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Health Disparities - Science topic

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  1. Public Health, Scope: Public health encompasses a broad range of activities aimed at improving the health of populations as a whole. This includes policies, research, disease prevention, health education, and health promotion on a national or global scale. Focus Areas: It deals with issues like epidemics, health policies, environmental health, and global health initiatives. Public health professionals work on reducing health disparities, improving healthcare systems, and conducting health research.
  • Community Health, Scope: Community health focuses more narrowly on the health and well-being of specific communities or populations within a larger society. It involves localized efforts to address health needs and issues unique to that community. Focus Areas: This includes activities like community health education, local health programs, access to healthcare services, and addressing specific health issues prevalent in the community. Community health practitioners often work directly with individuals and groups to improve health outcomes at the local level.
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Thank you for raising this insightful question about the distinctions between Community Health and Public Health. I would like to provide some perspective on this topic.
Public Health and Community Health are complementary fields, each playing crucial roles in promoting health and well-being but differing in scope, focus areas, and methodologies.
Public Health:
Scope: Public health operates on a macro level, encompassing a wide array of activities aimed at enhancing the health of populations on a national or global scale. It involves policy development, health education, disease prevention, and health promotion. Public health professionals engage in research to understand health trends and develop strategies to address emerging health issues.
Focus Areas: Key areas include epidemic control, health policy development, environmental health, and global health initiatives. Public health efforts often aim to reduce health disparities, improve healthcare systems, and promote health equity. This field is heavily influenced by epidemiological research, which provides data-driven insights to guide policy and intervention strategies.
Community Health:
Scope: Community health, on the other hand, is more focused and localized. It targets specific communities or populations within a larger society, addressing health needs and challenges unique to those groups. Community health practitioners work at the grassroots level, often tailoring interventions to the cultural, social, and economic contexts of the communities they serve.
Focus Areas: This includes community health education, local health programs, and ensuring access to healthcare services. Community health initiatives often address prevalent health issues within the community, such as chronic diseases, mental health conditions, and access to preventive services. Practitioners work directly with individuals and groups, fostering trust and collaboration to improve health outcomes.
Interconnectedness: While public health provides the overarching framework and resources necessary for broad-scale health improvements, community health ensures that these resources are effectively utilized at the local level. For instance, public health research might identify mental health disparities across a country, while community health initiatives develop and implement targeted interventions to address these disparities within specific communities.
Example in Mental Health and Psychiatry:
In my field of mental health and psychiatry, public health efforts might focus on national mental health policies, large-scale epidemiological studies, and broad mental health promotion campaigns. Community health initiatives, however, would implement these policies and findings at the community level, providing localized mental health services, conducting community-specific mental health education programs, and addressing barriers to mental health care access in underserved areas.
Both public health and community health are essential in creating a holistic and effective health system. Public health sets the stage for broad health improvements, while community health ensures these improvements reach and benefit all populations, particularly those at the grassroots level. Their synergy is crucial for achieving comprehensive health and well-being for all.
Thank you for this engaging discussion. I look forward to hearing more thoughts and perspectives on this topic.
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Dear Colleagues,
As many of you may well acknowledge, movement of the human body is intimately connected to a broader individual sense of autonomy and a pursuit of happiness. The promotion of physical activity for the “benefit” and “wellbeing” of individuals across their lifespan has been a preeminent feature of a broader public health initiative in the United States. However, many public health initiatives—enacted for the benefit of all citizens—and the broader praxis of practitioners—e.g., emboldened individual acts as saviorism for the greater good—have nearly universally maintained the historical inequalities experienced by those from marginalized communities.
Indeed, one’s physical health is rooted to one’s larger sense of being well. Yet, overly simplistic messages such as “eat less, exercise more” or “try walking more” neglect the documented systemic barriers such as cost, proximity, safety, etc., that limit historically and perpetually marginalized individuals from receiving such benefits. Presenting individualistic strategies to improve one’s health has served only to exacerbate entrenched issues and has often caused persons to engage in fewer and less enjoyable modes of physical activity; this has left only those with the affordances, such as those with more affluence, of the racial (i.e., white) or sexual (i.e., heterosexual) majority, or whose accommodation needs fit within those readily available.
