scholarly journals Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration

2011 ◽  
Author(s):  
Alison Scott ◽  
Rebecca Wilson
2020 ◽  
Vol 11 (2) ◽  
pp. 74-89
Author(s):  
Kyle L Thompson ◽  
Melissa Gutschall ◽  
Amanda Bliss ◽  
Grace Herman ◽  
Madison Zimmerman ◽  
...  

Introduction: Given that nutrition status is directly related to a variety of health outcomes, nutrition screening is a prime focus of public health nutrition practice.  Objectives: The purposes of this pilot study were to develop and pilot test a Rural Adult Nutrition Screen (RANS) that includes criteria addressing social determinants of health and to explore possible applications of the screen development methodology in other settings. Methods: Mixed-methods research including interviews and survey dissemination was conducted among a rural southern Appalachian population in the United States.  Themes identified in the research were used to construct a preliminary rural adult nutrition screen (RANS-1).  The RANS-1 was pilot-tested among a sample of community-dwelling rural residents (n = 83), and was revised based on participant, administrator, and nutrition practitioner comments.  The revised screen, the RANS, was pilot-tested among a sample of attendees of a free community medical clinic (n = 37).   Nutrition risk as determined by the RANS was compared with the Nutrition Triage Score of the Patient-Generated Subjective Global Assessment (PG-SGA), the United States Department of Agriculture 6-item Household Food Security Survey Module (USDA-6), and nutrition assessment performed by a Registered Dietitian Nutritionist who was also credentialed as a Physician Assistant (RDN, PA).  Non-parametric statistical tests were used to compare the results of the PG-SGA NTS and the USDA-6 with the RANS regarding “at risk” and “low risk” status. Results: In this small pilot study, no statistically significant differences were found among either comparative instrument and the RANS in determination of “at risk” and “low risk” status.  The RDN, PA’s agreement with the RANS was 100%.  Conclusion:  This pilot study provides some evidence that the RANS may be used to screen rural, community-dwelling adults for nutrition needs in light of social determinants of health common in rural settings.  Further research and formal validation of the RANS are needed in order to establish this tool as a valid nutrition screen for use in the rural community setting.  Procedures used to develop the RANS may be applicable to the development of population-specific nutrition screens in other rural and urban global populations.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 577-578
Author(s):  
Adrienne Aiken-Morgan ◽  
Dextiny McCain ◽  
Karon Phillips ◽  
Keith Whitfield

Abstract Research has shown the importance of social determinants of health in explaining racial/ethnic disparities in many health outcomes; however, less attention has been given to within-group differences in social determinants of health among low-income African American older adults. The Physical and Cognitive Health Pilot Study (n=50) was utilized to examine associations between level of neighborhood socioeconomic disadvantage and self-reported health in African American older adults living in public housing in Durham, NC and Annapolis, MD. Results from ANOVA showed that Durham participants living in more disadvantaged neighborhoods had statistically significantly worse cardiovascular health, higher depression symptoms, worse sleep quality, and higher alcohol use (p=.05) than Annapolis participants living in a more resource-rich neighborhood. These findings suggest that among low-income African American elders, greater neighborhood/state socioeconomic disadvantage is associated with worse health status. Future research should consider neighborhood context as an essential variable when assessing health status among aging African Americans.


2019 ◽  
Vol 101 (4) ◽  
pp. 357-395 ◽  
Author(s):  
Saty Satya-Murti ◽  
Jennifer Gutierrez

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.


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