bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Data Issues for Hispanics: Implications for Public Health Research
Authors: Zambrana Ruth E. , Carter-Pokras Olivia
Published: July 2012

The limited availability of Hispanic health data has hampered the development of targeted public health policies. Hispanics represent 11.5 percent of the population and are projected to become the largest minority group in the United States by the year 2010. This paper explores current issues in Hispanic health data collection, examines methodological concerns, and presents recommendations for future Hispanic public health data collection. Data are derived from statistical reports of the U.S. Bureau of the Census, National Center for Health Statistics, Bureau of Labor Statistics, and other empirical studies. Recommendations include: collecting both race and ethnic-specific data by Hispanic subgroup, designing appropriate data collection instruments and approaches, and selecting referent groups for comparison purposes. The authors conclude that the renewed national focus on health disparities among underserved populations requires an increased commitment to adequately identify Hispanic subgroups.
A Comprehensive Approach to Violence Prevention
Authors: White Michaele P.
Published: July 2012

Violence by and against youth has reached horrifying proportions. Debate continues about the causes of youth violence and appropriate solutions. This paper discusses a comprehensive holistic approach to violence prevention, as exemplified by the program at The Door-A Center of Alternatives in New York City, an organization that services at-risk youth aged 12 to 21. With a multinodal approach, The Door deals with the identified root causes of violence, such as the alienation and lack of empowerment experienced by many of today's youth, and provides life-skills training and concrete services related to the consequences of poverty, unemployment, low levels of achievement, and hopelessness.
Preventing Syphilis: Lessons From a Survey of Two Inner-City Communities in Houston, Texas
Authors: Leonard Lori , Chatterjee Nilesh , Ross Michael
Published: July 2012

To develop a relevant, community-based prevention campaign, the authors examined, using street-intercept interviews, syphilis-related knowledge, circulation of information, and screening and treatment practices among four hundred residents of two inner-city communities in Houston, Texas, where syphilis case rates exceed city, county, and national averages. Although awareness of syphilis was near universal, one-fourth of the respondents thought syphilis was incurable, and a large proportion confused syphilis with other sexually transmitted diseases (STDs), mentioning discharge and burning or itching in the genital area as symptoms. Almost four out of five respondents were aware of free treatment and screening facilities in the local area, yet, less than two of five expressed the intention to get tested within the next month. Only 22 percent had seen or heard anything about syphilis in the past twelve months. The resultant prevention campaign is discussed along with implications for the development of comprehensive STD prevention and control campaigns in similar poor and underserved communities.
Lessons Learned From the Healthy Heart Community Prevention Project in Reaching the African American Population
Authors: Ferdinand Keith C.
Published: July 2012

The Healthy Heart Community Prevention Project (HHCPP) is an ongoing program of cardiovascular risk identification and modification in the African American community in New Orleans, Louisiana. The program targets low socioeconomic status African American populations, which continue to have higher rates of coronary heart disease, stroke, and overall cardiovascular mortality than the general population. Among the HHCPP's initiatives have been the use of barbershops and beauty salons as blood pressure screening sites. Church-based programs, in which ministers provide "healthy heart sermons," as well as screenings at sports events, where volunteers provide health advice, have proven to be successful aspects of the program. The HHCPP has also offered educational sessions to a broad cross-section of health professionals, including physicians as well as nurse practitioners and nutritionists. Future initiatives include the establishment of cholesterol screening programs.
Barriers to Health Care for Abused Latina and Asian Immigrant Women
Authors: Bauer Heidi M. , Rodriguez Michael A. , Quiroga Seline Szkupinski , Flores-Ortiz Yvette G.
Published: July 2012

This study identifies social, political, and cultural barriers to help seeking from health care organizations faced by abused Latina and Asian immigrant women. Qualitative data were collected through four semistructured ethnic-specific focus group interviews with 28 abused Latina and Asian immigrant women. Participants who had suffered intimate partner abuse were recruited through urban community-based organizations in San Francisco, California. Sociopolitical barriers to help seeking and patient-provider communication included social isolation, language barriers, and, for some, discrimination and fears of deportation. Sociocultural barriers included dedication to the children and family unity, shame related to the abuse, and the cultural stigma of divorce. Abused Latina and Asian immigrant women face significant social, cultural, and political barriers to patient-provider communication and help seeking. Medical and social service providers and policy makers may improve the quality of care for these women by understanding and addressing these barriers.
Witnessing Violence: Making the Invisible Visible
Authors: Holton John K.
Published: July 2012

