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Health disparities

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176 papers 25 to 100 followers
By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
Jose F Figueroa, Karen E Joynt, Xiner Zhou, Endel J Orav, Ashish K Jha
OBJECTIVE: US hospitals that care for vulnerable populations, "safety-net hospitals" (SNHs), are more likely to incur penalties under the Hospital Readmissions Reduction Program, which penalizes hospitals with higher-than-expected readmissions. Understanding whether SNHs face unique barriers to reducing readmissions or whether they underuse readmission-prevention strategies is important. DESIGN: We surveyed leadership at 1600 US acute care hospitals, of whom 980 participated, between June 2013 and January 2014...
March 2017: Medical Care
Barry L Rosenberg, Joshua A Kellar, Anna Labno, David H M Matheson, Michael Ringel, Paige VonAchen, Richard I Lesser, Yue Li, Justin B Dimick, Atul A Gawande, Stefan H Larsson, Hamilton Moses
BACKGROUND: Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment. METHODS AND FINDINGS: We used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U...
2016: PloS One
Yu-Hsiu Lin, Jan M Eberth, Janice C Probst
INTRODUCTION: This study examined the association between the distribution of primary care physicians and Medicare beneficiaries' ambulatory care sensitive condition hospitalizations using both statistical and spatial analyses. METHODS: Data from the 2014 County Health Rankings, 2013-2014 Area Resource File, and the 2014 Food Environment Atlas Data File were integrated to perform county-level ordinary least squares and geographically weighted regression. Analyses were conducted in late 2015...
October 2016: American Journal of Preventive Medicine
Donna Z Bliss, Olga V Gurvich, Lynn E Eberly, Kay Savik, Susan Harms, Jean F Wyman, Christine Mueller, Beth Virnig, Kjerstie Wiltzen
AIMS: Maintaining continence of nursing home (NH) residents promotes dignity and well-being and may reduce morbidity and healthcare treatment costs. To determine the prevalence of older continent adults who received primary prevention of incontinence at NH admission, assess whether there were racial or ethnic disparities in incontinence prevention, and describe factors associated with any disparities. METHODS: The design was an observational cross-sectional study of a nation-wide cohort of older adults free of incontinence at NH admission (n = 42,693)...
April 2017: Neurourology and Urodynamics
Steven S Coughlin, Daniel S Blumenthal, Shirley Jordan Seay, Selina A Smith
BACKGROUND: In the USA, race and socioeconomic status are well-known factors associated with colorectal cancer incidence and mortality rates. These are higher among blacks than whites and other racial/ethnic groups. METHODS: In this article, we review opportunities to address disparities in colorectal cancer incidence, mortality, and survivorship among African Americans. RESULTS: First, we summarize the primary prevention of colorectal cancer and recent advances in the early detection of the disease and disparities in screening...
December 2016: Journal of Racial and Ethnic Health Disparities
Vishal K Gupta, Michael Winter, Howard Cabral, Lori Henault, Katherine Waite, Amresh Hanchate, Timothy W Bickmore, Michael S Wolf, Michael K Paasche-Orlow
OBJECTIVES: To examine health literacy as a mediator of racial disparities in cognitive decline as measured by executive function in elderly adults. DESIGN: Prospective cohort study. SETTING: Secondary analysis of ElderWalk trial in Boston, Massachusetts. PARTICIPANTS: English-speaking African-American and Caucasian individuals in a walking intervention for community-dwelling adults aged 65 and older without dementia at baseline who completed baseline and 12-month evaluations (N = 198)...
August 2016: Journal of the American Geriatrics Society
Benjamin J Becerra, Devin Arias, Monideepa B Becerra
Low health literacy is a significant barrier to healthcare access and service utilization; however, there are few studies that have evaluated the factors associated with having low health literacy, especially among immigrant minority populations. This exploratory study aimed to assess the key determinants of low health literacy among immigrant Hispanic adults in California using the California Health Interview Survey, the largest population-based state health survey in the United States. Analysis accounted for complex survey design, allowing generalizations to the entire state of California...
June 2017: Journal of Racial and Ethnic Health Disparities
Julie Zissimopoulos, Geoffrey F Joyce, Lauren M Scarpati, Dana P Goldman
OBJECTIVES: We assessed whether Medicare Part D reduced disparities in access to medication. STUDY DESIGN: Secondary data analysis of a 20% sample of Medicare beneficiaries, using Parts A and B medical claims from 2002 to 2008 and Part D drug claims from 2006 to 2008. METHODS: We analyzed the medication use of Hispanic, black, and white beneficiaries with diabetes before and after reaching the Part D coverage gap, and compared their use with that of race-specific reference groups not exposed to the loss in coverage...
February 2015: American Journal of Managed Care
Ran D Balicer, Moshe Hoshen, Chandra Cohen-Stavi, Sivan Shohat-Spitzer, Calanit Kay, Haim Bitterman, Nicky Lieberman, Orit Jacobson, Efrat Shadmi
OBJECTIVE: To assess a quality improvement disparity reduction intervention and its sustainability. DATA SOURCES/STUDY SETTING: Electronic health records and Quality Index database of Clalit Health Services in Israel (2008-2012). STUDY DESIGN: Interrupted time-series with pre-, during, and postintervention disparities measurement between 55 target clinics (serving approximately 400,000 mostly low socioeconomic, minority populations) and all other (126) clinics...
