scholarly journals Reducing public transit compounds social vulnerabilities during COVID-19

2021 ◽  
Author(s):  
Armita Kar ◽  
Andre L. Carrel ◽  
Harvey J. Miller ◽  
Huyen T. K. Le
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Access ◽  
Public Transit ◽  
The United States ◽  
Grocery Stores ◽  
Transit Service ◽  
Care Access ◽  
Transit Services ◽  
Social Vulnerabilities

The COVID-19 pandemic has severely impacted public transit services through a combination of plummeting ridership during the lockdown and subsequent budget cuts. This study investigates the equity impacts of reductions in accessibility due to public transit service cuts during COVID-19 and their association with urban sprawl. We evaluated accessibility to essential services such as grocery stores and both urgent and non-urgent health care across 22 cities across the United States in three phases during 2020: pre-lockdown, lockdown, and post-lockdown. We estimated the spatio-temporal coverage of transit service during the peak and off-peak periods in each phase. We found stark disparities in food and health care access for various socio-economic groups. Economically disadvantaged and suburban neighborhoods were more likely to lose food and health care access by public transit during COVID-19. In particular, transit service cuts worsened accessibility for population groups with multiple social vulnerabilities, such as low-income workers with zero vehicle ownership, poor households living in urban neighborhoods, and non-white populations residing in suburban neighborhoods. Moreover, our study suggests that sprawled cities experienced greater losses in access to food and health care during COVID-19 than compact cities, highlighting the influence of urban form on the functionality of transit services during crises.

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 Care of acute conditions and chronic diseases in Canada and the United States: Rapid systematic review and meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Keren M. Escobar ◽  
Dorian Murariu ◽  
Sharon Munro ◽  
Kevin M. Gorey
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Chronic Diseases ◽  
Low Income ◽  
Health Care Access ◽  
Meta Analysis ◽  
The United States ◽  
Care Access ◽  
Acute Conditions ◽  
The Usa

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors or biomarkers, Canadians’ chances of receiving better health care were estimated to be 36% greater than their American counterparts (RR=1.36, 95% CI 1.35-1.37). This estimate was significantly larger than that based on general patient or non-vulnerable population comparisons (RR=1.09, 95% CI 1.08-1.10). Contrary to prevalent political rhetoric, three studies observed that Americans experience more than twice the risk of long waits for breast or colon cancer care or of dying while they wait for an organ transplant (RR=2.36, 95% CI 2.09-2.66). These findings were replicated across externally valid national studies and more internally valid, metropolitan or provincial/state comparisons. Socioeconomically vulnerable Canadians are consistently and highly advantaged on health care access and outcomes compared to their American counterparts. Less vulnerable comparisons found more modest Canadian advantages. The Affordable Care Act ought to be fully supported including the expansion of Medicaid across all states. Canada’s single payer system ought to be maintained and strengthened, but not through privatization.

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.

Sign in / Sign up

Export Citation Format

Share Document