scholarly journals Geographic, Health Care Access, Racial Discrimination, and Socioeconomic Determinants of Maternal Mortality in Georgia, United States

2021 ◽  
Vol 10 (2) ◽  
pp. 278-286
Author(s):  
Elizabeth Afibah Armstrong-Mensah ◽  
Damilola Dada ◽  
Amber Bowers ◽  
Aruba Muhammad ◽  
Chisom Nnoli
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Determinants Of Health ◽  
Maternal Mortality Rate ◽  
Care Access ◽  
The Relationship

Over the past decade, the United States has been taking steps to reduce its rising maternal mortality rate. However, these steps have yet to produce positive results in the state of Georgia, which tops the list of all 50 states with the highest maternal mortality rate of 46.2 maternal deaths per 100,000 live births for all women, and a maternal mortality rate of 66.6 deaths per 100,000 live births for African American women. In Georgia, several social determinants of health such as the physical environment, economic stability, health care access, and the quality of maternal care contribute to the high maternal mortality rate. Addressing these determinants will help to reduce the state’s maternal mortality rate. This commentary discusses the relationship between social determinants of health and maternal mortality rates in Georgia. It also proposes strategies for reversing the trend.We conducted an ecological study of the relationship between social determinants of health and maternal mortality in Georgia. We searched PubMed and Google Scholar and reviewed 80 English articles published between 2005 and 2021. We identified five key social determinants associated with high maternal mortality rates in Georgia - geographic location of obstetric services, access to health care providers, socioeconomic status, racism, and discrimination. We found that expanding Medicaid coverage, reducing maternal health care disparities among the races, providing access to maternal care for women in rural areas, and training a culturally competent health workforce, will help to reduce Georgia’s high maternal mortality rate.   Copyright © 2021 Armstrong-Mensah et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

scholarly journals 182 Assessing Economic and Health Care Access Social Determinants of Health in the Emergency Department

2015 ◽  
Vol 66 (4) ◽  
pp. S65
Author(s):  
A.M. Park ◽  
A.L. Anderson ◽  
J.D. Nguyen ◽  
D.A. Saltzman ◽  
B.L. Kastetter ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Determinants Of Health ◽  
Care Access

Racial Disparities in Incidence of Legionnaires’ Disease and Social Determinants of Health: A Narrative Review

2021 ◽  
pp. 003335492110267
Author(s):  
Candis M. Hunter ◽  
Simone W. Salandy ◽  
Jessica C. Smith ◽  
Chris Edens ◽  
Brian Hubbard
Keyword(s):  
Health Care ◽  
Built Environment ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Narrative Review ◽  
Economic Stability ◽  
Care Access ◽  
Legionnaires Disease ◽  
Access And Quality

Objectives Racial and socioeconomic disparities in the incidence of Legionnaires’ disease have been documented for the past 2 decades; however, the social determinants of health (SDH) that contribute to these disparities are not well studied. The objective of this narrative review was to characterize SDH to inform efforts to reduce disparities in the incidence of Legionnaires’ disease. Methods We conducted a narrative review of articles published from January 1979 through October 2019 that focused on disparities in the incidence of Legionnaires’ disease and pneumonia (inclusive of bacterial pneumonia and/or community-acquired pneumonia) among adults and children (excluding articles that were limited to people aged <18 years). We identified 220 articles, of which 19 met our criteria: original research, published in English, and examined Legionnaires’ disease or pneumonia, health disparities, and SDH. We organized findings using the Healthy People 2030 SDH domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment. Results Of the 19 articles reviewed, multiple articles examined disparities in incidence of Legionnaires’ disease and pneumonia related to economic stability/income (n = 13) and comorbidities (n = 10), and fewer articles incorporated SDH variables related to education (n = 3), social support (none), health care access (n = 1), and neighborhood and built environment (n = 6) in their analyses. Conclusions Neighborhood and built-environment factors such as housing, drinking water infrastructure, and pollutant exposures represent critical partnership and research opportunities. More research that incorporates SDH and multilevel, cross-sector interventions is needed to address disparities in Legionnaires’ disease incidence.

