scholarly journals A picture of health: determining the core population served by an urban NHS hospital trust and understanding the key health needs

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Thomas Beaney ◽  
Jonathan M. Clarke ◽  
Emily Grundy ◽  
Sophie Coronini-Cronberg
Keyword(s):  
Urban Areas ◽  
Lower Layer ◽  
Local Population ◽  
Health Needs ◽  
Local Context ◽  
Similar Proportion ◽  
Health Improvement ◽  
Local Health ◽  
Catchment Population ◽  
Hospital Trust

Abstract Background NHS hospitals do not have clearly defined geographic populations to whom they provide care, with patients able to attend any hospital. Identifying a core population for a hospital trust, particularly those in urban areas where there are multiple providers and high population churn, is essential to understanding local key health needs especially given the move to integrated care systems. This can enable effective planning and delivery of preventive interventions and community engagement, rather than simply treating those presenting to services. In this article we describe a practical method for identifying a hospital’s catchment population based on where potential patients are most likely to reside, and describe that population’s size, demographic and social profile, and the key health needs. Methods A 30% proportional flow method was used to identify a catchment population using an acute hospital trust in West London as an example. Records of all hospital attendances between 1st April 2017 and 31st March 2018 were analysed using Hospital Episode Statistics. Any Lower Layer Super Output Areas where 30% or more of residents who attended any hospital for care did so at the example trust were assigned to the catchment area. Publicly available local and national datasets were then applied to identify and describe the population’s key health needs. Results A catchment comprising 617,709 people, of an equal gender-split (50.4% male) and predominantly working age (15 to 64 years) population was identified. Thirty nine point six percent of residents identified as being from Black and Minority Ethnic (BAME) groups, a similar proportion that reported being born abroad, with over 85 languages spoken. Health indicators were estimated, including: a healthy life expectancy difference of over twenty years; bowel cancer screening coverage of 48.8%; chlamydia diagnosis rates of 2,136 per 100,000; prevalence of visible dental decay among five-year-olds of 27.9%. Conclusions We define a blueprint by which a catchment can be defined for a hospital trust and demonstrate the value a hospital-view of the local population could provide in understanding local health needs and enabling population-level health improvement interventions. While an individual approach allows tailoring to local context and need, there could be an efficiency saving were such public health information made routinely and regularly available for every NHS hospital.

Short-Term Medical Missions: Enhancing or Eroding Health?

1993 ◽  
Vol 21 (3) ◽  
pp. 333-341 ◽  
Author(s):  
Laura M. Montgomery
Keyword(s):  
Care Delivery ◽  
Local Population ◽  
Health Needs ◽  
Local Health ◽  
Medical Missions ◽  
Negative Consequences ◽  
Short Term ◽  
Cultural Assumptions ◽  
Design And Implementation ◽  
Health Care Delivery Systems

This paper analyzes two case studies of short-term medical missions to Latin America. Its conclusions suggest that when such projects are evaluated in terms of their impact upon the health status of the local population or health care delivery systems, they are found to have insignificant and even negative consequences. The shortcomings of these short-term efforts reflect the cultural assumptions that inform their design and implementation, rather than local health realities. Recommendations are suggested to increase the effectiveness of these missions in terms of the health needs of local populations.

scholarly journals How research-based theatre is a solution for community engagement and advocacy at regional medical campuses: The Health and Equity through Advocacy, Research, and Theatre (HEART) program

2018 ◽  
Vol 9 (1) ◽  
pp. e6-13 ◽  
Author(s):  
Allison Brown ◽  
Natalie Ramsay ◽  
Michael Milo ◽  
Mo Moore ◽  
Rahat Hossain
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Local Community ◽  
Local Population ◽  
Social Accountability ◽  
Health Needs ◽  
Local Health ◽  
Future Health ◽  
Regional Medical ◽  
Regional Campus

