scholarly journals The ATHENA COVID-19 Study: Cohort profile and first findings for people diagnosed with COVID-19 in Queensland, 1 January to 31 December 2020

2021 ◽  
Vol 45 ◽  
Author(s):  
Jennifer Welsh ◽  
Rosemary J Korda ◽  
Ellie Paige ◽  
Mark A Morgan ◽  
Hsei-Di Law ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Health Care Access ◽  
Study Cohort ◽  
Adjusted Relative Risk ◽  
Care Access ◽  
Multiple Data ◽  
Queensland Health ◽  
Collection Data ◽  
System Data ◽  
Data Collections

Background: To date, there are limited Australian data on characteristics of people diagnosed with COVID-19 and on how these characteristics relate to outcomes. The ATHENA COVID-19 Study was established to describe health outcomes and investigate predictors of outcomes for all people diagnosed with COVID-19 in Queensland by linking COVID-19 notification, hospital, general practice and death registry data. This paper reports on the establishment and first findings for the ATHENA COVID-19 Study. Methods: Part 1 of the ATHENA COVID-19 Study used Notifiable Conditions System data from 1 January 2020 to 31 December 2020, linked to: Emergency Department Collection data for the same period; Queensland Health Admitted Patient Data Collections (from 1 January 2010 to 30 January 2021); and Deaths Registrations data (from 1 January 2020 to 17 January 2021). Results: To 31 December 2020, a total of 1,254 people had been diagnosed with SARS-CoV-2 infection in Queensland: half were female (49.8%); two-thirds (67.7%) were aged 20–59 years; and there was an over-representation of people living in less-disadvantaged areas. More than half of people diagnosed (57.6%) presented to an ED; 21.2% were admitted to hospital as an inpatient (median length of stay 11 days); 1.4% were admitted to an intensive care unit (82.4% of these required ventilation); and there were six deaths. Analysis of factors associated with these outcomes was limited due to small case numbers: people living in less-disadvantaged areas had a lower risk of being admitted to hospital (test for trend, p < 0.001), while those living in more remote areas were less likely than people living in major cities to present to an ED (test for trend: p=0.007), which may reflect differential health care access rather than health outcomes per se. Increasing age (test for trend, p < 0.001) and being a current/recent smoker (age-sex-adjusted relative risk: 1.61; 95% confidence interval: 1.00, 2.61) were associated with a higher risk of being admitted to hospital. Conclusion: Despite uncertainty in our estimates due to small numbers, our findings are consistent with what is known about COVID-19. Our findings reinforce the value of linking multiple data sources to enhance reporting of outcomes for people diagnosed with COVID-19 and provide a platform for longer term follow-up.

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.

scholarly journals Welfare, work, and health care access predictors of low-income children's physical health outcomes

2007 ◽  
Vol 29 (6) ◽  
pp. 782-801 ◽  
Author(s):  
Kristen Shook Slack ◽  
Jane L. Holl ◽  
Joan Yoo ◽  
Laura B. Amsden ◽  
Emily Collins ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Physical Health ◽  
Low Income ◽  
Health Care Access ◽  
Welfare Work ◽  
Care Access ◽  
Physical Health Outcomes ◽  
Work And Health

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 Can Precision Medicine Actually Help People Like Me? African American and Hispanic Perspectives on the Benefits and Barriers of Precision Medicine

2020 ◽  
Vol 30 (Suppl 1) ◽  
pp. 149-158 ◽  
Author(s):  
Vivian M. Yeh ◽  
Erin M. Bergner ◽  
Marino A. Bruce ◽  
Sunil Kripalani ◽  
Victoria B. Mitrani ◽  
...  
Keyword(s):  
Health Care ◽  
African American ◽  
African Americans ◽  
Health Outcomes ◽  
Precision Medicine ◽  
Health Care Access ◽  
Personal Information ◽  
Care Access ◽  
Potential Benefits ◽  
Access And Quality

Objective: To better understand African American and Hispanic perspectives on the potential benefits of precision medicine, along with the potential barriers that may prevent precision medicine from being equally beneficial to all. We also sought to identify if there were differences between African American and Hispanic perspec­tives.Design: Six semi-structured focus groups were conducted between May 2017 and February 2018 to identify benefits and barri­ers to precision medicine. Three groups oc­curred in Nashville, TN with African Ameri­can participants and three groups occurred in Miami, FL with Hispanic participants.Setting: At community-based and university sites convenient to community partners and participants.Participants: A total of 55 individuals participated (27 in Nashville, 28 in Miami). The majority of participants were women (76.5%) and the mean age of participants was 56.2 years old.Results: Both African Americans and His­panics believed precision medicine has the potential to improve medicine and health outcomes by individualizing care and de­creasing medical uncertainty. However, both groups were concerned that inadequacies in health care institutions and socioeconomic barriers would prevent their communities from receiving the full benefits of precision medicine. African Americans were also concerned that the genetic and non-genetic personal information revealed through precision medicine would make African Americans further vulnerable to provider racism and discrimination in and outside of health care.Conclusions: While these groups believed precision medicine might yield benefits for health outcomes, they are also skeptical about whether African Americans and His­panics would actually benefit from precision medicine given current structural limitations and disparities in health care access and quality. Ethn Dis. 2020;30(Suppl 1):149-158; doi:10.18865/ed.30.S1.149

“Texans Don’t Want Health Insurance”

2017 ◽  
Author(s):  
Emily K. Brunson
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Class ◽  
Health Outcomes ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Care Access ◽  
Coverage Gap ◽  
And Gender ◽  
Longitudinal Case Studies

Emily K. Brunson’s chapter examines how the ACA has unfolded in Texas, a state with significant popular and political sentiment against the law despite being home to the highest percentage of uninsured persons in the nation. Presenting longitudinal case studies of three previously uninsured women—some of whom were able to access insurance coverage following the ACA and some of whom fell into the coverage gap—Brunson shows how each person struggled with issues of choice, responsibility, and risk in relation to their health care. The chapter also considers how social class and gender affected these women’s experiences of the ACA. Brunson concludes that while the ACA has improved health care access and health outcomes for some Texans, it has also deepened inequalities by increasing stratification based on social class.

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