In his novel of Black life circa the 1950s, Invisible Man , Ralph Ellison laid bare the wasteful, destructive societal consequences of racism. At the close of the 20th century, we are faced with the phenomenon of another social problem, likewise unresolved and likely to haunt us similarly: urban violence. Following Ellison's example, this paper seeks to explore the impact of violence's stark invisibility by discussing a research strategy that better explains the terrifying phenomenon of violence. In order to comprehend the totality of violence, macro- and micro-level variables have to be introduced into the research design and measured over time. Therefore, research might best address violence if it was designed to include variables of poverty and racism, and was more inclusive of research from a broader range of scientific disciplines.
Health Care Utilization Among Homeless Adults Prior to Death
Authors: Hwang Stephen W. , O'Connell James J. , Lebow Joan M. , Bierer Michael F. , Orav E. John , Brennan Troyen A.
Published: July 2012

This study characterizes health care utilization prior to death in a group of 558 homeless adults in Boston. In the year before death, 27 percent of decedents had no outpatient visits, emergency department visits, or hospitalizations except those during which death occurred. However, 21 percent of homeless decedents had a health care contact within one month of death, and 21 percent had six or more outpatient visits in the year before death. Injection drug users and persons with HIV infection were more likely to have had contact with the health care system. This study concludes that homeless persons may be underusing health care services even when they are at high risk of death. Because a subset of homeless persons had extensive health care contacts prior to death, opportunities to prevent deaths may have been missed, and some deaths may not have been preventable through medical intervention.
Stroke Belt Initiative: The Tennessee Experience
Authors: Okwumabua Jebose O. , Martin Brenda , Clayton-Davis Joan , Pearson Cornelia M.
Published: July 2012

African Americans have a higher rate of stroke than other U.S. population groups. As part of the 11-state "Stroke Belt" region, Tennessee has the fifth highest death rate from stroke in the country. In 1993, a two-year community-based project was initiated to reduce the incidence of stroke and its associated risk factors among African Americans. Three counties, Shelby (Memphis), Davidson (Nashville), and Hamilton (Chattanooga), were selected as project sites because of their large African American populations. Specific objectives of the project were to promote risk factor awareness in African Americans, assist African American churches and community groups in developing and implementing intervention programs/and build the capacity for intervention programs within African American communities by collaborating with a variety of community organizations. This article describes the program's approach, which included using both adults and youth as mentors. In addition, it presents major accomplishments and lessons learned in project implementation.
Difficulty in Reaching Low-Income Women for Screening Mammography
Authors: Hardy Robert E. , Ahmed Nasar U. , Hargreaves Margaret K. , Semenya Kofi A. , Wu Ling , Belay Yigsaw , Cebrun Anthony J.
Published: July 2012

Low-income women have a high mortality from breast cancer. Yet, they participate in breast cancer early detection screening programs less than women in the general population. An intervention study to improve screening mammography rates of low-income women participating in Tennessee's TennCare program (state Medicaid and Medicare program) revealed significant barriers to reaching these women. Intervention methods included mail, telephone calls, and home visits. Results indicate that only 38 percent of the women could be contacted for a baseline survey. Reasons for noncontact included absence from home (39 percent), having moved (22 percent), refusal to participate (17 percent), having no physical domicile (15 percent), language barriers (4 percent), and miscellaneous other factors (4 percent). Women with telephones tended to have a relatively higher economic status and were more successfully reached than women without telephones. These findings provide useful insights for future program planning and research design.
The Cost of Tolerance for Violence
Authors: Sigler Robert T.
Published: July 2012

Our society evinces a high tolerance for violence. This acceptance of certain forms of violent behavior is ingrained in the American value system, established through our history in the simple struggle to survive. Beginning with the colonial era, through the settlement of the western frontier, and during the wave of immigrant arrivals, Americans often used violence to establish basic rights. Sociobiological explanations of individual violent tendencies focus on genetic predisposition established through natural selection-or survival of the fittest-while psychoanalytical perspectives define extreme violence as a deviant form of natural aggression. On the other hand, criminologists define all violence as deviant. In today's society, physical force is considered to be justifiable when expressing political dissent and protecting self and property, and less so during domestic disputes.
Gang Violence
Authors: Sigler Robert T.
Published: July 2012

During childhood and adolescence, the formation of groups or gangs is a normal part of the growing process. Playmates, school friends, Boy and Girl Scout troops are each examples of the natural inclination to form group attachments that provide a stable social outlet. However, gangs, as we now know them, are part of the pathological process brought on by the inability to disassociate from adolescent groupings, and more frightening, the result of infiltration by criminal elements, such as drug dealers, who exert violent influence on impressionable youngsters, particularly in major urban areas. The transition of gangs from innocent to deadly is due in large part to society's failure to respond to the environment that causes their pathology. In order to reverse the process, society must engage in programs that reinforce the gang or group experience as a positive one by incorporating adult supervision and mentoring as essential elements.
Public Health in a Managed Care Environment
Authors: Walker Bailus
Published: July 2012

