Sabrina M Darwiche, Anda K Kuo, Christine Schudel, Maya Morales, Helen Iat Chio Chan, Dayna Long
{"title":"What is Unspoken: The Discomfort Experienced by Pediatric Resident Physicians Delivering Racially Discordant Clinical Care.","authors":"Sabrina M Darwiche, Anda K Kuo, Christine Schudel, Maya Morales, Helen Iat Chio Chan, Dayna Long","doi":"10.1353/hpu.2025.a951593","DOIUrl":"10.1353/hpu.2025.a951593","url":null,"abstract":"<p><p>A diverse physician workforce is imperative to addressing health inequities, but few physicians identify as Black or Hispanic. Therefore, this study used the social constructionism framework to explore pediatric residents' perceptions of race in medical encounters. A qualitative study of 47 trainees at a tertiary care center revealed the following: (1) racism, not race, influences health; (2) trainee perceptions around race create feelings of discomfort during some racially discordant patient encounters, while they were a source of comfort for trainees of color during concordant encounters; and (3) trainee perceptions around race in racially discordant clinical encounters may result in a change in clinical practice. While participants expressed awareness that racism drives health disparities, they had limited understanding of how their interactions might further perpetuate disparate health outcomes for patients of color. This emphasizes the need to support anti-racism competencies in medical education and increase workforce diversity in health care.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"192-208"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Nicole Sisson, Catherine Tomko, Zhenglin Yuan, Katherine Haney, Emily Clouse, Katherine C Smith, Susan G Sherman
{"title":"Exploring the Role of Vaccine Confidence in COVID-19 Vaccination Among a Community-Based Sample of Women Who Use Drugs in Baltimore, Maryland.","authors":"Laura Nicole Sisson, Catherine Tomko, Zhenglin Yuan, Katherine Haney, Emily Clouse, Katherine C Smith, Susan G Sherman","doi":"10.1353/hpu.2025.a959112","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959112","url":null,"abstract":"<p><p>Prevalence of COVID-19 vaccination among women who use drugs is largely unknown. Using a community-based sample, we explored correlates of COVID-19 vaccination stratified by level of vaccine confidence, measured by the widely used Vaccine Hesitancy Scale. Level of vaccine confidence was found to be significantly associated with uptake of the COVID-19 vaccine as well as recent flu vaccination. Poisson regression with robust variance was used to identify correlates of vaccination within both groups. Among higher-confidence women, vaccine uptake was associated with education and experiencing pandemic-related health care barriers and food insecurity, and likelihood of vaccination was lower among those who did not believe the vaccine was FDA-approved than among those who did. Among lower-confidence women, likelihood of vaccination was greater among Black women, those in shared housing, and drug treatment, but lower among those recruited from high-vaccination neighborhoods and who believed newer vaccines carry greater risk.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"526-544"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Does the Health of Public Housing Residents Compare With the Rest of the Population? A Survey of OMHTR Residents.","authors":"Marc-André Blanchette, Stéphanie Wouters, Liette St-Pierre, Lisanne Guérin, Samuel Blain, Geneviève Lavigne, Caroline Poulin","doi":"10.1353/hpu.2025.a959116","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959116","url":null,"abstract":"<p><p>This study aimed to investigate the physical health, mental health, health-related behaviors, life satisfaction, and health care utilization of Office municipal d'habitation de Trois-Rivières (OMHTR) public housing residents compared with those of residents of the Mauricie region in Quebec. We administered a reduced version of the Canadian Community Health Survey (CCHS) to 150 OMHTR residents between July and November 2019, and compared the data with aggregated data from the 2018 CCHS for the Mauricie region using multivariable logistic regression. Results revealed significant disparities in health outcomes and service utilization patterns. OMHTR residents had higher odds of poor physical, oral, and mental health, along with dissatisfaction across various life domains. They also showed increased likelihood of seeking health care for mental health issues and reported injuries within the past year. These findings highlight considerable disparities in health outcomes and access to health care between OMHTR residents and their regional counterparts.