scholarly journals Drivers of differential views of health equity in the U.S.: Is the U.S. ready to make progress? Results from the 2018 National Survey of Health Attitudes

2021 ◽  
Author(s):  
Vivian Towe ◽  
Linnea Warren May ◽  
Wenjing Huang ◽  
Laurie T. Martin ◽  
Katherine Carman ◽  
...  
Keyword(s):  
Public Health ◽  
Latent Class Analysis ◽  
Health Equity ◽  
Social Determinants ◽  
Latent Class ◽  
Health Attitudes ◽  
The Public ◽  
Logistic Regressions ◽  
Using Data ◽  
The U.S

Abstract Objectives: The public health sector has long recognized the role of the social determinants of health in health disparities and the importance of achieving health equity. We now appear to be at an inflection point, as we hear increasing demands to dismantle structures that have perpetuated inequalities. Assessing prevailing mindsets about what causes health inequalities and the value of health equity is critical to addressing larger issues of inequity, including racial inequity and other dimensions. Using data from a nationally representative sample of adults in the United States, we examined the factors that Americans think drive health outcomes and their beliefs about the importance of health equity.Methods: Using data from the 2018 National Survey of Health Attitudes, we conducted factor analyses of 21 survey items and identified three factors from items relating to health drivers—traditional health influencers (THI), social determinants of health (SDoH), and sense of community health (SoC). Health equity beliefs were measured with three questions about opportunities to be healthy. Latent class analysis identified four groups with similar patterns of response. Factor mixture modeling combined factor structure and latent class analysis into one model. We conducted three logistic regressions using latent classes and demographics as predictors and the three equity beliefs as dependent variables.Results: Nearly 90% of respondents comprised one class that was characterized by high endorsement (i.e., rating the driver as having strong effect on health) of THI, but lower endorsement of SDoH and SoC. Logistic regressions showed that respondents endorsing (i.e., rated it as a top priority) all three health equity beliefs tended to be female, older, Black or Hispanic, more educated, and have lower incomes. The class of respondents that endorsed SDoH the most was more likely to endorse all three equity beliefs.Conclusions: Results suggested that people historically impacted by inequity, e.g., people of color and people with low incomes, had the most comprehensive understanding of the drivers of health and the value of equity. However, dominant beliefs about SDoH and health equity are still generally not aligned with scientific consensus and the prevailing narrative in the public health community.Trial Registration: Not applicable

scholarly journals Drivers of differential views of health equity in the U.S.: is the U.S. ready to make progress? Results from the 2018 National Survey of Health Attitudes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vivian L. Towe ◽  
Linnea Warren May ◽  
Wenjing Huang ◽  
Laurie T. Martin ◽  
Katherine Carman ◽  
...  
Keyword(s):  
Public Health ◽  
Latent Class Analysis ◽  
Health Equity ◽  
Social Determinants ◽  
Latent Class ◽  
Health Attitudes ◽  
The Public ◽  
Logistic Regressions ◽  
Using Data ◽  
The U.S

Abstract Objectives The public health sector has long recognized the role of the social determinants of health in health disparities and the importance of achieving health equity. We now appear to be at an inflection point, as we hear increasing demands to dismantle structures that have perpetuated inequalities. Assessing prevailing mindsets about what causes health inequalities and the value of health equity is critical to addressing larger issues of inequity, including racial inequity and other dimensions. Using data from a nationally representative sample of adults in the United States, we examined the factors that Americans think drive health outcomes and their beliefs about the importance of health equity. Methods Using data from the 2018 National Survey of Health Attitudes, we conducted factor analyses of 21 survey items and identified three factors from items relating to health drivers—traditional health influencers (THI), social determinants of health (SDoH), and sense of community health (SoC). Health equity beliefs were measured with three questions about opportunities to be healthy. Latent class analysis identified four groups with similar patterns of response. Factor mixture modeling combined factor structure and latent class analysis into one model. We conducted three logistic regressions using latent classes and demographics as predictors and the three equity beliefs as dependent variables. Results Nearly 90% of respondents comprised one class that was characterized by high endorsement (i.e., rating the driver as having strong effect on health) of THI, but lower endorsement of SDoH and SoC. Logistic regressions showed that respondents endorsing (i.e., rated it as a top priority) all three health equity beliefs tended to be female, older, Black or Hispanic, more educated, and have lower incomes. The class of respondents that endorsed SDoH the most was more likely to endorse all three equity beliefs. Conclusions Results suggested that people historically impacted by inequity, e.g., people of color and people with low incomes, had the most comprehensive understanding of the drivers of health and the value of equity. However, dominant beliefs about SDoH and health equity are still generally not aligned with scientific consensus and the prevailing narrative in the public health community.

