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Background: The U.S. population continues to age, and the identification of disparities in geriatric care -so that they may be understood and solutions addressed - is ever more critical. A systematic review is presented on current disparities found in access to care for geriatric diseases as well as in the delivery of care within the United States. Methods: A comprehensive search for the available literature from 2010 to 2024 was carried out through the PubMed, CINAHL, and Scopus databases in peer-reviewed journals. Studies that focused on disparities in access and provision of geriatric care for adults aged 65 years and above within the U.S. health system were included in this study. The Joanna Briggs Institute critical appraisal tools were used in the quality appraisal of studies included. Results: Of the total number of 5,218 studies that were identified initially, 132 studies were eligible for inclusion. Our analysis uncovered continued inequity in geriatric care across racial, ethnic, socioeconomic, and geographic lines. Findings include: (1) low rates of early diagnosis and delayed treatment of dementia and Alzheimer's among minority seniors, who were found to be 2.3 times more likely for African Americans and 1.9 times more likely for Hispanics than their white counterparts; (2) inability to access high-level geriatric care in regions outside of metropolitan areas, where it was identified that older adults had to commute, on average, 3.2 times farther to the nearest provider; (3) socioeconomic factors found to present obstacles to home health and long-term care, with seniors from a lower income bracket 1.8 times more likely to be placed in a poor-quality nursing home; and (4) disparities in the quality of end-of-life care for elders of lower socioeconomic status, with African Americans and Hispanics being respectively 38% and 51% less likely to use hospice care. Conclusion: This review has demonstrated that important and persistent disparities exist in the availability and delivery of geriatric care in the United States. Of the 132 studies, 34 directed their efforts toward reducing interventions to have such disparities with salutary results coming from culturally tailored community-based approaches. Multipronged interventions that include policy revision, workforce development, and community-based initiatives hold promise for reducing these disparities. This should be an area of focus for future targeted interventions, which should, therefore, be evaluated for effectiveness in reducing disparities in health outcomes for all older adults. Keywords: health disparities, geriatric care, access to care, care delivery, systematic review
Background: The U.S. population continues to age, and the identification of disparities in geriatric care -so that they may be understood and solutions addressed - is ever more critical. A systematic review is presented on current disparities found in access to care for geriatric diseases as well as in the delivery of care within the United States. Methods: A comprehensive search for the available literature from 2010 to 2024 was carried out through the PubMed, CINAHL, and Scopus databases in peer-reviewed journals. Studies that focused on disparities in access and provision of geriatric care for adults aged 65 years and above within the U.S. health system were included in this study. The Joanna Briggs Institute critical appraisal tools were used in the quality appraisal of studies included. Results: Of the total number of 5,218 studies that were identified initially, 132 studies were eligible for inclusion. Our analysis uncovered continued inequity in geriatric care across racial, ethnic, socioeconomic, and geographic lines. Findings include: (1) low rates of early diagnosis and delayed treatment of dementia and Alzheimer's among minority seniors, who were found to be 2.3 times more likely for African Americans and 1.9 times more likely for Hispanics than their white counterparts; (2) inability to access high-level geriatric care in regions outside of metropolitan areas, where it was identified that older adults had to commute, on average, 3.2 times farther to the nearest provider; (3) socioeconomic factors found to present obstacles to home health and long-term care, with seniors from a lower income bracket 1.8 times more likely to be placed in a poor-quality nursing home; and (4) disparities in the quality of end-of-life care for elders of lower socioeconomic status, with African Americans and Hispanics being respectively 38% and 51% less likely to use hospice care. Conclusion: This review has demonstrated that important and persistent disparities exist in the availability and delivery of geriatric care in the United States. Of the 132 studies, 34 directed their efforts toward reducing interventions to have such disparities with salutary results coming from culturally tailored community-based approaches. Multipronged interventions that include policy revision, workforce development, and community-based initiatives hold promise for reducing these disparities. This should be an area of focus for future targeted interventions, which should, therefore, be evaluated for effectiveness in reducing disparities in health outcomes for all older adults. Keywords: health disparities, geriatric care, access to care, care delivery, systematic review
BackgroundCancer disparities persist in the United States, with significant variations in incidence, mortality, and survival rates across different population groups. This systematic review aims to synthesize current evidence on the relationship between social determinants of health and cancer disparities, and to identify effective interventions for promoting equitable cancer prevention and control.MethodsWe conducted a systematic search of PubMed, Embase, and Cochrane Library databases for peer-reviewed articles published between 2010 and 2024. Studies were included if they examined the association between social determinants (e.g., socioeconomic status, race/ethnicity, education, healthcare access) and cancer outcomes, or evaluated interventions addressing these factors. Two independent reviewers screened articles, extracted data, and assessed study quality using standardized tools.ResultsOf 3,247 initially identified studies, 142 met inclusion criteria. The review found strong evidence linking various social determinants to cancer disparities, particularly in screening rates, stage at diagnosis, and survival outcomes. Socioeconomic status and healthcare access were the most frequently studied determinants. Effective interventions identified included patient navigation programs, community-based education initiatives, and policy changes to expand insurance coverage. However, the quality and long-term impact of many interventions were limited by short follow-up periods and small sample sizes.ConclusionThis systematic review confirms the significant role of social determinants in perpetuating cancer disparities and highlights promising strategies for addressing these inequities. Future research should focus on developing and evaluating multilevel interventions that target both individual and structural determinants. Policy makers and healthcare providers should prioritize evidence-based approaches to reduce social barriers and promote equitable cancer prevention and control.
Background: Mental health disparities persist as a significant public health concern in the United States, with certain populations experiencing disproportionate burdens of mental illness and barriers to care. This systematic review aims to synthesize current evidence on mental health disparities across various demographic groups and identify key factors contributing to these inequities. Methods: We conducted a comprehensive search of peer-reviewed literature published between 2010 and 2024 using PubMed, PsycINFO, and Scopus databases. Studies examining mental health outcomes, access to care, and treatment efficacy across racial/ethnic, socioeconomic, gender, sexual orientation, and geographic groups in the US were included. Two independent reviewers screened articles, extracted data, and assessed study quality. Results: Of 2,345 initially identified studies, 127 met inclusion criteria. Consistent disparities were observed across multiple domains, with racial/ethnic minorities, low-income individuals, LGBTQ+ populations, and rural residents experiencing higher rates of mental health disorders, lower access to quality care, and poorer treatment outcomes. Key contributing factors included systemic racism, socioeconomic barriers, stigma, lack of culturally competent care, and inadequate insurance coverage. Conclusion: This review highlights persistent and multifaceted mental health disparities in the US. Addressing these inequities requires comprehensive policy interventions, increased funding for community-based mental health services, improved cultural competence in healthcare delivery, and targeted research to develop effective, culturally-tailored interventions for underserved populations.
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