As the health care system moves in a new direction, toward managed care, the critical role of public health in society's efforts to mitigate illness and the realization of health become more apparent. Indeed, the public health problems of this era will not yield to simple solutions. They require a multitude of resources, both human and material, and a myriad of services derived from these resources. Public health's role is to serve as the government's presence in assessing health status, developing policy, evaluating the effectiveness of policy implementation, and assuring access to and quality of comprehensive health services. Increasingly, public health must coordinate a wide array of systems in both the private and public sectors to fulfill its purpose.
Health Status Measurement Performance and Health Status Differences by Age, Ethnicity, and Gender: Assessment in the Medical Outcomes Study
Authors: Cunningham William E. , Hays Ron D. , Burton Tanya M. , Kington Raynard S.
Published: July 2012

The comparative measurement performance of self-reported health status instruments for African American and Hispanic elderly has rarely been studied, despite evidence of their poor health status. This study examined psychometric performance and health status differences by age, ethnicity, and gender among 10,569 ethnically diverse patients who completed the Short-Form General Health Survey in the Medical Outcomes Study (MOS). Hispanics and African Americans tended to have slightly lower measurement performance than other ethnic groups. Compared with whites, health status scores for African American and Hispanic women were slightly but significantly lower. The small differences in health status by ethnicity may be due to the MOS sampling strategy, which excluded low-socioeconomic status minorities with poor education and no regular medical care. The psychometric performance of MOS health status measures should be examined in studies of ethnically diverse, community-dwelling, elderly populations who have poor access to care, poor education, and/or low socioeconomic status.
Health Care Access, Health Promotion, and Older Women of Color
Authors: Yee Donna L. , Capitman John A.
Published: July 2012

The U.S population is becoming increasingly older due to steady increases in longevity, especially among women. Statistics show that older women, those 65 and over, outnumber older men by three to two. It is likely that as this trend in longevity continues, older women will continue to outnumber older men. The health care system must respond to these changes in the population by incorporating appropriate modifications into every aspect of the system, including financing mechanisms, service organization and delivery, consumer-centered care approaches, quality assurance mechanisms, and health promotion efforts. This article discusses the longevity advantage of women (particularly women of color) and its implications for economic insecurity, underinsurance of health care, health status, functional disability, access to care, and service use. The article concludes with a discussion of the challenges and opportunities presented as health care reform and the devolution of federal roles continue to unfold.
Crossing the Border for Health Care
Authors: Macias Eduardo P. , Morales Leo S.
Published: July 2012

A survey was administered to adults attending a health fair in south Los Angeles County, approximately 140 miles from the U.S.-Mexico border. The survey revealed that 14 percent of respondents had crossed the border to seek medical care during the past year. Nearly 80 percent of respondents crossing the border for medical care were uninsured, while 70 percent reported the low cost of medical care obtained across the border as being the most common reason for seeking care there. Twenty-eight percent of respondents reported purchasing medication in Mexico, with antibiotics and pain medication being reported in highest frequency. Ninety percent of these respondents were uninsured. This study shows that the high cost of health care and lack of insurance compels the poor and uninsured to seek low-cost health care and medication in Mexico to meet their most urgent health care needs, despite the burden of cost and travel.
Managed Care and Medicaid Reform in Tennessee: The Impact of TennCare on Access and Health-Seeking Behavior
Authors: Lyons William , Scheb John M.
Published: July 2012

Tennessee's TennCare program, established in 1994, uses a managed care system to address the problem of escalating Medicaid costs while expanding coverage to the chronically uninsured. This paper examined TennCare based on results of survey research commissioned by the state and conducted by the authors. Findings indicated that respondents formerly on Medicaid who had previously indicated a preference for Medicaid were now much more likely to prefer TennCare and were now as satisfied with TennCare as they had been with Medicaid in 1993. TennCare has had some impact on health care behavior, with fewer recipients seeking care at a hospital and more seeking care at a doctor's office or a clinic. At this point, Tennessee's experience with TennCare seems to be successful. Tennessee has been able to fund a fairly significant increase in coverage of the uninsured population while staying within the projected cost parameters of the Medicaid system.
Concentrated Poverty and Nursing Home Bed Supply in Chicago
Authors: Reed Susan C. , Andes Steven , Tobias Ruth Anne
Published: July 2012

This study explores whether poverty areas of Chicago have fewer nursing home beds and unique staffing patterns. Using 1990 census data and Illinois's 1994 Long-Term Care Facility Survey, census tracts were compared by need for long-term care, bed supply, and nursing home characteristics. While facilities cluster on the north side, and the number of beds follow the elderly, the supply of beds per elderly is actually greater in tracts with high proportions of poverty, disability, and African American residents due, in part, to the predominance of larger facilities. Ironically, economic segregation may work together with Medicaid's policy of serving the poorest to increase the supply of beds to those who might otherwise remain unserved. Nursing homes in the poorest communities have high percentages of Medicaid residents, are larger, and employ fewer staff per resident; homes with a high Medicaid population are more likely to employ LPNs, which may reflect labor supply differences.
Achieving a Credible Health and Safety Approach to Increasing Seat Belt Use Among African Americans
Authors: Ellis Herman M. , Nelson Bettie , Cosby Otis , Morgan Loleathia , Haliburton William , Dew Paul
Published: July 2012