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 The Impact Of A Whole Health Model Of Care On Patient Outcomes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 838-838
Author(s):  
Anna Faul ◽  
Pamela Yankeelov ◽  
Joseph D'Ambrosio ◽  
Sam Cotton ◽  
Barbara Gordon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Social Determinants ◽  
Health Care Access ◽  
Determinants Of Health ◽  
Education Attainment ◽  
Psychological Determinants ◽  
Care Access ◽  
The Impact ◽  
Over Time

Abstract The FlourishCare Model (FCM) transforms primary care sites by addressing all determinants of health and focusing on helping patients to flourish. The FlourishCare Index (FCI) is a clinical measure to assess the effectiveness of the FCM to address all determinants of health. We will present data on the effectiveness of the FCM serving 159 older adults with MCCs. The sample was mostly female (77%), White (64%), retired (54%), married (30%) or widowed (20%) and living in urban areas (64%). The mean age was 69 (SD=15), with 13 years education (SD=3). Patients changed significantly over time on total FCI scores (57%-72%;□=3.80,SE=0.63). Results show significant growth over time for individual health behaviors (58%-67%;□=2.14,SE=0.84), health care access (71%-89%;□=4.43,SE=1.00) and social determinants (62%-85%;□=5.54,SE=1.02) with psychological determinants (54%-61%;□=1.74,SE=0.95) and environmental determinants (70%-81%;□=2.81,SE=1.62) showing a trend to significance. Interaction effects with time show that the FCM supported patients with lower education attainment to improve at a higher rate than those with higher education attainment, for the total FCI score (□=-0.59,SE=0.24) and health care access (□=-0.94,SE=0.38). Receiving mental health counseling resulted in more improvement in psychological determinants than those who did not receive counseling (□=3.43,SE=2.04). The FCM was able to support rural patients at a higher rate than urban patients to gain access to health care (□=4.13,SE=2.02). The FCM supported Hispanic patients the most in improving social determinants of health (□=8.40,SE=3.93). This study showed the importance of a systems approach to care using measures that focus on what matters most to older adults who value quality-of-life outcomes.

scholarly journals Social Determinants of Maternal Health in Afghanistan: A Review

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Said Ahmad Maisam Najafizada ◽  
Ivy Lynn Bourgeault ◽  
Ronald Labonté
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Local Economy ◽  
Determinants Of Health ◽  
Social Infrastructure ◽  
The Impact

Introduction: Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature.Methods: This narrative review was conducted using Arksey and O’Malley’s framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. Results: A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Conclusion: Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations’ long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

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 )

Limitations on Participation and Their Relation to Social Determinants of Health Among Occupational Therapists and Occupational Therapy Students During Coronavirus Lockdown

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Nuria Menéndez Álvarez ◽  
Emiliano Diez Villoria ◽  
Estíbaliz Jimenez Arberas ◽  
Ana María Castaño Pérez ◽  
Antonio León García Izquierdo
Keyword(s):  
Occupational Therapy ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Occupational Therapists ◽  
Determinants Of Health ◽  
World Health ◽  
International Classification Of Functioning ◽  
Occupational Therapy Students ◽  
The Impact ◽  
The Relationship

Importance: For the first time in recent history, people worldwide have faced severe restrictions in occupations because of the measures adopted by governments to contain the coronavirus disease 2019 (COVID-19) crisis. Objective: To determine the limitations on participation of occupational therapists and occupational therapy students during “lockdown” and their impact on social determinants of health. Design: A cross-sectional, descriptive study conducted via an online survey. Participants: A total of 488 occupational therapists and occupational therapy students in North America, South America, and Europe. Outcomes and Measures: A questionnaire consisting of the World Health Organization Disability Assessment Schedule 2.0 of the International Classification of Functioning, Disability and Health and items developed to assess the impact of lockdown on daily life was emailed to occupational therapy professional associations, organizations, and universities between April and June 2020. It was available in English, Spanish, and Portuguese and met all the parameters listed in the Declaration of Helsinki. Results: The roles and routines of people across the developed world have been affected by lockdown measures. The study shows marked differences between participants in the domains of getting along and life activities, as well as influence on the environment. Moreover, South American participants experienced these difficulties to a greater extent than European participants. Conclusions and Relevance: This study quantifies the limitations in the participation of occupational therapists and occupational therapy students and the relationship of occupation to social determinants of health. What This Article Adds: The results of this research corroborate the relationship between health and occupation and highlight elements, such as the environment and context, that are important in occupational therapy. Therapists’ ability to analyze occupation in relation to contextual and cultural factors will benefit clients.

scholarly journals Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Issues ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Health Questionnaire ◽  
Improvement Project ◽  
The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

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