To combat historical inequity and prepare for the ever-diversifying populace of the US, we are soliciting contributions for a Special Issue of Societies, titled “Interwoven Nuance: An Exploration of Youth Physical Activity Promotion and the Connection to Family Wellbeing”. This collection will consist of critical inquiries into wellbeing, physical activity, and family dynamics and their relationship to persistent, pervasive health disparities among perpetually marginalized communities. Such manuscripts may consider one or multiple forms of marginalization as related to racism, sexism, homo/transphobia, ableism, anti-immigrant, antisemitic, etc., and their influence on individual or collective wellbeing—defined as an individual’s perception of doing or being “well”—as part of, connected to, (un)related to, or otherwise linked with physical activity—defined as the intentional act of moving one’s entire body in a coordinated manner.
We, for this Special Issue, request submission of original empirical research studies or reviews. Manuscripts may be descriptive, exploratory, experimental, or theoretical; data of all forms (e.g., qualitative, or quantitative) will be considered. We will not consider manuscripts that are purely methodological; theoretical manuscripts may be considered but empirical articles will be prioritized.
We are hopefully awaiting submissions that are highly critical of the status quo or established traditions; this may include—but is not limited to—the following:
  • The gendered design of sport in American culture;
  • The imperialistic origins of physical education in schools;
  • Sport within the “School-to-Prison” pipeline;
  • Impact of trans sport bans on the wellbeing of children and families;
  • (Re)constructing assumptions of physical activity, family dynamics, and equity;
  • Transformative community-driven solutions to community issues possibly pertaining to community safety, educational affordances, or accessibility;
  • Offering a more holistically aligned description for wellbeing or physical activity itself;
  • Offering insight, deeply and authentically, on any topics connected to the intention of this request.
We will accept submissions from individuals of any affiliation and with all forms of credentials and expertise. All manuscripts will be expected to be transparent with their methodology and uphold the ethical standards for research as prescribed in the Belmont Report, the Declaration of Helsinki, and the Nuremberg Code.
We look forward to receiving your contributions; submissions can be made at: https://www.mdpi.com/journal/societies/special_issues/GCFZ2B127T.
Please feel free share this announcement or the attached flyer amongst your networks. Reply with any questions.
Your guest editors,
Dr. Andrew Colombo-Dougovito Dr. Yolanda Mitchell
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Dear Professor, would you be willing to accept articles that are not research-based
Regards
Dr Lucy
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I am interested in understanding the most effective public health interventions that have successfully addressed health inequalities across diverse global settings. In your experience or from your research, which interventions have shown the greatest impact in reducing health disparities and improving overall population health? Additionally, what are the key factors that contribute to the success of these interventions, and how can they be adapted for use in different contexts? I am eager to hear your insights and engage in a fruitful discussion that can help inform future public health strategies.
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The most effective interventions include community-based programs, access to healthcare services, health education, social determinants-focused policies, and vaccination campaigns. Success factors: strong political support, multisectoral collaboration, cultural sensitivity, scalability, and sustainable funding. Adaptation involves understanding local contexts and engaging stakeholders for effective implementation.
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Dear Colleagues,
How many people in the USA who speak two or more languages represent ethnic minorities? I am looking for numbers and sources to cite.
Thank you!
Monika
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As a part of my PhD, I conducted a study to assess health inequities in Amaravati capital region of Andhra Pradesh using two composite indices made from health determinants indicators and health outcome indicators.
Health outcome indicators data was available at the sub-district level. The data were interpolated to create a heatmap of the health outcome index. Whereas health determinants data was available at the village level. Thus I created a choropleth map using the health determinants index.
Later interpolated health outcome index map was overlayered on the choropleth map of health outcomes. It highlighted some interesting findings, i.e. areas of concern (Villages). The colour combinations created because of overlaying two layers revealed the areas with poor health outcomes and poor health determinants and areas with poor health outcomes with better determinants.
Kindly check these files and give your valuable opinions. Whether this type of analysis can be used to highlight the areas with health inequities or not? Please comment on the method used and the results obtained in the overlayered map.
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The OPGD model and "GD" R software package were recommended to identify spatial determinants from a perspective of spatial heterogeneity. You can refer the guide to use the model https://cran.r-project.org/web/packages/GD/vignettes/GD.html. As a result, you can visualise contributions of determinants, and the interactive impacts of spatial variables.
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I am conducting research for a Health Psychology MSc. My chosen topic is to explore racial healthcare experience disparities, and healthcare inequalities, in the maternal/perinatal period. I am trying to find an appropriate health psychological theories that can be applied to these to help underpin my research and interview schedule.