scholarly journals Drivers of differential views of health equity in the U.S.: Is the U.S. ready to make progress? Results from the 2018 National Survey of Health Attitudes

2020 ◽  
Author(s):  
Vivian Towe ◽  
Linnea Warren May ◽  
Wenjing Huang ◽  
Laurie T. Martin ◽  
Katherine Carman ◽  
...  
Keyword(s):  
Public Health ◽  
Latent Class Analysis ◽  
Health Equity ◽  
Social Determinants ◽  
Latent Class ◽  
Health Attitudes ◽  
The Public ◽  
Logistic Regressions ◽  
Using Data ◽  
The U.S

Abstract Objectives: The public health sector has long recognized the role of the social determinants of health in health disparities and the importance of achieving health equity. We now appear to be at an inflection point, as we hear increasing demands to dismantle structures that have perpetuated inequalities. Assessing prevailing mindsets about what causes health inequalities and the value of health equity is critical to the addressing larger, racial inequity issues. Using data from a nationally representative sample of adults in the United States, we examined the factors that Americans think drive health outcomes and their beliefs about the importance of health equity.Methods: Using data from the 2018 National Survey of Health Attitudes, we conducted factor analyses of 21 survey items identified three factors out of the items relating to health drivers—traditional health influencers (THI), social determinants of health (SDoH), and sense of community health (SoC). Beliefs about health equity were measured with three questions about opportunities to be healthy. Latent class analysis identified four groups with similar patterns of response. Factor mixture modeling combined factor structure and latent class analysis into one model. We conducted three separate logistic regressions using latent classes and demographics as predictors and the three equity beliefs as dependent variables. Results: Nearly 90% of respondents comprised one class that was characterized by high endorsement (i.e., rating the driver as having strong effect on health) of THI, but lower endorsement of SDoH and SoC. Logistic regressions showed that respondents endorsing (i.e., rated it as a top priority) all three health equity outcomes tended to be female, older, Black or Hispanic, more educated, and have lower incomes. The class of respondents that endorsed SDoH the most was more likely to endorse all three equity beliefs.Conclusions: Results suggested that people historically most impacted by inequity, e.g., people of color and people with low incomes, had the most comprehensive understanding of the drivers of health and the value of equity. Prevailing beliefs about SDoH and health equity are still generally not aligned with scientific consensus and the prevailing narrative in the public health community.Trial Registration: Not applicable

scholarly journals A Panel Evaluation of the Changes in the General Public’s Social-Media-Following of United States’ Public Health Departments during COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272199545
Author(s):  
Areej Khokhar ◽  
Aaron Spaulding ◽  
Zuhair Niazi ◽  
Sikander Ailawadhi ◽  
Rami Manochakian ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
State Level ◽  
The State ◽  
Public Health Department ◽  
Health Departments ◽  
The Public ◽  
Public Health Departments ◽  
The Social ◽  
The U.S

Importance: Social media is widely used by various segments of society. Its role as a tool of communication by the Public Health Departments in the U.S. remains unknown. Objective: To determine the impact of the COVID-19 pandemic on social media following of the Public Health Departments of the 50 States of the U.S. Design, Setting, and Participants: Data were collected by visiting the Public Health Department web page for each social media platform. State-level demographics were collected from the U.S. Census Bureau. The Center for Disease Control and Prevention was utilized to collect information regarding the Governance of each State’s Public Health Department. Health rankings were collected from “America’s Health Rankings” 2019 Annual report from the United Health Foundation. The U.S. News and World Report Education Rankings were utilized to provide information regarding the public education of each State. Exposure: Data were pulled on 3 separate dates: first on March 5th (baseline and pre-national emergency declaration (NED) for COVID-19), March 18th (week following NED), and March 25th (2 weeks after NED). In addition, a variable identifying the total change across platforms was also created. All data were collected at the State level. Main Outcome: Overall, the social media following of the state Public Health Departments was very low. There was a significant increase in the public interest in following the Public Health Departments during the early phase of the COVID-19 pandemic. Results: With the declaration of National Emergency, there was a 150% increase in overall public following of the State Public Health Departments in the U.S. The increase was most noted in the Midwest and South regions of the U.S. The overall following in the pandemic “hotspots,” such as New York, California, and Florida, was significantly lower. Interesting correlations were noted between various demographic variables, health, and education ranking of the States and the social media following of their Health Departments. Conclusion and Relevance: Social media following of Public Health Departments across all States of the U.S. was very low. Though, the social media following significantly increased during the early course of the COVID-19 pandemic, but it still remains low. Significant opportunity exists for Public Health Departments to improve social media use to engage the public better.

