Explore the vast range of titles available.

The contributors to this latest volume of Research in the Sociology of Health Care investigate macro-level system issues and micro-level issues involving the socially disadvantaged and underserved. Looking specifically at the factors impacting on health and health care differentials, this book is an examination of the health and health care issues of both patients and providers of care in the United States and around the globe. Chapters focus on linkages to policy, population concerns and patients and providers of care as ways to meet health care needs. -- Provided by publisher.

The contributors to this latest volume of Research in the Sociology of Health Care investigate macro-level system issues and micro-level issues involving the socially disadvantaged and underserved. Looking specifically at the factors impacting on health and health care differentials, this book is an examination of the health and health care issues of both patients and providers of care in the United States and around the globe. Chapters focus on linkages to policy, population concerns and patients and providers of care as ways to meet health care needs.

Purpose of Review To summarize key recent evidence regarding the impact of Home-Based Palliative Care (HBPalC) and to highlight opportunities for future study. Recent Findings HBPalC is cost effective and benefits patients and caregivers across the health care continuum. Summary High-quality data support the cost effectiveness of HBPalC. A growing literature base supports the benefits of HBPalC for patients, families, and informal caregivers by alleviating symptoms, reducing unwanted hospitalizations, and offering support at the end of life. Numerous innovative HBPalC models exist, but there is a lack of high-quality evidence comparing specific models across subpopulations. Our wide literature search captured no research regarding HBPalC for underserved populations. Further research will also be necessary to guide quality standards for HBPalC.

For individuals living with a chronic illness who require use of long-term medications, adherence is a vital aspect of successful symptom management and outcomes. This study investigated the effect of a smartphone app on adherence, self-efficacy, knowledge, and medication social support in a medically underserved adult population with various chronic illnesses. Participants were randomized to a group who used the app for one month or a control group provided with a printed medication list. Compared to the control group, participants receiving the intervention had significantly greater medication adherence (Cohen’s d = -0.52, p = .014) and medication self-efficacy (Cohen’s d = 0.43, p = .035). No significant effects were observed related to knowledge or social support. The findings suggest use of the app could positively impact chronic disease management in a medically underserved population in the United States.

We developed a testing program for severe acute respiratory syndrome coronavirus 2 in an urban Latinx neighborhood in Providence, Rhode Island, USA. Approximately 11% of Latinx participants (n = 180) tested positive. Culturally tailored, community-based programs that reduce barriers to testing help identify persons at highest risk for coronavirus disease.

Access to oral health care is essential to promoting and maintaining overall health and well-being, yet only half of the population visits a dentist each year. Poor and minority children are less likely to have access to oral health care than are their nonpoor and nonminority peers. Older adults, people who live in rural areas, and disabled individuals, uniformly confront access barriers, regardless of their financial resources. The consequences of these disparities in access to oral health care can lead to a number of conditions including malnutrition, childhood speech problems, infections, diabetes, heart disease, and premature births. Improving Access to Oral Health Care for Vulnerable and Underserved Populations examines the scope and consequences of inadequate access to oral health services in the United States and recommends ways to combat the economic, structural, geographic, and cultural factors that prevent access to regular, quality care. The report suggests changing funding and reimbursement for dental care; expanding the oral health work force by training doctors, nurses, and other nondental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices. It also recommends changes to incorporate oral health care into overall health care. These recommendations support the creation of a diverse workforce that is competent, compensated, and authorized to serve vulnerable and underserved populations across the life cycle. The recommendations provided in Improving Access to Oral Health Care for Vulnerable and Underserved Populations will help direct the efforts of federal, state, and local government agencies; policy makers; health professionals in all fields; private and public health organizations; licensing and accreditation bodies; educational institutions; health care researchers; and philanthropic and advocacy organizations.

Background Globally, 2.2 billion individuals live with visual impairment (VI). However, many cases remain undetected, particularly among older adults. Therefore, novel interventions for detection are needed. Community-based interventions (CBIs) that target people where they live provide a promising approach. This systematic review aimed to synthesize the existing literature describing potentials and barriers regarding uptake, feasibility, and effects of CBIs in detecting VI among community-dwelling older adults aged ≥ 75 years. Methods We conducted a mixed methods systematic literature review. PubMed, Scopus, CINAHL, PsycInfo, Cochrane, and Embase were searched for articles with no restrictions on publication date. Studies were eligible if they reported on a CBI to detect VI among older adults aged ≥ 75 years. Two reviewers independently extracted data and appraised the quality and risk of bias of the included studies using the Mixed Methods Appraisal Tool. A narrative meta-synthesis of the relevant evidence was conducted. Results We identified 3,019 articles of which 26 of varying methodological quality were included. The VI detection methods included surveys, optometric tests, eye examinations, and self-reported visual status. Potentials and barriers regarding the uptake, feasibility, and effects of the interventions were identified at the individual, interpersonal, and community and system levels. Key potentials that may lead to successful interventions included leveraging community resources, tailoring of interventions, targeting underserved populations, high participant satisfaction, increased accessibility, and the use of tele-ophthalmology technology. Conversely, barriers that may negatively affect intervention uptake, feasibility, and effectiveness included financial constraints, poor general health, lack of eye-health awareness, poor referral systems, lack of institutional resources or access to detection technology, and technological challenges. Conclusion The synthesized results emphasize the importance of developing CBIs that target multiple levels, including the individual, interpersonal, community and system levels. Our results indicate that this may involve combining components such as eye health education, targeted strategies, use of appropriate detection methodologies, and ensuring affordability. These results may inform the development of novel CBIs to foster more effective detection of VI among older populations, improve community eye health, and reduce the burden of VI. Trial registration CRD42023468155.

This study explores the outcomes and impacts of sanitary sewer overflows (SSOs) and basement backups in underserved communities in Baltimore, Maryland. The larger effort is an environmental and community-driven mixed-methods project, however, the research in this manuscript focuses on the household survey portion with residents who have experienced SSOs or sewage backups. Based on the snowball sampling method applied, the resulting residents engaged are predominantly African-American individuals, females, homeowners, and residents between the ages of 50 and 69. Strikingly, 70% of respondents reported that their frequency of SSOs is between moderate to frequent. The findings reveal that SSOs are a pervasive issue affecting residents’ physical and mental health and overall quality of life. Despite residents’ perceptions that their household infrastructure is in good condition, the recurring nature of SSOs highlights systemic problems within the city’s aging sewer systems, urging a deeper understanding of the social and structural vulnerabilities involved. This research calls attention to the importance of comprehensive interventions, including effective risk communication strategies and substantial investment in infrastructure rehabilitation, to mitigate the risks posed by SSOs and promote long-term resilience in urban environments. Additionally, it emphasizes the importance of community-driven research in addressing engineering, urban planning, and public health challenges with particular support for the most affected populations.

Financial strain was an issue for many Canadians long before the arrival of the global novel coronavirus pandemic in early 2020. However, it has worsened in recent months in relation to the pandemic and public health measures put in place to prevent the spread of COVID-19. Members of underserved groups and people who experience poverty are particularly vulnerable to financial strain and its negative health impacts. As public health professionals, we should be concerned. In this commentary, we discuss the concept of financial strain and its health consequences and highlight how existing research in the area is falling short and why. We suggest next steps to guide research and practice related to financial strain such that it reflects the core values of public health, including equity, life course approaches, and the social determinants of health. This commentary is a call to action for public health researchers and practitioners in Canada to take a more prominent role in shaping the agenda on financial strain to support financial well-being for all.

Background Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene’s Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care. Methods During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services. Results The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants’ own care. Conclusions This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.