Racial And Ethnic Disparities Persist At Veterans Health Administration Patient-Centered Medical Homes [Addressing Inequities In Health Care]
Patient-centered medical homes are widely promoted as a primary care delivery model that achieves better patient outcomes. It is unknown if their benefits extend equally to all racial/ethnic groups. In 2010 the Veterans Health Administration, part of the Department of Veterans Affairs (VA), began implementing patient-centered medical homes nationwide. In 2009 significant disparities in hypertension or diabetes control were present for most racial/ethnic groups, compared with whites. In 2014 hypertension disparities were similar for blacks, had become smaller but remained significant for Hispanics, and were no longer signif...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Washington, D. L., Steers, W. N., Huynh, A. K., Frayne, S. M., Uchendu, U. S., Riopelle, D., Yano, E. M., Saechao, F. S., Hoggatt, K. J. Tags: Minority Health, Quality Of Care Addressing Inequities In Health Care Source Type: research
New Kidney Allocation System Associated With Increased Rates Of Transplants Among Black And Hispanic Patients [Addressing Inequities In Health Care]
Before the 2014 implementation of a new kidney allocation system by the United Network for Organ Sharing, white patients were more likely than black or Hispanic patients to receive a kidney transplant. To determine the effect of the new allocation system on these disparities, we examined data for 179,071 transplant waiting list events in the period June 2013–September 2016, and we calculated monthly transplantation rates (34,133 patients actually received transplants). Implementation of the new system was associated with a narrowing of the disparities in the average monthly transplantation rates by 0.29 per...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Melanson, T. A., Hockenberry, J. M., Plantinga, L., Basu, M., Pastan, S., Mohan, S., Howard, D. H., Patzer, R. E. Tags: Access To Care, Health Reform, Minority Health Addressing Inequities In Health Care Source Type: research
Impact Of Ambulance Diversion: Black Patients With Acute Myocardial Infarction Had Higher Mortality Than Whites [Evidence Of Inequities In Health Care]
This study investigated whether emergency department crowding affects blacks more than their white counterparts and the mechanisms behind which this might occur. Using a nonpublic database of patients in California with acute myocardial infarction between 2001 and 2011 and hospital-level data on ambulance diversion, we found that hospitals treating a high share of black patients with acute myocardial infarction were more likely to experience diversion and that black patients fared worse compared to white patients experiencing the same level of emergency department crowding as measured by ambulance diversion. The ninety-day...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Hsia, R. Y., Sarkar, N., Shen, Y.-C. Tags: Hospitals, Minority Health, Quality Of Care Evidence Of Inequities In Health Care Source Type: research
For Selected Services, Blacks And Hispanics More Likely To Receive Low-Value Care Than Whites [Evidence Of Inequities In Health Care]
US minority populations receive fewer effective health services than whites. Using Medicare administrative data for 2006–11, we found no consistent, corresponding protection against the receipt of ineffective health services. Compared with whites, blacks and Hispanics were often more likely to receive the low-value services studied. (Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Schpero, W. L., Morden, N. E., Sequist, T. D., Rosenthal, M. B., Gottlieb, D. J., Colla, C. H. Tags: Medicare, Minority Health, Quality Of Care Evidence Of Inequities In Health Care Source Type: research
Racial Disparities In Surgical Mortality: The Gap Appears To Have Narrowed [Evidence Of Inequities In Health Care]
Despite substantial attention to the greater likelihood of poor clinical outcomes among black versus white surgical patients, little is known about whether racial disparities in postoperative mortality in the United States have narrowed over time. Using nationwide Medicare inpatient claims data for the period 2005–14, we examined trends in thirty-day postoperative mortality rates in black and white patients for five high-risk and three low-risk procedures. Overall, national mortality trends improved for both black and white patients, by 0.10 percent per year and 0.07 percent per year, respectively—whi...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Mehtsun, W. T., Figueroa, J. F., Zheng, J., Orav, E. J., Jha, A. K. Tags: Minority Health, Quality Of Care Evidence Of Inequities In Health Care Source Type: research
Identifying Policy Levers And Opportunities For Action Across States To Achieve Health Equity [Politics, Law & Equity]
We describe promising, feasible state-level approaches for states to "do something, do more, do better" when they take action on the five selected policies that can promote health equity. (Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Berenson, J., Li, Y., Lynch, J., Pagan, J. A. Tags: Health Promotion/Disease Prevention, State/Local Issues, Variations, Determinants Of Health Politics, Law & amp; Equity Source Type: research
Challenges To Reducing Discrimination And Health Inequity Through Existing Civil Rights Laws [Politics, Law & Equity]
More than fifty years after the passage of the Civil Rights Act of 1964, health care for racial and ethnic minorities remains in many ways separate and unequal in the United States. Moreover, efforts to improve minority health care face challenges that differ from those confronted during de jure segregation. We review these challenges and examine whether stronger enforcement of existing civil rights legislation could help overcome them. We conclude that stronger enforcement of existing laws—for example, through executive orders to strengthen enforcement of the laws and congressional action to allow private individual...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Chandra, A., Frakes, M., Malani, A. Tags: Legal/Regulatory Issues, Minority Health Politics, Law & amp; Equity Source Type: research
The United States Leads Other Nations In Differences By Income In Perceptions Of Health And Health Care [Politics, Law & Equity]
