scholarly journals Equity at the Ballot Box: Health as a Resource for Political Participation Among Low-Income Workers in Two United States Cities

2021 ◽  
Vol 2 ◽  
Author(s):  
Cydney M. McGuire ◽  
Sarah E. Gollust ◽  
Molly De Marco ◽  
Thomas Durfee ◽  
Julian Wolfson ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Health Insurance ◽  
Political Participation ◽  
Low Income ◽  
Voter Turnout ◽  
Local Level ◽  
Health Resources ◽  
City Council ◽  
Marginal Effect

Objective: The purpose of this study is to identify health resources associated with propensity to vote at the local-level among low-wage workers in two United States. cities. Literature confirms individuals of lower income have a lower propensity of turning out to vote, yet few studies have focused on low-income populations to identify the variation in factors associated with voting within this group. Furthermore, few studies have investigated health and voter turnout at the local-level. In this study, we examine factors related to political participation at the local-level within a low-wage sample, examine mental, physical, behavioral, and social health and their association with voter turnout, and assess if these relationships differ by city.Methods: We use cross-sectional survey data from a sample of 974 low-wage workers in Minneapolis, MN and Raleigh, NC. We computed descriptive statistics and employed a logistic regression to predict their likelihood of local voter turnout, with the key independent variables being health resources, such as self-rated health, body mass index (BMI), mental disability, smoking status, and health insurance status. We employed a logistic regression fully interacted with a city indicator variable to assess if these associations differed by city.Results: In both cities, less than 50 percent of respondents reported voting in the last election for mayor or city council. About three-quarters of the sample reported food or housing insecurity and the majority of respondents reported utilizing some government assistance, such as supplemental nutrition programs. BMI greater than 30 was significantly associated with lower likelihood of voter turnout compared to those of lower BMI status (marginal effect = −0.10, p = 0.026). Never smoking or quitting was significantly associated with higher likelihood of voter turnout compared to those who reported being a current smoker (marginal effect = 0.10, p = 0.002). Those with health insurance were significantly more likely to report voting compared to those without any insurance (marginal effect = 0.10, p = 0.022). These results did not significantly differ by city.Conclusions: Our research suggests low-wage workers face significant health burdens which may impact their propensity to vote at the local-level, and these associations do not significantly vary by city despite demographic and political differences between two jurisdictions.

Health

Getting By ◽  
2019 ◽  
pp. 329-428
Author(s):  
Helen Hershkoff ◽  
Stephen Loffredo
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
The United States ◽  
Health Coverage ◽  
Eligibility Criteria ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Child Health Insurance

This chapter addresses the issue of health care for low-income people. The United States, virtually alone among developed nations, does not offer universal access to health care, leaving many millions of individuals without health insurance or other means of obtaining necessary medical services. In 2010, Congress enacted the landmark Patient Protection and Affordable Care Act (ACA)—popularly known as “Obamacare”—marking an important but incomplete response to the nation’s health care crisis. This chapter examines the ACA in detail, including its impact on Medicaid and Medicare, the major government health programs in the United States, its creation of Health Insurance Exchanges and tax credits to help low-income households obtain private health coverage, and the reform of private health insurance markets through a patient’s bill of rights, which, among other measures, prohibits insurance companies from refusing coverage for preexisting medical conditions. Perhaps the most critical aspect of the ACA was its expansion of Medicaid to cover virtually all low-income citizens (and certain immigrants) who do not qualify for other health coverage. Although several states opted out of the ACA’s Medicaid expansion, the Medicaid program nevertheless remains the largest single provider of health coverage in the United States. This chapter also provides a detailed description of Medicaid, its eligibility criteria and scope of coverage; the Child Health Insurance Program (CHIP), a government-funded health insurance program for children in households with too much income to qualify for Medicaid; and Medicare, the federal health insurance program for aged, blind, and disabled individuals.

scholarly journals Citizens local political participation in the Czech Republic: rural-urban comparison

