S. Veldheer, K. Houser, Brianna Hoglen, A. Hobkirk, Michael Hayes, William A Curry, S. Allen
{"title":"“If they’re going to ask the questions, they need to address concerns”: Clinical screening for social determinants of health","authors":"S. Veldheer, K. Houser, Brianna Hoglen, A. Hobkirk, Michael Hayes, William A Curry, S. Allen","doi":"10.1370/afm.20.s1.2784","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2784","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131180417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Higher exposure to social risks, such as food and housing insecurity are linked to worse outcomes for people with type 2 diabetes (T2DM). Social risks can be assessed at the individual-level (self-report of personal experience) and in aggregate at the community level (e.g. census data). What is less understood is how self-reported vs. community level information compare to one another, and which is most relevant for understanding individuals’ T2DM management. Objective: To exam ine the degree of overlap between self-reported social risk (SRSR) and community social contextual factors (CSCF), and document to what extent each is associated with T2DM management. Study Design: Cross-sectional survey geocoded and linked to publicly available data on CSCF. Setting: 12 community health centers in the San Francisco Bay Area. Population: 668 adults with T2DM. Measures: SRSR was assessed through four binary (yes/no) items related to housing instability, food insecurity, access to transportation, and difficulties paying bills. CSCF was assessed by the California Healthy Places Index (HPI), a measure that combines 25 community characteristics from five domains (neighborhood and built environment, health/health care, social/community context, education, economic stability) into a single indexed percentile score (0-100%). T2DM management outcomes included HbA1c from medical records, self-reported missed medication days and depression symptoms (PHQ8). Results: 38.2% (n=252) of our sample endorsed ≥ 1 SRSR. HPI quartiles yielded the following distribution: Q1=31.7% (n=211); Q2=30.3% (n=202); Q3=24.0% (n=160); Q4=14.0% (n=93). 10.4% of individuals in Q4 endorsed ≥1 SRSR (vs. 34.7% in Q1).
{"title":"What do self-reported social risk and community-level social contextual factors tell us about diabetes self-management?","authors":"Sarah Alowdi, D. Jones, J. Parra","doi":"10.1370/afm.20.s1.2854","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2854","url":null,"abstract":"Context: Higher exposure to social risks, such as food and housing insecurity are linked to worse outcomes for people with type 2 diabetes (T2DM). Social risks can be assessed at the individual-level (self-report of personal experience) and in aggregate at the community level (e.g. census data). What is less understood is how self-reported vs. community level information compare to one another, and which is most relevant for understanding individuals’ T2DM management. Objective: To exam ine the degree of overlap between self-reported social risk (SRSR) and community social contextual factors (CSCF), and document to what extent each is associated with T2DM management. Study Design: Cross-sectional survey geocoded and linked to publicly available data on CSCF. Setting: 12 community health centers in the San Francisco Bay Area. Population: 668 adults with T2DM. Measures: SRSR was assessed through four binary (yes/no) items related to housing instability, food insecurity, access to transportation, and difficulties paying bills. CSCF was assessed by the California Healthy Places Index (HPI), a measure that combines 25 community characteristics from five domains (neighborhood and built environment, health/health care, social/community context, education, economic stability) into a single indexed percentile score (0-100%). T2DM management outcomes included HbA1c from medical records, self-reported missed medication days and depression symptoms (PHQ8). Results: 38.2% (n=252) of our sample endorsed ≥ 1 SRSR. HPI quartiles yielded the following distribution: Q1=31.7% (n=211); Q2=30.3% (n=202); Q3=24.0% (n=160); Q4=14.0% (n=93). 10.4% of individuals in Q4 endorsed ≥1 SRSR (vs. 34.7% in Q1).","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121556095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Using a QR code to register voters in a family medicine residency clinic","authors":"Yumiko Nakamura, Bich-May Nguyen, Vishnu Muppala","doi":"10.1370/afm.20.s1.3213","DOIUrl":"https://doi.org/10.1370/afm.20.s1.3213","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121035214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A quasi-experimental evaluation of a clinic-based referral program to address food insecurity","authors":"Daniel Walker, Gennaro Di Tosto","doi":"10.1370/afm.20.s1.2869","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2869","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125547841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Webster, Laura Connoy, K. Rice, J. Katz, Abhimanyu Sud, C. Dale
