Health Equity最新文献

{"title":"The Time for Race-Neutral Pulmonary Function Norms is Now.","authors":"Peter H S Sporn, Cheryl Conner, Min J Joo, Bijal Jain, Sheryl Lowery, Natasha Nichols","doi":"10.1089/heq.2023.0274","DOIUrl":"10.1089/heq.2023.0274","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"683-685"},"PeriodicalIF":2.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Discrimination Among Women and Gender Diverse Veterans Using Veterans Health Administration Health Care.","authors":"Jodie G Katon, Samantha K Benson, Vyshnika Sriskantharajah, Lisa S Callegari, Karissa Fenwick, Kristen E Gray, P Adam Kelly, Ashley C Mog","doi":"10.1089/heq.2024.0085","DOIUrl":"10.1089/heq.2024.0085","url":null,"abstract":"<p><strong>Introduction: </strong>Women Veterans are diverse in terms of racial, ethnic, and gender identities and sexual orientation and may experience a variety of forms of discrimination and stigma in health care settings. Our objective was to understand discrimination experienced by women Veterans in the context of Veterans Health Administration (VA) care.</p><p><strong>Methods: </strong>We analyzed data from a series of semistructured telephone interviews with Veterans identified as females in the VA medical record who received VA health care in the past 12 months, purposively sampled by race/ethnicity and age (<i>N</i> = 28). The interview guide elicited experiences with VA health care, including discrimination. Interviews were audio-recorded, transcribed, and analyzed using inductive and deductive content analysis.</p><p><strong>Results: </strong>We identified themes regarding structural discrimination, interpersonal discrimination, and strategies employed in response to discrimination. Veterans described structural discrimination, including challenges with spaces not designed to accommodate disabilities or safety needs and care not sensitive to their gender, trauma histories, or sexual orientation. Interpersonal discrimination included harassment from other Veterans and biased treatment from VA providers and staff based on gender, appearance, and sexual orientation. Gender-based discrimination compounded across additional axes of marginalization including body size and stigma regarding mental illness. Experiences of discrimination undermined Veterans' sense of belonging and trust in VA and created barriers to accessing care. Veterans engaged in various strategies to protect themselves from discrimination and get needed care.</p><p><strong>Discussion: </strong>Quality improvement efforts that address the experience of women Veterans using VA health care must consider multiple forms and sources of discrimination and the intersection of gender-based discrimination with other forms of marginalization.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"692-700"},"PeriodicalIF":2.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Transfeminine Youth Health Disparities in Thailand: An Online Survey Analysis of Characteristics and Hormonal Use Patterns.","authors":"Nadvadee Aungkawattanapong, Thitaporn Prownpuntu, Chansuda Bongsebandhu-Phubhakdi","doi":"10.1089/heq.2023.0258","DOIUrl":"10.1089/heq.2023.0258","url":null,"abstract":"<p><strong>Background: </strong>Transgender youth in Thailand often encounter limitations when accessing gender services, leading many to use nonprescribed hormones.</p><p><strong>Objectives: </strong>This study aimed to explore 1) the pattern of Gender-Affirming Hormone Treatment (GAHT) use among Thai transfeminine youth, 2) the baseline characteristics of transfeminine youth, and 3) the self-reported happiness score and depression screening.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey among Thai transfeminine youth aged 12 to 25 years. Data were collected using a self-administered questionnaire distributed via social media platforms from September 2021 to October 2022.</p><p><strong>Results: </strong>Of the 256 participants, 226 (88%) reported having used hormones. The average age at which participants first used hormones was 15.5 years (SD 2.5). A majority (94.6%) of those who had used hormones disclosed their gender identity, compared with a lower percentage (60%) in the nonhormone use group. Among those with hormone use experience, only 36.1% reported use that strictly aligned with the recommended regimen, according to the 2017 Endocrine Society Clinical Practice Guideline, which includes an antiandrogen agent (oral cyproterone acetate) and estrogen (either oral estradiol valerate, oral 17 beta-estradiol, or estrogen gel). Furthermore, the average happiness scores and PHQ-A scores showed no significant differences between individuals who have or have not used GAHT.</p><p><strong>Conclusion: </strong>Thai transfeminine youth have started using GAHT during adolescence. However, many of them use it in ways that deviate from the recommended standard of gender care. The findings underscore the urgent need to enhance medical access, education, and supervision for gender health care among transfeminine youth.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"676-682"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Incidence of Diaper Dermatitis and Implications for Diaper Inequities.","authors":"Jennifer Randles, Justin van Zerber, Kristian Browning, Balaraman Rajan, Benito Delgado-Olson","doi":"10.1089/heq.2024.0083","DOIUrl":"10.1089/heq.2024.0083","url":null,"abstract":"<p><strong>Objectives: </strong>To examine if the likelihood of infants and toddlers requiring medical care for diaper dermatitis, a condition linked to infrequent diaper changes and possible diaper need, is different across racial/ethnic groups.</p><p><strong>Materials/methods: </strong>This is a population-based retrospective study. We collected data via public records requests from the California Department of Health Care Access and Information to determine the number of patients aged 0 to 3 years diagnosed with diaper dermatitis from 2010 to 2021 in emergency departments (EDs) and hospitals. We used two sample t-tests to compare the incidences of ED visits and in-patient hospitalization during the 11-year time period to identify differences across racial/ethnic groups.