scholarly journals The wealth gradient and the effect of COVID-19 restrictions on income loss, food insecurity and health care access in four sub-Saharan African geographies

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260823
Author(s):  
Elizabeth Gummerson ◽  
Carolina Cardona ◽  
Philip Anglewicz ◽  
Blake Zachary ◽  
Georges Guiella ◽  
...  
Keyword(s):  
Health Care ◽  
Food Insecurity ◽  
Household Income ◽  
Access To Health Care ◽  
Economic Effects ◽  
African Countries ◽  
Income Loss ◽  
Access To Health ◽  
Nationally Representative ◽  
Representative Samples

Introduction While there has been considerable analysis of the health and economic effects of COVID-19 in the Global North, representative data on the distribution and depth of social and economic impacts in Africa has been more limited. Methods We analyze household data collected prior to the COVID-19 pandemic and during the first wave of COVID in four African countries. We evaluate the short-term changes to household economic status and assess women’s access to health care during the first wave of COVID-19 in nationally representative samples of women aged 15–49 in Kenya and Burkina Faso, and in sub-nationally representative samples of women aged 15–49 in Kinshasa, Democratic Republic of Congo and Lagos, Nigeria. We examine prevalence and distribution of household income loss, food insecurity, and access to health care during the COVID-19 lockdowns across residence and pre-pandemic wealth categories. We then regress pre-pandemic individual and household sociodemographic characteristics on the three outcomes. Results In three out of four samples, over 90% of women reported partial or complete loss of household income since the beginning of the coronavirus restrictions. Prevalence of food insecurity ranged from 17.0% (95% CI 13.6–20.9) to 39.8% (95% CI 36.0–43.7), and the majority of women in food insecure households reported increases in food insecurity during the COVID-19 restriction period. In contrast, we did not find significant barriers to accessing health care during COVID restrictions. Between 78·3% and 94·0% of women who needed health care were able successfully access it. When we examined pre-pandemic sociodemographic correlates of the outcomes, we found that the income shock of COVID-19 was substantial and distributed similarly across wealth groups, but food insecurity was concentrated among poorer households. Contrary to a-priori expectations, we find little evidence of women experiencing barriers to health care, but there is significant need for food support.

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.

scholarly journals Health and Socio-economic Implications of Poverty in Bangladesh

2018 ◽  
Vol 14 (29) ◽  
pp. 301
Author(s):  
Sacchidanand Majumder ◽  
Soma Chowdhury Biswas
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Household Income ◽  
Access To Health Care ◽  
Construction Materials ◽  
Poverty Level ◽  
Economic Implications ◽  
Access To Health ◽  
Chronic Fever ◽  
Socio Economic Factors

The objective of this study was to explore the influences of the health and socio-economic factors associated with the poverty level of households in Bangladesh, through an analysis of data from the Household Income and Expenditure Survey (HIES) 2010 conducted by Bangladesh Bureau of Statistics (BBS). A total of all 12,240 households was considered in this study. CBN method was applied for estimating poverty of the household. A logistic regression analysis was used to identify the main factors that influence the household’s poverty. The results showed that the probability of the household being poor was higher when the household’s head suffered from various chronic diseases like chronic fever, injuries/disability, eczema, leprosy, and asthma/breathing trouble as compared to the household whose head didn’t suffer from any chronic diseases. From the analysis, it was also found that when a large number within household suffered from any chronic disease, the probability of the household being poor was increased. The household that had no access to health care was poorer than the household that had access to health care. The results also showed that with increased investment in health, the probability of the household being poor was decreased. The results showed that rural households were poorer than urban households. Monthly income, land ownership, construction materials of walls and roofs, types of the latrine, source of drinking water, household size; age, sex, and employment status of the household’s head all had a significant impact on the poverty level of the household.

scholarly journals Intersection of Migration and Access to Health Care: Experiences and Perceptions of Female Economic Migrants in Canada

2020 ◽  
Vol 17 (10) ◽  
pp. 3682
Author(s):  
Solina Richter ◽  
Helen Vallianatos ◽  
Jacqueline Green ◽  
Chioma Obuekwe
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Access To Health Care ◽  
Social Connectedness ◽  
Reproductive Age ◽  
African Countries ◽  
Access To Health ◽  
Care System