Thank you.
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This article may be
Exploring the Group Prenatal Care Model: A Critical Review of the Literature useful.published J perinatal education 2012
ALSO
THIS ARTICLE RELATE 2019
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This funding opportunity announcement (FOA) seeks to support research that examines how health information technology adoption impacts minority health and health disparity populations in access to care, quality of care, patient engagement, and health outcomes.
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Hi Learned friends,
Are you working on a project and need a co-author? please feel free to reach out to me.
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Health disparities in general, I will be happy to discuss with you some possibilities. We can use existing (secondary data).
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What can you do to effect positive change in Healthcare by years end?
There is a tremendous amount of discussion related to healthcare quality, population health and “disparities”. Lots of questions but few actionable answers. Let’s identify the low hanging fruit it our daily practice that can lead to positive outcomes!
Let’s be part of the solution and not part of the problem. Let’s be change agents.
Please join the movement!
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Khaled,
Thank you for your response. The concepts of Lean are quite valuable. The only criticism I have is that the process must take into account that the input into a healthcare system can not be controlled like in manufacturing. Therefore, outputs will not and cannot be the same. Retouching and throughput varies. Keep up the good work!
Cheers,
Christopher
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Empowering patients through their personal health record: scoping review for NHS England 
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Hi, I am general practitioner in France where primary care is a paradox. Public health is from eighteen century but most of population can have acces to the newest technologies. As health profesionals work independently, there are few well structured health networks.
Sincerely yours
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Can anyone help me with papers that sum up old and new health disparity or inequality theories or conceptual frameworks?
thank you
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Health disparities can be best understood from health inequity framework. Here is a review article that yo will benefit from:
" Inequalities in health: definitions, concepts, and theories "
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Does anyone have data on lead paint and learning disability?
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Marie Lynn Miranda did some work on this issue about 10 years ago.
Bruce Lamphear has also conducted some research on this issue and was a co-author on this recent paper
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Just sharing a cooking based analogy about research that dawned on me this morning.- Any comments?
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Clever analogy... agree with Craig.
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Most people think of affluence as a one sided blessing.  One need not worry about food or clothing or shelter.  But there are problems, very real problems, associated with affluence that are quite daunting, and in need of attention.  Control, secrecy, theft, are only a few of these problems.  
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The problem is, in my view, clearly the connection between affluence (and one could say also influence or political power) and economic and political inequality.   As Andrew McCulloch noted in his reply, this also gets to the issue of unequal consumption, which is a big and extremely important issue in the current global context of international (and national) economic inequality, and how forms of inequality and consumption interact to promote other inequalities and other detrimental outcomes such as ecological disorganization and destruction.  You can't really (in my opinion) talk about these issues without referring to Marx's analysis of capitalism and inequality, and modern theoretical and empirical studies relating that view to ecological destruction and disorganization (e.g., see for example, works by John Bellamy Foster [1992, The absolute and general law of environmental degradation under capitalism]; and numerous excellent empirical studies related to this approach by Andrew K. Jorgenson).  I would argue that the problem of inequality has never been "well-managed."  For example, examine the data from inequality.org (https://inequality.org/facts/global-inequality/)
In 2015, 0.7% of the world's population had a wealth share of one million dollars of more, and that 0.7% of the population owned 45.2% of global wealth. (And here, I am ignoring some refinements we could make here since as Oxfam reports, wealth is unevenly distributed among this group as well, with the EIGHT richest people in the world own $462 billion in wealth).
At the other end of the spectrum, 71% of the world's population owns less than $10,000 in wealth, and owns only 3% of global wealth.
Part of the issue with the above relates to the definition of "affluence," since being "affluent" in different national contexts can be defined relative to a nation rather than globally.  To get an idea of that issue in a national context we can refer to measures such as the GINI Index of income inequality.  (Although there are problems with the GINI index, ( see, http://www.hsrc.ac.za/en/review/hsrc-review-november-2014/limitations-of-gini-index)
Matthew Dada suggests that its not affluence, but how it is managed -- which might be correct -- and the question is -- what would a GINI index look like in a country where affluence was "managed properly"?   Denmark, for example, has -- compared to other countries -- a low GINI around 0.25.  Relative to other countries (e.g., US, 0.47) that is "good," but is 0.25 the best that can be achieved?  Is it appropriately defined as "well managed?"  So, it seems that there is some need to answer the question Dada raised about what "well managed" means before some conclusions can be reached.
