scholarly journals Community Engagement in Health Care: An Approach to Improve Health Care Access for People with Disabilities

2017 ◽  
Vol 37 (3) ◽  
Author(s):  
Dianne Sabat ◽  
Michael Richardson ◽  
Kathe F. Matrone ◽  
Darrin Umbarger ◽  
Angela Weaver
Keyword(s):  
Health Care ◽  
Community Engagement ◽  
Health Care Access ◽  
People With Disabilities ◽  
Local Communities ◽  
Provider Attitudes ◽  
Care Access ◽  
Physical Accessibility ◽  
Significant Health ◽  
Improve Health

People with disabilities (PWD) experience significant health disparities, at least partly due to difficulties accessing health care. These difficulties are multi-focal, including difficulties with transportation, effective communication, physical accessibility, and provider attitudes. Community engagement offers one method for working with local communities around health care access for PWD. By engaging PWD and the local infrastructure (e.g., providers, government, transportation, advocates), unique solutions are generated and awareness in the community is increased. We describe the use of our approach "Community Engagement in Health Care" with one such Oregon community.

scholarly journals Medical Students Screen for Social Determinants of Health: A Service Learning Model to Improve Health Equity

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Lucy Bickerton ◽  
Nicolle Siegart ◽  
Crystal Marquez
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Service Learning ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Social Needs ◽  
Community Resources ◽  
Care Access ◽  
Improve Health

Introduction: Medical schools are now required to address health disparities within their curriculum, with a recent emphasis on social determinants of health (SDOH). However, there is scant evidence that incorporating educational experiences around SDOH impacts health equity for patients. The COVID-19 pandemic provided a unique setting to engage students to address SDOH directly with patients. Methods: The authors designed a service-learning experience in which medical students conducted a patient needs assessment survey by phone to assess SDOH in the domains of health care access, economic stability, and social cohesion. We drew descriptive statistics from a deidentified Excel database of call outcomes to quantify health care interactions and community resource referrals generated by callers. Results: The call outcomes revealed unmet health and social needs among the patient population and generated a substantial number of actions to improve health care access and awareness of community resources. Conclusion: The results of this project show that employing medical students to engage with SDOH through action-oriented service learning positively impacts health care access and referrals to community resources. This initiative provides a flexible model to engage medical trainees in addressing health-related social needs that can be applied to a range of clinical settings and learner levels.

scholarly journals Access to health care for people with disabilities in rural Malawi what are the barriers?

2019 ◽  
Author(s):  
Josephine Harrison ◽  
Rachael Thomson ◽  
Hastings T. Banda ◽  
Grace B. Mbera ◽  
Stefanie Gregorius ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People With Disabilities ◽  
Randomised Control Trial ◽  
Care Access ◽  
Health Care Accessibility ◽  
Access To Health ◽  
Lung Condition ◽  
The Impact

Abstract Introduction People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside an impairment, on health care accessibility is explored. Method Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Questions, were recruited. People with cognitive impairments were excluded. Each of the selected participants underwent an individual in-depth interview and full recordings of these were then transcribed and translated. Findings and discussion Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Other barriers identified were distance to a facility, which was most hindering for the participants with a chronic lung condition, and unfavourable health seeking behaviour, whilst ‘time’ was found to be a common underlying factor. Attitudinal factors were not found to influence health care accessibility for this cohort. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.

Medicaid's Post-ACA Paradoxes

2020 ◽  
Vol 45 (4) ◽  
pp. 617-632
Author(s):  
Colleen M. Grogan
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Health Coverage ◽  
Medicaid Program ◽  
Working Adults ◽  
The Past ◽  
Care Access ◽  
American States ◽  
The Us ◽  
Improve Health

