Social Determinants of Health in a Kansas Community Health Center.

Kansas journal of medicine Pub Date : 2024-06-04 eCollection Date: 2024-01-01 DOI:10.17161/kjm.vol17.21220
Randall B Schmidt, Faith M Butler
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Abstract

Introduction: This study explored the connection between social determinants and patient self-rated health at Health Ministries Clinic (HMC) in a rural Kansas community. Community health centers, like HMC, strive to deliver comprehensive care that addresses patients' social needs.

Methods: The authors employed a convenience sampling method to survey HMC patients with appointments from September to December 2018. The authors analyzed the data using Chi-square tests and descriptive statistics in RStudio, considering p <0.05 as significant.

Results: Among 200 patient responses, education, income, employment, and insurance status were negatively correlated with self-rated health. Notably, 86.2% of college or graduate school graduates reported positive health ratings, compared to 40% of those who did not finish high school (χ2(12, N = 185) = 25.75, p = 0.012). Lower income individuals (income <$34,000 per year) consistently rated their health poorer than their higher income counterparts (χ2(12, N = 174) = 23.96, p = 0.021). Patients without insurance or with public insurance (Medicaid/ CHIP) perceived their health as worse than those on private health insurance and Medicare (χ2(12, N = 137) = 35.67, p <0.001).

Conclusions: Our findings suggest that low educational attainment, income, and lack of health insurance are associated with barriers to healthcare, resulting in poor health outcomes and chronic disease among those with lower socioeconomic status. This underscores the strong association between social determinants and self-rated health among HMC patients. These results can be used by other clinics to assess the needs of their patient population and enhance community health initiatives.

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堪萨斯州社区医疗中心的健康社会决定因素。
导言:本研究探讨了堪萨斯州一个农村社区的健康牧师诊所(Health Ministries Clinic,HMC)的社会决定因素与患者自评健康之间的联系。像 HMC 这样的社区医疗中心致力于提供全面的医疗服务,以满足患者的社会需求:作者采用便利抽样方法,对 2018 年 9 月至 12 月期间预约的 HMC 患者进行了调查。作者使用 RStudio 中的卡方检验和描述性统计对数据进行了分析,考虑了 p 结果:在 200 份患者回复中,教育程度、收入、就业和保险状况与自评健康状况呈负相关。值得注意的是,86.2% 的大学或研究生院毕业生报告了积极的健康评分,而未完成高中学业者的这一比例为 40%(χ2(12, N = 185) = 25.75, p = 0.012)。收入较低者(收入 2(12,N = 174)= 23.96,P = 0.021)。没有保险或享受公共保险(医疗补助/CHIP)的患者比享受私人医疗保险和医疗保险的患者认为自己的健康状况更差(χ2(12, N = 137) = 35.67, p 结论:没有保险或享受公共保险(医疗补助/CHIP)的患者比享受私人医疗保险和医疗保险的患者认为自己的健康状况更差:我们的研究结果表明,教育程度低、收入低和没有医疗保险与医疗保健障碍有关,导致社会经济地位较低的人健康状况较差并患慢性病。这凸显了社会决定因素与哈医大一院患者自评健康之间的密切联系。其他诊所可利用这些结果来评估其病人群体的需求,并加强社区健康计划。
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