In the Caribbean, colonialism and inequality mean hurricanes hit harder
Hurricane Maria, the 15th tropical depression this season, is now battering the Caribbean, just two weeks after Hurricane Irma wreaked havoc in the region. The devastation in Dominica is “mind-boggling,” wrote the country’s prime minister, Roosevelt Skerrit, on Facebook just after midnight on September 19. The next day, in Puerto Rico, NPR reported via member station WRTU in San Juan that “Most of the island is without power…or water.” Among the Caribbean islands impacted by both deadly storms are Puerto Rico, St Kitts, Tortola and Barbuda. In this region, disaster damages are frequently amplified by needlessly protracted and incomplete recoveries. Nor were the effects of a 7 magnitude earthquake that rocked Haiti in 2010 limited to killing some 150,000 people. These are not isolated instances of random bad luck. Risk, vulnerability and poverty The country is among the Western Hemisphere’s poorest in large part because of imperialism. Geography and gender No place for politics
Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health
Developing a Multilevel Approach to Improving Population Health
Heart disease is the leading cause of death for both men and women in the United States, yet heart disease is largely preventable through healthful lifestyle practices. Effective prevention requires more than just educating people on how they can live healthier lifestyles; it’s critical for a community to support its citizens in their efforts to do so. Inspired by this, the Minneapolis Heart Institute Foundation (MHIF), Allina Health, New Ulm Medical Center (NUMC), and the rural community of New Ulm, Minnesota, teamed up to create Hearts Beat Back: The Heart of New Ulm Project (HONU). This population-based prevention demonstration project aims to reduce heart attacks and heart disease risk factors over 10 years among the New Ulm population. Recognizing the complex web of personal, institutional, and societal factors that influence an individual’s heart health, HONU leaders implemented a multilevel population health strategy. Key aspects of this strategy included: Health outcomes
In the Caribbean, colonialism and inequality mean hurricanes hit harder
Hurricane Maria, the 15th tropical depression this season, is now battering the Caribbean, just two weeks after Hurricane Irma wreaked havoc in the region. The devastation in Dominica is “mind-boggling,” wrote the country’s prime minister, Roosevelt Skerrit, on Facebook just after midnight on September 19. The next day, in Puerto Rico, NPR reported via member station WRTU in San Juan that “Most of the island is without power…or water.” Among the Caribbean islands impacted by both deadly storms are Puerto Rico, St Kitts, Tortola and Barbuda. In this region, disaster damages are frequently amplified by needlessly protracted and incomplete recoveries. Nor were the effects of a 7 magnitude earthquake that rocked Haiti in 2010 limited to killing some 150,000 people. These are not isolated instances of random bad luck. Risk, vulnerability and poverty The country is among the Western Hemisphere’s poorest in large part because of imperialism. Geography and gender No place for politics
Designing and Assessing Multilevel Interventions to Improve Minority Health and Reduce Health Disparities | AJPH | Vol. 109 Issue S1
Investments in biomedical, social, and behavioral sciences have greatly expanded knowledge of the etiology, prevention, detection, and treatment of many diseases, and many of these advances have contributed to improved population health. Nonetheless, not everyone has benefited equally from scientific development and medical advancement,1 and strategies to reduce socioeconomic and racial/ethnic disparities frequently remain elusive. In large part, this is because the factors that underlie disparities are wide ranging and multifaceted; these factors encompass every socioecological level, including individual, interpersonal, community, and societal (in this supplement issue, Alvidrez et al. describe the National Institute on Minority Health and Health Disparities [NIMHD] framework).2 NIMHD defines a health disparity as a health difference that adversely affects disadvantaged populations on the basis of 1 or more of the following health outcomes: Source. Adapted from Warnecke et al.11 Note.
Association of the Social Determinants of Health With Quality of Primary Care
+ Author Affiliations CORRESPONDING AUTHOR: Alan Katz, MBChB, MSc, Manitoba Centre for Health Policy, University of Manitoba, 408-727 McDermot Ave, Winnipeg, MB R3E 3P5, alan_katz@cpe.umanitoba.ca Abstract PURPOSE In primary care, there is increasing recognition of the difficulty of treating patients’ immediate health concerns when their overall well-being is shaped by underlying social determinants of health. We assessed the association of social complexity factors with the quality of care patients received in primary care settings. METHODS Eleven social complexity factors were defined using administrative data on poverty, mental health, newcomer status, and justice system involvement from the Manitoba Population Research Data Repository. RESULTS Among 626,264 primary care patients, 54% were living with at least 1 social complexity factor, and 4% were living with 5 or more. Key Words: Study Setting and Participants Data Sources Social Complexity Factors Main Outcome: Quality of Primary Care
Health, Income, & Poverty: Where We Are & What Could Help
Poverty has long been recognized as a contributor to death and disease, but several recent trends have generated an increased focus on the link between income and health. First, income inequality in the United States has increased dramatically in recent decades, while health indicators have plateaued, and life expectancy differences by income have grown. Second, there is growing scholarly and public recognition that many nonclinical factors—education, employment, race, ethnicity, and geography—influence health outcomes. Third, health care payment and delivery system reforms have encouraged an emphasis on addressing social determinants of health, including income. In this brief, we review the evidence supporting the income-health relationship and the likely mechanisms through which income affects health. Economic inequality is increasingly linked to disparities in life expectancy across the income distribution, and these disparities seem to be growing over time.
Equity in health care improves people's health
Promoting equity in health care improves people’s health. Doing so can be low cost and have high impact. Based on more than 15 years of research, we provide concrete examples of actions that can be taken by people working in health care — and the impact on patients. Our interdisciplinary team of EQUIP Health Care researchers from universities across Canada has been studying strategies for improving care. We are among the first to show that providing more equity-oriented health care predicts improvements in important patient health outcomes across time. This benefit occurs despite the negative toll of poverty, racism and other forms of discrimination on peoples’ health. Read more: 9 ways racism impacts maternal health Equity affects mental health Our evidence shows that when care is more equity-oriented, patients feel more comfortable and confident about the care they receive, leading to more confidence in their own ability to prevent and manage health problems. A focus on harm reduction
