scholarly journals Health Disparities in Kidney Transplantation for African Americans

2017 ◽  
Vol 46 (2) ◽  
pp. 165-175 ◽  
Author(s):  
Kimberly Harding ◽  
Tesfaye B. Mersha ◽  
Phuong-Thu Pham ◽  
Amy D. Waterman ◽  
Fern J. Webb ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
African Americans ◽  
Low Socioeconomic Status ◽  
Cultural Sensitivity ◽  
National Level ◽  
Risk Factor Control ◽  
Low Socioeconomic ◽  
Policy Interventions ◽  
The Impact ◽  
Timely Referral

Background: The persistent challenges of bridging healthcare disparities for African Americans (AAs) in need of kidney transplantation continue to be unresolved at the national level. This healthcare disparity is multifactorial: stemming from limited kidney donors suitable for AAs; inconsistent care coordination and suboptimal risk factor control; social determinants, low socioeconomic status, reduced access to care; and mistrust of clinicians and the healthcare system. Summary: There are numerous opportunities to significantly lessen the disparities in kidney transplantation for AAs through the following measures: the adoption of new care and patient engagement models that include education, enhanced practice-level cultural sensitivity, and timely referral as well as increased research on the impact of the environment on genetic risk, and implementation of new transplantation-related policies. Key Messages: This systematic review describes pretransplant concerns related to access to kidney transplantation, posttransplant complications, and policy interventions to address the challenging issues associated with kidney transplantation in AAs.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

scholarly journals Segregación Social y Desigualdad de Logros Educativos en Argentina

2013 ◽  
Vol 21 ◽  
pp. 86 ◽  
Author(s):  
Natalia Krüger
Keyword(s):  
Low Socioeconomic Status ◽  
Social Inclusion ◽  
Multilevel Models ◽  
Family Background ◽  
Low Socioeconomic ◽  
Social Composition ◽  
The Social ◽  
Educational Risk ◽  
Socioeconomic Segregation ◽  
The Impact

This paper analyzes the impact of high school socioeconomic segregation on educational equity in Argentina. The presence of segregation means that students are unevenly distributed throughout the system, concentrating in certain schools according to their social origin. The aim is to assess whether this process can increase educational attainment inequality. Using the PISA 2009 database, multilevel models are estimated in order to examine the effects of schools` social composition on individual reading performance. The evidence supports the existence of significant compositional effects which help explain test score dispersion. This suggests that young people of low socioeconomic status face a double educational risk: i) an initial disadvantage related to their social and family background; and ii) a high probability of assisting a school with a vulnerable student population, where they may be exposed to negative peer effects. The findings support the need to consider the social composition of schools as a key educational policy factor, and the relevance of analyzing ways to promote social inclusion in the system.

scholarly journals Impact of national interventions to promote responsible antibiotic use: a systematic review

2019 ◽  
Vol 75 (1) ◽  
pp. 14-29 ◽  
Author(s):  
Jane Mingjie Lim ◽  
Shweta Rajkumar Singh ◽  
Minh Cam Duong ◽  
Helena Legido-Quigley ◽  
Li Yang Hsu ◽  
...  
Keyword(s):  
Systematic Review ◽  
National Level ◽  
Public Health Problem ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Middle Income ◽  
Middle Income Countries ◽  
Policy Interventions ◽  
The Impact

Abstract Background Global recognition of antimicrobial resistance (AMR) as an urgent public health problem has galvanized national and international efforts. Chief among these are interventions to curb the overuse and misuse of antibiotics. However, the impact of these initiatives is not fully understood, making it difficult to assess the expected effectiveness and sustainability of further policy interventions. We conducted a systematic review to summarize existing evidence for the impact of nationally enforced interventions to reduce inappropriate antibiotic use in humans. Methods We searched seven databases and examined reference lists of retrieved articles. To be included, articles had to evaluate the impact of national responsible use initiatives. We excluded studies that only described policy implementations. Results We identified 34 articles detailing interventions in 21 high- and upper-middle-income countries. Interventions addressing inappropriate antibiotic access included antibiotic committees, clinical guidelines and prescribing restrictions. There was consistent evidence that these were effective at reducing antibiotic consumption and prescription. Interventions targeting inappropriate antibiotic demand consisted of education campaigns for healthcare professionals and the general public. Evidence for this was mixed, with several studies showing no impact on overall antibiotic consumption. Conclusions National-level interventions to reduce inappropriate access to antibiotics can be effective. However, evidence is limited to high- and upper-middle-income countries, and more evidence is needed on the long-term sustained impact of interventions. There should also be a simultaneous push towards standardized outcome measures to enable comparisons of interventions in different settings.

scholarly journals Medical Students’ Participation in Longitudinal Community Service During Preclerkship Years: A Qualitative Study on Experiences and Perceived Outcomes

