: 32–75) vs 59 (range: 27–80), respectively (p<0.0001). The distribution of isotype and stage of MM at diagnosis were similar between the two groups. Approximately 20% patients in each group presented with renal insufficiency. Among the AA patients, 45% had albumin < 3.5 g/dL; 14% and 18% had beta2-microglobulin > 3.5 mg/L and > 5.5 mg/L, respectively. Initial cytogenetic data were not available for the majority of patients. Median time from diagnosis to ASCT was significantly longer for AA than for Caucasian patients at 0.8 yrs (range: 0.23–9.2) vs 0.5 yrs (range: 0.1– 7.0), respectively (p<0.0001). There was no difference in incidence of transplant-related complications, as reflected by similar lengths of hospital stay, with a median of 15 days for both groups. No significant difference in response to ASCT was found between the two groups. Median EFS was 1.7 yrs (range: 1.5–2.7) for AAs and 1.8 yrs (range: 1.5–2.4) for Caucasians (p=NS). At a median follow up of 5 yrs, 74% of AA and 70% of Caucasian patients were alive. Median OS was also not significantly different at 9 yrs (range: 6.7- not reached) for AAs and 8 yrs (range: 5.9-not reached) for Caucasians (p=NS). Cox regression model for prognostic markers: albumin, calcium, creatinine, hemoglobin, and platelet count were significant for OS in AA patients (p range 0.004–0.0001). The current study is the largest one of AA patients undergoing SCT at a single institution. AA patients with MM present at a younger age, but undergo ASCT at a significantly later time from diagnosis than Caucasian patients. This delay may reflect a disparity in referral pattern and access to health care. AA patients have similar EFS and OS after ASCT. It is likely that better responses to the newer anti-myeloma agents, as well as favorable impact of ASCT, even if delayed, may explain the improvement of AA patients with MM over the past decade. Further studies of responses of AA patients to novel myeloma agents are needed.

scholarly journals Global Access to Health Care and Well-Being: A Place for Policy and Science

2016 ◽  
Vol 4 ◽  
Author(s):  
Ladislav Záliš ◽  
Áine Maguire ◽  
Kristen Soforic ◽  
Kai Ruggeri
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Well Being ◽  
Access To Health ◽  
Global Access ◽  
Policy And Science

scholarly journals Javanese Muslim with Diabetes in Yogyakarta Managing The Daily Self-Care Activity

2015 ◽  
Vol 4 (4) ◽  
pp. 241
Author(s):  
Muflikh Try Harbiyan
Keyword(s):  
Access To Health Care ◽  
Diabetes Management ◽  
Self Care ◽  
Well Being ◽  
Structured Education ◽  
Peace Of Mind ◽  
Poor Access ◽  
Access To Health ◽  
Care Activity

<p>Self-care, capability in performing certain activity in maintaining well-being in daily life, was regarded important especially among people with long-term condition such as diabetes. Locus of control and self-efficacy are among the self-agency factors that might influence how people engage with daily self-care activity in diabetes management. While, Javanese and Islamic values and norms are other parts of structure that support the effort. This study aimed to seek further into the experiences and perceptions among the Javanese Muslim on how they managed to do self-care in diabetes management. The study was done utilizing a mixed method approach with the usage of the Summary of Diabetes Self-care Activity (SDSCA) questionnaire to measure the level of self-care and followed by further interview to dig deeper into the perception and experiences and what are the opportunity or obstacle in performing daily self-care. A convenient sample of 100 participants has filled the questionnaires, with further 24 interviews. The study identified the moderate self-care practices as a separate notion, instead of an integrated and comprehensive concept amid the unavailability of a structured education program. Five themes were generated from the interviews, those are: education and knowledge, being in or out of control, Javanese way – sensitivity and surrender, peace of mind and role of Allah or God, and poor access to health care.</p>

scholarly journals EAP and ECPCP Statement Risks for Children's Health During the COVID-19 Pandemic and a Call for Maintenance of Essential Pediatric Services

2021 ◽  
Vol 9 ◽  
Author(s):  
Łukasz Dembiński ◽  
Gottfried Huss ◽  
Igor Radziewicz-Winnicki ◽  
Zachi Grossman ◽  
Artur Mazur ◽  
...  
Keyword(s):  
Health Care ◽  
Children And Adolescents ◽  
Access To Health Care ◽  
Healthcare Professionals ◽  
Well Being ◽  
Psychological Effects ◽  
Negative Consequences ◽  
State Health ◽  
Access To Health ◽  
Pediatric Services

The COVID-19 pandemic and global lockdown have had drastic socioeconomic and psychological effects on countries and people, respectively. There has been limited access to health care and education. These negative consequences have had a significant impact on the well-being of children and adolescents. Therefore, the EAP and the ECPCP are requesting state, health, and education authorities as well as European pediatric societies and the healthcare professionals that special attention be given to this population and the problems they face as a result of the pandemic.

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