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"605-623"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety-Net Providers: A Missing Feature of the Health Equity Research Landscape.","authors":"Maureen R Benjamins, Helen Margellos-Anast","doi":"10.1353/hpu.2025.a959125","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959125","url":null,"abstract":"<p><p>Safety-net health care systems disproportionately serve the most marginalized and historically excluded groups in the U.S. Research from these systems not only focuses on those most affected by health inequities but is often strengthened by environments that are rich in direct experience, genuine community engagement, and awareness of social injustices. Despite this, research from safety-net systems is limited. Safety-net institutions face substantial structural barriers, primarily financial, that undermine their capacity to develop necessary infrastructure and compete for grants. We present a case study of a research center based in a safety-net system in Chicago to explore these challenges and potential solutions. Recommendations include the implementation of equity-focused funding approaches, research collaborations that take advantage of the expertise and community connections of safety-net providers, and strengthening the complex funding structure for safety-net hospitals. Health equity research must be driven by those most affected, and safety-net systems are well-positioned to help accomplish this.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"730-747"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer L Kemper, Rasheeda T Monroe, Theodore R Zarzar
{"title":"Making Correctional Health Care Education Integral to Health Care Training.","authors":"Jennifer L Kemper, Rasheeda T Monroe, Theodore R Zarzar","doi":"10.1353/hpu.2025.a951601","DOIUrl":"10.1353/hpu.2025.a951601","url":null,"abstract":"<p><p>A growing body of literature links incarceration to negative health outcomes for individuals, families, and communities, yet health care learners often have little structured training in this area. In the last several years, many health care training programs have incorporated or expanded equity-focused curricula for their learners but have not consistently provided training on the impact of incarceration. Given the disproportionate rates at which Black, Indigenous, and Latinx individuals are brought into the correctional system, the authors argue that a curriculum on incarceration is an integral part of health care training. In this commentary, the authors summarize the history of structural racism within the correctional system; discuss the impact of incarceration on individual, family, and community health; and suggest methods to expand didactic curricula and direct clinical experiences within carceral and post-release settings.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"344-360"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laima Licitis, Leigh E Szucs, Zach Oberholtzer, Kathleen H Krause, Jennifer Smith, Emily Young, Ari Fodeman, Sanjana Pampati
{"title":"Adolescent Sexual Behavior, Contraceptive Use, and STI Testing during the COVID-19 Pandemic (January-June 2021).","authors":"Laima Licitis, Leigh E Szucs, Zach Oberholtzer, Kathleen H Krause, Jennifer Smith, Emily Young, Ari Fodeman, Sanjana Pampati","doi":"10.1353/hpu.2025.a951587","DOIUrl":"10.1353/hpu.2025.a951587","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected adolescents' sexual and reproductive health (SRH) behaviors and access to services.</p><p><strong>Methods: </strong>We analyzed data from the 2021 Adolescent Behaviors and Experiences Survey (n=7,705) on sexual activity, condom and contraceptive use, and sexually transmitted infection (STI) testing. We tested differences in SRH outcomes by demographics, racism experience, and English proficiency.</p><p><strong>Results: </strong>Current sexual activity was higher among students reporting ever experiencing racism at school and self-rating how well they can speak English as \"not well.\" Condom use differed by sex, sexual identity, and sex of sexual contacts. Demographic differences in contraceptive use were also identified. Sexually active females (vs. males) and males with same-sex or both-sex contacts (vs. opposite-sex) had higher STI testing.</p><p><strong>Conclusion: </strong>Differences by students' demographic characteristics and experiences during the pandemic highlight needs to enhance accessibility and quality of adolescent SRH services and education in schools, clinics, and communities.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"82-95"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul L Wilson, Marlow Schulz, Ashley Carlson, Chelsea Koessel, Erin Petersen, Anna McEvoy, Kelcey Daily, Gerry Groggel