2008 ◽  
Vol 53 (No. 1) ◽  
pp. 21-29
Author(s):  
J. Cmejrek
Keyword(s):  
Czech Republic ◽  
Political Participation ◽  
Public Administration ◽  
Voter Turnout ◽  
Local Level ◽  
Political Process ◽  
The Political ◽  
Local Administration ◽  
The Czech Republic ◽  
The Public

The Velvet Revolution in November 1989 in the former Czechoslovakia opened the way to the renewal of the democratic political system. One of the most visible aspects of the Czech political development consisted in the renewal of the essential functions of elections and political parties. On the local level, however, the political process - as well as in other post-communist countries - continued to be for a long time influenced by the remains of the former centralized system wherein the local administration used to be subjected to the central state power. Municipal elections took hold in these countries, however, the local government remained in the embryonic state and a certain absence of real political and economic decision-making mechanism on the local level continued to show. The public administration in the Czech Republic had to deal with the changes in the administrative division of the state, the split of the Czechoslovak federation as well as the fragmentation of municipalities whose number increased by 50 percent. Decision making mechanisms on the local and regional level were suffering from the incomplete territorial hierarchy of public administration and from the unclear division of power between the state administration and local administration bodies. Only at the end of the 1990s, the public administration in the Czech Republic started to get a more integrated and specific shape. Citizens participation in the political process represents one of the key issues of representative democracy. The contemporary democracy has to face the decrease in voter turnout and the low interest of citizens to assume responsibility within the political process. The spread of democratising process following the fall of the iron curtain should not overshadow the risk of internal weakness of democracy. The solution should be looked for in more responsible citizenship and citizens’ political participation. The degree of political participation is considered (together with political pluralism) to be the key element of representative democracy in general terms, as well as of democratic process on the local and regional level. The objective of this paper is to describe the specifics of citizens local political participation in the Czech Republic and to show the differences between rural and urban areas. The paper concentrates on voting and voter turnout but deals also with other forms of citizens political participation.

scholarly journals Assessing clinical quality performance and staffing capacity differences between urban and rural Health Resources and Services Administration-funded health centers in the United States: A cross sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242844
Author(s):  
Nadereh Pourat ◽  
Xiao Chen ◽  
Connie Lu ◽  
Weihao Zhou ◽  
Hank Hoang ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Rural Areas ◽  
Health Resources ◽  
Quality Measures ◽  
The United States ◽  
Health Centers ◽  
Quality Performance ◽  
Clinical Quality

Background In the United States, there are nearly 1,400 Health Resources and Services Administration-funded health centers (HCs) serving low-income and underserved populations and more than 600 of these HCs are located in rural areas. Disparities in quality of medical care in urban vs. rural areas exist but data on such differences between urban and rural HCs is limited in the literature. We examined whether urban and rural HCs differed in their performance on clinical quality measures before and after controlling for patient, organizational, and contextual characteristics. Methods and findings We used the 2017 Uniform Data System to examine performance on clinical quality measures between urban and rural HCs (n = 1,373). We used generalized linear regression models with the logit link function and binomial distribution, controlling for confounding factors. After adjusting for potential confounders, we found on par performance between urban and rural HCs in all but one clinical quality measure. Rural HCs had lower rates of linking patients newly diagnosed with HIV to care (74% [95% CI: 69%, 80%] vs. 83% [95% CI: 80%, 86%]). We identified control variables that systematically accounted for eliminating urban vs. rural differences in performance on clinical quality measures. We also found that both urban and rural HCs had some clinical quality performance measures that were lower than available national benchmarks. Main limitations included potential discrepancy of urban or rural designation across all HC sites within a HC organization. Conclusions Findings highlight HCs’ contributions in addressing rural disparities in quality of care and identify opportunities for improvement. Performance in both rural and urban HCs may be improved by supporting programs that increase the availability of providers, training, and provision of technical resources.

scholarly journals 859. Same-Day HIV Pre-exposure Prophylaxis (PrEP) Initiation During Drop-in STD Clinic Appointments Is a Safe, Feasible, and Effective Method to Engage Patients at Risk for HIV in PrEP Care