Background: Regional medical campuses are often located in geographic regions that have different populations than the main campus, and are well-positioned to advocate for the health needs of their local community to promote social accountability within the medical school.Methods: At the Niagara Regional Campus of McMaster University, medical students developed a framework which combined research, advocacy, and theatre to advocate for the needs of the local population of the regional campus to which they were assigned. This involved a qualitative study using semi-structured interviews with homeless individuals to explore their experience accessing the healthcare system and using a transformative framework to identify barriers to receiving quality healthcare services. Findings from the qualitative study informed a play script that presented the experiences of homeless individuals in the local health system, which was presented to health sciences learners and practicing health professionals. Participants completed two instruments to examine the utility of this framework.Results: Research-based theatre was a useful intervention to educate current and future health professionals about the challenges faced by homeless individuals in the region. Participants from both shows felt the framework of research-based theatre was an effective strategy to promote change and advocate for marginalized populations.Conclusion: Research-based theatre is an innovative approach which can be utilized to promote social accountability at regional medical campuses, advocating for the health needs of the communities in which they are located, with the added bonus of educating current and future health professionals.

Health needs, community and network in primary care: an action research program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Milani ◽  
G Occhini ◽  
C Francini ◽  
G Orsini ◽  
L Baggiani ◽  
...  
Keyword(s):  
Action Research ◽  
Health Workers ◽  
Participant Observation ◽  
Local Population ◽  
Health Needs ◽  
Local Health ◽  
Structured Interviews ◽  
Health Networks ◽  
Comprehensive Primary Health Care ◽  
Health Related

Abstract Issue According to the Alma Ata Declaration, Comprehensive Primary Health Care (C-PHC) addresses the main health problems in the community, promotes participation and involves all health related sectors. In Italy the so called Case della Salute model aims at realizing these principles. The purpose of the project is to understand how this model should be implemented in order to better answer the community needs. In the outskirts of Florence there is an area mostly made of public housing, devoted to people with housing and economic problems. There it is Casa della Salute (a health center where a PHC multidisciplinary team works), which could represent the key to cope with health inequalities and to create a network with the multiple associations rooted in the community. The implementation of an experimental model of C-PHC needs to involve local population, community actors, health professionals and researchers in a process of action-research. Results • An epidemiological study described a heavily deprived population compared with the rest of the city, with a burden of mortality especially affecting those most deprived and women. Mental health and addictions showed a deep need of care. A map of the neighbourhood was created in order to analyse formal and informal resources.The health needs of the community were deepened using social and ethnographic methodologies (semi-structured interviews, participant observation and focus groups with health workers, associations' representatives and individuals).Standing multi professional briefings were launched in order to facilitate the process of taking care of complex situations as a team. Lessons Preliminary results show the need for stronger collaborations with the actors in the community; further exploration of health related topics; community participation in the process of informing and transforming health practices; involvement of health workers in interprofessional practices to create a shared knowledge. Key messages Local health networks need a methodology to expand knowledge of peoples’ needs. Complexity in health and inequalities require a paradigm based on social determinants of health such as PHC.

Stakeholders’ Perspectives on the Unmet Needs and Health Priorities of the Urban Poor in South-East Nigeria

2021 ◽  
pp. 0272684X2110334
Author(s):  
Ifeyinwa Arize ◽  
Daniel Ogbuabor ◽  
Chinyere Mbachu ◽  
Enyi Etiaba ◽  
Benjamin Uzochukwu ◽  
...  
Keyword(s):  
Urban Areas ◽  
Urban Poor ◽  
Health Workers ◽  
Cost Of Care ◽  
Health Needs ◽  
Health Priorities ◽  
Primary Health Care System ◽  
Dual Practice ◽  
Double Burden ◽  
Primary Health

Relatively little is known about readiness of urban health systems to address health needs of the poor. This study explored stakeholders’ perception of health needs and strategies for improving health of the urban poor using qualitative analysis. Focus group discussions (n = 5) were held with 26 stakeholders drawn from two Nigerian states during a workshop. Urban areas are characterised by double burden of diseases. Poor housing, lack of basic amenities, poverty, and poor access to information are determinants of health of the urban poor. Shortage of health workers, stock-out of medicines, high cost of care, lack of clinical practice guidelines, and dual practice constrain access to primary health services. An overarching strategy, that prioritises community-driven urban planning, health-in-all policies, structured linkages between informal and formal providers, financial protection schemes, and strengthening of primary health care system, is required to address health needs of the urban poor.