</p><p><strong>Results: </strong>From 2010 to 2021, there were 184,097 total diagnoses of diaper dermatitis, 53,678 of which received in-patient treatment. The annual mean was 15,341 and ranged between 9,407 and 17,425. The prevalence (per 1,000 children aged 0-5 of the respective race) was highest for the Black population averaging 9.56 (range: 5.79 to 11.37). The prevalence was 5.93 (3.75 to 7) for the White population, 2.49 (1.78 to 3.14) for Asian/Pacific Islanders, and 6.67 (4.25 to 7.52) for the Hispanic population. We find that Black children were disproportionately diagnosed with diaper dermatitis in California hospitals and EDs (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Racial disparities in medical conditions that can result from lack of sufficient diapers point to diaper need as a social determinant of health deserving of greater public attention and policy redress.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"686-691"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Conceptual Model to Achieve Health Equity in APOL-1 Clinical Studies.","authors":"Raven A Hardy Richard, Rebecca Hayes, Robert Flemming, Cesia Portillo, Richardae Araojo, Christine Lee","doi":"10.1089/heq.2024.0109","DOIUrl":"10.1089/heq.2024.0109","url":null,"abstract":"<p><p>The socioecological model (SEM) conceptualizes health broadly and focuses on multiple factors that might affect health. This article takes a novel approach to leverage an SEM framework to identify challenges and sustainable opportunities to advance diversity for clinical study participation in apolipoprotein L1 (APOL-1)-mediated kidney disease. We describe four levels of an APOL-1 SEM-intrapersonal, interpersonal, community, and structures/systems-for improved diverse APOL-1 clinical study enrollment and engagement. This SEM can serve as a model for improving clinical study diversity and equity to help improve the generalizability of clinical study results in other disease conditions that disproportionally impact racial and ethnic minority populations.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"701-706"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa.","authors":"Jennifer M C Sukalski, Natoshia M Askelson, Julie C Reynolds, Peter C Damiano, Wei Shi, Xian Jin Xie, Susan C McKernan","doi":"10.1089/heq.2023.0227","DOIUrl":"10.1089/heq.2023.0227","url":null,"abstract":"<p><strong>Purpose: </strong>Perceived social status (PSS), a measure of social status, reflects cumulative lifetime effects of an individual's relative social status based on resources and lived experiences. PSS is hypothesized to better capture social status compared to traditional measures of socioeconomic status (SES) (i.e., education, occupation, and income). Although recognized as a predictor of health-related morbidity and mortality, limited research has explored PSS and oral health. This study investigated PSS as a predictor of self-reported oral health among low-income adults.</p><p><strong>Methods: </strong>In spring 2018, a survey was administered to a random sample of low-income adults in the state of Iowa with public dental insurance (<i>N</i> = 18,000). Respondents were asked about PSS, oral health status, and demographics. Multivariable linear regression models examined PSS as a predictor of self-reported oral health and compared the predictive power of PSS and SES indicators.</p><p><strong>Results: </strong>The final adjusted sample size was 2,331. The mean PSS (range 1-10) was 5.3 (standard deviation 2.0). A significant positive association was noted between PSS (<i>ß</i> = 0.16, <i>p</i> < 0.0001) and self-reported oral health status when controlling for demographics. Furthermore, PSS accounted for an additional 3% of variance when controlling for demographic and SES indicators.</p><p><strong>Conclusions: </strong>PSS was associated with self-reported oral health status after adjusting for SES indicators, which reflects the importance of exploring the impact of individuals' perceptions of their social status in addition to objective measures of SES. Results suggest the need for future dental research to explore cumulative effects of lived experiences on current oral health status.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"667-675"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Steps to Advance Health Equity in Research from the UCLA COVID-19 Health Equity Research and Advisory Committee.","authors":"Enrico G Castillo, Alma D Guerrero, Eraka P J Bath, Rochelle A Dicker, Eric Esrailian, Helena Hansen, Nina T Harawa, Breena R Taira, Christina Harris","doi":"10.1089/heq.2024.0088","DOIUrl":"10.1089/heq.2024.0088","url":null,"abstract":"<p><strong>Introduction: </strong>The University of California, Los Angeles COVID-19 Health Equity Research and Advisory Committee was created to identify and fund research to address COVID-19 inequities.</p><p><strong>Methods: </strong>The committee addressed barriers to health equity research and funded $1.5 million of research.</p><p><strong>Results: </strong>These actions facilitated dialogue, shifted research infrastructure, and piloted strategies to enhance health equity impacts through consultation and feedback. We provide an overview of projects funded and highlight one to demonstrate impact.</p><p><strong>Conclusion: </strong>We provide a framework to help institutions implement similar approaches to centering health equity in research.