Several of the factors influencing team effectiveness in PACE are potentially modifiable and, therefore, could offer insights for improving team practice.
Nonconfrontational treatment may significantly enhance outcomes for DWI offenders with ASPD when delivered in an incarcerated setting, and in the present study, such effects were found in a primarily American-Indian sample.
Background Recent avoidable mortality trends in Australia suggest that health care has made a substantial contribution to reducing mortality. This study investigates if the benefits of health care have been distributed equally by comparing declines in avoidable with non-avoidable mortality over time by socioeconomic status (SES).
MethodsWe calculated avoidable and non-avoidable mortality rates in Australia by small areas for 1986, 1991, 1997 and 2002. We performed pooled cross-sectional trend analysis of indirectly standardized mortality rates by SES and year, modelling using Poisson regression with over-dispersion. Socioeconomic inequalities were quantified using the relative (RII) and slope (SII) index of inequality.
ResultsThe annual percentage decline in avoidable mortality at the higher end of the socioeconomic continuum (5.0%; 95% CI: 4.7-5.4%) was larger than at the lower end (3.5%; 3.2-3.8%), with increasing relative inequality between 1986 (RII ¼ 1.54; 1.46-1.63) and 2002 (RII ¼ 2.00; 1.95-2.06), greater than that in non-avoidable mortality (P ¼ 0.036). In absolute terms, avoidable deaths fell annually by 7.4 (6.9-7.8) and 8.4 (7.9-8.9) deaths per 100 000 at the higher and lower end of the spectrum, respectively, with absolute inequality decreasing between 1986 (SII ¼ 97.8; 87.6-107.9) and 2002 (SII ¼ 81.5; 74.6-88.5).Conclusions Health care has contributed to decreasing the absolute SES mortality gap. However, advantaged people have obtained a disproportionate benefit of health care, contributing to widening relative health inequalities. A universal heath care system does not guarantee equality in health-care-related outcomes.
Collecting epidemiologic data by ethnicity and race is a highly useful undertaking; but "bench mark" comparisons relative to majority Americans should not take priority over defining the determinants of health status within a minority group. Thus, it is necessary to identify factors contributing to the measured health status and to modify the environment, lifestyles, and behaviors to diminish the likelihood of undesirable health outcomes. This article presents an overview of the health status of African Americans, Asians and Pacific Islanders, and Hispanics. The goals are to provide a framework for the rational interpretation of both health status data and its determinants both within and between minority groups. This approach recognizes the heterogeneity of health status that exists within a minority group and encourages investigators to place more emphasis on the within-group health status differentials as they search for modifiable factors that underlie the risk for undesirable health outcomes.
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