scholarly journals A tridimensional view of the Hispanic Health Paradox: Its relationship with faith, the enclave theory, and familism

2021 ◽  
Vol 8 (12) ◽  
pp. 317-345
Author(s):  
Shivaughn Hem-Lee-Forsyth ◽  
Bibiana Sandoval ◽  
Hanna Bryant
Keyword(s):  
Social Justice ◽  
Health Disparities ◽  
Physical Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Chronic Conditions ◽  
Hispanic Americans ◽  
Health Inequities ◽  
Hispanic Health Paradox ◽  
Health Paradox

This paper examines the "Hispanic (American) Health Paradox," the juxtaposition of Hispanics’ longer lifespan than the average American amid numerous inequities regarding social determinants of health. Hispanic Americans endure multiple health disparities with a higher incidence and prevalence of chronic conditions. They also experience multiple psychosocial and physical health challenges, including higher rates of food insecurity, poverty, segregation, discrimination, and limited or no access to medical care. Nevertheless, Hispanics enjoy better physical well-being and lower mortality rates when compared to non-Hispanics in the United States (Ruiz et al., 2021). This project aims to analyze the sources of this group’s biosocial advantages and resilience, allowing them to have a longer lifespan amidst their lower health status and increased risk for chronic conditions. It explores the political and social justice implications of these inequities. It also examines the strategies to close the gap on Latinos' current health care disparities via public policy aspects of federal and state legislature. A narrative review method was utilized to examine the existing literature on this paradoxical effect. Keywords based on Medical Subject Headings (MeSH) used to search resources for relevant studies included: Hispanic health paradox (health paradox, immigrant paradox), ethnic minorities (Latinos, LatinX), health disparities (disproportionate health, health inequities), social justice (healthcare stakeholders, health inequities solutions, inequities recommendations), mental health, physical health, and co-morbidities.  A quality assessment of full-text peer-reviewed articles yielded 80 articles to compile this narrative review. The research revealed that, despite glaring disparities in social determinants of health, Hispanic Americans have overall experienced better health outcomes through a culture that emphasizes spirituality, community support, and strong family ties.

Social determinants of health affecting treatment of pediatric brain tumors

2019 ◽  
Vol 24 (2) ◽  
pp. 159-165
Author(s):  
Jillian M. Berkman ◽  
Jonathan Dallas ◽  
Jaims Lim ◽  
Ritwik Bhatia ◽  
Amber Gaulden ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Brain Tumors ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Cns Tumor ◽  
Initial Symptoms ◽  
Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

Health Disparities and the Social Determinants of Health: Ethical and Social Justice Issues

2019 ◽  
pp. 265-276
Author(s):  
Sridhar Venkatapuram
Keyword(s):  
Health Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Global Justice ◽  
Social Epidemiology ◽  
Social Groups ◽  
Determinants Of Health ◽  
Housing Conditions ◽  
Early Infant ◽  
The Social

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.

scholarly journals Training Medical Residents to Address Social Determinants of Health for Better Health Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 258-259
Author(s):  
Angela Zell ◽  
Joan Ilardo ◽  
Adesuwa Olomu ◽  
Cristian Meghea ◽  
Supratik Rayamajhi
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Chronic Conditions ◽  
Local Community ◽  
Patient Activation ◽  
Resident Training ◽  
Determinants Of Health ◽  
Medical Residents ◽  
Patient Response ◽  
Future Clinical Practice

Abstract Gaps exist in training medical residents to assess social determinants of health (SDOH) related to chronic conditions. To address the need for better screening, we partnered with two Internal Medicine (IM) residency programs based in Lansing and Flint (Michigan) to pilot the Caring for Patients with Chronic Conditions (CPCC) project. IM residencies train internists with expertise in diagnosis, treating chronic conditions, promoting health through wellness education, and preventing and managing diseases. CPCC incorporated information during didactic sessions that residents could apply during their clinical activities that can influence their current and future clinical practice patterns. Presentations and panels from local community organizations on specific topics were incorporated into the curriculum that address needs of patients age 50 and older. To build on this education, the residents adapted the Office- Guidelines Applied in Practice (Office-GAP) checklist to identify SDOH affecting a patient’s ability to managed chronic conditions. Using this tool: 1) involves resident training; 2) provides a decision support checklist; 3) influences patient activation; and 4) increases provider and patient communication through shared decision making. The checklist includes questions for patient response pertaining to SDOH that prevents them from managing their chronic conditions in addition to the level of action the patient is willing to do. Areas identified are discussed between patient and resident increasing patient activation. Referrals to community-based resources to identified SDOH needs are guided by the clinic’s care manager. The Office-GAP tool is administered during three subsequent visits to ensure that patients actually accessed the community resources.

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