African American youth are 60 percent less likely than children from other racial or ethnic backgrounds to be buckled up. Seat belt use among African American males has largely remained stagnant while that for outer groups has increased. Overall, African Americans buckle up less often than other racial or ethnic populations. Seat belt use is a preventive health care action within public health. Clearly, a credible health and safety message is not being communicated effectively to African American communities. This paper proposes a number of possible solutions, including: recognition of the role that health care providers play in shaping patient or consumer attitudes and subsequent behavior in terms of prevention of disease and injury, educating physicians and health care providers to routinely recommend seat belt use especially for children, culturally appropriate educational safety programs, an improved relationship between law enforcement and communities, and zero tolerance for nonuse of seat belts.
Ethnic and Racial Differences in Long-Term Survival From Hospitalization for HIV Infection
Authors: Cunningham William E. , Mosen David M. , Morales Leo S. , Andersen Ronald M. , Shapiro Martin F. , Hays Ron D.
Published: July 2012

This prospective cohort study compares 200 hospitalized, HIV-infected patients (Hispanic, African American, and white) from May 1992 to October 1998 to assess mortality (versus survival) over 75 months of follow-up. The relative risk of six-year mortality for each ethnic group is compared using Cox proportional hazards models after control- ling for sociodemographic and clinical characteristics, access to general medical care, and HIV-specific treatment. The median survival of Hispan- ics (15.5 months) was significantly (p < 0.05) shorter than that of whites (23.8); survival for African Americans (35.1) did not differ from whites. In multivariate analysis, the adjusted relative risk of six-year mortality for Hispanics compared with whites was 2.14 (95 percent confidence interval = 1.26-3.66). The poor outcomes of Hispanics was not explained by access to general care or by HIV-specific treatment.
Health Problems and Service Utilization in the Homeless
Authors: Sachs-Ericsson Natalie , Wise Emily , Debrody Corey Phillips , Paniucki Heather Bradley
Published: July 2012

This study examined the health problems and utilization patterns of homeless individuals (n = 292) seeking medical services in a small, southern community. Results showed that the medical problems for which the homeless sought treatment were often (72.6 percent) a reoccurring problem for which treatment had been previously received. The most prevalent medical problem was upper respiratory infection (47 percent), likely exacerbated by the high rate (73 percent) of cigarette smoking found among the sample. More than half (51.4 percent) of the participants had used other medical services in the past month. Despite these high rates of utilization, the homeless may, in fact, be underutilizing appropriate preventive medical services, waiting until the medical problem becomes serious before seeking treatment, and overutilizing emergency rooms for nonemergency care. Community-based services sensitive to the needs of the homeless are likely to cost communities less money while providing better services to the homeless.
Health Services Utilization Among Latinos and White Non-Latinos: Results From a National Survey
Authors: Guendelman Sylvia , Wagner Todd H.
Published: July 2012

Utilization patterns may be changing as managed care organizations actively market services to Latinos. This study compares use of any care, emergency services, inpatient hospitalization, nonemergency outpatient care only, and preventive care among 1,001 self-identified Latino and 1,107 white non-Latino adults. Data were from the 1994 Commonwealth Fund Survey of Minority Health. Latinos were less likely than white non-Latinos to have entered the health system for any type of care, to have been admitted to a hospital, or to have used preventive care. Access to a regular source of care along with financial factors reduced the ethnic/racial gap in the use of any care and preventive care, yet cultural and behavioral factors contributed little. Latinos in managed care plans, compared with fee-for-service systems, were twice as likely to receive preventive care. This suggests that managed care has the potential to reduce inequities in preventive care utilization.
Access to Care for Low-Income Women: The Impact of Medicaid
Authors: Salganicoff Alina , Wyn Roberta
Published: July 2012

This study was undertaken to assess how low-income women with Medicaid, private insurance, or no insurance vary with regard to personal characteristics, health status, and health utilization. Data are from a telephone interview survey of a representative cross-sectional sample of 5,200 low-income women in Minnesota, Oregon, Tennessee, Florida, and Texas. On the whole, low-income women were found to experience considerable barriers to care; however, uninsured low-income women have significantly more trouble obtaining care, receive fewer recommended services, and are more dissatisfied with the care they receive than their insured counterparts. Women on Medicaid had access to care that was comparable with their low-income privately insured counterparts, but in general had significantly lower satisfaction with their providers and their plans. Future federal and state efforts should focus on expanding efforts to improve the scope and reach of health care coverage to low-income women through public or private means.
Individual Sociodemographic Characteristics Associated With Hospitalization for Pediatric Ambulatory Care Sensitive Conditions
Authors: Shi Leiyu , Lu Ning
Published: July 2012

