scholarly journals Labor and Delivery Unit Closures in Rural Georgia from 2012–2016 and the Impact on Black Women: A Mixed-Methods Investigation

2021 ◽  
Author(s):  
Anna E. C. Daymude ◽  
Joshua J. Daymude ◽  
Roger Rochat
Keyword(s):  
Black Women ◽  
Low Income ◽  
Financial Distress ◽  
Care Service ◽  
Metropolitan Statistical Area ◽  
Labor And Delivery ◽  
Service Areas ◽  
Delivery Unit ◽  
Provider Shortages ◽  
The Impact

Background. Obstetric provider coverage in rural Georgia has worsened, with nine rural labor and delivery units (LDUs) closing outside the Atlanta Metropolitan Statistical Area from 2012–2016. Georgia consistently has one of the highest maternal mortality rates in the nation and faces increased adverse health consequences from this decline in obstetric care.Objective. This study explores what factors may be associated with rural hospital LDU closures in Georgia from 2012–2016.Methods. This study describes differences between rural Georgia hospitals based on LDU closure status through a quantitative analysis of 2011 baseline regional, hospital, and patient data, and a qualitative analysis of newspaper articles addressing the closures.Results. LDUs that closed had higher proportions of Black female residents in their Primary Care Service Areas (PCSAs), of Black birthing patients, and of patients with Medicaid, self-pay or other government insurance; lower LDU birth volume; more women giving birth within their PCSA of residence; fewer obstetricians and obstetric provider equivalents per LDU; and fewer average annual births per obstetric provider. Qualitative results indicate financial distress primarily contributed to closures, but also suggest that low birth volume and obstetric provider shortage impacted closures.Conclusions for Practice. Rural LDU closure in Georgia has a disproportionate impact on Black and low-income women and may be prevented through funding maternity healthcare and addressing provider shortages.

scholarly journals The Impact of Sociodemographic Factors, Comorbidities, and Physiologic Responses on 30-Day Mortality in Coronavirus Disease 2019 (COVID-19) Patients in Metropolitan Detroit

2020 ◽  
Author(s):  
Joseph Miller ◽  
Raef A Fadel ◽  
Amy Tang ◽  
Giuseppe Perrotta ◽  
Erica Herc ◽  
...  
Keyword(s):  
Black Women ◽  
Low Income ◽  
Sociodemographic Factors ◽  
Hospitalized Patients ◽  
Adjusted Risk ◽  
Area Of Interest ◽  
Risk Of Mortality ◽  
Physiological Abnormalities ◽  
Relationship Of ◽  
The Impact

Abstract Background The relationship of health disparities and comorbidities in coronavirus disease 2019 (COVID-19)–related outcomes are an ongoing area of interest. This report assesses risk factors associated with mortality in patients presenting with COVID-19 infection and healthcare disparities. Methods We conducted a retrospective cohort study of consecutive patients presenting to emergency departments within an integrated health system who tested positive for COVID-19 between 7 March and 30 April 2020 in metropolitan Detroit. The primary outcomes were hospitalization and 30-day mortality. Results A total of 3633 patients with a mean age of 58 years were included. The majority were female and Black non-Hispanic. Hospitalization was required for 64% of patients, 56% of whom were Black. Hospitalized patients were older, more likely to reside in a low-income area, and had a higher burden of comorbidities. By 30 days, 433 (18.7%) hospitalized patients died. In adjusted analyses, the presence of comorbidities, an age >60 years, and more severe physiological disturbance were associated with 30-day mortality. Residence in low-income areas (odds ratio [OR], 1.02; 95% confidence interval [CI], .76–1.36) and public insurance (OR, 1.24; 95% CI, .76–2.01) were not independently associated with a higher risk of mortality. Black female patients had a lower adjusted risk of mortality (OR, 0.46; 95% CI, .27–.78). Conclusions In this large cohort of COVID-19 patients, those with comorbidities, advanced age, and physiological abnormalities on presentation had higher odds of death. Disparities in income or source of health insurance were not associated with outcomes. Black women had a lower risk of dying.

scholarly journals Financial crises and the attainment of the SDGs: an adjusted multidimensional poverty approach

2019 ◽  
Vol 15 (6) ◽  
pp. 1683-1698 ◽  
Author(s):  
Andreas Antoniades ◽  
Indra Widiarto ◽  
Alexander S. Antonarakis
Keyword(s):  
Low Income ◽  
Financial Distress ◽  
Financial Crises ◽  
Multidimensional Poverty ◽  
Low Income Countries ◽  
Domino Effect ◽  
Average Decrease ◽  
Poverty Indicators ◽  
The Impact ◽  
Dynamic Linkages

