Journal of Health Care for the Poor and Underserved最新文献

Safety-net health care systems disproportionately serve the most marginalized and historically excluded groups in the U.S. Research from these systems not only focuses on those most affected by health inequities but is often strengthened by environments that are rich in direct experience, genuine community engagement, and awareness of social injustices. Despite this, research from safety-net systems is limited. Safety-net institutions face substantial structural barriers, primarily financial, that undermine their capacity to develop necessary infrastructure and compete for grants. We present a case study of a research center based in a safety-net system in Chicago to explore these challenges and potential solutions. Recommendations include the implementation of equity-focused funding approaches, research collaborations that take advantage of the expertise and community connections of safety-net providers, and strengthening the complex funding structure for safety-net hospitals. Health equity research must be driven by those most affected, and safety-net systems are well-positioned to help accomplish this.

A growing body of literature links incarceration to negative health outcomes for individuals, families, and communities, yet health care learners often have little structured training in this area. In the last several years, many health care training programs have incorporated or expanded equity-focused curricula for their learners but have not consistently provided training on the impact of incarceration. Given the disproportionate rates at which Black, Indigenous, and Latinx individuals are brought into the correctional system, the authors argue that a curriculum on incarceration is an integral part of health care training. In this commentary, the authors summarize the history of structural racism within the correctional system; discuss the impact of incarceration on individual, family, and community health; and suggest methods to expand didactic curricula and direct clinical experiences within carceral and post-release settings.

Community-level projects are a cornerstone in efforts to provide medical care to unhoused populations. The Community Medicine Cabinet (CMC) is a novel program created to supply residents of a local warming shelter with access to free over-the-counter medications. This report details the initial 18 months of operation including patient-reported evaluations.

The See, Test, & Treat® program has provided free cervical and breast cancer screening to more than 8,500 medically underserved women across the U.S. since 2011. This report explores its successful uptake strategies, its outcomes, and the challenges it faces to enhance uptake.

The goal of this research is to investigate the relationship between social interactions and self-reported mental and physical health of resettled refugees. Social relationships and interactions consist of different layers extending from individual personal relations to social networking activities to collective engagement. Using data from a public opinion survey of recently resettled Bhutanese and Rohingya refugees in Michigan (N=352), we find that along with their socioeconomic situations, such as employment, social integration is an important determinant of mental and physical health. Resettled refugees tend to report better health if they are more socially engaged. This study contributes to the literature on refugee resettlement and integration through a quantitative analysis of a variety of measures of social interactions and their relationship to resettled refugee health. The findings have potentially important country- and world-wide policy implications for developing cost-effective health initiatives for resettled refugees.

Innovative policy solutions are needed to create environments in which Black youth thrive. This paper describes evaluation of a youth-adult partnership advisory council (AC) convened to guide identification and implementation of innovative policy. Results of this evaluation demonstrate the promise and challenges of youth-adult partnerships in mental health policy development.

COVID-19 does not affect all populations equally. From November 2021 to June 2024, the Vaccine Ambassador Program (VAP) employed peer workers across 15 cities to engage three focus populations. The VAP model has changed the way these organizations' structure care teams, leveraging peer relationships to provide more than 50,000 immunizations.

Background: The COVID-19 pandemic affected adolescents' sexual and reproductive health (SRH) behaviors and access to services.

Methods: We analyzed data from the 2021 Adolescent Behaviors and Experiences Survey (n=7,705) on sexual activity, condom and contraceptive use, and sexually transmitted infection (STI) testing. We tested differences in SRH outcomes by demographics, racism experience, and English proficiency.

Results: Current sexual activity was higher among students reporting ever experiencing racism at school and self-rating how well they can speak English as "not well." Condom use differed by sex, sexual identity, and sex of sexual contacts. Demographic differences in contraceptive use were also identified. Sexually active females (vs. males) and males with same-sex or both-sex contacts (vs. opposite-sex) had higher STI testing.

Conclusion: Differences by students' demographic characteristics and experiences during the pandemic highlight needs to enhance accessibility and quality of adolescent SRH services and education in schools, clinics, and communities.

Many Americans lack dental coverage and cannot afford dental care. Medicaid generally only requires comprehensive dental coverage for children. Little is known about public attitudes about Medicaid oral health benefits. We fielded a national survey (N=5,784) to assess whether Americans believe that pediatric and adult Medicaid beneficiaries should have access to comprehensive oral health services. The survey contained an experiment with various informational treatments. We found no differences across the treatments. Analysis of the pooled data in unadjusted and adjusted models indicated that Americans were broadly supportive of comprehensive dental access for both children and adults, and, to a lesser degree, orthodontic services, favoring children over adults. We identified consistent differences based on partisanship, ideology, racial resentment, and to a lesser degree, gender, insurance type, race and ethnicity, and age. Our findings are a first step towards better understanding public attitudes about oral health access for Medicaid beneficiaries.