Improving the prognosis of health care in the USA

Galvani, Alison P.; Parpia, Alyssa S.; Foster, E. Michael; Singer, Burton H.; Fitzpatrick, Meagan C.

doi:10.1016/s0140-6736(19)33019-3

Cited by 84 publications

(65 citation statements)

References 45 publications

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“…Broader reforms are also needed of the economic and financial system that currently forces families into debt simply as a result of living their daily lives. These include public provision of rights such as healthcare, housing and education (Baradaran 2019b, Galvani et al 2020), access to good jobs with living wages and decent benefits (Paul et al 2018), and a banking system that is regulated specifically to rebalance wealth inequality (Baradaran 2019b). Reforms such as reparations and baby bonds are needed to focus specifically on redressing massive racial wealth inequality (Darity and Mullen 2020; Hamilton and Darity 2010).…”

Section: Resultsmentioning

confidence: 99%

“Let Me Be Bill-free”: Consumer Debt in the Shadow of Incarceration

Harper

Bardelli

Barrenger

2020

Sociological Perspectives

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Low-income U.S. households are increasingly burdened by unaffordable debt, with profound long-term economic and health consequences. Households of color are disproportionately negatively affected. This article examines the nexus of this rising indebtedness and mass incarceration through the experiences of a particularly marginalized group, people with mental illness. Drawing on qualitative research with 31 individuals with mental illness and recent incarceration in the city of New Haven, Connecticut, we show how carceral institutions and predatory financial practices intersect to create complex entanglements for poor and vulnerable people. While a growing body of scholarship focuses on criminal justice fines and fees, we highlight other types of debt that add to the overall burden, describing how incarceration deepens people’s existing debts of poverty and adds new debts from in-prison costs and identity theft. After release, those debts complicate the search for housing, employment, and financial stability, leading to further debt, stressing social relationships and reproducing social and economic inequality. The experiences of people with mental illness illuminates structures of marginalization and disadvantage that affect many others involved with the criminal justice system.

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Section: Resultsmentioning

confidence: 99%

“Let Me Be Bill-free”: Consumer Debt in the Shadow of Incarceration

Harper

Bardelli

Barrenger

2020

Sociological Perspectives

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“…• A recent Yale study projects that 68,000 deaths a year would be prevented, together with savings of more than $450 billion a year. 41 • Risk for the costs of illness and accidents would be shared across our entire population of 330 million Americans. • The poverty level can be reduced by more than 20% by eliminating cost sharing, self-payments and other out-of-pocket costs at the point of care.…”

Section: Positive Directions For System Reform That Can Expand Primarmentioning

confidence: 99%

A Family Systems Curriculum: Evaluating Skills and Empathy

Schiefer

Levy

Rdesinski

2021

Fam Med

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Background and Objectives: Training residents in family-centered approaches offers an opportunity to investigate how learners translate skills to real clinical encounters. Previous evaluations of a family systems curriculum have relied on self-assessment and narrative reflection to assess resident learning. Assessment of learning using encounter observation and objective tools, including evaluation of empathy, allows for a deeper understanding of how residents transform curricular education into clinical practice. Methods: We evaluated resident learning from a longitudinal family systems curriculum delivered during the third year of a four-year residency training program. Using the Family-Centered Observation Form (FCOF), we analyzed seven pre- and postcurriculum videotaped encounters for changes in family-centered interviewing skills. We assessed changes in empathy before and after the curriculum using the Jefferson Empathy Scale. Results: There was a trend toward improvement in all family-centered skills, as measured by the FCOF, though the improvements were only statistically significant in the area of rapport building. Statistically significant improvement in empathy occurred for all participants. Narrative reflection demonstrated that residents found the curriculum valuable in ways that we were unable to objectively measure. Conclusions: Training in family systems can enhance patient interactions and may improve empathy. Evaluation of family-centered skills is challenging and takes a significant amount of time and planning. The FCOF can help learners identify how to use family-centered concepts and skills in a typical family medicine outpatient visit. Further study is needed to determine whether patients seen by doctors who use family-oriented skills have better experiences or outcomes.

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“…Structural reform is needed to address deep-rooted poverty and inequality, such as Baby Bondstrust funds set up for all children, the amount depending on the child's family's existing wealth (Hamilton et al, 2020;Hamilton & Darity, 2010) -public provision of healthcare, housing and education (Baradaran, 2019;Galvani, Parpia, Foster, Singer, & Fitzpatrick, 2020), and access to good jobs with living wages and decent benefits (Paul, Darity, Hamilton, & Zaw, 2018).…”

Section: Anti-poverty Measuresmentioning

confidence: 99%

Debt, Incarceration, and Re-entry: a Scoping Review

et al. 2020

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People involved with the criminal justice system in the United States are disproportionately low-income and indebted. The experience of incarceration intensifies financial hardship, including through worsening debt. Little is known about how people who are incarcerated and their families are impacted by debt and how it affects their reentry experience. We conducted a scoping review to identify what is known about the debt burden on those who have been incarcerated and their families and how this impacts their lives. We searched 14 data bases from 1990 to 2019 for all original research addressing financial debt held by those incarcerated in the United States, and screened articles for relevance and extracted data from pertinent studies. These 31 studies selected for inclusion showed that this population is heavily burdened by debt that was accumulated in three general categories: debt directly from criminal justice involvement such as LFOs, preexisting debt that compounded during incarceration, and debts accrued during reentry for everyday survival. Debt was generally shown to have a negative effect on financial well-being, reentry, family structure, and mental health. Debts from LFOs and child support is very common among the justice-involved population and are largely unpayable. Other forms of debt likely to burden this population remain largely understudied. Extensive reform is necessary to lessen the burden of debt on the criminal justice population in order to improve reentry outcomes and quality of life.

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Improving the prognosis of health care in the USA

Cited by 84 publications

References 45 publications

“Let Me Be Bill-free”: Consumer Debt in the Shadow of Incarceration

“Let Me Be Bill-free”: Consumer Debt in the Shadow of Incarceration

A Family Systems Curriculum: Evaluating Skills and Empathy

Debt, Incarceration, and Re-entry: a Scoping Review

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