Purpose To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and stigma.
Purpose This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.
Purpose This chapter seeks to quantify the effects of geographic access to community health centers on the likelihood of an individual having a regular source of health care.
Purpose The study examines health care inequities in viral load testing among hepatitis C (HCV) antibody-positive patients. The analysis predicts whether individual and census tract sociodemographic characteristics impact the likelihood of viral load testing.
Purpose The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.
Purpose Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.
Purpose Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.
Purpose -:This study compared different types of full-time caregivers (e.g., children, older adults, COVID-19 patients) and subgroups (e.g., disability, race/ethnicity, sexual orientation) in the United States during the COVID-19 pandemic for potentially meaningful distinctions. Methodology/Approach -:Data from the 9,854 full-time caregivers identified in Phase 3.2 (July 21 -October 11, 2021) of the U.S. Census Household Pulse Survey (HPS) were analyzed in this study using multinomial logistic regression to examine relationships between caregiver types, marginalized subgroups, generation, and vaccination status. Findings -:The prevalence of caregiving was low, but the type of full-time caregiving performed varied by demographic group (i.e., disability, race/ethnicity, sexual orientation, gender, generation, and vaccination status). The relative risk of being a COVID-19 caregiver remained significant for being a member of each of the marginalized groups examined after all adjustments. Limitations/Implications -:To date, the HPS has not been analyzed to predict the type of full-time informal caregiving performed during the COVID-19 pandemic or their characteristics. Research limitations of this analysis include the cross-sectional, experimental dataset employed, as well as some variable measurement issues. Originality/Value of Paper -:Prior informal caregiver research has often focused on the experiences of those caring for older adults or children with special healthcare needs. It may be instructive to learn whether and how informal caregivers excluded from paid employment during infectious disease outbreaks vary in meaningful ways from those engaged in other full-time caregiving. Because COVID-19 magnified equity concerns, examining demographic differences may also facilitate customization of pathways to post-caregiving workforce integration.
Purpose This paper explores the rural experiences of the COVID-19 pandemic and seeks to understand the variations in these experiences between rural residents working in health care and those outside of health care occupations. This paper considers the impacts on physical health and access to health care (including challenges related to caretaking) as well as on mental health.
Purpose: Micro hospitals are a new form of for-profit healthcare facility with rapid expansion in some parts of the country. They continue to grow in Texas without in-depth public understanding or explicit policy guidance on their role in the healthcare system. Our project aims to define socioeconomic and demographic characteristics of areas served by micro and regular hospitals, and by doing so assess micro hospitals’ impact in expanding healthcare access for disadvantaged populations in Texas.Methodology/Approach: We 1) estimated hospital service areas (catchment areas) with a spatial model based on advanced Geographic Information System (GIS) methods using a proprietary ESRI traffic network; 2) assigned population socioeconomic measures to the catchment areas from the 2014–2018 American Community Survey 5-Year Estimates, weighted with an empirically tested Gaussian distribution; 3) used two-tailed t-tests to compare means of population characteristics between micro and regular hospital catchment areas, and 4) conducted logistic regressions to examine relationships between selected population variables and the associated odds of micro hospital presence.Findings: We found micro hospitals in Texas tend to serve a population less stressed in healthcare access compared to those who are more in need as measured by various dimensions of disadvantages.Research Limitations/Implications: Our analysis takes a cross sectional look at the population characteristics of micro hospital service areas. Even though the initial geographic choices of micro hospitals may not reflect the long-term population changes in specific neighborhoods, our analysis can provide policy makers a tool to examine healthcare access for disadvantaged populations at given point in time. As the population socioeconomic characteristics have long been associated with healthcare inequality, we hope our analysis will help foster structural policy considerations that balance growing healthcare delivery innovations and their social accountability.Originality/Value of Paper: We used GIS based spatial modeling to dynamically capture the potential patient basis by travel time calculated with a street network dataset rather than using the traditional static census tract to define hospital service areas. By mapping these boundaries in space we illustrated patterns that regression alone might not. Most importantly, by integrating both spatial and nonspatial dimensions of healthcare access, we demonstrated that the policy considerations on the implications of equal opportunity for healthcare access need to take into account the social realities for those experiencing the most vulnerability in our society, rather than a conceptual “equality” existing in the spatial and market abstraction.
Purpose How is medical knowledge produced and what are the implications of that knowledge production for medical practice? Using theoretical ideas on evidence-based medicine, standardization in medical research and practice, and biopower, I examine the relationship between medical knowledge and medical practice through the case of pelvic pain care in the US.
Background Pandemic along with causing disruption in economy and health of the communities, has also exposed the vulnerabilities of the people and the government. Innumerable research papers reported that this is leading to an increase in psychological issues like depression, OCD, anxiety, etc.,. However, our past experiences with pandemics has shown that the survival of communities depends on the level of adaptability and change management. This study aims to observe the influence of the disruption in emotional health measured in terms of Level of Adaptability and Level of Resistance to Change as a result of Lockdown.
Purpose Existing knowledge about differences in well-being is still incomplete. Based on the previous research, we hypothesize that there is a positive relationship between the use of health information from the media and well-being, and that the strength of this relationship increases with the number of years of schooling.
Purpose:We present findings from a longitudinal investigation, the purpose of which was to compare health disparities of rural Latino older adult patients diagnosed with diabetes to their non-Latino White counterparts.Methodology/Approach:A pre-post design was implemented treating Medicare Accountable Care Organization (ACO) participation by Rural Health Clinics (RHCs) as an intervention, and using diabetes-related hospitalizations to measure disparities. Data for a nationwide panel of 2,683 RHCs were analyzed for a study period of eight years: 2008 - 2015. In addition, data were analyzed for a subset of 116 RHCs located in Florida, Texas, and California that participated in a Medicare ACO in one or more years of the study period.Findings:Two broad findings resulted from this investigation. First, for both the nationwide panel of RHCs and the three-state sample of "ACO RHCs," there was a decrease in the mean disparities in diabetes-related hospitalization rates over the eight-year study period. Second, in comparing a three-year time period after Medicare ACO implementation in 2012 to a four-year period before the implementation, a statistically significant difference in mean disparities was found for the nationwide panel.Research limitations/implications:There are a number of factors that may contribute to the decrease in diabetes-related hospitalization rates for Latinos in more recent years. Future research will identify specific contributors to reducing diabetes-related hospitalization disparities between Latinos and the general population, including the possible influence of ACO participation by RHCs.Originality/Value of Paper:This paper presents original research conducted using data related to rural Latino older adults. The data represent multiple states and an eight-year time period. The U.S. Latino population is growing at a rapid pace. As a group, they are at a high risk for developing diabetes, the complications of which are serious and costly to the patient and the U.S. healthcare system. With the continued growth of the Latino population, it is critical that their health disparities be monitored, and that factors that contribute to their health and well-being be identified and promoted.
Originality/Value of the Chapter – My hope is to raise the volume on narratives of pregnancy trauma and reproductive experience using HG as a case study and my intention is to argue gender is a salient factor in health-care disparities.