2020 ◽  
Vol 7 ◽  
pp. 238212052093661
Author(s):  
Amier Haidar ◽  
Samuel G Erickson ◽  
Tiffany Champagne-Langabeer
Keyword(s):  
Medical Students ◽  
Nutrition Education ◽  
Community Service ◽  
Low Socioeconomic Status ◽  
Well Being ◽  
Low Socioeconomic ◽  
Volunteer Program ◽  
Semistructured Interviews ◽  
Community Issues ◽  
The Impact

The aim of this study was to qualitatively evaluate medical students perspectives of the benefits of a longitudinal volunteering experience compared with a 1-day community service experience. Fifteen medical students participated in 2 types of community service: (1) longitudinal, weekly volunteering from February to April of 2019 and (2) a single day of community service in March of 2019. Semistructured interviews were conducted to identify medical students perspectives of the impact of volunteering. Interview data was analyzed thematically based on the common ideas expressed by the participants. Four themes emerged: development of communication and interpersonal skills; understanding how to teach; ability to understand community issues in a low socioeconomic status (SES) neighborhood and the improvement of overall well-being. Medical students’ participation in a longitudinal nutrition education volunteer program was perceived as being an effective way to develop communication, interpersonal, and teaching skills. Medical students were able to interact with a diverse and vulnerable community located in a low SES neighborhood, to help them understand current community issues and risk factors.

scholarly journals A neurobehavioral study on the efficacy of price interventions in promoting healthy food choices among low socioeconomic families

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tannista Banerjee ◽  
Veena Chattaraman ◽  
Hao Zou ◽  
Gopikrishna Deshpande
Keyword(s):  
Low Socioeconomic Status ◽  
Calorific Value ◽  
Healthy Food ◽  
Fiscal Policies ◽  
Healthy Foods ◽  
Status Change ◽  
Low Socioeconomic ◽  
Food Items ◽  
Policy Interventions ◽  
The Brain

Abstract Given the healthcare costs associated with obesity (especially in childhood), governments have tried several fiscal and policy interventions such as lowering tax and giving rebates to encourage parents to choose healthier food for their family. The efficacy of such fiscal policies is currently being debated. Here we address this issue by investigating how behavioral and brain-based responses in parents with low socioeconomic status change when rebates and lower taxes are offered on healthy food items. We performed behavioral and brain-based experiments, with the latter employing electroencephalography (EEG) acquired from parents while they shop in a simulated shopping market as well as follow up functional magnetic resonance imaging (fMRI) in the more restricted scanner environment. Behavioral data show that lower tax and rebate on healthy foods increase their purchase significantly compared to baseline. Rebate has a higher effect than lower tax treatment. From the EEG and fMRI experiments, we first show that healthy/unhealthy foods elicit least/maximal reward response in the brain, respectively. Further, by offering lower tax or rebate on healthy food items, the reward signal for such items in the brain is significantly enhanced. Second, we demonstrate that rebate is more effective than lower tax in encouraging consumers to purchase healthy food items, driven in part, by higher reward-related response in the brain for rebate. Third, fiscal interventions decreased the amount of frontal cognitive control required to buy healthy foods despite their lower calorific value as compared to unhealthy foods. Finally, we propose that it is possible to titrate the amount of tax reductions and rebates on healthy food items so that they consistently become more preferable than unhealthy foods.

scholarly journals The Role of Social Media for Patients and Consumer Health

2011 ◽  
Vol 20 (01) ◽  
pp. 131-138 ◽  
Author(s):  
K. A. Siek ◽  
L. Fernandez-Luque ◽  
H. Tange ◽  
P. Chhanabhai ◽  
S. Y. W. Li ◽  
...  
Keyword(s):  
Social Media ◽  
Low Socioeconomic Status ◽  
Computer Games ◽  
Health Behaviours ◽  
Chronically Ill ◽  
Human Factors Engineering ◽  
Low Socioeconomic ◽  
People Search ◽  
The Impact

SummaryTo provide an overview on social media for consumers and patients in areas of health behaviours and outcomes.A directed review of recent literature.We discuss the limitations and challenges of social media, ranging from social network sites (SNSs), computer games, mobile applications, to online videos. An overview of current users of social media (Generation Y), and potential users (such as low socioeconomic status and the chronically ill populations) is also presented. Future directions in social media research are also discussed.We encouragethe health informaticscommunity to consider the socioeconomic class, age, culture, and literacy level of their populations, and select an appropriate medium and platform when designing social networkedinterventionsforhealth.Little isknown about the impact of second-hand experiences faciliated by social media, nor the quality and safety of social networks on health. Methodologies and theories from human computer interaction, human factors engineering and psychology may help guide the challenges in design-ingand evaluatingsocial networkedinterventionsforhealth. Further, by analysing how people search and navigate social media for health purposes, infodemiology and infoveillance are promising areas of research that should provide valuable insights on present and emergening health behaviours on a population scale.

scholarly journals Impact of Socioeconomic Status on Return to Work after Acute Ankle Fracture