We examined income gaps in the period 2011–13 in self-assessments of personal health and health care across thirty-two middle- and high-income countries. While high-income respondents were generally more positive about their health and health care in most countries, the gap between them and low-income respondents was much bigger in some than in others. The United States has among the largest income-related differences in each of the measures we studied, which assessed both respondents’ past experiences and their confidence about accessing needed health care in the future. Relatively low levels of moral discomfo...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Hero, J. O., Zaslavsky, A. M., Blendon, R. J. Tags: Public Opinion Politics, Law & amp; Equity Source Type: research
Simulations Test Impact Of Education, Employment, And Income Improvements On Minority Patients With Mental Illness [Addressing Social Determinants Of Health]
Social determinants of health, such as poverty and minority background, severely disadvantage many people with mental disorders. A variety of innovative federal, state, and local programs have combined social services with mental health interventions. To explore the potential effects of such supports for addressing poverty and disadvantage on mental health outcomes, we simulated improvements in three social determinants—education, employment, and income. We used two large data sets: one from the National Institute of Mental Health that contained information about people with common mental disorders such as anxiety an...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Alegria, M., Drake, R. E., Kang, H.-A., Metcalfe, J., Liu, J., DiMarzio, K., Ali, N. Tags: Mental Health/Substance Abuse, Minority Health Addressing Social Determinants Of Health Source Type: research
HUD Housing Assistance Associated With Lower Uninsurance Rates And Unmet Medical Need [Addressing Social Determinants Of Health]
To investigate whether receiving US Department of Housing and Urban Development (HUD) housing assistance is associated with improved access to health care, we analyzed data on nondisabled adults ages 18–64 who responded to the 2004–12 National Health Interview Survey that were linked with administrative data from HUD for the period 2002–14. To account for potential selection bias, we compared access to care between respondents who were receiving HUD housing assistance at the time of the survey interview (current recipients) and those who received HUD assistance within twenty-four months of completing...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Simon, A. E., Fenelon, A., Helms, V., Lloyd, P. C., Rossen, L. M. Tags: Access To Care Addressing Social Determinants Of Health Source Type: research
Transitions Clinic Network: Challenges And Lessons In Primary Care For People Released From Prison [Addressing Social Determinants Of Health]
Low-income and minority communities are disproportionately affected by incarceration, which exacerbates health disparities. Through enhanced primary care, the Transitions Clinic Network (TCN) seeks to improve the health of people with chronic conditions who return to their communities from prison. Using TCN data, we assessed the impact of early engagement in primary care and referral from correctional systems to TCN on the use of acute care (emergency department visits and hospitalizations) and recidivism. Of 751 patients, 29.8 percent were referred by correctional partners, and 52.7 percent were engaged in TCN c...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Shavit, S., Aminawung, J. A., Birnbaum, N., Greenberg, S., Berthold, T., Fishman, A., Busch, S. H., Wang, E. A. Tags: Health Promotion/Disease Prevention, Minority Health, Determinants Of Health Addressing Social Determinants Of Health Source Type: research
Mapping Neighborhood Health Geomarkers To Clinical Care Decisions To Promote Equity In Child Health [Addressing Social Determinants Of Health]
Health disparities, which can be understood as disadvantages in health associated with one’s social, racial, economic, or physical environment, originate in childhood and persist across an individual’s life course. One’s neighborhood may drive or influence these disparities. Information on neighborhoods that can characterize their risks—what we call place-based risks—is rarely used in patient care. Community-level data, however, could inform and personalize interventions such as arranging for mold removal from the home of a person with asthma from the moment that person’s address is reco...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Beck, A. F., Sandel, M. T., Ryan, P. H., Kahn, R. S. Tags: Maternal And Child Health, Determinants Of Health Addressing Social Determinants Of Health Source Type: research
Emerging Trends Could Exacerbate Health Inequities In The United States [Pursuing Health Equity]
Health inequities among people of different races and ethnicities, geographical locations, and social classes are not a new phenomenon, although the size of the inequities has changed since researchers first began documenting them. While interventions to improve the health of targeted disadvantaged groups may help combat disparities, broader trends that disproportionately benefit privileged groups or harm vulnerable populations can eclipse the progress made through isolated interventions. These trends threaten equity in health and health care in the United States either through direct effects on health or through impacts o...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Arcaya, M. C., Figueroa, J. F. Tags: Health Reform, Health Information Technology Pursuing Health Equity Source Type: research
Progress In Achieving Health Equity Requires Attention To Root Causes [Pursuing Health Equity]
Life expectancy and disease rates in the United States differ starkly among Americans depending on their demographic characteristics and where they live. Although health care systems are taking important steps to reduce inequities, meaningful progress requires interventions outside the clinic, in sectors such as employment, housing, transportation, and public safety. Inequities exist in each of these sectors, and barriers to educational attainment, higher-income jobs, and social mobility limit the opportunity of disadvantaged people to improve their circumstances. Financial institutions and other stakeholders are investing...
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Woolf, S. H. Tags: Public Health, Determinants Of Health Pursuing Health Equity Source Type: research
House Passes AHCA; HHS Acts On Regulations [Web First]
As the GOP worked to pass ACA repeal legislation, HHS finalized a market stabilization rule, and the debate over cost-sharing reduction payments continued. (Source: Health Affairs)
Source: Health Affairs - June 5, 2017 Category: International Medicine & Public Health Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