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S20-S20 ◽  
Author(s):  
Kevin Kamis ◽  
Kenneth Scott ◽  
Edward Gardner ◽  
Karen Wendel ◽  
Grace Marx ◽  
...  
Keyword(s):  
At Risk ◽  
Logistic Regression ◽  
Health Insurance ◽  
Low Income ◽  
Median Income ◽  
Navigation Support ◽  
Patients At Risk ◽  
Exposure Prophylaxis ◽  
Research Grant

Abstract Background Patients at risk for HIV generally do not have immediate access to PrEP. We hypothesized that by offering free, 30-day PrEP starter packs and navigation support during drop-in STD clinic appointments, individuals would be likely to initiate and continue PrEP. Methods Individuals aged ≥18 years presenting for drop-in appointments in the Metro Denver STD Clinic and indicated for PrEP were eligible for the study. Exclusion criteria were history of renal dysfunction, chronic hepatitis B (HBV), HIV, pregnancy, and indications for postexposure prophylaxis. Eligible individuals were provided PrEP education and offered a free, 30-day PrEP starter pack and navigation support for cost assistance. Participants were tested for creatinine, HBV, HIV, and pregnancy at enrollment, and navigated to an appointment for ongoing PrEP care. Participants’ medical records were reviewed for a minimum of 4 months after enrollment. Descriptive statistics and logistic regression were used to characterize the study population and follow-up. Results From April to October 2017, 100 individuals filled a tenofovir–emtricitabine prescription (figure). Median participant age was 28 years, 98% were male, 53% were non-Hispanic White, 8% non-Hispanic Black, and 34% Hispanic. Median annual income was $24,000, 62% had health insurance, 26% had a primary care provider (PCP), and 50% had a recent bacterial STI. No participants had abnormal baseline creatinine or HBV. 77% completed ≥1 PrEP follow-up visit during the study period; 57% completed their first visit within 31 days. 56% completed a second follow-up visit. No HIV seroconversions were detected during follow-up. Factors significantly associated with attending ≥1 follow-up appointment were age ≥ 30 years, higher income, and having health insurance or a PCP at enrollment. In multivariate logistic regression, only higher income was associated with attending ≥1 follow-up appointment (median income for those with ≥1 follow-up visit vs. no follow-up: $24,960 vs. $14,000, P <0.01). Conclusion Providing immediate access to PrEP during drop-in STD clinic visits is a safe and feasible approach to initiation of PrEP care. Additional resources are needed to support PrEP continuity care, particularly for low-income individuals. Disclosures K. Kamis, Gilead Scienes: Research Coordinator, Research grant. S. Rowan, Gilead Sciences: Investigator, Research grant.

E-Shopping for Health: Issues for Latinos Using the Health Insurance Marketplace

2015 ◽  
Vol 37 (1) ◽  
pp. 40-45
Author(s):  
Georgia Beilmann ◽  
Ying-Jen Lin ◽  
Sabrina Perlman ◽  
Kimberly Ross ◽  
Michael Cavanaugh ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
Positive Impact ◽  
The United States ◽  
Health Issues ◽  
Data Collection Strategy ◽  
History Of ◽  
Racial Ethnic

Health care in the United States is undergoing a radical restructuring, mandated in the Affordable Care Act (ACA), designed to improve access to care and increase the efficiency of our health care system. Key features include a revamped health insurance market and increased reliance on electronic technologies for buying insurance and tracking patient care. One goal of these changes is to reduce the unequal burden of disease carried by low-income racial/ethnic minorities. However, the long history of racial/ethnic health disparities in the United States raises concern for how diverse populations will be affected by these innovations. Applied anthropologists are well equipped to produce knowledge and insight to inform how changes are enacted and to maximize positive impact for vulnerable populations. Employing a holistic framework and an in-depth data collection strategy, anthropologists are especially adept at uncovering the insider's perspective. This adds important insight and nuance to understandings of how the ACA's health care innovations affect specific groups.

Dentistry and Childhood Poverty in the United States

2012 ◽  
Vol 37 (1) ◽  
pp. 113-116 ◽  
Author(s):  
HB Waldman ◽  
D Cannella ◽  
SP Perlman
Keyword(s):  
United States ◽  
Health Insurance ◽  
Low Income ◽  
The United States ◽  
Dental Services ◽  
Childhood Poverty ◽  
Low Income Families ◽  
The Impact ◽  
Localized Levels

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.