This study examined the association of individual sociodemographic characteristics with pediatric ambulatory care sensitive condition (ACSC) hospitalizations in American hospitals while controlling for selected hospital characteristics. Data came from the 1994 National Hospital Discharge Survey. Bivariate statistical comparisons were performed to test the differences between ACSC and non-ACSC hospitalization rates in patient demographic and hospital characteristics. Logistic regression was followed to examine the relative significance of patient and hospital characteristics associated with pediatric ACSC hospitalizations. Such individual sociodemographic characteristics as age, race, and insurance status were significant predictors of ACSC hospitalization. Younger children were more likely to have ACSC hospitalization than older ones. Black children were 1.653 times more likely than white children to be hospitalized for ACSC (confidence interval = 1.53-1.79). Those with Medicaid or no secondary insurance were more likely to be hospitalized for ACSC than those with private insurance or with secondary insurance.
Collaborative Inquiry With Low-Income Latina Women
Authors: Flaskerud Jacquelyn H. , Nyamathi Adeline M.
Published: July 2012

Collaborative inquiry is a form of research in which researchers and participants work collaboratively as partners. The purpose of this paper is to demonstrate the process of collaborative inquiry through an example of a longitudinal, community-based study conducted over a six-year period. The research program focused on HIV education, counseling, and antibody testing with low-income Latina women attending a nutrition program for women, infants, and children (WIC) in Los Angeles. Collaborative, community-based inquiry emerges from the community and uses members of the targeted group to design the program, convey the message, act as advocates, evaluate the outcomes of the program, and disseminate research findings. The goal is empowerment and emancipation of both participants and researchers. Five areas in the conduct of community-based collaborative inquiry are demonstrated here: program design, implementation, evaluation, dissemination of the results of the program, and empowerment and emancipation.
Gaps in Health Coverage Among Working-Age Americans and the Consequences
Authors: Hoffman Catherine , Schoen Cathy , Rowland Diane , Davis Karen
Published: July 2012

This paper examines health coverage and access to care among working-age adults using the Kaiser/Commonwealth 1997 National Survey of Health Insurance. One in three (52 million) working-age adults were either uninsured at the time of the survey or had a recent gap in their health coverage in the past two years. Having even a temporary gap in health coverage made a significant difference in access to care. Compared to the elderly, who are continuously covered by Medicare, working-age adults have greater problems paying their medical bills and gaining access to care and are less satisfied with their health insurance coverage.
Integrating Buddhism and HIV Prevention In U.S. Southeast Asian Communities
Authors: Loue Sana , Lane Sandra D. , Lloyd Linda S. , Loh Leng
Published: July 2012

Asian Pacific Islander communities in the United States have experienced an alarming increase in HIV infection over the past few years, possibly due to a lack of knowledge and the relative absence of appropriate educational interventions. The authors propose a new approach to the development of HIV prevention programs in U.S. southeast Asian communities. This article reviews the cultural and economic factors that may facilitate HIV transmission within these communities. Relying on the basic precepts of Buddhism, the dominant religion of many southeast Asian populations in the United States, the health belief model is utilized to demonstrate how recognizable, acceptable religious constructs can be integrated into the content of HIV prevention messages. This integration of religious concepts with HIV prevention messages may increase the likelihood that the message audience will accept the prevention messages as relevant. This nuanced approach to HIV prevention must be validated and refined through field research.
Insurance and Education Determine Survival in Infantile Coarctation of the Aorta
Authors: Kuehl Karen S. , Baffa Jeanne M. , Chase Gary A.
Published: July 2012

Health outcomes are determined by case severity, physician decisions, and patient variables. In a population-based study between 1981 and 1989, 103 cases of infant coarctation of the aorta were diagnosed before one year of age. The goal of this study was to determine whether patient race, gender, income, and insurance status had effects on outcome of coarctation of the aorta that were distinct from the effect of case severity. Survival of infants with coarctation of the aorta, a common congenital cardiovascular malformation, is associated with greater maternal education and with having any health insurance but not with measures of severity. Infants without health insurance are 12.8 times more likely to die than infants with any health insurance. Fifty-five percent of all deaths in infant coarctation occur prior to surgical treatment. One-third of deaths occur without diagnosis. Outcome measures require knowledge of the entire population and of insurance status to inform policy.
Termination From Medicaid: How Does It Affect Access, Continuity of Care, and Willingness to Purchase Insurance?
Authors: Weissman Joel S. , Witzburg Robert , Linov Pamela , Campbell Eric G.
Published: July 2012

