Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel

Abu‐Qarn, Aamer S.; Lichtman-Sadot, Shirlee

doi:10.1016/j.econmod.2021.105695

Cited by 5 publications

(3 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some of the most common factors driving health disparities include inaccessible socioeconomic resources, patient-provider ethnicity discordance, and gaps in cultural competency [ 19 ]. In Israel, these disparities are often manifested in Arab and ultra-orthodox, immigrant, elderly, and low-income populations, as well as those living in the geographical periphery of the country and those with a lower level of education [ 20 – 22 ]. This often translates to higher morbidity and a lower life expectancy [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The association of medical, social, and normative factors with the implementation of end-of-life care practices

Ziv,

Shaulov,

Rubin

et al. 2024

Isr J Health Policy Res

View full text Add to dashboard Cite

Background End-of-life (EoL) care practices (EoLCP) are procedures carried out at the EoL and bear directly on this stage in the patient’s life. Public support of these practices in Israel is far from uniform. Previous studies show that while ∼30% of participants support artificial respiration or feeding of terminally ill patients, 66% support analgesic treatment, even at the risk of shortening life. This study aimed to create a typology of six end-of-life care practices in Israel and assess the association of medical, social, and normative factors with the implementation of those practices. These practices included mechanical ventilation, artificial feeding, deep sedation, providing information to the patient and family caregivers, including family caregivers in EoL decision-making, and opting for death at home. Methods This cross-sectional study was performed as an online survey of 605 adults aged 50 or more in Israel, of which ~ 50% (n = 297) reported supporting a dying terminally ill relative in the last 3 years. Participants were requested to provide their account of the EoL process of their relative dying from a terminal illness in several aspects, as well as the EoL care practices utilized by them. Results The accounts of the 297 interviewees who supported a dying relative reveal a varied EoL typology. The utilization of end-of-life care practices was associated with the socio-normative beliefs of family caregivers but not with their socioeconomic status. Strong correlations were found between family caregiver support for three key practices (mechanical ventilation, artificial feeding, and family involvement in EoL) and the actual utilization of these practices in the care of dying patients. Conclusions The findings portray an important image of equity in the utilization of EoLCP in Israel, as the use of these practices was not associated with socioeconomic status. At the same time, the study found substantial diversity in family caregivers’ preferences regarding EoL care practices use not related to socioeconomic status. We believe that differences in preferences that do not lead to problems with equity or other important societal values should be respected. Accordingly, policymakers and health system leaders should resist calls for legislation that would impose uniform EoL practices for all Israelis. Instead, they should take concrete steps to preserve and enhance the widespread current practice of practitioners to adapt EoL care to the varied needs and preferences of Israeli families and cultural, social, and religious subgroups. These steps should include providing frameworks and tools for family caregivers to support their loved ones close to their deaths, such as educational programs, seminars, supportive care before and during the end of life of their loved ones, etc.

show abstract

Section: Discussionmentioning

confidence: 99%

The association of medical, social, and normative factors with the implementation of end-of-life care practices

Ziv,

Shaulov,

Rubin

et al. 2024

Isr J Health Policy Res

View full text Add to dashboard Cite

show abstract

“…If these factors are compromised, vulnerabilities can create health inequalities and human disasters ( 1 ). Low socioeconomic status is associated with poor birth outcomes, infectious diseases, chronic conditions, and life expectancy, which result from disparities that include poor access to health care, financial constraints, environmental differences, differential access to information, geographic locality, and behavioral factors ( 2 ). Economic instability is associated with worse health outcomes, forcing individuals to prioritize other issues such as rent and utility bills over food and health needs.…”

Section: Introductionmentioning

confidence: 99%

Food and housing security at a US Hispanic-Serving Institution: An examination before and during the COVID-19 pandemic

Wagler

Schober

Chávez-Baray

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

University students occupy a socially marginal position and therefore are often underserved by academic and service institutions. This article analyzes food and housing security among students at The University of Texas at El Paso, a Hispanic-Serving Institution located in the U.S.-Mexico Border region. Findings of a sample of n = 7,633 university students are presented in the first cross-sectional, two-year food and housing security study on campus administered via platform Campus Labs Baseline. The first sample in 2019 consisted of n = 2,615 students representing 10.4% of student enrollment (25,177 total 2019 enrollment), and the second sample in 2020 was n = 5,018 representing 20.2% of student enrollment (24,879 total 2020 enrollment). To measure food security, the six-item short form of the U.S. Department of Agriculture (USDA) Household Food Security Survey Module was used. To document housing security, we created questions informed by student input. In this study, survey results are reported, and tests are conducted to assess the relationships between various student characteristics and food and housing security. Student characteristics significantly impacting food and housing security are probed further using data visualizations and subpopulation analysis with a focus on analyzing factors impacted by the COVID-19 pandemic. Results indicate that employment status, consistent employment status, hours per week, academic level, number of dependents, and gender are all factors associated with food security during the pandemic but not prior to the pandemic. Other factors, including, college affiliation, ethnicity/race, having any dependents and being head of household, living alone, mode of campus transportation and mode of the transportation, household income, and age, all were associated with food security in both academic years. Using these results, a critical analysis of past interventions addressing food and housing security is presented with a focus on changes made during the pandemic. Recommendations are made for further data-driven interventions and future steps.

show abstract

“…Secondary healthcare services require travel to larger (Jewish) cities, but this is less relevant for the young adult population. Indeed, in another study, we assess the effect of greater access to secondary healthcare services following public transportation penetration to Arab communities on the health of adults ages 50 to 75, a population for whom secondary healthcare services are relevant (Abu-Qarn & Lichtman-Sadot, 2021).…”

Section: Introductionmentioning

confidence: 99%

The Trade‐Off Between Work and Education: Evidence from Public Transportation Penetration to Arab Towns in Israel

Abu‐Qarn¹,

Lichtman-Sadot²

2021

J Policy Anal Manage

View full text Add to dashboard Cite

Disadvantaged communities are often geographically segregated from employment and higher education opportunities. Increasing access can entail substantial welfare gains, but this can also affect the trade‐off faced by young adults between investing in higher education and working for pay. We evaluate the introduction of bus services to Arab towns in Israel, which substantially and differentially increased access either to work only or to work and higher education opportunities among a disadvantaged population. Exploiting the variation that different bus line connections created in the cost of accessing higher education institutions, we find that young adult male responses are consistent with a trade‐off between investing in higher education and working for pay. For females, our results are less clear‐cut and while there is evidence of responses in terms of the probability of currently studying, we do not observe sufficiently concise labor market responses. Our results demonstrate the importance of accounting for potential reductions in educational attainment when expanding work opportunities to disadvantaged communities.

show abstract

Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel

Cited by 5 publications

References 35 publications

The association of medical, social, and normative factors with the implementation of end-of-life care practices

The association of medical, social, and normative factors with the implementation of end-of-life care practices

Food and housing security at a US Hispanic-Serving Institution: An examination before and during the COVID-19 pandemic

The Trade‐Off Between Work and Education: Evidence from Public Transportation Penetration to Arab Towns in Israel

Contact Info

Product

Resources

About