4. Political Participation

2020 ◽  
pp. 79-100
Author(s):  
Patrick Bernhagen ◽  
Angelika Vetter
Keyword(s):  
Political Participation ◽  
Voter Turnout ◽  
Local Level ◽  
Social Groups ◽  
Existing Problems

This chapter provides an overview of political participation, ranging from conventional forms such as voting at elections to less conventional forms such as attending a demonstration or boycotting a brand for political reasons. The authors look at how voter turnout and protest participation have developed in recent decades and review the main theoretical explanations for differences and trends in participation between social groups and across European democracies. The chapter also considers new opportunities for participation at the local level and asks whether these have the potential to ameliorate or exacerbate existing problems of unequal participation.

Role of Perceptions in Health Insurance Buying Behaviour of Workers Employed in Informal Sector of India

2017 ◽  
Vol 18 (1) ◽  
pp. 250-266 ◽  
Author(s):  
Pooja Kansra ◽  
Harinder Singh Gill
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Informal Sector ◽  
Low Income ◽  
Vital Role ◽  
Policy Makers ◽  
Lack Of Information ◽  
Buying Behaviour ◽  
Urban Informal Sector

Health insurance can be an effective tool of personal protection. But India’s health insurance market still lags behind the other countries in terms of penetration. The present article identified the role of perceptions in the enrolment of health insurance among the urban informal sector of Punjab, India. First, data were obtained from the urban informal sector of Punjab. Then factor analysis was applied to identify the perceptions associated with enrolment of health insurance. After this, logistic regression was performed to determine the associations of identified perceptions with enrolment of health insurance. The present study identified 12 perceptions factors associated with health insurance enrolment of the informal sector in India. Out of the 12 factors, the logistic regression results proved that 8 were statistically significant influencers of health insurance enrolment decisions. The significant perceptions factors were lack of awareness about the need to buy health insurance; comprehensive coverage; income constraint; future contingencies and social obligations; lack of information; availability of subsidized government health care; linkage with government hospitals; and preference for government schemes. It was found that perceptions play a vital role in the household decisions to enrol for health insurance. Policy makers or marketers of health insurance policies should recognize the household perceptions as a potential barrier and try to develop a health insurance package as per the actual needs of the informal sector (low income) in India.

scholarly journals Assessing the awareness and adoptability of pellet cookstoves for low-income households in Lusaka, Zambia

2021 ◽  
Vol 32 (3) ◽  
pp. 41-50
Author(s):  
Mukuka Mpundu Mulenga ◽  
Anders Roos
Keyword(s):  
Energy Consumption ◽  
Low Income ◽  
Local Level ◽  
Policy Instruments ◽  
City Council ◽  
Government Policies ◽  
Wood Fuel ◽  
Qualitative Approaches ◽  
Limited Supply

Wood fuel, charcoal, and firewood comprise over 70 percent of the national energy consumption in Zambia, as only about 25 percent of the population has access to electricity. Replacing charcoal braziers with cookstoves using sawdust pellets can support sustainable energy provision in urban Zambia while reducing deforestation on the countryside. However, acceptability of pellet cookstoves remains low, while the demand for wood fuel is increasing. The study investigated the acceptability of pellet cookstoves, in view of governmental policies, in the Matero-George compound, Lusaka. Qualitative approaches were applied, and respondents were households, and officers at the Departments of Energy and Forestry, and at Lusaka City Council. Factors shaping the stoves’ acceptability included their convenience, possibility of reusing pellets, their long-term cost advantages, and the perceived health benefits of pellets. The barriers included limited supply of pellets, combustible pellet cookstoves, stove size, maintenance costs, cooking traditions, and government policies for dissemination, sensitisation, and communication about pellet stoves. This study demonstrated that implementation of pellet cookstoves at the local level depends on a multitude of contextual factors, and confirms the need for relevant policy instruments if such energy consumption is to be accepted.

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