Welfare reform has raised fears that Medicaid recipients will lose coverage, yet efforts to insure the poor via waiver programs may fall short. A telephone sample of 351 enrolled and terminated members of a Medicaid managed care plan based in community health centers were asked about insurance status, source of care, willingness to purchase new insurance, and access. Of terminated families, 78 percent had one member without insurance, 93 percent retained a regular source of care (vs. 96 percent enrolled), and 86 percent retained the same source as before losing coverage. Only 11 percent of uninsured respondents were willing to pay $200 per month and 57 percent to pay $50 per month for replacement coverage, and they were more likely to report problems getting prescription medications and obtaining treatment for serious symptoms and to go without care because of the expense. Access to care is diminished for those who lose Medicaid coverage, even for persons attending community health centers.
Effectiveness of Reminder Systems on Appointment Adherence Rates
Authors: Maxwell Susan , Maljanian Rose , Horowitz Sheryl , Pianka Mary Ann , Cabrera Yolanda , Greene John
Published: July 2012

The aim of this study was to determine the impact of reminder systems on appointment nonadherence rates in an low-income inner-city clinic population. A total of 2,304 consenting patients were randomly assigned to one of three groups: (1) automated telephone reminder, (2) postcard reminder, or (3) no reminder. In contrast with research on other populations, the results of this study demonstrated no significant difference in appointment adherence rates among the three groups. To aid in the development of more effective interventions in the future, individuals not attending their scheduled appointments were interviewed by telephone to determine reason for nonadherence.
Behaviors, Attitudes, and Knowledge of Low-Income Consumers Regarding Nutrition Labels
Authors: McArthur Laura , Chamberlain Valerie , Howard Alan B.
Published: July 2012

This exploratory study interviewed 130 participants in federal food assistance programs and 51 low-income nonparticipants to assess their behaviors and attitudes toward and awareness of the nutrition label. Regarding label use, 35.4 percent of participants and 45.1 percent of nonparticipants seldom/never read labels while grocery shopping, 31.5 percent of participants and 19.6 percent of nonparticipants sometimes read them, and 33.1 percent of participants and 35.3 percent of nonparticipants always/frequently read labels in the grocery store. In addition, 38.5 percent of participants and 41.2 percent of nonparticipants seldom/never read labels at home, 33.1 percent of participants and 27.5 percent of nonparticipants sometimes read them, and 28.5 percent of participants and 31.4 percent of nonparticipants always/frequently read labels at home. There were no significant differences between mean scores of participants and nonparticipants on how to use the nutrition label. Findings challenge nutritionists working with low-income individuals to develop more learning opportunities that teach how to use nutrition labels.
Maternal Health Insurance Coverage as a Determinant of Obstetrical Anesthesia Care
Authors: Obst Thomas E. , Nauenberg Eric , Buck Germaine M.
Published: July 2012

This study measures the association between health insurance and the likelihood of receiving different obstetrical anesthesia protocols among 121,351 singleton live births in upstate New York during 1992. Mothers receiving a cesarean under Medicaid were approximately twice as likely to receive general anesthesia as those with traditional private coverage. Those receiving a cesarean under an HMO were least likely to receive general anesthesia with adjusted odds of 0.73 (confidence interval [CI] = 0.68-0.79), compared to those with traditional private insurance. Those delivering vaginally under Medicaid, HMO, or no coverage had adjusted odds of receiving an epidural of 0.45 (CI = 0.43-0.48), 0.68 (CI = 0.64-0.71), and 0.44 (CI = 0.38-0.52), respectively, compared to those under traditional private insurance. Although there was some differences by race, the strongest determinant of anesthesia remained insurance type. Insurance-mediated disparities in obstetrical anesthesia care are evident in upstate New York and warrant further study nationally.
Physician Perceptions of Barriers to Care for Inner-City Latino Children With Asthma
Authors: Lara Marielena , Allen Felicia , Lange Linda
Published: July 2012

This article describes physician perspectives on barriers to quality primary care experienced by inner-city children with asthma and presents policy recommendations to reduce these barriers. The authors interviewed 30 physicians who take care of children with asthma in an inner-city Latino neighborhood, conducted a qualitative analysis of interview themes, and used a consensus group method to recommend policy actions. Inner-city physicians described significant access, quality of care, and other barriers in providing state-of-the-art primary care for asthma. Physicians recommended that eliminating financial barriers to care, including lack of health insurance and/or comprehensive health coverage for necessary medications and equipment, is the most important required policy action. In addition, inner-city physicians recommended that medical care and public health programs provide bilingual education for children with asthma and their families and train primary care physicians about how to provide effective asthma care to children with asthma in the inner city.
Diabetic Retinopathy Screening among Hispanics in Lea County, New Mexico
Authors: Navuluri Ramesh B.
Published: July 2012