AbstractThis paper analyses the impact of financial crises on the Sustainable Development Goal of eradicating poverty. To do so, we develop an adjusted Multidimensional Poverty Framework (MPF) that includes 15 indicators that span across key poverty aspects related to income, basic needs, health, education and the environment. We then use an econometric model that allows us to examine the impact of financial crises on these indicators in 150 countries over the period 1980–2015. Our analysis produces new estimates on the impact of financial crises on poverty’s multiple social, economic and environmental aspects and equally important captures dynamic linkages between these aspects. Thus, we offer a better understanding of the potential impact of current debt dynamics on Multidimensional Poverty and demonstrate the need to move beyond the boundaries of SDG1, if we are to meet the target of eradicating poverty. Our results indicate that the current financial distress experienced by many low-income countries may reverse the progress that has been made hitherto in reducing poverty. We find that financial crises are associated with an approximately 10% increase of extreme poor in low-income countries. The impact is even stronger in some other poverty aspects. For instance, crises are associated with an average decrease of government spending in education by 17.72% in low-income countries. The dynamic linkages between most of the Multidimensional Poverty indicators, warn of a negative domino effect on a number of SDGs related to poverty, if there is a financial crisis shock. To pre-empt such a domino effect, the specific SDG target 17.4 on attaining long-term debt sustainability through coordinated policies plays a key role and requires urgent attention by the international community.

The Impact of Labor and Delivery Unit Management on Long Childbirth Length of Stay [27L]

2017 ◽  
Vol 129 ◽  
pp. S128 ◽  
Author(s):  
Avery C. Plough ◽  
Grace E. Galvin ◽  
Zhonghe Li ◽  
Eugene R. Declercq ◽  
Aaron B. Caughey ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Labor And Delivery ◽  
Unit Management ◽  
Delivery Unit ◽  
Labor And Delivery Unit ◽  
The Impact

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

Monitoring the Impact of Family Health Benefits for Low-Income Families

2001 ◽  
Author(s):  
Trish Livingstone ◽  
Lisa Lix ◽  
Mary McNutt ◽  
Evan Morris ◽  
William Osei ◽  
...  
Keyword(s):  
Low Income ◽  
Health Benefits ◽  
Family Health ◽  
Low Income Families ◽  
The Impact

THE IMPACT OF ZONATION SYSTEM POLICY IN THE PPDB ON STUDENTS' OBTAINING AT SMA NEGERI 8 SURABAYA

2020 ◽  
Vol 4 (3) ◽  
pp. 525
Author(s):  
Idawati Idawati
Keyword(s):  
Junior High School ◽  
Low Income ◽  
Educational Background ◽  
Quantitative Approach ◽  
National Examination ◽  
New Students ◽  
The Impact ◽  
New Student ◽  
Academic Year ◽  
Descriptive Method

This research was conducted by using a descriptive method with a quantitative approach. The quantitative approach was chosen to be tested theories by examining and measuring variables in the form of relationships, differences, influences, contributions, and the others. The research was carried out by describing the students acquisition data on the new student admission (PPDB) using zoning system based on the academic year 2019-2020 and the student acquisition data on the academic year PPDB 2018-2019 as a comparison. Based on the results of the study, the new students of PPDB using zoning system was considered lower in terms of economic and educational background of parents. There were more parents with less education (elementary & junior high school) in the zoning system than in the rayon system, whereas parents with higher education in the zoning system were fewer than the rayon system.  Likewise, in terms of income, there were more people with the low income in the zoning system than in the rayon system, and those having high income were fewer than in the rayon system. The study showed that the intelligence and the result of National Examination Score (NUN) in the zoning system is lower than in the rayon system. The intelligent level of the students in the zoning system is mostly dominated by the scores under 90-109, while in the rayon system were dominated by the scores above 90-109.  The National Examination Scores (NUN) in the zoning system were evenly distributed from a range of scores 0 to 30, while in the rayon system the scores were dominated by a range of scores 28-30, with the lowest score 24.

Women's rural-urban migration in Lebanon

2019 ◽  
Author(s):  
◽  
Sally N. Youssef
Keyword(s):  
Internal Migration ◽  
Low Income ◽  
Lived Experiences ◽  
Urban Migration ◽  
Structural Factors ◽  
Migrant Women ◽  
Migration Studies ◽  
Rural Urban Migration ◽  
Low Income Women ◽  
The Impact

Women’s sole internal migration has been mostly ignored in migration studies, and the concentration on migrant women has been almost exclusively on low-income women within the household framework. This study focuses on middleclass women’s contemporary rural-urban migration in Lebanon. It probes into the determinants and outcomes of women’s sole internal migration within the empowerment framework. The study delves into the interplay of the personal, social, and structural factors that determine the women’s rural-urban migration as well as its outcomes. It draws together the lived experiences of migrant women to explore the determinants of women’s internal migration as well as the impact of migration on their expanded empowerment.

Sign in / Sign up

Export Citation Format

Share Document