scholarly journals Making equal rights to health an election issue in NZ local body elections

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Stone ◽  
D e b Leyland
Keyword(s):  
Public Health ◽  
Social Media ◽  
Human Rights ◽  
New Zealand ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequity ◽  
Equal Rights ◽  
The Public ◽  
Local Body

Abstract In New Zealand there are 20 district health boards (DHBs) with local elections every 3 years. There is low voter turnout for these, we suspect because the public has low cognizance of the role DHBs have in governing their health and disability system. Good governance ensures everyone whatever ethnicity, gender or sexual proclivity, from birth to old age, able or disabled, mentally well or unwell, drugfree or addicted, has equal rights of dignified access to healthcare. Without public engagement in DHB elections, the community risks having candidates elected that also don't understand their role through a preventative public health framework or human rights lens. The United Community Action Network (UCAN) developed a human rights framework and Health Charter for people driven into poverty by the costs of staying well in NZ. The framework outlines 6 social determinants of health needing protection through policy, to ensure all enjoy their rights to health. UCAN and the Public Health Association of New Zealand (PHA) partnered to raise public and the candidates' awareness during 2019 elections, of these social determinants causing inequity in health outcomes. A series of short explainer-videos were created for sharing through social media during the election build-up period, helping to promote PHA Branches' public Meet the Candidates events. Post-election, a longer film was produced to send to the elected DHB members. Our theory of change centred on spotlighting health inequity for voters, so that they would elect DHB members who had the greatest understanding and commitment to addressing this issue. With shareable videos we aimed to attract audience, raise awareness and debate the policy solutions to health inequity with candidates, enabling more informed choice amongst the voting public. Post-election, we maintain supportive relationships with the elected DHB members that promised their commitment to our Health Charter during their campaigns. Key messages Using videos and social media, local body elections provide an opportunity to promote everyone’s right to affordable healthcare, supporting and informing voter decision-making. UCAN's Health Charter is an advocacy resource for raising awareness of the social determinants of health inequity and poverty for people with mental illness, addiction and disability.

Using Profiles of Human and Social Capital to Understand Adult Immigrants’ Education Needs: A Latent Class Approach

2018 ◽  
Vol 69 (1) ◽  
pp. 3-23 ◽  
Author(s):  
Calonie M. K. Gray
Keyword(s):  
Social Capital ◽  
Adult Learners ◽  
Latent Class ◽  
Service Providers ◽  
Education Needs ◽  
International Assessment ◽  
Using Data ◽  
Adult Immigrants ◽  
Human And Social Capital ◽  
The U.S

With the U.S. adult education system providing education services to millions of immigrants annually, understanding the unique skills and assets among adult immigrant learners is important. Using data from the U.S. Program for the International Assessment of Adult Competencies, this study used data on immigrants ( n = 1,873) to identify latent classes along dimensions of human and social capital. Latent class analysis indicated five discrete profiles: High Opportunity, Upskill Ready, Satisfactorily Skilled, Motivated and Engaged, and Highly Skilled. The results provide support for using customized education approaches to capitalize on the collection of assets adult learners have while concurrently increasing education service providers’ capacity to serve.

scholarly journals Exploring Agenda-Setting for Healthy Border 2010

2006 ◽  
Vol 4 (1) ◽  
pp. 141-161 ◽  
Author(s):  
Charles T. Kozel ◽  
Anne P. Hubbell ◽  
James Dearing ◽  
William M. Kane ◽  
Sharon Thompson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Promotion ◽  
Agenda Setting ◽  
Border Health ◽  
Policy Makers ◽  
The Public ◽  
Mexico Border ◽  
Paso Del Norte ◽  
Policy Agendas ◽  
The U.S

Policy makers take action largely on issues that attain the pinnacle of the policy agenda (Pertschuck, 2001). As a result, how decision makers choose which issues are important has been the subject of much research. Agenda-setting conceptualizes the process of how issues move from relative unimportance to the forefront of policymakers’ thoughts (Dearing & Rogers, 1996). An area within agenda-setting research, Health Promotion Agenda-Setting, provides Health Promotion practitioners with an innovative framework and strategy to set agendas for sustained courses of action (Kozel, Kane, Rogers, & Hammes, 1995). In this interdisciplinary and bi-national exploratory study, funded by the Center for Border Health Research of the Paso del Norte Health Foundation, we examine agenda-setting processes in the Paso del Norte Region and evaluates how the public health agenda is determined within the U.S.-Mexico border population. Integrating both quantitative and qualitative data collection methods, the current research is focused on identifying deficiencies in the public health infrastructure in the U.S.-Mexico border area, and identifying channels that exist for working toward the bi-national goals presented in Healthy Border 2010 (U.S.-Mexico Border Health Commission, 2003). Research directions, design, and methodologies for exploring health promotion agenda-setting in applied settings, such as Healthy Border 2010, provide health practitioners and policy makers the potential to improve public health leadership by influencing the public health and policy agendas.