Abstract Medicaid's experience one decade after the passage of the Affordable Care Act represents extreme divergence across the American states in health care access and utilization, policy designs that either expand or restrict eligibility, and delivery model reforms. The past decade has also witnessed a growing ideological divide about the very purpose and intent of the Medicaid program and its place within the US health care system. While liberal-leaning states have actively embraced the program and used it to expand health coverage to working adults and families as an effort to improve health and prevent poverty and the insecurity and instability that comes with high medical costs (evictions, bankruptcy), conservative states have actively rejected this expanded idea of Medicaid and argued instead that the program should revert back to its “original” purpose and be used only for the “truly” needy. This article highlights several paradoxes within Medicaid that have led to this growing bifurcation, and it concludes by shedding light on important targets for future reform.

scholarly journals Workshop: MigHealthCare - strengthening Community Based Care to minimize health inequalities

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Health Care ◽  
Health Inequalities ◽  
Health Care Access ◽  
Community Based ◽  
Improve Health Care ◽  
Care Access ◽  
Health And Social Care ◽  
Care Models ◽  
Improve Health ◽  
The Eu

Abstract Over the past few years, a large number of refugees, migrants and asylum seekers have reached the south-eastern points of entry of the EU, challenging health and social systems of bordering countries with a spillover effect to the rest of the EU. Refugees, asylum seekers and migrants are at higher risk of poverty and social exclusion compared to the local populations, while the different vulnerable groups face diverse barriers when accessing health services. In many cases they do not receive appropriate health and social care that best meets their needs. Furthermore, in the EU MS, different practices apply to health and social care delivery for migrants/refugees. Research has shown the importance of community-based models to improve health care access of vulnerable migrants and refugees. Such models include elements of good communication, cultural awareness, sensitivity and respect for the diverse cultural and ethnic backgrounds by community health care staff as well health education and primary healthcare services. Mig-HealthCare - strengthening Community Based Care to minimize health inequalities and improve the integration of vulnerable migrants and refugees into local communities, is a 3-year project, launched in 2017, with the financial support of the European Commission. It is implemented by a consortium of 14 partners among them universities, national authorities and NGOs from ten countries across Europe (Greece, France, Malta, Germany, Austria, Italy, Cyprus, Spain, Sweden and Bulgaria). The overall objective of Mig-HealthCare is to improve health care access for vulnerable migrants and refugees, support their inclusion and participation in European communities and reduce health inequalities. The project’s specific objectives are: Describe the current physical and mental health profile of vulnerable migrants and refugees including needs, expectations and capacities of service providers.Develop a roadmap and toolbox for the implementation of community based care models, following an assessment of existing health services and best practices.Train community service providers on appropriate delivery of health care models for vulnerable migrants and refugees.Pilot test and evaluate community based care models which emphasize prevention, physical and mental health promotion and integration. The project results are presented on behalf of the Mig-HealthCare consortium. Key messages The overall objective of Mig-HealthCare is to improve health care access for vulnerable migrants and refugees. The Mig-HealthCare project focuses on developing a roadmap to facilitate the effective implementation of community care models.

scholarly journals Access to health care for people with disabilities in rural Malawi: what are the barriers?

2020 ◽  
Author(s):  
Josephine Harrison ◽  
Rachael Thomson ◽  
Hastings T. Banda ◽  
Grace B. Mbera ◽  
Stefanie Gregorius ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People With Disabilities ◽  
Randomised Control Trial ◽  
Sensory Impairment ◽  
Care Access ◽  
Health Care Accessibility ◽  
Access To Health ◽  
The Impact

Abstract Background People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored. Methods Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Short Set (WGSS) questions, were recruited. The WGSS questions concern a person’s ability in core functional domains (including seeing, hearing and moving), and a score of 3 indicates ‘a lot of difficulty’ whilst 4 means ‘cannot do at all’. People with cognitive impairments were not included in this study. All who were selected for the study participated in an individual in-depth interview and full recordings of these were then transcribed and translated. Results Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Attitudinal factors were explored and, whilst unfavourable health seeking behaviour was found to act as an access barrier for some participants, community and health care workers’ attitudes towards disability were not reported to influence health care accessibility in this study. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.

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