Primary Care in Underserved Populations Definitions, Scope, Challenges and Future Considerations

Morelli, Vincent

doi:10.1016/j.cpha.2018.08.016

Cited by 4 publications

(16 citation statements)

References 45 publications

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“…32 Some U.S.-based work has used structural violence to examine urban retail food markets and low birth weight 33 as well as to understand racial disparities in HIV transmission, 34 while other U.S.-based work on structural violence has focused on safety-net mechanisms for health care delivery. 35,36 Also in the United States, Zakrison and colleagues poignantly argued that "gun violence is structural violence" and went on to describe the need for work that sees gun violence in its social and political context. 37 For Zakrison and colleagues, structural violence is the analytic lens through which social class and racism can be understood: "African Americans are disproportionately affected by unemployment, poverty and hunger.…”

Section: Use Of "Structural Violence" In Health Studiesmentioning

confidence: 99%

“As Natural as the Air Around Us”: On the Origin and Development of the Concept of Structural Violence in Health Research

Maio

Ansell

2018

Int J Health Serv

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This article examines the concept of "structural violence." Originating in the work of Johan Galtung in 1969 and popularized by Paul Farmer, structural violence is increasingly invoked in health literature. It is a complex concept - rich in its explanatory potential but vague in its operational definition and arguably limited in its theoretical precision. Its potential lies in the focus it gives to the deep structural roots of health inequities; in contrast to the more passive term "social determinants of health," structural violence explicitly identifies social, economic, and political systems as the causes of the causes of poor health. It is also evocative in its framing of health inequities as an act of violence. Yet the formulation of structure used in this literature is largely atheoretical and, by extension, apolitical. Development of the concept hinges on clarifying the precise aspects of structure it points to (perhaps through using the concept in conjunction with larger theoretical frameworks) as well as improving operational definitions to enable its use in quantitative social epidemiology. We argue that the concept of structural violence can provide a useful lens for understanding health inequities, but its full potential is only realized when combined with larger theoretical frameworks.

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Section: Use Of "Structural Violence" In Health Studiesmentioning

confidence: 99%

“As Natural as the Air Around Us”: On the Origin and Development of the Concept of Structural Violence in Health Research

Maio

Ansell

2018

Int J Health Serv

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“…The Health Resources & Services Administration takes each of these variables into account for a given area or population and then converts them into weighted values. 5 According to 2017 data from the Association of American Medical Colleges, there are 892 856 active or practicing physicians in the US. 11,12 Only approximately one-third are involved in primary care.…”

Section: Access To Health Carementioning

confidence: 99%

“…11,12 The concerning fact about the primary care physician pool is more than half are over the age of 50, with almost one-third being projected to retire in the next 10 years. 5,13 Exacerbating this problem is the fact that just 25% of medical school graduates are going into primary care practice. 5,13 The World Health Organization designates any country with fewer than 1.13 physicians per 1000 people as having a critical physician shortage.…”

Section: Access To Health Carementioning

confidence: 99%

“…4 This problem is expected to worsen as more individuals gain health insurance coverage due to current policy changes; access to providers is reduced due to an aging physician population, and fewer physicians choose to practice primary care. 4,5 Additionally, medically underserved areas and populations continue to grow at a pace faster than health care can manage these populations. 4,5 As a result, US residents are overusing emergency care.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Additionally, medically underserved areas and populations continue to grow at a pace faster than health care can manage these populations. 4,5 As a result, US residents are overusing emergency care. 4 This overuse leads to poor coordination of care, lower quality care, and incurs unnecessary costs, resulting in unsatisfied patients.…”

Section: Introductionmentioning

confidence: 99%

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Medically Underserved Populations: The Athletic Trainer's Role

Wetherington

Pecha

2020

Athletic Training Education Journal

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Context Health care cost continues to rise; the US continues to spend dramatically more money than other developed nations per individual without increased health outcomes. More individuals are finding it harder to get access to a health care provider, especially those in medically underserved areas and populations. Objective To increase the knowledge of the athletic training educator about medically underserved populations and the roles athletic trainers (ATs) play as leaders in health care delivery. Background Current and future physician shortages are known and are only going to increase as more than one-third of current primary care physicians are expected to retire in the next 10 years. Forty percent of the population lives in areas that are medically underserved and designated by the government as areas of professional medical shortage; patients in these areas are primarily served by primary care physicians. Synthesis As with access to physicians, access to ATs has been shown to be based upon socioeconomic status and presents more challenges for the medically underserved. Early access to health care providers has shown to be important in adolescents, as negative health behaviors can carry into adulthood, leading to poorer health-related outcomes throughout life. Recommendation(s) To ensure that athletic training educational programs include opportunities to provide service to the medically underserved, education on social determinates of health, and the means by which ATs can fill critical holes in providing care for these patients. More research is needed to validate ATs' roles in providing quality health care. Additionally, more research is needed around how AT education can help meet patient needs. Conclusion(s) As the athletic training profession continues to evolve and responds to the growing demands of the complex health care system, access to an AT may provide a vital bridge to overall health care for patients within medically underserved populations.

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Predictors of Nonadherence to Colorectal Cancer Screening among Hospitalized Women

Siraj

Kauffman

Khaliq

2022

Southern Medical Journal

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Objectives: Despite proven mortality benefit, disparities in colorectal cancer (CRC) screening utilization persist, especially among younger women, minorities, and low-income women, even those who are insured. The purpose of the present study is to evaluate and estimate the effects of sociodemographic and clinical variables associated with nonadherence to CRC screening among hospitalized women.Methods: A cross-sectional bedside survey was conducted to collect sociodemographic and clinical comorbidity data believed to affect CRC screening adherence of hospitalized women aged 50 to 75 years who were cancer free (except skin cancer) at enrollment. Logistic regression models were used to assess the association between these factors and nonadherence CRC screening.Results: In total, 510 women were enrolled for participation in the study. After adjustment for sociodemographic and clinical predictors, only two variables were found to be independently associated with nonadherence to CRC screening: age younger than 60 years (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.58-4.33) and nonadherence to breast cancer screening (OR 3.72, 95% CI 2.29-6.04). By contrast, hospitalized women at high risk for CRC were more likely to be compliant with CRC screening (OR 0.14, 95% CI 0.04-0.50).Conclusions: Both younger age and behavior toward screening remain barriers to CRC screening. Hospitalization creates an environment where patients are in close proximity to healthcare resources, and strategies could be used to capitalize on this opportunity to counsel, educate, and motivate patients toward this screening that is necessary for health maintenance. Seizing on this opportunity may help improve CRC screening adherence.

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Primary Care in Underserved Populations Definitions, Scope, Challenges and Future Considerations

Cited by 4 publications

References 45 publications

“As Natural as the Air Around Us”: On the Origin and Development of the Concept of Structural Violence in Health Research

“As Natural as the Air Around Us”: On the Origin and Development of the Concept of Structural Violence in Health Research

Medically Underserved Populations: The Athletic Trainer's Role

Predictors of Nonadherence to Colorectal Cancer Screening among Hospitalized Women

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