Medicine often ignores the social aspects of health experience. Applying the lens of social determinants of health has not fully mitigated the tendency of Western medicine to focus on biological causes and pharmaceutical solutions. Objective: We present the stories of 26 people living with chronic pain who have been rendered socially, economically, and politically marginal by existing systems and structures of inequity in ways that exacerbate suffering. We argue that their diverse and multi-faceted experiences are better understood by the term “chronic struggle” rather than “chronic pain”, thus de -centering the medical aspects of people's experiences. Study Design: Institutional ethnography (IE) is a sociological approach increasingly used in health studies. IE begins in the standpoint of people with lived experience and considers them as experts of that experience. IE analysis follows sequences of action, with one informant’s interview leading the way to the next or to a text for analysis. Through this process, we linked participants’ micro level experiences to macro level systems and structures. Setting or Dataset: Participants were recruited for in-depth telephone interviews in online spaces (e.g. Twitter and Kijiji) and through existing networks of our multi-disciplinary research team across several provinces in Canada. Population Studied: Our study focuses on people who are over the age of 18, speak fluent English and who self-identify as living with chronic pain and marginalization. Results: Our findings call attention to the complexities and ‘everyday emergencies’ (Millar, 2014; Mitchell, 2020) that come to shape and d efine one’s experiences with chronic pain. Our themes capture the cascading and inter - related experiences of illness, mental illness, addiction and poverty as they are described and understood by people with lived experience. Combined, we are made aware of how chronic pain is not the key defining difficulty of one’s life— a biographical disruption — but rather one additional difficulty in a life that is always already defined by health and social complexities. Conclusions: As
{"title":"Chronic struggle: A new framework for understanding chronic pain and marginalization","authors":"F. Webster, Laura Connoy, K. Rice, J. Katz, Abhimanyu Sud, C. Dale","doi":"10.1370/afm.20.s1.2965","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2965","url":null,"abstract":"Medicine often ignores the social aspects of health experience. Applying the lens of social determinants of health has not fully mitigated the tendency of Western medicine to focus on biological causes and pharmaceutical solutions. Objective: We present the stories of 26 people living with chronic pain who have been rendered socially, economically, and politically marginal by existing systems and structures of inequity in ways that exacerbate suffering. We argue that their diverse and multi-faceted experiences are better understood by the term “chronic struggle” rather than “chronic pain”, thus de -centering the medical aspects of people's experiences. Study Design: Institutional ethnography (IE) is a sociological approach increasingly used in health studies. IE begins in the standpoint of people with lived experience and considers them as experts of that experience. IE analysis follows sequences of action, with one informant’s interview leading the way to the next or to a text for analysis. Through this process, we linked participants’ micro level experiences to macro level systems and structures. Setting or Dataset: Participants were recruited for in-depth telephone interviews in online spaces (e.g. Twitter and Kijiji) and through existing networks of our multi-disciplinary research team across several provinces in Canada. Population Studied: Our study focuses on people who are over the age of 18, speak fluent English and who self-identify as living with chronic pain and marginalization. Results: Our findings call attention to the complexities and ‘everyday emergencies’ (Millar, 2014; Mitchell, 2020) that come to shape and d efine one’s experiences with chronic pain. Our themes capture the cascading and inter - related experiences of illness, mental illness, addiction and poverty as they are described and understood by people with lived experience. Combined, we are made aware of how chronic pain is not the key defining difficulty of one’s life— a biographical disruption — but rather one additional difficulty in a life that is always already defined by health and social complexities. Conclusions: As","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130747773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. D. De Marchis, O. Nguyễn, Laura Gottlieb, N. Razon, E. Brown
{"title":"Hospital team perspectives on social care activities at an urban safety-net hospital during the COVID-19 pandemic","authors":"E. D. De Marchis, O. Nguyễn, Laura Gottlieb, N. Razon, E. Brown","doi":"10.1370/afm.20.s1.2873","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2873","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122084583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Walker, Matthew J. Depuccio, Aaron D Clark, Jennifer Garner, Nicolette Coovert, Jennifer L. Hefner
{"title":"Examining a clinic-based referral program to address food insecurity: A multi-stakeholder qualitative study of implementation","authors":"D. Walker, Matthew J. Depuccio, Aaron D Clark, Jennifer Garner, Nicolette Coovert, Jennifer L. Hefner","doi":"10.1370/afm.20.s1.2868","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2868","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128976846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Establishing prescription drug affordability as a new vital sign in primary care: Findings from a community health center","authors":"Rita K. Kuwahara","doi":"10.1370/afm.20.s1.3256","DOIUrl":"https://doi.org/10.1370/afm.20.s1.3256","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133636650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Wright, P. Cronholm, S. Wheat, Carla M. Villarreal, Deborah S Clements, P. Ravenna
