The role of primary care in improving health equity: report of a workshop held by the WONCA Health Equity Special Interest Group at the 2015 WONCA Europe Conference in Istanbul, Turkey

Chetty, Ula; O’Donnell, Patrick; Blane, David; Willems, Sara

doi:10.1186/s12939-016-0415-8

Cited by 9 publications

(7 citation statements)

References 12 publications

(14 reference statements)

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“…The gender difference, with a predominant impact on female GPs related to the stress adaptation response, has multiple explanations starting from women’s typology-detail oriented, with a focus on the safety of their family and that of their patients, but with a low capacity of simultaneously managing multiple tasks in both sectors of their lives, personal and professional, justified in itself by a higher number of tasks taken on compared to men. This is also supported by the sociological evaluation of the Romanian society, still deeply traditional, which leaves on women’s shoulders both household chores and professional duties, in a somehow hypocritical attempt to observe women’s right to work equality [ 34 , 35 ]. Female GPs from the north east and south east had a higher nervous and physical consumption compared to their male colleagues, perceiving the pandemic context as more difficult regarding stress management, the burden of prevention, and the adjustment to pandemic.…”

Section: Resultsmentioning

confidence: 99%

The Professional and Psycho-Emotional Impact of the COVID-19 Pandemic on Medical Care—A Romanian GPs’ Perspective

Stafie

Profire

Apostol³

et al. 2021

IJERPH

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The aim of this study was to assess the psycho-emotional impact and the adjustment degree of Romanian general practitioners (GPs) in the coronavirus disease 2019 (COVID-19) pandemic context. With a cross-sectional design, the study included 677 GPs to whom a validated questionnaire based on different items targeting three factors was sent: burden of prevention, presence of stress symptoms, and adjustment to pandemic. The burden of prevention and the adjustment effort to the pandemic were felt significantly more by female doctors and by GPs working in associated offices. The case definition quality, the support received, the professional life changes, and the stress symptoms proved to be the main predictors for the adjustment to pandemic. The adjustment measurement questionnaire can be used in further studies to identify the most supportive public health practices in difficult epidemiological contexts.

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Section: Resultsmentioning

confidence: 99%

The Professional and Psycho-Emotional Impact of the COVID-19 Pandemic on Medical Care—A Romanian GPs’ Perspective

Stafie

Profire

Apostol³

et al. 2021

IJERPH

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“…[1,2] Primary care has been recognized as a key means by which to promote health equity and care access-given its broad interaction with the population, its role as the chief point of direct patient contact within the greater health care system for many people, its degree of care continuity and function in comprehensive care coordination, and its typically strong level of appreciation for the social contexts in which patients live. [3] Indeed, primary care has been described as the bedrock upon which health care systems can achieve better individual and population health, access to health services, cost control, and experience and quality of care-and, as such, primary care has been the driving force behind many policy efforts to overcome health care barriers for disadvantaged populations in particular. [4] Access to primary care, however, remains a significant challenge in the United States, as more than 6,000 areas in the nation have been classified as primary care Health Professional Shortage Areas (pcHPSAs), and several thousand areas and populations have also been classified as medically underserved.…”

Section: Introductionmentioning

confidence: 99%

The geographic alignment of primary care Health Professional Shortage Areas with markers for social determinants of health

et al. 2020

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Background The Health Resources and Services Administration (HRSA), an agency within the U.S. Department of Health and Human Services (HHS), works to ensure accessible, quality, health care for the nation's underserved populations, especially those who are medically, economically, or geographically vulnerable. HRSA-designated primary care Health Professional Shortage Areas (pcHPSAs) provide a vital measure by which to identify underserved populations and prioritize locations and populations lacking access to adequate primary and preventive health care-the foundation for advancing health equity and maintaining health and wellness for individuals and populations. However, access to care is a complex, multifactorial issue that involves more than just the number of health care providers available, and pcHPSAs alone cannot fully characterize the distribution of medically, economically, and geographically vulnerable populations. Methods and findings In this county-level analysis, we used descriptive statistics and multiple correspondence analysis to assess how HRSA's pcHPSA designations align geographically with other established markers of medical, economic, and geographic vulnerability. Reflecting recognized social determinants of health (SDOH), markers included demographic characteristics, race and ethnicity, rates of low birth weight births, median household income, poverty, educational attainment, and rurality. Nationally, 96 percent of U.S. counties were either classified as whole county or partial county pcHPSAs or had one or more established markers of medical, economic, or geographic vulnerability in 2017, suggesting that at-risk populations were nearly ubiquitous throughout the nation. Primary care HPSA counties in HHS Regions 4 and 6 (largely lying within the southeastern and south central United States) had the most pervasive and complex patterns in population risk.

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“…Strengthening primary care’s capacity for mental health care improves health equity outcomes by providing timely access to coordinated and integrated mental health care [ 10 , 43 , 44 ]. Health equity refers to the absence of preventable and unjust disparities between different populations [ 45 ].…”

Section: Introductionmentioning

confidence: 99%

Inequities in the delivery of mental health care: a grounded theory study of the policy context of primary care

Ashcroft

Menear

Silveira

et al. 2021

Int J Equity Health

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Background Strengthening capacity for mental health in primary care improves health outcomes by providing timely access to coordinated and integrated mental health care. The successful integration of mental health in primary care is highly dependent on the foundation of the surrounding policy context. In Ontario, Canada, policy reforms in the early 2000’s led to the implementation of a new interprofessional team-model of primary care called Family Health Teams. It is unclear the extent to which the policy context in Ontario influenced the integration of mental health care in Family Health Teams emerging from this period of policy reform. The research question guiding this study was: what were key features of Ontario’s policy context that influenced FHTs capacity to provide mental health services for mood and anxiety disorders? Methods A qualitative study informed by constructivist grounded theory. Individual interviews were conducted with executive directors, family physicians, nurse practitioners, nurses, and the range of professionals who provide mental health services in interprofessional primary care teams; community mental health providers; and provincial policy and decision makers. We used an inductive approach to data analysis. The electronic data management programme NVivo11 helped organise the data analysis process. Results We conducted 96 interviews with 82 participants. With respect to the contextual factors considered to be important features of Ontario’s policy context that influenced primary care teams’ capacity to provide mental health services, we identified four key themes: i) lack of strategic direction for mental health, ii) inadequate resourcing for mental health care, iii) rivalry and envy, and, iv) variations across primary care models. Conclusions As the first point of contact for individuals experiencing mental health difficulties, primary care plays an important role in addressing population mental health care needs. In Ontario, the successful integration of mental health in primary care has been hindered by the lack of strategic direction, and inconsistent resourcing for mental health care. Achieving health equity may be stunted by the structural variations for mental health care across Family Health Teams and across primary care models in Ontario.

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The role of primary care in improving health equity: report of a workshop held by the WONCA Health Equity Special Interest Group at the 2015 WONCA Europe Conference in Istanbul, Turkey

Cited by 9 publications

References 12 publications

The Professional and Psycho-Emotional Impact of the COVID-19 Pandemic on Medical Care—A Romanian GPs’ Perspective

The Professional and Psycho-Emotional Impact of the COVID-19 Pandemic on Medical Care—A Romanian GPs’ Perspective

The geographic alignment of primary care Health Professional Shortage Areas with markers for social determinants of health

Inequities in the delivery of mental health care: a grounded theory study of the policy context of primary care

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