scholarly journals Perspective: POTUS Trump’s Executive Orders - Implications for Immigrants and Health Care

2017 ◽  
Vol 27 (2) ◽  
pp. 121 ◽  
Author(s):  
Efrain Talamantes ◽  
Sergio Aguilar-Gaxiola
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Underserved Populations ◽  
The United States ◽  
Executive Orders ◽  
Health Care Workforce ◽  
Care Access ◽  
Deferred Action ◽  
National Leaders ◽  
Improving Health Care

<p class="Default">The United States, under new executive orders proposed by its 45th president, may quickly lose its greatness in serving Emma Lazarus’ untimely portrait of immigrants and refugees as <strong>“</strong><em>the tired, poor and huddled masses yearning to breathe free</em><strong>.” </strong>After years of progress in improving health care access to underserved populations, new executive orders threaten our nation’s advancements in health equity. Within this perspective, we offer examples on how these actions may result in damaging impacts on patients, families, communities and the health care workforce. We add our voices to a myriad of national leaders who are advocating for the preservation of the Affordable Care Act (ACA) and the protection of immigrants, including Deferred Action for Childhood Arrivals (DACA).</p><p class="Default"><em>Ethn Dis. </em>2017;27(2):121-124; doi:10.18865/ed.27.2.121</p>

scholarly journals The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations

2017 ◽  
Vol 38 (1) ◽  
pp. 489-505 ◽  
Author(s):  
Gerald F. Kominski ◽  
Narissa J. Nonzee ◽  
Andrea Sorensen
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Low Income ◽  
Health Care Access ◽  
Underserved Populations ◽  
The United States ◽  
Outpatient Services ◽  
Care Access ◽  
The Law ◽  
Long Term Impact

The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

scholarly journals States Can Transform Their Health Care Workforce

2014 ◽  
Vol 6 (4) ◽  
pp. 805-808 ◽  
Author(s):  
Paul H. Rockey ◽  
Richard E. Rieselbach ◽  
Katherine Neuhausen ◽  
Thomas J. Nasca ◽  
Robert L. Phillips ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
The United States ◽  
Institute Of Medicine ◽  
Care Needs ◽  
Health Care Workforce ◽  
Care Access ◽  
Unmet Health Care Needs ◽  
Workforce Needs ◽  
Distribution Of Physicians

Abstract The United States faces the simultaneous challenges of improving health care access and balancing the specialty and geographic distribution of physicians. A 2014 Institute of Medicine report recommended significant changes in Medicare graduate medical education (GME) funding, to incentivize innovation and increase accountability for meeting national physician workforce needs. Annually, nearly $4 billion of Medicaid funds support GME, with limited accountability for outcomes. Directing these funds toward states' greatest health care workforce needs could address health care access and physician maldistribution issues and make the funding for resident education more accountable. Under the proposed approach, states would use Medicaid funds, in conjunction with Medicare GME funds, to expand existing GME programs and establish new primary care and specialty programs that focus on their population's unmet health care needs.

scholarly journals Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

2018 ◽  
Vol 5 ◽  
pp. 233339281774340 ◽  
Author(s):  
Tammy Toscos ◽  
Maria Carpenter ◽  
Mindy Flanagan ◽  
Kislaya Kunjan ◽  
Bradley N. Doebbeling
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Community Health ◽  
Health Care Access ◽  
Underserved Populations ◽  
The United States ◽  
Patient Centered ◽  
Clinic Staff ◽  
Care Access ◽  
Improve Access

Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.

State-Level Sexism and Women’s Health Care Access in the United States: Differences by Race/Ethnicity, 2014–2019

2021 ◽  
pp. e1-e10
Author(s):  
Kristen Schorpp Rapp ◽  
Vanessa V. Volpe ◽  
Hannah Neukrug
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Hispanic Women ◽  
State Level ◽  
The United States ◽  
Barriers To Health Care ◽  
Care Access ◽  
Race Ethnicity ◽  
The Relationship ◽  
Barriers To Health

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

Sexually Transmitted Infections in the U.S. Military: A Sexual Health Paradigm to Address Risk Behaviors, Unintended Pregnancy, Alcohol Use, and Sexual Trauma

2021 ◽  
Author(s):  
Cherrie B Boyer ◽  
Charlotte A Gaydos ◽  
Amy B Geller ◽  
Eric C Garges ◽  
Sten H Vermund
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Health Care Access ◽  
The United States ◽  
Universal Health Care ◽  
Sexually Transmitted ◽  
Care Access ◽  
Control And Prevention ◽  
The Military ◽  
Universal Health

ABSTRACT To address the ongoing epidemic of sexually transmitted infections (STIs) in the United States, the National Academies of Sciences, Engineering, and Medicine (National Academies) conducted a consensus study on STI control and prevention in the United States to provide recommendations to the Centers for Disease Control and Prevention and the National Association of County and City Health Officials. The culminating report identified military personnel as one of the priority groups that require special consideration given the high prevalence of STIs and their associated behaviors (e.g., concurrent sexual partners and infrequent condom use) that occur during active duty service. Universal health care access, the relative ease and frequency of STI screening, and the educational opportunities within the military are all assets in STI control and prevention. The report offers a comprehensive framework on multiple and interrelated influences on STI risk, prevention, health care access, delivery, and treatment. It also provides an overview of the multilevel risk and protective factors associated with STIs that could be applied using a sexual health paradigm. The military context must integrate the multilevel domains of influences to guide the effort to fill current gaps and research needs. The Department of Defense, with its large clinical and preventive medicine workforce and its well-established universal health care system, is well positioned to enact changes to shift its current approach to STI prevention, treatment, and control. STI control based on highlighting behavioral, social, cultural, and environmental influences on service members’ sexual health and wellness may well drive better STI care and prevention outcomes.

scholarly journals The Role of Immigration in the Health of Lesbian, Gay, Bisexual, and Transgender Older Adults in the United States

2019 ◽  
Vol 89 (1) ◽  
pp. 3-21
Author(s):  
Jane J. Lee ◽  
Hyun-Jun Kim ◽  
Karen Fredriksen Goldsen
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Health Care Access ◽  
Well Being ◽  
The United States ◽  
Foreign Born ◽  
Care Access ◽  
Bisexual And Transgender

Lesbian, gay, bisexual, and transgender (LGBT) aging research is growing around the globe. Yet, few studies have examined the interconnectedness of different populations and cultures. This study examines whether LGBT foreign-born older adults experience greater health disparities than their U.S.-born counterparts. We conducted a cross-sectional analysis of the National Health, Aging, and Sexuality/Gender Study: Aging with Pride from 2014, which assessed measures of health and well-being among LGBT adults aged 50 years and older ( n = 2,441). We compared sociodemographic characteristics, health-care access, health behaviors, and health outcomes between foreign-born and U.S.-born participants. Foreign-born LGBT older adults reported greater socioeconomic disadvantage and higher levels of experiencing barriers to health-care access than U.S.-born LGBT older adults. Groups did not significantly differ in health behaviors and health outcomes when controlling for sociodemographic factors. Greater understanding of the mechanisms that shape the relationship between migration and health among the LGBT population is warranted.

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