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Specific groups of workers are at greater risk of exposure to dangerous substances at work in the woodworking and furniture enterprises. According to some recent studies, these are the newly appointed workers, young workers, migrant workers and workers with certain medical problems, etc. How to properly and thoroughly identify these groups?
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The workers can be screened for various substances that you do suspect they are exposed to and are resulting in harm to their health status. 
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women living in the rural communities in Africa within the above age range wants to be given the opportunity to be educated from primary to university level because they where denied such because they are full time farmers producing food for the public that where busy going to school.
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Exacto, ese era mi mensaje. Hay una importante oportunidad para el crecimiento personal y social en grupos con menos recursos y aislados.
La mujer por tradición, por habilidades y por vínculos sociales es una buena trasmisora de cuidados, un elemento clave en las culturas.
Apostamos por estas mejoras.
Saludos
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The current trial debit card bill provides cashless welfare benefits to recipients. The rational and purpose of the bill aims at reducing the amount of money spent on alcohol , drugs and gambling. Originally , the bill targeted to address the issues that arose within the Aboriginal Torres Islander communities. 
Are there any underlying disadvantages , this bill has towards the recipients and the general community as a whole?
What maybe the social justice issues that needs to be addressed from the  bill?
If i was to submit a reform proposal to the commission, what recommendations could I come up with? 
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Thanks again.. I will take a look at the links straight away. 
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I am interested in researching this topic and want to know what has been done alr any, 
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Most studies would have assessed factors related to early or late booking for Ante natal care or factors related to access to  access to health care services.
You may not want to start directly on the assumption that black women do not engage with ANC services.
You need to identify an ecological theoretical framework that will help you to identify all factors such as individual, family, community,  health care organization and the broader global perspectives
You may also want to review studies on disparities in access to health care services since in most cases the reasons for non utilization of ANC services maybe lack of availability, cost and inaccessibility to those services
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Community forest management is a popular concept that can be used to empowering local community while contributing forest management, yet in practice gathering community as a group not easy work. What do you think about Theory of Community Empowerment'? Is it useful for above work?   
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 Thanks all for your contribution regarding my question.
I agree with Raoul [An important finding is that practices largely vary, that empowerment as often works as it fails, and that all depends on context. Don't think too easy about it]
. As I alsobelieve  gathering community as a group is a not easy work since project planners have to face many practical challenges in the ground. On the other hand challenges also will be different place to place. For an example caste issue will be a one of the great challenges in the Asian context which is not common to the other contexts. 
But theoretically (as I understood) community empowerment is one of the major objectives of bottom up development projects and the idea of power is at the core of empowerment. The theory of community empowerment is about ‘giving social and political power to marginalized people to obtain more control over their lives’.
This power can be developed either by particular social groups or by taking help from others. The notion of ‘social empowerment’ can be well used by project planners to prepare a particular social structure before applying a bottom up development approach. especially as Frances Moore Lappé  has highlighted  the concept of ‘political empowerment’ is another aspect of community empowerment and it is an essential and important part in any bottom-up and community based development . What do you think about those ideas?  
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those who did study on Empowerment of geriatrics
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Thank you very much Mr.Glenn
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Is there anybody who has worked to estimate the unmet need of particular services? I am thinking specifically of our aboriginal people who live in remote areas where dialysis is not readily available. Renal failure is common in this collective and obviously given the remoteness, diabetes as well as renal failure are vastly underdiagnosed, but also the treatment for renal failure (if culturally appropriate at all) in native patients of any country is not always given. I wonder if people have experience quantifying the 'unmet need'. i am aware of studies where investigators have looked at death certificates issued after patients in remote areas have died, but also these are non-specific as they often crudely list some known morbidites. How do we measure 'unmet need'?
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If you look at Stewart Harris and the CIRCLE study in Canada, I think you will see this.
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The use of CHW is a growing in some states (CA, MA, NY) that have a large racial and ethnic populations as they have been proven to be effective in reducing readmission rates and healthcare disparities. However, each states' training curriculum varies and programs are not regulated.
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Perhaps it is time for to establish core competencies for the differing levels of CHW activities in different settings?
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what keywords would lead me there?
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I hadn't thought about the SInti and Roma people, but they were pretty systematically persecuted and I could see there being medical distrust  there.  THanks.