More people are migrating than ever before. There are an estimated 1 billion migrants globally—of whom, 258 million are international migrants and 763 million are internal migrants. Almost half of these migrants are women, and most are of reproductive age. Female migration has increased. The socioeconomic contexts of women migrants need investigation to better understand how migration intersects with accessing health care. We employed a focused ethnography design. We recruited 29 women from three African countries: Ghana, Nigeria, and South Africa. We used purposive and convenient sampling techniques and collected data using face-to-face interviews. Interviews were audio-recorded and transcribed verbatim. Data were analyzed with the support of ATLAS.ti 8 Windows (ATLAS.ti Scientific Software Development GmbH), a computer-based qualitative software for data management. We interviewed 10 women from both South Africa and Ghana and nine women from Nigeria. Their ages ranged between 24 and 64 years. The four themes that developed included social connectedness to navigate access to care, the influence of place of origin on access to care, experiences of financial accessibility, and historical and cultural orientation to accessing health care. It was clear that theses factors affected economic migrant women’s access to health care after migration. Canada has a universal health care system but multiple research studies have documented that migrants have significant barriers to accessing health care. Most migrants indeed arrive in Canada from a health care system that is very different than their country of origin. Access to health care is one of the most important social determinants of health.

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.

Socioeconomic factors associated with pituitary apoplexy

2013 ◽  
Vol 119 (6) ◽  
pp. 1432-1436 ◽  
Author(s):  
Arman Jahangiri ◽  
Aaron J. Clark ◽  
Seunggu J. Han ◽  
Sandeep Kunwar ◽  
Lewis S. Blevins ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Household Income ◽  
Access To Health Care ◽  
Pituitary Apoplexy ◽  
Primary Health Care Provider ◽  
Primary Health ◽  
Access To Health

Object Pituitary apoplexy is associated with worse outcomes than are pituitary adenomas detected without acute clinical deterioration. The association between pituitary apoplexy and socioeconomic factors that may limit access to health care has not been examined in prior studies. Methods This study involved retrospectively evaluating data obtained in all patients who underwent surgery for nonfunctioning pituitary adenoma causing visual symptoms between January 2003 and July 2012 at the University of California, San Francisco. Patients were grouped into those who presented with apoplexy and those who did not (“no apoplexy”). The 2 groups were compared with respect to annual household income, employment status, health insurance status, and whether or not the patient had a primary health care provider. Associations between categorical variables were analyzed by chi-square test and continuous variables by Student t-test. Multivariate logistic regression was also performed. Results One hundred thirty-five patients were identified, 18 of whom presented with apoplexy. There were significantly more unmarried patients and emergency room presentations in the apoplexy group than in the “no apoplexy” group. There was a nonsignificant trend toward lower mean household income in the apoplexy group. Lack of health insurance and lack of a primary health care provider were both highly significantly associated with apoplexy. In a multivariate analysis including marital status, emergency room presentation, income, insurance status, and primary health care provider status as variables, lack of insurance remained associated with apoplexy (OR 11.6; 95% CI 1.9–70.3; p = 0.008). Conclusions The data suggest that patients with limited access to health care may be more likely to present with pituitary apoplexy than those with adequate access.

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.

scholarly journals The rural tax: comprehensive out-of-pocket costs associated with patient travel in British Columbia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jude Kornelsen ◽  
Asif Raza Khowaja ◽  
Gal Av-Gay ◽  
Eva Sullivan ◽  
Anshu Parajulee ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Household Income ◽  
Access To Health Care ◽  
Rural Patient ◽  
Urban Patient ◽  
Access To Health ◽  
Patient Stress ◽  
Rural Patients ◽  
Out Of Pocket Costs

Abstract Background A significant concern for rural patients is the cost of travel outside of their community for specialist and diagnostic care. Often, these costs are transferred to patients and their families, who also experience stress associated with traveling for care. We sought to examine the rural patient experience by (1) estimating and categorizing the various out of pocket costs associated with traveling for healthcare and (2) describing and measuring patient stress and other experiences associated with traveling to seek care, specifically in relation to household income. Methods We have designed and administered an online, retrospective, cross-sectional survey seeking to estimate the out-of-pocket (OOP) costs and personal experiences of rural patients associated with traveling to access health care in British Columbia. Respondents were surveyed across five categories: Distance Traveled and Transportation Costs, Accommodation Costs, Co-Traveler Costs, Lost Wages, and Patient Stress. Bivariate relationships between respondent household income and other numerical findings were investigated using one-way ANOVA. Results On average, costs for respondents were $856 and $674 for transport and accommodation, respectively. Strong relationships were found to exist between the distance traveled and total transport costs, as well as between a patient’s stress and their household income. Patient perspectives obtained from this survey expressed several related issues, including the physical and psychosocial impacts of travel as well as delayed or diminished care seeking. Conclusions These key findings highlight the existing inequities between rural and urban patient access to health care and how these inequities are exacerbated by a patient’s overall travel-distance and financial status. This study can directly inform policy related efforts towards mitigating the rural-urban gap in access to health care.

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