America's Health Centers: Reducing Racial and Ethnic Disparities in Perinatal Care and Birth Outcomes

Shi, Leiyu; Stevens, Gregory D.; Wulu, John T.; Politzer, Robert M.; Xu, Jiahong

doi:10.1111/j.1475-6773.2004.00323.x

Cited by 68 publications

(45 citation statements)

References 54 publications

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“…Our findings also support the notion that absence of racial disparities may be related to CHCs' culturally sensitive practices and community involvement – features that other primary care settings may lack and speaks to the success of CHC models in improving health outcomes for these most vulnerable patients 23, 33, 34…”

Section: Discussionsupporting

confidence: 78%

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

Battaglia

Santana

Bak

et al. 2010

Cancer

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BACKGROUND:We sought to measure time and identify predictors of timely follow-up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities. METHODS: Eligible women had an abnormality detected on a mammogram or Papanicolaou (Pap) test between January 2004 and December 2005 in 1 of 6 community health centers in Boston, Massachusetts. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality). RESULTS: Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 vs 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow-up for both mammogram and Pap test abnormalities. CONCLUSIONS: Site-specific community-based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations. Cancer 2010;116:913-21.

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Section: Discussionsupporting

confidence: 78%

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

Battaglia

Santana

Bak

et al. 2010

Cancer

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“…CHCs are mission-driven organizations that are widely viewed as providers of culturally competent care. Because of their specialized knowledge about treating underserved populations, they are thought to play an important role in eliminating racial and ethnic disparities in care quality and health outcomes (118). …”

Section: Primary Care Integration and The Health Of Latinosmentioning

confidence: 99%

Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

Ortega

Rodríguez

Bustamante

2015

Annu. Rev. Public Health

178

125

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The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers.

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“…41,42 Shi’s study of the 2003 National Health Care Disparities Report and the 2002 Community Health Center (CHC) User Survey found that patients of federally qualified health centers experienced fewer racial/ethnic and socioeconomic disparities in access and quality of care compared to patients of non-CHCs. 43 In a separate study of the Veterans Administration Health System, McGuire et al found that implementation of community-based primary care clinics decreased access disparities to VA services for homeless veterans with serious mental illness. 44 Rehman found that the ethnic disparity in BP control between African Americans and Whites was approximately 40% less at VA than at non-VA health care sites.…”

Section: Paths To Success For Eliminating Us Health Disparitiesmentioning

confidence: 99%

Paths to Success: Optimal and Equitable Health Outcomes for All

Rust¹,

Levine²,

Fry-Johnson³

et al. 2012

hpu

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U.S. health disparities are real, pervasive, and persistent, despite dramatic improvements in civil rights and economic opportunity for racial and ethnic minority and lower socioeconomic groups in the United States. Change is possible, however. Disparities vary widely from one community to another, suggesting that they are not inevitable. Some communities even show paradoxically good outcomes and relative health equity despite significant social inequities. A few communities have even improved from high disparities to more equitable and optimal health outcomes. These positive-deviance communities show that disparities can be overcome and that health equity is achievable. Research must shift from defining the problem (including causes and risk factors) to testing effective interventions, informed by the natural experiments of what has worked in communities that are already moving toward health equity. At the local level, we need multi-dimensional interventions designed in partnership with communities and continuously improved by rapid-cycle surveillance feedback loops of community-level disparities metrics. Similarly coordinated strategies are needed at state and national levels to take success to scale. We propose ten specific steps to follow on a health equity path toward optimal and equitable health outcomes for all Americans.

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America's Health Centers: Reducing Racial and Ethnic Disparities in Perinatal Care and Birth Outcomes

Cited by 68 publications

References 54 publications

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

Paths to Success: Optimal and Equitable Health Outcomes for All

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