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In the past thirty years, the United States has made remarkable progress in reducing barriers in access to health care faced by racial and ethnic minority Americans. Most minority Americans born in the 1950s have vivid memories of 'separate and unequal' health facilities. By the 1980s, overt and blatant barriers to care were uncommon. In spite of the progress achieved, recent studies continue to provide evidence that minority Americans experience differential access to health coverage and to some health procedures. To investigate these differentials, contributors to this volume were asked to examine the health care experiences of nonelderly Hispanics and African-Americans within a nationally representative data source: the 1987 National Medical Expenditure Survey. Through this effort, the authors document the extent to which barriers to access persist and provide insight on possible explanations for variations in access. This volume will provide policymakers, practitioners, and advocates with an objective base of important information to guide decision-making about health care policy.
As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.
The Agency for Healthcare Research Quality commissioned the Institute of Medicine establish a committee to provide guidance on the National Healthcare Disparities Report is of access to health care, utilization of services, and the services received. The committee was asked to con population characteristics as race and ethnicity, society status, and geographic location. It was also asked to examine factors that included possible data sources and types of measures for the report.
The United States has spent two productive decades implementing a variety of prevention programs. While these efforts have slowed the rate of infection, challenges remain. The United States must refocus its efforts to contain the spread of HIV and AIDS in a way that would prevent as many new HIV infections as possible. No Time to Lose presents the Institute of Medicine's framework for a national prevention strategy.
An event-by-event look at how institutionalized racism harms the health of African Americans in the twenty-first century A crucial component of anti-Black racism is the unconscionable disparity in health outcomes between Black and white Americans. Sickening examines this institutionalized inequality through dramatic, concrete events from the past two decades, revealing how unequal living conditions and inadequate medical care have become routine. From the spike in chronic disease after Hurricane Katrina to the lack of protection for Black residents during the Flint water crisis—and even the life-threatening childbirth experience for tennis star Serena Williams—author Anne Pollock takes readers on a journey through the diversity of anti-Black racism operating in healthcare. She goes beneath the surface to deconstruct the structures that make these events possible, including mass incarceration, police brutality, and the hypervisibility of Black athletes’ bodies. Ultimately, Sickening shows what these shocking events reveal about the everyday racialization of health in the United States. Concluding with a vital examination of racialized healthcare during the COVID pandemic and the Black Lives Matter rebellions of 2020, Sickening cuts through the mind-numbing statistics to vividly portray healthcare inequalities. In a gripping and passionate style, Pollock shows the devastating reality and consequences of systemic racism on the lives and health of Black Americans.
Hispanics in the United States represents a collective exploration providing a basic foundation of the information available to understand Hispanics in the United States and create an effective policy agenda. Hispanics are projected to be the largest minority group in the United States in the twenty-first century. The contributions define an agenda which will be useful for students, scholars, service practitioners, political activists, as well as policy makers. The opening essays define the diversity of the Hispanic experience in America and put each of the other essays within a larger context. This edition adds a new introduction by the editors incorporating and evaluating the implications of the results of the national 2000 census. The book is organized into two sections: the first establishes the historical, demographic, religious, and cultural context of Hispanics in the United States. The second describes the major issues facing this population in the American social structure, specifically the areas of health care, the labor market, criminal justice, social welfare, and education. The work concludes with a discussion of the role played by Hispanics in the political life of the nation. The contributors, all of whom are scholars with demonstrated competence in the areas, include: Teresa A. Sullivan, David Maldonado, Melissa Roderick, Barry Chiswick, Michael Hurst, Zulema Suarez, Alvin Korte, Katie McDonough, Cruz Reynoso, and Christine Marie Sierra, as well as David Engstrom and Pastora San Juan Cafferty. Together they have produced a book which will be extremely useful to anyone developing public policies and creating social interventions at either the national or local levels during the coming decade. This new edition is a valuable contributor to discussions about the issues defining the population that will be the largest minority group in the United States in this century.
Poor Families in America's Health Care Crisis examines the implications of the fragmented and two-tiered health insurance system in the United States for the health care access of low-income families. For a large fraction of Americans their jobs do not provide health insurance or other benefits and although government programs are available for children, adults without private health care coverage have few options. Detailed ethnographic and survey data from selected low-income neighborhoods in Boston, Chicago, and San Antonio document the lapses in medical coverage that poor families experience and reveal the extent of untreated medical conditions, delayed treatment, medical indebtedness, and irregular health care that women and children suffer as a result. Extensive poverty, the increasing proportion of minority households, and the growing dependence on insecure service sector work all influence access to health care for families at the economic margin.
The American health care system is a unique mix of public and private programs that critics argue has produced a two-tier system - one for the rich and the other for the poor - that delivers dramatically unequal care and leaves millions of Americans seriously underinsured or with no coverage at all. This book examines the root causes of the inequalities of the American health care system and discusses various policy alternatives. It systematically documents the demands on and the performance of our health care system for different population groups as defined on the basis of gender (women), age (children), race and ethnicity (African Americans, Hispanics, Native Americans), and residence in high poverty areas (rural and inner city locales).For each population, the book documents: historical and demographic profile, data on health status, aspects of inequality including access; quality of care; and endemic, cultural, and lifestyle issues affecting health; policies, laws, and programs relevant to health care; and, indicators of improvement or negative trends.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
Latina Evangelicas: A Theological Survey from the Margins is a constructive and postcolonial examination of the theology of Protestant Latinas who reside in the United States. Written by three Latinas who have pastored and who teach in Latina/o communities, the book seeks to expand beyond Latina feminist and mujerista voices to include those whose perspectives have not yet been heard. It thus introduces an important theological perspective to a wider audience, and provides an important resource that has been lacking for evangelicas/os and other marginalized groups who study in various theological programs. Key terminology, such as evangelica, is defined throughout, and a glossary is included for non-Spanish-speaking readers. Each chapter considers theological themes important to the Latina Protestant worshiping community, beginning with a constructive discussion of the doctrine of the Holy Spirit and followed by the doctrines of salvation and Jesus Christ, the Trinity, the church, Scripture, and "the last things" (eschatology). Given that one of the characteristics of Latina/o theologies is their dialogical and collaborative nature, the book concludes with a conversation among the three authors about the theological thinking that took place in its composition. Study questions are included at the end of each chapter. .embed-container { position: relative; padding-bottom: 56.25%; height: 0; overflow: hidden; max-width: 100%; } .embed-container iframe, .embed-container object, .embed-container embed { position: absolute; top: 0; left: 0; width: 100%; height: 100%; }