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Alessandra L. Falk ◽  
Regina Hanstein ◽  
Chaiyaporn Kulsakdinun
Keyword(s):  
Socioeconomic Status ◽  
Return To Work ◽  
Low Socioeconomic Status ◽  
Ankle Fracture ◽  
Low Ses ◽  
Insurance Status ◽  
Low Socioeconomic ◽  
The Impact ◽  
Zip Code

Category: Ankle; Trauma Introduction/Purpose: Socioeconomic status has been recognized throughout the medical literature, both within orthopedics and beyond, as a factor that influences outcomes after surgery, and can result in substandard care. Within the foot and ankle subspecialty, there is limited data regarding socioeconomic status and post-operative outcomes, with the current literature focusing on outcomes for diabetic feet. However, ankle fractures are among the most common fractures encountered by orthopedic surgeons. While a few studies have explored the impact of ankle fractures on employment and disability status, the effect of socioeconomic status on return to work post operatively has not yet been investigated. The purpose of this study was to determine the impact of low socioeconomic status on return to work. Methods: We retrospectively reviewed 592 medical charts of patients with CPT code 27766, 27792, 27814, 27822, 27823, 27827, 27829, 27826, 27828 from 2015-2018. Included were patients >18 yrs of age who sustained an acute ankle fracture, were employed prior to the injury, and with information on return to work after ankle surgery, zip code, race, ethnicity and insurance status. Excluded were patients who were not employed prior to their injury. Socioeconomic status was either defined by insurance status - Medicaid/Medicare, commercial, or workman’s compensation -, or by assessing socioeconomic status (SES) using medial household per capita income by zip code as generated and reported by the US National Census Bureau’s 2013-2017 American Community Survey 5-Year Estimates. The national dataset was divided into quartiles with the lowest quartile defined as low SES. Patients who had income that fell within this income category were classified as low SES. Results: 174 patients were included with an average follow-up of 10.2months. 22/174 (12.6%) patients didn’t return to work post-operatively. Univariate analysis identified non-sedentary work to decrease the likelihood of return to work (HR:0.637; p=0.03). Patients with a low SES were more prevalent in the no return group compared to the return to work group (86% vs 60%; p=0.028). 95% of patients with low SES were a minority compared to 56% with average/high SES (p<0.005). Patients with low SES had a higher BMI (p=0.026), a longer hospitalization (p=0.04) and more wound complications (p=0.032). Insurance type didn’t affect return to work (p=0.158). Patients with workman’s compensation had a longer follow-up time and a longer time to return to work compared to other insurances (p<0.005 for each comparison). Conclusion: Low socioeconomic status based on income, not insurance type, affected return to work after an ankle fracture ORIF. Patients with workman’s compensation took a longer time to return to work compared to other insurance types. These findings warrants the need to consider socioeconomic status when allocating resources to treat these patients.

Utilization of a multisite financial reimbursement program to promote racial/ethnic diversity and inclusion in therapeutic cancer clinical trials: The iMPACT Study.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 85-85
Author(s):  
Hala Borno ◽  
Sylvia Zhang ◽  
Elena Nieves ◽  
Dana Dornsife ◽  
Robert G. Johnson ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Low Socioeconomic Status ◽  
Ethnic Diversity ◽  
Phone Call ◽  
Cancer Clinical Trials ◽  
Impact Study ◽  
Low Socioeconomic ◽  
Diversity And Inclusion ◽  
The Impact ◽  
Racial Ethnic

85 Background: A lack of racial/ethnic diversity among cancer therapeutic clinical trial (TCT) participants remains a critical problem. The significance of costs, both direct and indirect, associated with cancer TCT participation are increasingly understood. Here, we report findings observed in the IMproving Patient Access to Cancer clinical Trials (IMPACT) study, a pilot feasibility study investigating the feasibility and efficacy of offering a financial reimbursement program (FRP) during cancer TCT discussion with or without additional outreach in improving enrollment and diversity. Methods: Participants for this study were recruited at two Comprehensive Cancer Centers (CCCs) from April to September 2019. Patients were randomized 1:1 to receive a brochure about a FRP at time of consent for a TCT or receive brochure and outreach through a scripted follow-up phone call regarding the FRP. Results: No difference in TCT enrollment was observed between study arms. Among 170 patients approached to participate, 132 (78%) provided consent. The participant mean age was 57 years old (std dev = 14 years). Among participants 57% were male and 49% were white. The remaining major racial/ethnic groups were Black (5%) Asian (13%) and Hispanic (26%). The proportion of non-whites was greater among IMPACT study (43%) compared to CCC TCT (28%) participants. Among FRP participants, 24% reported a household income < $25,000 and 14% from $25,001 to $56,000. Conclusions: This study observed that offering an FRP as part of TCT discussion is feasible and effective at CCCs. An outreach phone call is not required in order to influence enrollment in TCT. FRP recipients are racially/ethnically diverse and low socioeconomic status.

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