A project of diabetic retinopathy screening among Hispanics was implemented to increase awareness among the participants about diabetic retinopathy, screen for retinopathy, and make recommendations for further follow-up to enable them to save years of vision. Hispanics with diabetes are at a higher risk than non-Hispanics to develop retinopathy. A convenience group of 19 adults participated in the project. A pretest to determine participants' knowledge about diabetic retinopathy was administered. Subsequently, the participants were screened for diabetic retinopathy. On that occasion, a nurse instructed the individual participants about different aspects of diabetic retinopathy and provided them with brochures. After three weeks, posttests were administered to evaluate their awareness level and compliance with recommendations. Data were analyzed using a dependent groups' t-test. A significant increase (6.6 percent) in the awareness levels of the participants was found. It is recommended that voluntary collaborative efforts among various individuals and institutions should occur to organize similar community projects that may otherwise become prohibitive due to costs.
Quality of Hospital Care of Children With Asthma: Medicaid Versus Privately Insured Patients
Authors: Merrick Nancy J. , Houchens Robert , Tillisch Sandra , Berlow Bruce , Landon Chris
Published: July 2012

Asthma is an important condition to study in the Medicaid population because it is the most frequent reason for hospital admission of Medicaid children, with rates substantially higher than those of non-Medicaid children. This study addressed how the quality of hospital care provided to children with asthma on Medicaid compares with that provided to privately insured children. Children inpatient records were studied in California, Georgia, and Michigan, comparing the care that was provided to standards created by a national panel of physician experts. Process-of-care analysis showed that Medicaid children in each state were more likely than privately insured children to be discharged on suboptimal medication regimens. This study concluded that hospitals serving Medicaid children, at least in these three states, are providing asthma inpatient care of fairly comparable quality to that of privately insured children. However, there remain significant problems surrounding outpatient medication regimens and follow-up care.
Homeless Women's Gynecological Symptoms and Use of Medical Care
Authors: Wenzel Suzanne L. , Andersen Ronald M. , Gifford Deidre Spelliscy , Gelberg Lillian
Published: July 2012

Information is lacking on homeless women's gynecological symptoms and use of medical care for symptoms. This paper documents and explains gynecological symptoms and conditions and use of medical care in a probability sample of 974 reproductive-age (15-44) homeless women. Two-thirds of women reported symptoms during the previous year; 71 percent of those received medical care for their gynecological symptoms. Pregnancy, drug dependence, more episodes of homelessness, and general physical health symptoms were positively associated with a number of gynecological symptoms. Gynecological symptoms, younger age, better perceived health, and insurance coverage were positively associated with medical care; women reporting recent drug use and rape received less care. These findings support the importance of medical care and other treatment and support services for homeless women, including expanded care during pregnancy and substance abuse treatment. Health insurance coverage and an interruption in the cycle of homelessness also appear vital to women's health.
Using Focus Groups to Design a Community Health Program: What Roles Should Volunteers Play?
Authors: Trettin Lillian , Musham Catherine
Published: July 2012

This volunteer-based community health advisory program illustrated the benefits of using focus groups to monitor and guide program development. Three focus groups, conducted by program evaluators, obtained input regarding the role of community volunteers. Focus group findings confirmed some of the assumptions held by program developers but refuted others. For example, prospective community participants and program developers were found to view the role of "volunteer" in the neighborhood health advisory program differently. As a result, adjustments were made in recruitment strategies and other procedural aspects to accommodate the residents' perspectives and values. This experience illustrated how preliminary focus group research can enhance linkage between program developers and community members.
Linking African American Mothers Across Life Stage and Station Through Photovoice
Authors: Killion Cheryl M. , Wang Caroline C.
Published: July 2012

Homeless young African American women and low-income, elderly African American women have housing needs specific to their age cohorts, yet they also have parallel and complementary housing, health, and personal needs. The young struggle to afford decent housing, while the old may have difficulty maintaining their homes. In this pilot study, intergenerational contact was established between young homeless women and elderly independently housed women through photovoice. Over six months, five African American women discussed photographs they had taken that focused on their current living arrangements and activities. Although the women spanned three generations, had different life experiences, and resided in a variety of home settings, the sharing of photographs revealed many commonalities. In the process of discussing photographs, fa women established mutual respect, exercised reciprocal affirmation, and built alliances. The preliminary study is preparatory to exploring the feasibility of establishing house-sharing arrangements for mutual assistance between these cohorts.
Development as Health: Employing the Collective Right to Development to Achieve the Goals of the Individual Right to Health
Authors: Meier Benjamin Mason , Fox Ashley M.
Published: July 2012

