The Effect of Race on the Knowledge and Use of Health Services Among Rural Elderly

The Effect of Race on the Knowledge and Use of Health Services Among Rural Elderly
Author: Chantelle Bodison
Publisher:
Total Pages: 230
Release: 1999
Genre: Older African Americans
ISBN:

This study was unique in that it focused on the rural elderly of both Black and White ethnicity's, explored differences between groups by comparing use and knowledge of health services, and controlled for gender, income, educational attainment, health status, age, and health beliefs - the independent variables of the study. Knowledge and use of health services were dependent factors. The Anderson behavioral model (Anderson, 1995) has been extensively used to examine health service utilization. It conceptualizes health care use as the outcome of a complex pattern of interactions between predisposing, enabling, and need-for care characteristics. The literature has supported the utility of the behavioral model for assessing the health care practices of rural older adults. Four questions were posed. These were translated into hypotheses for statistical testing purposes. Black and White elderly residents of one rural county in South Carolina comprised the target population. A sample of 150 elderly residents, 75 Black and 75 White, were randomly selected for participation. The multidimensional health locus of control scales were modified and used in the test instrument to assess health beliefs (both internal and external). Descriptive and background data were gathered from administration of the survey. Data were analyzed using SPSS statistical software. Analysis of variance (ANOVA) and the LSD (least significant differences) test, in addition to regression analysis, were used to compute and identify differences between and among groups of data. This research concluded that there was no correlation between use of services and knowledge of facilities. There were differences in utilization by race, with Whites making greater use of health care facilities. Educational levels, health status, income, household composition, type of insurance, and age influenced health care use. It was not influenced by gender, distance from facilities, and health beliefs. There was a statistically significant difference between knowledge and race, with Blacks having higher knowledge scores. Gender, health status, income, distance from facilities, and health beliefs did not influence knowledge. However, educational attainment, type of insurance, household composition, and age did. Service use and knowledge were adequate, in contrast to findings in the literature. Recommendations for further study were formulated.

Communities in Action

Communities in Action
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 583
Release: 2017-04-27
Genre: Medical
ISBN: 0309452961

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Modern Epidemiology

Modern Epidemiology
Author: Kenneth J. Rothman
Publisher: Lippincott Williams & Wilkins
Total Pages: 776
Release: 2008
Genre: Medical
ISBN: 9780781755641

The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research. The book covers a broad range of concepts and methods, such as basic measures of disease frequency and associations, study design, field methods, threats to validity, and assessing precision. It also covers advanced topics in data analysis such as Bayesian analysis, bias analysis, and hierarchical regression. Chapters examine specific areas of research such as disease surveillance, ecologic studies, social epidemiology, infectious disease epidemiology, genetic and molecular epidemiology, nutritional epidemiology, environmental epidemiology, reproductive epidemiology, and clinical epidemiology.

Retooling for an Aging America

Retooling for an Aging America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 316
Release: 2008-08-27
Genre: Medical
ISBN: 0309131952

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Understanding Racial and Ethnic Differences in Health in Late Life

Understanding Racial and Ethnic Differences in Health in Late Life
Author: National Research Council
Publisher: National Academies Press
Total Pages: 184
Release: 2004-09-08
Genre: Social Science
ISBN: 0309165865

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Unequal Treatment

Unequal Treatment
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 781
Release: 2009-02-06
Genre: Medical
ISBN: 030908265X

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

The Future of the Public's Health in the 21st Century

The Future of the Public's Health in the 21st Century
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 536
Release: 2003-02-01
Genre: Medical
ISBN: 0309133181

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Families Caring for an Aging America

Families Caring for an Aging America
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 367
Release: 2016-11-08
Genre: Medical
ISBN: 0309448093

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.