scholarly journals Challenges and Opportunities in Early Stage Planning of Transport Infrastructure Projects: Environmental Aspects in the Strategic Choice of Measures Approach

2021 ◽  
Vol 13 (3) ◽  
pp. 1295
Author(s):  
Sofia Eckersten ◽  
Berit Balfors ◽  
Ulrika Gunnarsson-Östling
Keyword(s):  
Urban Areas ◽  
Road Traffic ◽  
Early Stage ◽  
Strategic Choice ◽  
Transport Infrastructure ◽  
Local Context ◽  
Research Approach ◽  
Infrastructure Projects ◽  
Environmental Aspects ◽  
Transport Planning

The Strategic Choice of Measures (SCM) approach aims to integrate different perspectives and identify measures to adapt new infrastructure projects to their local context at an early stage of Swedish transport planning. SCM is a loosely structured framework for collaboration between actors from, e.g., municipalities and the Swedish Transport Administration, in order to facilitate the coordination of transport planning and land use planning. This paper aims to explore the consideration of environmental aspects in early-stage transport planning by analyzing the SCM approach. An explorative research approach is applied based on literature studies, semi-structured interviews, and a focus group interview. The result shows that in the SCM process, environmental aspects such as noise and air pollution generated by road traffic in urban areas, engage the actors, whereas aspects related to landscape and water were perceived as poorly addressed and received less attention. The consideration of environmental aspects in the SCM process is affected by the local and national authorities’ different interests and the competences involved. To consolidate environmental aspects in early transport planning, these aspects need to be explicitly addressed in the SCM guidelines and the link between the SCM and preceding and following planning stages needs to be strengthened.

scholarly journals Mapping 20 Years of Urban Expansion in 45 Urban Areas of Sub-Saharan Africa

2021 ◽  
Vol 13 (3) ◽  
pp. 525
Author(s):  
Yann Forget ◽  
Michal Shimoni ◽  
Marius Gilbert ◽  
Catherine Linard
Keyword(s):  
Case Studies ◽  
Urban Areas ◽  
Urban Expansion ◽  
Local Population ◽  
Sub Saharan Africa ◽  
Annual Growth Rate ◽  
Urban Dynamics ◽  
Mapping Approach ◽  
Sub Saharan ◽  
The Impact

By 2050, half of the net increase in the world’s population is expected to reside in sub-Saharan Africa (SSA), driving high urbanization rates and drastic land cover changes. However, the data-scarce environment of SSA limits our understanding of the urban dynamics in the region. In this context, Earth Observation (EO) is an opportunity to gather accurate and up-to-date spatial information on urban extents. During the last decade, the adoption of open-access policies by major EO programs (CBERS, Landsat, Sentinel) has allowed the production of several global high resolution (10–30 m) maps of human settlements. However, mapping accuracies in SSA are usually lower, limited by the lack of reference datasets to support the training and the validation of the classification models. Here we propose a mapping approach based on multi-sensor satellite imagery (Landsat, Sentinel-1, Envisat, ERS) and volunteered geographic information (OpenStreetMap) to solve the challenges of urban remote sensing in SSA. The proposed mapping approach is assessed in 17 case studies for an average F1-score of 0.93, and applied in 45 urban areas of SSA to produce a dataset of urban expansion from 1995 to 2015. Across the case studies, built-up areas averaged a compound annual growth rate of 5.5% between 1995 and 2015. The comparison with local population dynamics reveals the heterogeneity of urban dynamics in SSA. Overall, population densities in built-up areas are decreasing. However, the impact of population growth on urban expansion differs depending on the size of the urban area and its income class.

Integrated community-based sexual health services for young people in urban areas: are we meeting the needs of the local community?

2008 ◽  
Vol 19 (10) ◽  
pp. 713-714 ◽  
Author(s):  
K M Forbes ◽  
N Rahman ◽  
S Mccrae ◽  
I Reeves
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Urban Areas ◽  
Local Community ◽  
Local Population ◽  
Nucleic Acid Amplification ◽  
Community Based ◽  
Transmitted Infection ◽  
Sti Testing ◽  
Hiv Test

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.

