COVID 19 对弱势群体影响的范围审查:美国的 LGBTQ+ 人士、无家可归者和移民农场工人。

Archives of internal medicine research Pub Date : 2024-01-01 Epub Date: 2024-07-29 DOI:10.26502/aimr.0172
Donald J Alcendor, Paul D Juarez, Aramandla Ramesh, Katherine Y Brown, Mohammad Tabatabai, Patricia Matthews-Juarez
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引用次数: 0

摘要

目的:国家医学教育发展与研究中心(NCMEDR)的目标是支持医科学生在弱势群体护理方面的教育和培训。在美国,无论其社会经济地位如何,获得初级保健服务是所有人健康和幸福的基础。在美国,LGBQ+人群(女同性恋、男同性恋、双性恋、变性人、同性恋和其他性与性别少数群体)、无家可归者(PEH)和移民农场工人(MFW)是服务最不足、最边缘化和社会最弱势的群体。Meharry 医学院家庭与社区医学系的 NCMEDR 部分是在卫生与公众服务部 (DHHS) 和卫生资源与服务管理局 (HRSA) 的资助下成立的。开发 NCMEDR 的目的是为美国医学教育和临床实践改革提供教育途径,确定医科学生是否接受了为 LGBTQ+ 人士、PEH 和 MFW 提供初级保健和行为健康服务的培训。在此,我们将重点关注 COVID-19 大流行对这些特定人群的影响,因为他们代表着受到大流行严重影响的边缘化群体,其健康的社会决定因素(SDOH)较差,更有可能没有保险,并且不太可能在急诊室护理之外接触初级保健提供者:本研究进行了范围性文献回顾,以评估 COVID-19 对 LQBTQ+ 人士、PEH 和 MFW 初级保健的影响:这次大流行为国家医疗卫生发展报告所审查的弱势群体提供了严重的健康差距。大流行确定了临床实践、医学教育和医疗保健政策所需的变革性措施,以改善弱势群体的医疗保健。我们就针对特定人群的干预措施提出了建议,这些措施可能会在 COVID 时代对临床、环境健康和 SDOH 产生影响:COVID大流行说明医学院、医疗保健机构和社会组织需要以新的和不同的方式对弱势群体和边缘化社区进行干预。这些建议为促进健康公平、获取、质量、利用、护理协调和治疗提供了一种模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Scoping Review on the Impact of COVID 19 on Vulnerable Populations: LGBTQ+ Persons, Persons Experiencing Homelessness, and Migrant Farm Workers in the US.

Purpose: The goal of the National Center for Medical Education Development and Research Center (NCMEDR) is to support the education and training of medical students in the care of vulnerable populations. Access to primary care services in the US is fundamental to the health and wellness of all people regardless of their socioeconomic status. LGBQ+ persons, (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority), Persons Experiencing Homelessness (PEH), and Migrant Farm Workers (MFW) are among the most underserved, marginalized, and socially vulnerable groups in the US. NCMEDR in the Department of Family and Community Medicine at Meharry Medical College was established in part, with funding from the Department of Health and Human Services (DHHS) and the Health Resources and Services Administration (HRSA). NCMEDR was developed to provide educational pathways for transforming medical education and clinical practice in the US by ascertaining whether medical students were being trained to provide primary care, and behavioral health services to LGBTQ+ persons, PEH, and MFW. Here we focus on the impact of the COVID-19 pandemic on these specific populations because they represent marginalized groups that have been heavily impacted by the pandemic, have poor social determinants of health (SDOH), and are more likely to be uninsured, and are less likely to engage primary care providers outside of emergency room care.

Methods: In this study, a scoping literature review was conducted to assess the impact of COVID-19 on primary care of LQBTQ+ persons, PEH, and MFW.

Results and discussion: The pandemic provided a serious health disparities gap for the defined vulnerable populations under review by the NCMEDR. The pandemic identified the need for transformative measures for clinical practices, medical education, and health care policies required for implementation to improve health care for vulnerable groups. We make recommendations for interventions with defined populations that may influence clinical, environmental health, and SDOH in the COVID era.

Conclusions: The COVID pandemic directed the need for medical schools, health care and social organizations to intervene in new and different ways in vulnerable and marginalized communities. The recommendations provide a model for advancing health equity, access, quality, utilization, care coordination, and treatment.

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