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"654-658"},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Patient-Centered Forensic Nursing Model of Care for Victims of Law Enforcement Violence.","authors":"Maija Anderson, Jacqueline Callari-Robinson, Margaret Glembocki, Elizabeth Louden","doi":"10.1089/heq.2023.0270","DOIUrl":"10.1089/heq.2023.0270","url":null,"abstract":"<p><strong>Background: </strong>The manuscript examines the nature, manifestations, and potential causes of law enforcement violence as well the need for a model of care for victims. Specifically, it explores development of a preliminary forensic nursing model of care. The questions posed over the course of development of the model follow (1) What are the challenges to developing a rudimentary forensic nursing model of care for victims of law enforcement violence? (2) What are the tenets to be utilized in developing the model? (3) What additional recommendations are to be considered in refining and expanding the model?</p><p><strong>Key concept: </strong>A review of the literature in forensic nursing found a gap in care for victims of law enforcement violence. To address the gap given the lack of research, a preliminary model of care was developed based on key constructs from the following established models: (1) Theory of Abolition, (2) Critical Race Theory, (3) Levels of Racism, (4) Intersectionality, (5) Social Determinants of Health, (6) Emancipatory Praxis - Theory of Forensic Nursing, (7) Trauma-Informed Model of Care, and (8) Patient-Centered Model of Care.</p><p><strong>Implications for practice: </strong>The preliminary model developed adheres to the International Council of Nurses guidelines, which emphasize the nurse's duty to care without judgment or bias. Protocols established must be followed precisely to mitigate potential conflicts of interest in care of the victim. A practical application algorithm was developed based on care provided to other victims of violence.</p><p><strong>Conclusion: </strong>The model developed was focused on forensic nursing care. There is a need for further refinement involving an interdisciplinary approach. There is also a need for additional research as it relates to forensic nursing's role in caring for victims of law enforcement violence.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"619-635"},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of a Culturally Congruent Perinatal Home-Visiting Program on Gestational Age at Delivery for Black Women.","authors":"Erin Snowden, Deborah F Perry, Rabiyah Amina, Bryan Shaw, Aza Nedhari","doi":"10.1089/heq.2024.0076","DOIUrl":"10.1089/heq.2024.0076","url":null,"abstract":"<p><strong>Purpose: </strong>There is a Black maternal health crisis in America, with significant racial disparities in birth outcomes for Black women in Washington, DC. Programs designed to reduce these inequities must intentionally address the role of systemic racism and the ongoing legacy of oppression that is endemic to traditional perinatal care services. This article describes the findings from the quantitative analysis of an innovative perinatal program (Mothers Rising) designed by and for Black women in the Washington, DC, metropolitan area that was part of a larger mixed methods study.</p><p><strong>Methods: </strong>Using data provided by a Medicaid managed care organization that insured program participants and women who did not receive Mothers Rising, program participants (<i>n</i> = 102) were matched with a group of Black women who did not receive the program (<i>n</i> = 102) using propensity scores matching. Perinatal outcomes were extracted from electronic health records from the managed care dataset, including birth weight and gestational age.</p><p><strong>Results: </strong>Statistical analyses of the differences in birth outcomes between program participants and their matched peers demonstrated small but statistically significant differences in gestational age, favoring the Mothers Rising group.</p><p><strong>Conclusions: </strong>This study adds to the evidence base for the effectiveness of culturally tailored interventions to successfully address persistent racial disparities in Black women's perinatal health outcomes that result from persistent racism. Hyperlocal, community-developed home-visiting programs, such as Mothers Rising, should be funded to sustain impact and optimize maternal health outcomes.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"599-607"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Women's Experiences Along the HIV Care Continuum in the United States: A Scoping Review.","authors":"Jacqueline P Thomas, Will Ballew, Miu Ha Kwong","doi":"10.1089/heq.2024.0020","DOIUrl":"10.1089/heq.2024.0020","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of HIV among Black women is higher than the prevalence among other ethnic groups. Although antiretroviral therapy reduces HIV transmission and mortality, Black women still face health disparities when it comes to receiving health care. The purpose of this scoping review is to synthesize research regarding health disparities and health inequities faced by Black women living with HIV (BWLH).</p><p><strong>Methods: </strong>We searched three scholarly databases, PsychNet, MEDLINE, and CINAHL, and 18 peer-reviewed complete studies that met the inclusion criteria.</p><p><strong>Results: </strong>Several themes emerged from the literature, including discrimination, poverty, mental and physical health, health care, and social support. Each theme had a role in the progression of BWLH along the HIV care continuum.</p><p><strong>Conclusion: </strong>Black women continue to be disproportionately affected by HIV, which involves active engagement in HIV care to sustain viral suppression to prevent the spread of the virus. Factors continue to exist that contribute to health disparities and inequities, such as discrimination, internal and enacted HIV-related stigma, and poverty. Thematic findings in this review indicate that patient-centered care and support systems can positively impact BWLH experiences along the HIV continuum.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"608-617"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}