Local Communities as a Tool for the Development of Municipal Democracy: German Experience and Lessons for Russia

2020 ◽  
Vol 29 (5) ◽  
pp. 74-88
Author(s):  
Aleksandr Larichev ◽  
Emil Markwart
Keyword(s):  
Local Government ◽  
Urban Areas ◽  
Local Population ◽  
Local Communities ◽  
The State ◽  
Household Waste ◽  
Small Scale ◽  
Issue Management ◽  
State Management ◽  
Municipal Level

Local government as a political, legal and social institution finds itself in a very difficult period of development in Russia. The long-established tendency of its subordination to the state has intensified today in connection with the newly adopted constitutional amendments. At the same time, it seems obvious that further “embedding” of local government into the state management vertical, in the absence of any positive effect in terms of solving socio-economic and infrastructural problems, will inevitably lead to other hard to reverse, negative results both for local government institutions and the system of public authority as a whole. The normal functioning of local government requires, however, not only the presence of its sufficient institutional and functional autonomy from the state, but also an adequate territorial and social base for its implementation. To ensure the formation of viable territorial collectives, especially in urban areas, it seems appropriate to promote the development of self-government based on local groups at the intra-municipal level. Such local groups can independently manage issues of local importance on a small scale (landscaping, social volunteering, and neighborly mutual assistance), and provide, within the boundaries of a local territory, due civil control over the maintenance by municipal authorities of more complex and large-scale local issues (repair and development of infrastructure, removal of solid household waste and more). At the same time, the development of local communities can by no means be a self-sufficient and substitutional mechanism, whose introduction would end the need for democracy in the full scope of municipal structures overall. In this regard, the experience of local communities’ development in Germany, a state with legal traditions similar to Russian ones, with a centuries-old history of the development of territorial communities and a difficult path to building democracy and forming civil society, seems to be very interesting. Here, the progressive development of local forms of democracy and the participation of residents in local issue management are combined with stable mechanisms of municipal government, and the interaction of municipalities with the state does not torpedo the existing citizen forms of self-government. At the same time, the experience of Germany shows that the decentralization of public issue management which involves the local population can only be effective in a situation where, in addition to maintaining a full-fledged self-government mechanism at the general municipal level, relevant local communities are endowed with real competence and resources to influence local issue decision-making. The role of formalized local communities in urban areas, as the German experience shows, can not only facilitate the decentralization of solving public problems, but can also help in timely elimination of triggers for mobilizing citywide supercollectives with negative agendas. This experience seems useful and applicable in the Russian context.

scholarly journals Community Needs Assessments in a Student-Run Clinic serving a West Philadelphia Neighborhood

2020 ◽  
Author(s):  
Daniel J. Arenas ◽  
Dania D. Hallak ◽  
Rommell Noche ◽  
Gilberto Vila-Arroyo ◽  
Swathi Raman ◽  
...  
Keyword(s):  
Pap Smear ◽  
Health Needs ◽  
Local Health ◽  
Community Members ◽  
Community Needs ◽  
Needs Assessments ◽  
Healthcare Needs ◽  
Health Related ◽  
Healthcare Interventions ◽  
Local Healthcare

ABSTRACTBackgroundWhile Community Needs Assessments (CNAs) are an important tool for Student-Run Clinics (SRCs) to understand local communities’ healthcare needs, few studies have evaluated CNAs and their impact on care provided at SRCs.ObjectiveEvaluate results from two CNAs of an SRC in East Parkside, Philadelphia to better comprehend (1) community awareness and opinions regarding the SRC and (2) local healthcare concerns and access.Methods58 and 105 East Parkside residents were surveyed in 2011 and 2015 respectively. The results were analyzed to quantify various health-related measures in the community.ResultsResults showed high rates of hypertension, asthma, and diabetes. Rates of pap-smear and hypertension screening matched national averages while mammograms and colonoscopies were below national rates. Both CNAs showed that less than 40% of community members were aware of the clinic’s existence.ConclusionsCNAs can provide valuable insights regarding local health needs which can inform future healthcare interventions.

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