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We asked this question and posed these concerns in the commentary below.
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I think a movement would be appropriate; however, multiple organizations should be involved that can support the cause. For example, there exists several organizations, WHO, for international health, US health by NIH, and Kellogs funds NACCHO, see below for the link. The fact that a food organization funds a health equity cause could be problematic. After all, cereal is a processed food and it does not contribute to fresh produce consumption.
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i intend to research of whether there are specific provisions for the poor and the vulnerable in the Nigerian National Health Bill 2014. They key questions include, are  the provisions rights or privileges; who is eligible and who is to advocate for the poor? I would like read about other researchers critique of Health Bill in relation to equity and inequity in the Nigerian health system.
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Yes Westin.  The Nigerian Government is attempting to implement a free basic minimum health services (whatever that means) to all Nigerians and also to implement another category of exemption from payment from health services for an unspecified poor and vulnerable group to be determined by the health minister. Apart from the problem of eligibility, there is lack of a legal framework for the enforcement of these services in the 2014 National Health Bill and health system. In other words, from the Government’s point of view, these provisions are merely privileges and governmental philanthropy and not rights to health care. The citizens cannot seek redress in the court if government fails to implement this policy effectively.
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We are conducting a surveillance study looking at various socio-demographic factors and birth outcomes such as LBW and prematurity using birth certificate data. Given the limited info on the birth certificate, which would be a better predictor of adequate prenatal care, the Kotelchuck or the Kessner index.
 
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The Kotelchuck Index, is also called the Adequacy of Prenatal Care Utilization (APNCU) Index, It uses two crucial elements obtained from birth certificate data-when prenatal care began (initiation) and the number of prenatal visits from when prenatal care began until delivery (received services). The Kotelchuck index classifies the adequacy of initiation as  i.e pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. The final Kotelchuck index measure combines these two dimensions into a single summary score. The profiles define adequate prenatal care as a score of 80% or greater on the Kotelchuck Index, or the sum of the Adequate and Adequate Plus categories.The Kotelchuck Index does not measure the quality of prenatal care.
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I'm task to do a research on any particular disease that is either common or uncommon in the cultural perspective that when people are affected by it, beliefs may arises from it  such as to why, how and when this disease is affecting a particular group or an individual. The beliefs may be in the form of spirits, nature etc, and the practices that are used to combat  this particular disease.
Placing it in a cultural perspective when modern technologies were not yet available to either identify and point out it's origin.
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I would say that, culture is one of the very important and influencing aspect on the lives of every individuals.
As for us Melanesians; we view life in a cosmological way in order to interpret ideas and thoughts.(Gahare, 2014) Further more on this, we also view this through our interactions and behaviors towards us and the environment.
So to answer your question: in my area mouth cancer is one of the diseases that is destroying the lives of the people in the communities. This happen as a result of poison where the people used the spirits of the deaths to control them and to destroy the other person. For instance, if someone in a village is wealthy and the people respect him. But on the other side , his enemy will be jealous of him and use poison to kill or make the person get moth cancer in ways like giving him a poison betelnut for him to chew.
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I work in a rural town in Kenya and my heart bleeds each time there's a delay to patient care, either due to patient delays or because the hospital is not well equipped.
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There is no limit for financial requirements to meet the unmet needs of the poor. In this context, the government should plan the use of its resources better in such a way that the resources are spent on cost-effective services. Often, this is not the case. Governments allow their resources flow into developed places to serve the better-off even while keeping their policies targeted at the poor and primary healthcare. Unless there is a positive correlation between the policy priorities and budget spending, this kind of scenario is unfortunately unavoidable. The private not-for-profit sector attempts to bridge the healthcare gap to some extent in some areas in Africa, but they too face resource constraint.
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Traditional approaches have focused on improving communication by clinicians so that it can be better understood by patients with low health literacy. We are interested in specific approaches to improving health literacy especially is disadvantaged population groups.
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This answer is self-serving. Nevertheless we (Stanford) have been working with these populations around the word for years with or various chronic disease and caregiver self-management programs. Many of these are given in conjunction with primary care, patienteducation.stanford.edu They have now reached 200,000 people in the United States and have numerous publications .