scholarly journals Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

2021 ◽  
Author(s):  
Bo Burström
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Primary Healthcare ◽  
Communicable Diseases ◽  
Determinants Of Health ◽  
Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

scholarly journals Preference for artificial intelligence medicine after COVID-19 pandemic: Discrete choice experiment (Preprint)

2021 ◽  
Author(s):  
Wai-Kit Ming ◽  
Taoran Liu ◽  
Winghei Tsang ◽  
Yifei Xie ◽  
Kang Tian ◽  
...  
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Health System ◽  
Waiting Time ◽  
Latent Class ◽  
Public Health System ◽  
Individual Preference ◽  
Female Respondent ◽  
Reference Level ◽  
The Public

BACKGROUND The COVID-19 pandemic poses a great threat to the public health system globally and has squeezed medical and doctor resources. Artificial intelligence (AI) has potential uses in virus detection and relieving the public health pressure caused by the pandemic. In the case of a shortage of medical resources caused by the pandemic, whether people’s preference for AI doctors and traditional clinicians has changed is worth exploring. OBJECTIVE We aim to quantify and compare people’s preference for AI medicine and traditional clinicians before and after the COVID-19 pandemic to check whether people’s preference is affected by the pressure of pandemic METHODS The propensity score matching (PSM) method was applied to match two different groups of respondents recruited in 2017 and 2020 with similar demographic characteristics. A total of 2048 respondents (1520 from 2017 and 528 from 2020) completed the questionnaire and were included in the analysis. The Multinomial Logit Model (MNL) and Latent Class Model (LCM) were used to explore people’s preferences for different diagnosis methods. RESULTS Among these respondents, 84.7% in 2017 and 91.3% in 2020 were confident that AI diagnosis would outperform human clinician diagnoses in the future. Both groups of respondents matched from 2017 and 2020 attached most importance to the attribute ‘accuracy’, followed by ‘diagnosis expense’, and they prefer the combined diagnosis of AI and human clinicians (2017: odds ratio [OR] 1.645; 95% CI 1.535,1.763, p < 0.001; 2020: OR 1.513, 95% CI 1.413, 1.621, p < 0.001, Reference level: Clinician). LCM identified three classes with different attribute priorities. In Class 1, the preference for combination diagnosis and accuracy remains constant in 2017 and 2020, and higher accuracy (e.g., 2017 OR for 100% 1.357; 95% CI 1.164, 1.581) is preferred. People in 2017 and 2020 prefer 0 min outpatient waiting time and 0 RMB diagnosis expense. In Class 2, the 2017 matched data is also very similar to class 2 in 2020, AI combined with human clinicians (2017: OR 1.204, 95% CI 1.039, 1.394, p = 0.011; 2020: OR 2.009, 95% CI 1.826, 2.211, p < 0.001, Reference level: Clinician) and 20 minutes (2017: OR 1.349, 95% CI 1.065, 1.708, p < 0.001; 2020: OR 1.488, 95% CI 1.287, 1.721, p < 0.001, Reference level, 0 min) of outpatient waiting time were consistently preferred. In Class 3, the respondents in 2017 and 2020 had different preferences for diagnosis method; respondents in Class 3 of 2017 prefer clinicians, whereas respondents in Class 3 of 2020 prefer AI diagnosis. The odds ratios of accuracy continued increasing with the increasing of accuracy, like other classes of 2017 and 2020. As for the latent class segmented according to different sexes, all of the male and female respondent classes from 2017 and 2020 rank accuracy as the most important attribute. CONCLUSIONS Individual preference for clinical diagnosis between AI and human clinicians were very similar and mostly unaffected by the burden of the public health system caused by the pandemic. Diagnosis accuracy and expense for diagnosis were of the most important attributes of choice of the type of diagnosis. These findings can provide guidance for policymaking relevant to the development of AI-based healthcare.

Comparison of Suicide Attempters and Decedents in the U.S. Army: A Latent Class Analysis

2016 ◽  
Vol 46 (4) ◽  
pp. 413-426 ◽  
Author(s):  
Nancy A. Skopp ◽  
Derek J. Smolenski ◽  
Sean C. Sheppard ◽  
Nigel. E. Bush ◽  
David D. Luxton
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Class Analysis ◽  
Suicide Attempters ◽  
The U.S
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