{"title":"Social determinants of health: More is more. Results from a CERA survey of program directors","authors":"Katherine Wright, P. Cronholm, S. Wheat, Carla M. Villarreal, Deborah S Clements, P. Ravenna","doi":"10.1370/afm.20.s1.2612","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2612","url":null,"abstract":"","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124294777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Webster, Laura Connoy, K. Rice, J. Katz, Abhimanyu Sud, C. Dale
Context: The current pandemic has drawn attention to the importance, failings and weaknesses of the public health system in promoting and maintaining health for all and especially vulnerable groups and those living with serious chronic conditions; this includes those living with chronic pain. COVID-19 response measures are creating barriers to accessing services for those living with pain, such as pain management services and supervised injection sites, which is contributing to a spike in overdoses. Objective: Our project examines how people living with chronic pain and marginalization persevere during COVID-19. Our overa rching research question is “how do participants with chronic pain, who also live with poverty, addictions and mental illness, manage their lives in the time of this pandemic?”. Study Design: Our research is conducted using applied qualitative methods, drawing on an approach known as institutional ethnography, which uses people’s everyday experiences as the starting point for an exploration of the often invisible social relations that orient those experiences. Setting or Dataset: Given the pandemic restrictions, participants were recruited in online spaces (e.g. Twitter and Kijiji) and through the existing networks of our multi-disciplinary study team and interviewed by telephone. Interviews were approximately 60-90 minutes in length depending on how much information the participants wanted to share. Population Studied: Our study focused on people living in Canada over the age of 18, who speak fluent English and who self-identify as living with chronic pain, and marginalization. Results: Our findings highlight the complex ways in which people have been impacted by policies, both negatively and positively. For some people, the pandemic was an equalizer, insofar as they already lived lives marked by isolation and believed that others now knew "how that felt". Others described their mistrust of or inability to adhere to public health recommendations as causing additional stress. Conclusions: By identifying the strategies people use to persevere we are able to provide information for targeted interventions to address structural vulnerabilities
{"title":"Chronic pain and marginalization in a time of pandemic","authors":"F. Webster, Laura Connoy, K. Rice, J. Katz, Abhimanyu Sud, C. Dale","doi":"10.1370/afm.20.s1.2971","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2971","url":null,"abstract":"Context: The current pandemic has drawn attention to the importance, failings and weaknesses of the public health system in promoting and maintaining health for all and especially vulnerable groups and those living with serious chronic conditions; this includes those living with chronic pain. COVID-19 response measures are creating barriers to accessing services for those living with pain, such as pain management services and supervised injection sites, which is contributing to a spike in overdoses. Objective: Our project examines how people living with chronic pain and marginalization persevere during COVID-19. Our overa rching research question is “how do participants with chronic pain, who also live with poverty, addictions and mental illness, manage their lives in the time of this pandemic?”. Study Design: Our research is conducted using applied qualitative methods, drawing on an approach known as institutional ethnography, which uses people’s everyday experiences as the starting point for an exploration of the often invisible social relations that orient those experiences. Setting or Dataset: Given the pandemic restrictions, participants were recruited in online spaces (e.g. Twitter and Kijiji) and through the existing networks of our multi-disciplinary study team and interviewed by telephone. Interviews were approximately 60-90 minutes in length depending on how much information the participants wanted to share. Population Studied: Our study focused on people living in Canada over the age of 18, who speak fluent English and who self-identify as living with chronic pain, and marginalization. Results: Our findings highlight the complex ways in which people have been impacted by policies, both negatively and positively. For some people, the pandemic was an equalizer, insofar as they already lived lives marked by isolation and believed that others now knew \"how that felt\". Others described their mistrust of or inability to adhere to public health recommendations as causing additional stress. Conclusions: By identifying the strategies people use to persevere we are able to provide information for targeted interventions to address structural vulnerabilities","PeriodicalId":163371,"journal":{"name":"Social determinants and vulnerable populations","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124362517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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