Beyond the Stanford programs there are a suite of evidence based programs, (health behavior and or health status outcomes, published, and translated into practice beyond the study site) More about these on the Agency for Community Living site. These programs are usually offered by community organizations from the YMCA to the Area Agencies on Aging. (Enhanced Wellness, Enhanced Fitness, Matter of Balance, Fit and Strong, PEARLS and Healthy Ideas for depression, and med reconciliation.
If we really want to improve health literacy it needs to be a community affair and while primary care can do a lot, the most important role is probably to refer to what is already existing or to work in partnership with community agencies. People like to learn in their own communities in comfortable settings.
One last point. Just because someone has low literacy does not mean they have low intelligence.
Kate
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How can I find health care barriers among pregnant women in Saudi Arabia?
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Seems the factors could be inherent to the Saudi Healthcare system. However, you could also look at literature from studies around other Muslim dominant countries like Pakistan and Indonesia. Will give some references later.
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I'm looking some strategies for expand the coverage and quality of dental services in marginalized communities.
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get in contact with the dental department of the Ministry of Health. They just published a paper on the use of ART in marginalised population groups in Mexico as part of a oral health strategy. Free to be downloaded from PubMed.
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I am now conducting research on gender in mental health in order to discover differences of care, treatment, rehabilitation between male and female having mental disorders/mental illness.
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You may also want to review three older texts by Beere 'Gender Roles: A Handbook of Tests and Measures ' and 'Sex and Gender Issues: A Handbook of Tests and Measures' (1990) and Women and women's issues : a handbook of tests and measures (1979). More recent texts include 'Handbook of gender research in psychology, volumes 1 & 2' (Chrisler & McCreary, 2010).
If I were searching in PsycINFO, I would use the specific disorders in which I am interested, choose female as the population, add any other qualifier(s), and be sure to 'limit' those using TESTS & MEASURES from the PsycINFO LIMITS options.
Treatment AND Female[limit:population group] AND tests & measures[limit] AND 300 adulthood <age 18 yrs and older>"[limit:age group] AND yr=2007-Current
resulted in 2038 retrievals. Of course this is a dumpster search that is not very precise. However, the important thing is that EACH of these articles/book chapters will have a listing of the tests & measures used in the articles.
In "Suicide risk assessment: Gateway to treatment and management," there are four tests& measures discussed: Systematic Suicide Risk Assessment, Admission Systematic Suicide Risk Assessment, Discharge systematic suicide risk assessment, and the Reasons for Living Inventory.
Simple if you know how to craft searches and exploit databases, which I have been doing for the past twenty years.
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I am looking to explore the use of systems sciece/ecology methods to health disparities research
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I could be someone like who you are looking for... Check my profile, and let me know with a message...
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In instances of natural disaster, persons with disability are the most affected and may required specialized attention to cater to their needs. Also, wars, natural disasters and other circumstances impact individuals, families and communities requiring them to need some form of mental health services
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Dear Wolfgang and Brian
It is indeed a complicated subject with many aspects. One known problem is the fact
that it is related not only to "what to do " but to " who should do what " ? Local authorities? HMOs ? Health ministery?, volunteer organisations etc. ? As with many other questions the answers could be offered by academic research. I agree with you . I will soon post such subject as bachelor thesis .>
Arthur
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Health Care systems based on compulsory social insurance alone tend to regulate access to care through control and rationing of human and material resources. As a consequence, motivation for developping and improving therapeutic concepts and procedures is often low. Economic growth and major disposability of financial resources for individual citizens enlarge the field of choice for treatment. Insurance companies and the medical profession are tempted to offer a broad spectrum of treatment options that tends to increase demand and might undermine the quality of indication, thereby causing an increase in complications and in cost for secondary repair which results in spoiling of resources. Measuring and managing quality under these conditions becomes a major concern, especially in mixed economies with both social and private health insurances schemes.
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Dear Colleague, thank you very much for your answer which will help me and others to address the question in a well structured way. I am not a pessimist but my personal experience as a clinician is biased by the fact that I have seen some very unpleasant and unfortunate decisions in high risk and therefore complication-prone diabetes patients that have been driven by incentives such as private insurance coverage and networking based on financial criteria alone. I shall be pleased to discuss the subject in more depth in the future.
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I am just starting research focused on the decolonization of tribal healthcare as a means to improve tribal health disparities. This article will be helpful since there is a dearth of information on the topic in the primary care realm. Integrated (biopsychosocial) care is always the ideal. If anyone out there has information on any pilot programs or individuals who are doing work in this area, please let me know!