Although there exists widespread recognition that the shared benefits of economic development can improve health, health advocates rarely appreciate the connections between the right to health and the right to development. The collective right to development, transcending the right to health's focus on the individual, offers public health actors an opportunity to work through development discourses to obligate and empower states to allocate public goods for the public's health. This article concludes that health scholars and advocates could employ the right to development to ensure that development policies guide states in realizing the highest attainable standard of health, fulfilling underlying determinants of health through the strengthening of national public health systems.
Latecomers to the ILO and the Authorship and Ownership of the International Labour Code
Authors: Chigara Ben
Published: July 2012

The article examines the extent to which latecomers to the International Labour Organization (ILO) that comprise more than one half of the organization could be said to have contributed to the establishment of the International Labour Code, about two-thirds of which had already been established by the time that they began to join the ILO as politically sovereign independent states. The article focuses on the recent work of the ILO Working Party on Policy Regarding the Revision of Standards (1994-2002). It evaluates both the significance of outcomes of the Working Party's achievements and the role of the latecomers in that enterprise. It shows that the latecomers have appropriated the ILO dynamic and utilized the ILO's working party and committee structures both to project matters of foremost concern to themselves onto the agenda of the ILO and to update the International Labour Code by evaluating, categorizing, and suspending some of the conventions and recommendations that they had deemed to be irrelevant. It concludes that after the conclusion of the work of the Working Party on Policy Regarding the Revision of Standards, latecomers to the ILO have become equal coauthors [End Page 706] and co-owners of the International Labour Code together with all the other member states parties of the ILO.
Human Rights Education (HRE) and Transnational Activism
Authors: Mihr Anja , Schmitz Hans Peter
Published: July 2012

Transnational human rights activism occupies today a significant place in the practice and scholarship of current global affairs. This article reviews the past successes and limits of this activism and suggests Human Rights Education (HRE) as a strategic tool currently underutilized by activists and rarely taken seriously by academics. We argue that the current practice of transnational human rights activism frequently lacks solid and reciprocal ties to local activists and emphasizes "shaming" and exposure of human rights abuses over their prevention. The professionalization and campaign-driven character of rights activism often increases the distance between transnational activists and local causes and beneficiaries and disconnects the general public from human rights struggles. While claims of impartial activism based on legalistic strategies have the benefit of lifting human rights groups above the fray of politics, the promotion of human rights norms remains a deeply political and contentious struggle. We argue that a greater emphasis on HRE strengthens transnational ties and local support for international human rights standards and leads to societal mobilization beyond the narrow nongovernmental sector.
Poverty, Inequality, and Democracy (II): Aiding Latin America's Poor
Authors: Díaz-Cayeros Alberto , Magaloni Beatriz
Published: July 2012

Abstract: Social policy in Latin America has traditionally failed to benefit the poor. Throughout most of the twentieth century, the main redistributive efforts in the region went into building welfare states. Social insurance schemes generally foster a "reverse Robin Hood effect" in which the poor are made to pay for the benefit of the rich. In addition, subsidies—another form of social policy commonly used in Latin America—have historically tended to go disproportionately to the urban middle classes. If the tremendous income disparities that characterize Latin American life are not mitigated, the stability of the region's democracies may be jeopardized.
Morocco's Elections: Islamists, Technocrats, and the Palace
Authors: Tozy Mohamed
Published: July 2012

Abstract: The 2007 elections in Morocco were not about putting competing political projects or societal options before the voters in order to let them choose among them. In fact, the elections were mainly about changing the methods by which the system can adapt in the face of a crisis among its elites. Morocco is a country with a “defused” political game.
Senegal: The Return of Personalism
Authors: Mbow Penda
Published: July 2012

From a democratic perspective, the era of President Wade has been a severe disappointment, dashing hopes that the great turnover of 2000 would pave the way for democratic consolidation. President Wade was reelected to a fresh term on 25 February 2007 but the problems gripping the country have done nothing but intensify since his reelection. The signs of trouble include a twelve-party boycott of the 3 June 2007 elections for the 150-seat National Assembly, the lack of dialogue among contending political factions, and the demand by the leading opposition coalition for a national conference. Despite the promise of democracy in 2000, Senegal today has declined to the point of mere electoral authoritarianism.
Struggling to Survive: Soviet Women in the Postwar Years
Authors: Bucher Greta
Published: July 2012

Based on propaganda, archival sources, and interviews, this
article argues that under conditions of extreme material hardship,
traditional Russian culture and Soviet values united to place unrealistic
expectations on women who bore the brunt of post-World War II
production and reproduction goals. As women faced the conflicting
responsibilities of rebuilding the economy and repopulating the Soviet
Union, the press bombarded them with images of women who successfully
fulfilled all the demands placed upon them. In the absence of
adequate support facilities, economic reality shaped women's lives more
profoundly than state demands, and most women attempted to balance their
duties by privileging domestic concerns over professional advancement,
limiting family size, and developing strategies to deal with the
difficulties of postwar life.