{"title":"The Community Medicine Cabinet: Experiences and Evaluation from Free Over-the-Counter Medication Access to Residents of a Small-City Homeless Shelter.","authors":"Paul L Wilson, Marlow Schulz, Ashley Carlson, Chelsea Koessel, Erin Petersen, Anna McEvoy, Kelcey Daily, Gerry Groggel","doi":"10.1353/hpu.2025.a951604","DOIUrl":"10.1353/hpu.2025.a951604","url":null,"abstract":"<p><p>Community-level projects are a cornerstone in efforts to provide medical care to unhoused populations. The Community Medicine Cabinet (CMC) is a novel program created to supply residents of a local warming shelter with access to free over-the-counter medications. This report details the initial 18 months of operation including patient-reported evaluations.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"384-391"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carey August, Julieta E Barroeta, Joanna L Conant, Ranjana D Paintal
{"title":"Using See, Test & Treat® to Increase Uptake of Breast and Cervical Cancer Screenings: Report from the Field.","authors":"Carey August, Julieta E Barroeta, Joanna L Conant, Ranjana D Paintal","doi":"10.1353/hpu.2025.a959127","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959127","url":null,"abstract":"<p><p>The See, Test, & Treat® program has provided free cervical and breast cancer screening to more than 8,500 medically underserved women across the U.S. since 2011. This report explores its successful uptake strategies, its outcomes, and the challenges it faces to enhance uptake.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"757-764"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Re-Evaluating the Medicaid Sterilization Consent Process.","authors":"Cynthia Abraham","doi":"10.1353/hpu.2025.a951599","DOIUrl":"10.1353/hpu.2025.a951599","url":null,"abstract":"<p><p>Currently, individuals with federally-funded health insurance who desire sterilization are required to sign the Consent for Sterilization form (Title XIX form) at least 30 days before the date of the procedure. The form remains valid for 180 days with the only exceptions being cases in which emergency abdominal surgery or premature delivery is warranted. These tenets were constructed in response to public outcry over sterilization abuses that had occurred during the early 20th century. Although the intention of the Medicaid sterilization consent process lay in protecting the reproductive rights of individuals and preventing forced or coerced sterilization, the restrictions associated with the consent for sterilization currently serve as a barrier to access to care. This commentary is a call to modify the Medicaid sterilization consent form.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"327-334"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aize Cao, Arielle M Fisher, Russell E Poland, Todd Gary, Jeffrey Schnipper, Kenneth Sands
{"title":"Racial Disparities in Mortality and Readmission Among COVID-19 Hospitalized Patients.","authors":"Aize Cao, Arielle M Fisher, Russell E Poland, Todd Gary, Jeffrey Schnipper, Kenneth Sands","doi":"10.1353/hpu.2025.a951589","DOIUrl":"10.1353/hpu.2025.a951589","url":null,"abstract":"<p><p>We conducted a cross-sectional study to investigate racial disparities among patients hospitalized for COVID-19 using electronic health records from a large community-based health care system between March 2020 and February 2021. The primary outcomes were in-hospital mortality and 30-day readmission. Demographics, clinical characteristics, and socioeconomic factors were analyzed using logistic regression, with adjusted odds ratios (AOR) reported. The study identified 90,490 patients, including Hispanic (29%), White (45.5%), Black (17.3%), Asian (3.1%), and Others (4.1%). The mortality model demonstrated a strong performance with an area under curve (AUC) of 0.88 (95%CI=0.877-0.885) and a Brier score of 0.093 (95%CI=0.092-0.095). For the 30-day readmission model, the AUC was 0.726 (95%CI=0.717-0.734) with a Brier score of 0.091 (95%CI=0.088-0.093). Compared with Whites, Hispanics exhibited a higher risk of mortality (AOR=1.23; 95%CI=1.16-1.31) but a lower likelihood of readmission (AOR=0.89; 95%CI=0.83-0.97). These findings highlight the critical need for targeted health management strategies across different racial and ethnic groups.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"115-143"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}