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Dear Mary,
I have gone through your post and your proposed research programme.
In case you need information on Tribal Health Research in India at this period, you may contact the RMRCT (Regional Medical Research Centre for Tribals) at Jabalpur (address: Nagpur Road, P.O. Garha, Jabalpur 482003, M.P. INDIA <www.rmrct.org>) This is one of the institutes under ICMR (Indian Council of Medical Research) Besides, you can see the website of ICMR for its publication especially for the one study by Dr. Kanjakshya Ghosh& associates of Institute of Immuno Heamatology, of Mumbai (another ICMR Institute) I worked as Librarian at NICED of ICMR for more than 15 years and I believe that in case you want to have an idea of contemporary research on Tribal Health in India, you will get ample study materials from them. In case you have any difficulty, you can contact me. I presume though I left ICMR more than a decade & a half, I still have some connection with many of them.
Good luck to your research endeavour!!
Siddhartha S. Ray
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We see that the health of the black/african american population have the worst health as a whole in comparison to the white population, in the United States of America. I am hearing more and more that the circumstances that blacks faced during slavery have had a toll in the health of the population today. Examples being that black babies less than 1 years of age have a higher death rate than white babies and this is being linked to the stress black women endured during life and it effecting the child before birth. Stress that have been inheritated from generations and generations and a lifetime of discrimination, rooted from slavery. I am simply curious if there are any more articles or research being done on this topic and the thoughts of others.
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I certainly believe there is support for Dr. Joy DeGruy Leary's theory. I didn't want to assume you had read her book entitled Post Traumatice Slave Syndrome: America's Legacy of Enduring Injury and Healing. So I would like to offer it for starters. Also, Dr. Kenneth Hardy's work on trauma and oppression and his book entitled The Psychological Residuals of Slavery provides a good foundation to begin to research your question. I'd be interested to know what you think. Thanks. Norma Mtume
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I'll be looking more at social and historical determinants of health disparities, but I am even more specifically interested in looking at "upstream" issues (to coin John Snow!) that are perhaps more rooted in history and culture, resulting in what is today an abysmal situation for Native Americans.
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I am a First Nations RN and work with the BC Centre for Disease Control. I work specifically in TB control, where the root causes are due to social determinants of health. I also teach a class at the University of BC in this very area. My underlying belief for upstream solutions lay within policy across many levels of government, including the current European system of governance on-reservations. Although the USA and Canada are quite different in many aspects, when it came to colonizing Indigenous Peoples, the tactics were very much the same. As the above lady Irene has mentioned, history is very relevant to why and where we are today in health disparities. For example, with TB, housing, poverty and access to health care services are a few of the SDH's that keep TB thriving in communities. Social exclusion and the history and policies that keep Indigenous Peoples from fully participating in society, both culturally and economically. It is a very complex issue, as you mentioned, throwing money at the problem is not the solution...Life expectancy for American Indians is very similar to Canada's First Nations. Putting more money into health care programs does not constitute increasing life expectancy, this is seen more as a bandaide solution. The term "wellness" for Indigenous Peoples has different meaning, it consists of more than "programs or health care", it includes community, culture, '"belonging and connection", good mental and spiritual health, good relationships, healthy family, healthy ways of being, inclusive of good physical health. Would love to send you some powerpoints I used for teaching if this would help...:)
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The jury is still out on HIT and Im curious as to your experience with it.
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Every new health technology will impact on inequities one way or another – either increase, decrease or help maintain. It depends on what the HT is used for – does it address the needs of the most marginalised or is it used to help treat the problems faced by the white worried well? If it does address the needs of both marginalised and non-marginalised populations – who benefits most? I suggest you look at a health impact assessment – the New Zealand Whanau Ora HIA is a good place to start.
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Has anyone compared the important factors towards quality of life in these populations and their relationship with healthcare?
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Other than that: Yes, there are important differences in barriers to care for youth, mid-life, and elderly LGBT populations. For example, LGBT youth disproportionally face barriers to healthcare related to homelessness. Also, LGBT minors may have difficulty accessing healthcare because they are less autonomous AND in the closet to their parents; thus, many cannot ask their guardian to take them to the doctor in order to get LGBT-specific healthcare or advice. In terms of comparing QOL measures between age cohorts: I am not aware of such research, but indeed, that is an interest topic (i.e. intersectional analysis between specific LGBT populations).