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.

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.

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.

Coverage Matters

Coverage Matters
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 204
Release: 2001-10-27
Genre: Medical
ISBN: 0309076099

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Unequal Coverage

Unequal Coverage
Author: Jessica M. Mulligan
Publisher: NYU Press
Total Pages: 316
Release: 2018
Genre: Medical
ISBN: 1479848735

"The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA. It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions"--Publisher's website.

Health Insurance is a Family Matter

Health Insurance is a Family Matter
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 296
Release: 2002-09-18
Genre: Medical
ISBN: 0309169054

Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.

Measuring the Quality of Health Care

Measuring the Quality of Health Care
Author: The National Roundtable on Health Care Quality
Publisher: National Academies Press
Total Pages: 42
Release: 1999-02-23
Genre: Medical
ISBN: 0309570689

The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.

Health Care Politics, Policy, and Services

Health Care Politics, Policy, and Services
Author: Gunnar Almgren, MSW, PhD
Publisher: Springer Publishing Company
Total Pages: 364
Release: 2006-11-07
Genre: Political Science
ISBN: 0826104797

Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! Who Has a Right to Health Care? What Is the Government's Role in Providing Accessible Health Care? How Are Corporations, Insurance Companies, and Health Care Providers Affecting the Quality of Health Care? And, Most Importantly, Can We Reform the U.S. Health Care System? We often debate these issues in health care policy or public health courses, yet we do so without the proper knowledge of the underlying structure of the U.S. health care system--or a framework by which it can be judged. Many health care workers entering the system are ill-equipped to address the issues faced in direct health care practice, in part because they have no ability to evaluate it. In this innovative text, Gunnar Almgren provides all the tools necessary to understand and critique a health care policy in dire need of change. First, he describes the historical evolution of U.S. health care, explaining how the early roles of hospitals, doctors, and nurses still influence today's system. He explains the complex financial aspects of health care, including the concerns of all its major stakeholders. He looks at the government's role in regulating and funding health care, and how that role has expanded and contracted through various political administrations. An entire chapter describes the facilities and services available for the elderly--an issue that will continue to rise in importance as America ages. Finally, he examines the many causes of disparities in the U.S. health care system. In addition, Almgren offers a unique social justice analysis as a framework by which the current system--and proposed reforms--can be judged. By analyzing the health care system through various models of social justice, we can begin to understand and address the urgent issues of economic, racial, and geographic disparities that plague our current system. With its clear, thorough, and comprehensive coverage of U.S. health care, this unique text is accessible to all those in public health, nursing, social work, public policy, or public administration. No other book addresses the underlying issues of the U.S. health care system alongside a variety of social justice models that we can use to evaluate, and perhaps eventually, change it.