Understanding and Measuring Health Care Insecurity

Tomsik, Philip E.; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J.; Stange, Kurt C.; Werner, James Joseph; Flocke, Susan A.

doi:10.1353/hpu.2014.0180

Cited by 8 publications

(2 citation statements)

References 19 publications

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“…Regarding mental conditions, our findings of the greater levels of both anxiety and stress among those denied of healthcare due to financial barriers echoed previous research supporting the relationship between cost-related avoidance of medical care and frequent mental distress[ 43 ]. These observations supported the notion that healthcare insecurity (i.e., uncertainty about the ability to access and sustain needed health services) is associated with poorer health-related quality of life and greater mental distress[ 44 ]. In contrast, other studies reported that being unable to seek healthcare with respect to lack of financial means might lead to poor health status [ 45 – 47 ].…”

Section: Discussionsupporting

confidence: 70%

What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

et al. 2018

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Although Hong Kong is one of the richest cities in the world and has some of the best health outcomes such as long life expectancy, little is known about the people who are unable to access healthcare due to lack of financial means. Cross-sectional data from a sample of 2,233 participants aged 18 or above was collected from the first wave of the “Trends and Implications of Poverty and Social Disadvantages in Hong Kong” survey. Socio-demographic factors, lifestyle factors, and physical and mental health conditions associated with people who were unable to seek medical services due to lack of financial means in the past year were examined using forward stepwise logistic regression analyses. Of the 2,233 participants surveyed, 8.4% did not seek medical care due to lack of financial means during the past year. They were more likely to be income-poor. With respect to physical and mental health, despite having less likelihood to have multimorbidity, they tended to have higher levels of both anxiety and stress, poorer physical and mental health-related quality of life, and suffer from more severe disability and pain symptoms affecting their daily activities, when compared to the rest of the Hong Kong population. People who were denied of medical care due to financial barriers are generally sicker than people in the general Hong Kong population, implying that those with greater healthcare needs may have financial difficulties in receiving timely and appropriate medical care. Our findings suggest that inequity in healthcare utilization remains a critical issue in Hong Kong.

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Section: Discussionsupporting

confidence: 70%

What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

et al. 2018

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“…Healthcare insecurity has been defined as the feeling of uncertainty, anxiety, and vulnerability towards obtaining or maintaining sufficient healthcare services. This concept evaluates an individual's mental feeling of vulnerability, lack of control, and worry about getting healthcare services when needed (19).…”

Section: Discussionmentioning

confidence: 99%

Psycho-emotional Consequences of Hospitalized Elder Abuse from Older Patients’ Perspective

et al. 2020

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Introduction and Objective:The present study aimed to identify and describe psycho-emotional consequences of hospitalized elder abuse from older patients' views.Methods: An inductive qualitative content analysis research was conducted at various wards of six educational hospitals affiliated to Shiraz University of Medical Sciences. A total of 16 elderly patients aged 60 years and older were selected using purposive sampling and data gathering was done using semi-structured, individual interviews. The data were analyzed using the qualitative content analysis method proposed by Elo and Kyngas (2008). Results:The Psycho-emotional consequences of hospitalized elder abuse were reflected in three main categories, namely feeling of insecurity, aggression, and learned helplessness. Conclusion:Hospitalized elder abuse could be accompanied with immediate Psycho-emotional consequences, such as feeling of insecurity and aggression, as well as persistent and long-term consequences, such as helplessness. Thus, monitoring and training the healthcare staff and raising their awareness regarding consequences of hospitalized elder abuse are necessary to prevent this phenomenon.

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A Tale of Two Cities During the COVID-19 Pandemic: Evaluating Food Insecurity in Chicago and New York City

Mazzeo

Qusair

Gadhoke

et al. 2022

J. Racial and Ethnic Health Disparities

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Background COVID-19 revealed and broadened existing disparities in large cities. This article interprets the early impacts of COVID-19 on food insecurity (FI) in the Chicago and New York City (NYC) metropolitan areas for Black, Indigenous, and People of Color (BIPOC) and provides a study using a Social Determinants of Health (SDOH) framework. Methods A cross-sectional survey adapted from the National Food Access and COVID Research Team (NFACT) was deployed in Chicago ( N = 680) and in NYC ( N = 525) during summer 2020 and oversampled for race, ethnicity, and socioeconomic status. Multivariate binary logistic regression generated adjusted odds ratios (aOR) and 95% CIs for FI and select SDOH variables, which was conducted on each dataset. Results The prevalence of FI in NYC increased to 66.8% (from 57.8%) and in Chicago to 44.8% (from 41.0%). While higher income protected against FI before, protection was diminished or eliminated since COVID-19. FI declined for households with children in NYC while odds increased and became significant in Chicago. Respondents with chronic health conditions experienced increased odds of FI since COVID. In Chicago, this variable had the highest odds of FI. Respondents with depression or anxiety had increased odds of FI. In NYC, depression had the highest odds of FI. Females in NYC were protected against FI. Hispanics in NYC lost protection against FI from before to since COVID-19. Conclusions Results support the observed rise of FI for BIPOC and its association with health status. The analysis has multifaceted, structural policy implications for reducing FI in urban centers.

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Understanding and Measuring Health Care Insecurity

Cited by 8 publications

References 19 publications

What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

What are the financial barriers to medical care among the poor, the sick and the disabled in the Special Administrative Region of China?

Psycho-emotional Consequences of Hospitalized Elder Abuse from Older Patients’ Perspective

A Tale of Two Cities During the COVID-19 Pandemic: Evaluating Food Insecurity in Chicago and New York City

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