December 2015: Health Services Research
Carolyn A Mendez-Luck, Jeffrey W Bethel, R Turner Goins, Marc B Schure, Elizabeth McDermott
BACKGROUND: A 2011 report by the Oregon Health Authority and the Department of Human Services documented disparities in its Latino and American Indian populations on multiple individual-level health indicators. However, research is lacking on the social contexts in which Latinos and American Indians in Oregon live and how these environments influence the health of communities as a whole. To help fill this gap, this study sought to contextualize the social environments that influence the health of Latinos and American Indian residents in three Oregon communities...
December 2015: BMC Public Health
Chandra L Jackson, Susan Redline, Karen M Emmons
Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD)...
March 18, 2015: Annual Review of Public Health
Stephanie Alexander, Elaine M Walker
Health disparities by gender constitute an important yet often overlooked aspect of health around the globe. Within the United States, there is both a paucity of research as well as planned programs that take into account how socio-cultural roles and expectations for men and women may differentially affect symptoms, access to care, and treatment. Viewing women's health exclusively as a function of sex (i.e., biological) differences represents a narrow understanding that does not fully explain gaps in health disparities between men and women...
August 2015: Evaluation and Program Planning
Amy Chesser, Anne Burke, Jared Reyes, Tessa Rohrberg
eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria...
2016: Informatics for Health & Social Care
Judith Aponte, Giselle Campos-Dominguez, Diana Jaramillo
Diabetes mellitus is a public health concern disproportionately affecting Hispanics. Because Hispanics are greatly affected by a high prevalence of diabetes, a qualitative study was conducted, which explored how Hispanics understand, perceive, and experience behavioral change and how they maintain such change while managing their diabetes. Twenty Caribbean (Dominican and Puerto Rican) Hispanic adults with diabetes, who were either English- or Spanish-speaking, participated in the study. Twenty individual interviews were conducted, audiotaped, and transcribed and translated...
2015: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
Smruti Jadav, Suja S Rajan, Susan Abughosh, Sujit S Sansgiry
OBJECTIVES: Considerable disparities in breast cancer screening exist between Hispanic and non-Hispanic white (NHW) women. Identifying and quantifying the factors contributing to these racial-ethnic disparities can help shape interventions and policies aimed at reducing these disparities. This study, for the first time, identified and quantified individual-level sociodemographic and health-related factors that contribute to racial-ethnic disparities in breast cancer screening using the nonlinear Blinder-Oaxaca decomposition method...
September 2015: Journal of Public Health Management and Practice: JPHMP
Anh Bao Nguyen, Nancy Breen, Trenette T Clark, Richard Moser
OBJECTIVES: To examine health outcomes and chronic conditions for the biracial Asian population in California. We hypothesized that the biracial population will display intermediate (or an average of) outcomes in comparison to their monoracial counterparts. DESIGN: The study was cross-sectional. After adjusting for sociodemographic variables, multivariable regression models predicted health outcomes (ie, diabetes, heart disease, high blood pressure, disability status, BMI, and general health) and compared health outcomes among various (mono- and bi-) racial and ethnic groups...
2014: Ethnicity & Disease
G Garcia-Garcia, V Jha
The increased burden of chronic kidney disease (CKD) in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities and exacerbate the negative effects of genetic or biological predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies...
May 2015: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Rebecca Luebbert, Amelia Perez
UNLABELLED: Clinical research requires representation of racially and ethnically diverse participants to accurately represent the general population. Overall life expectancy of African Americans is shorter than that of the general U.S. POPULATION: Compared with the other ethnic groups in the United States, African Americans have higher rates of hypertension, stroke, obesity, and diabetes, and higher rates of mortality related to stroke and cancer. Although many health disparities exist among African Americans, they are well underrepresented in clinical research...
September 2016: Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society
Keith C Ferdinand, Samar A Nasser
Although several risk factors contribute to cardiovascular disease (CVD) overall, hypertension (HTN) is the major controllable risk factor. Hypertension is disproportionately more prevalent among Blacks or African-Americans compared with other race/ethnic populations, and the control rates among this disparate population are alarming. Several pathophysiologic mechanisms have been demonstrated and evaluated among hypertensives and the conglomeration of genetics, environmental, and personal lifestyle activities concurrently impact the progression of hypertension-related comorbidities (i...
March 2015: Current Hypertension Reports
Brent M Egan, Veita J Bland, Angela L Brown, Keith C Ferdinand, German T Hernandez, Kenneth A Jamerson, Wallace R Johnson, David S Kountz, Jiexiang Li, Kwame Osei, James W Reed, Elijah Saunders
A 2014 hypertension guideline raised goal systolic blood pressure (SBP) from <140 mm Hg to <150 mm Hg for adults 60 years and older without diabetes mellitus (DM) or chronic kidney disease (CKD). The authors aimed to define the status of hypertension in black adults 60 to 79 years from the National Health and Nutrition Examination Survey 2005-2012 and provide practical guidance. Black patients were more often aware and treated (P≤.005) for hypertension than whites and had higher rates of DM/CKD (P<...
April 2015: Journal of Clinical Hypertension
2015-03-12 17:27:43
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