Rethinking the Leading Health Indicators for Healthy People 2030

Johnson, Sheri L.; Gold, Marthe R.; Baciu, Alina

doi:10.1001/jamahealthforum.2020.0426

Cited by 11 publications

(8 citation statements)

References 1 publication

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“…13 These efforts, in addition to addressing SDH, are critical to reduce new HIV infections consistent with the goals of Healthy People 2030 and the Ending the HIV Epidemic initiative. 12,13,42,43…”

Section: Discussionmentioning

confidence: 99%

A Census Tract–Level Examination of Differences in Social Determinants of Health Among People With HIV, by Race/Ethnicity and Geography, United States and Puerto Rico, 2017

et al. 2021

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Objective Social and structural factors, referred to as social determinants of health (SDH), create pathways or barriers to equitable sexual health, and information on these factors can provide critical insight into rates of diseases such as HIV. Our objectives were to describe and identify differences, by race/ethnicity and geography, in SDH among adults with HIV. Methods We conducted an ecological study to explore SDH among people with HIV diagnosed in 2017, by race/ethnicity and geography, at the census-tract level in the United States and Puerto Rico. We defined the least favorable SDH as the following: low income (<$40 000 in median annual household income), low levels of education (≥18% of residents have <high school diploma), high levels of poverty (≥19% of residents live below the federal poverty level), unemployment (≥6% of residents in the workface do not have a job), lack of health insurance (≥16% of residents lack health insurance), and vacant housing (≥15% of housing units are vacant). Results HIV diagnosis rates increased 1.4 to 4.0 times among men and 1.5 to 5.5 times among women as census-tract poverty levels increased, education levels decreased, income decreased, unemployment increased, lack of health insurance increased, and vacant housing increased. Among racial/ethnic groups by region and SDH, we observed higher HIV diagnosis rates per 100 000 population among non-Hispanic Black (49.6) and non-Hispanic White (6.5) adults in the South and among Hispanic/Latino (27.4) adults in the Northeast than in other regions. We observed higher HIV diagnosis rates per 100 000 population among non-Hispanic Black (44.3) and Hispanic/Latino (21.1) adults than among non-Hispanic White (5.1) adults. Conclusion Our findings highlight the importance of SDH in HIV infection and support the need for effective, targeted local interventions to specific populations based on HIV diagnoses and prevalence to prevent infection and reduce racial/ethnic disparities.

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Section: Discussionmentioning

confidence: 99%

A Census Tract–Level Examination of Differences in Social Determinants of Health Among People With HIV, by Race/Ethnicity and Geography, United States and Puerto Rico, 2017

et al. 2021

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“…Prior studies have identified racial and ethnic disparities in the management and treatment of acute coronary syndromes (ACS) and have consistently demonstrated that individuals of Black race are less likely than White individuals to receive invasive cardiac procedures such as coronary angiography and percutaneous cutaneous intervention (PCI). 1 , 2 , 3 , 4 , 5 , 6 Professional societies such as the American Heart Association 7 and Centers for Disease Control and Prevention's Healthy People 2030 8 , 9 have asserted that addressing racial disparities is a priority. 4 , 10 , 11 Identifying the extent of differences in ACS treatment by race and ethnicity in contemporary data is essential for documenting progress toward their resolution.…”

mentioning

confidence: 99%

Association of Race and Ethnicity on the Management of Acute Non−ST‐Segment Elevation Myocardial Infarction

Tertulien

Broughton

Swabe

et al. 2022

JAHA

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Background Prior studies have reported disparities by race in the management of acute myocardial infarction (MI), with many studies having limited covariates or now dated. We examined racial and ethnic differences in the management of MI, specifically non–ST‐segment‐elevation MI (NSTEMI), in a large, socially diverse cohort of insured patients. We hypothesized that the racial and ethnic disparities in the receipt of coronary angiography or percutaneous coronary intervention would persist in contemporary data. Methods and Results We identified individuals presenting with incident, type I NSTEMI from 2017 to 2019 captured by a health claims database. Race and ethnicity were categorized by the database as Asian, Black, Hispanic, or White. Covariates included demographics (age, sex, race, and ethnicity); Elixhauser variables, including cardiovascular risk factors and other comorbid conditions; and social factors of estimated annual household income and educational attainment. We examined rates of coronary angiography and percutaneous coronary intervention by race and ethnicity and income categories and in multivariable‐adjusted models. We identified 87 094 individuals (age 73.8±11.6 years; 55.6% male; 2.6% Asian, 13.4% Black, 11.2% Hispanic, 72.7% White) with incident NSTEMI events from 2017 to 2019. Individuals of Black race were less likely to undergo coronary angiography (odds ratio [OR], 0.93; [95% CI, 0.89–0.98]) and percutaneous coronary intervention (OR, 0.86; [95% CI, 0.81–0.90]) than those of White race. Hispanic individuals were less likely (OR, 0.88; [95% CI, 0.84–0.93]) to undergo coronary angiography and percutaneous coronary intervention (OR, 0.85; [95% CI, 0.81–0.89]) than those of White race. Higher annual household income attenuated differences in the receipt of coronary angiography across all racial and ethnic groups. Conclusions We identified significant racial and ethnic differences in the management of individuals presenting with NSTEMI that were marginally attenuated by higher household income. Our findings suggest continued evidence of health inequities in contemporary NSTEMI treatment.

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“…Similarly, 70% of the case scenarios had triggers addressing one or more social determinants of health. Improving our understanding social determinants of health such as environments in which people are born, grow, live, work and age, factors such as socioeconomic status, education, employment, and access to health care is critical to provide targeted healthcare and in shaping people's health [16][17][18] A majority of the PBL case scenarios (87%) re ected contextual integration of medical professionalism, evolving roles of doctors in health system (79%) and re ected healthcare referral system based on the case complexity (73%). We believe these traits are critical in providing good clinical care, maintaining good medical practice, relationships with patients, working with colleagues, probity, and health [19].…”

Section: Discussionmentioning

confidence: 99%

Title Evaluation of the Integration of Social Accountability Values into Medical Education using a Problem-Based Learning Curriculum

Dash¹,

Taha²,

Shorbagi³

et al. 2021

Preprint

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BackgroundMedical schools have the obligation to direct their education toward addressing the priority health concerns of the societies that they serve. The purpose of this study was to evaluate the integration of the concepts and values of social accountability into the case scenarios that are used in a problem-based learning (PBL) curriculum at a medical school in the United Arab Emirates (UAE). Methods A validated “social accountability inventory for PBL” was used for examining 70 case scenarios in a problem-based learning (PBL) medical curriculum.ResultsThe findings of the study indicate that the majority of the case scenarios integrated the social accountably values in addressing the following: the major health problems or social health concerns of the UAE (73%), the social determinants of health (70%), the contextual integration of medical professionalism (87%), the evolving roles of doctors in the health system (79%), the healthcare referral system based on the case complexity (73%), the involvement of different stakeholders in healthcare (87%) and the psychosocial issues rather than only the disease-oriented issues (80%). However, the case scenarios were deficient in integrating other social accountability values that related to the importance of a multidisciplinary approach to patient management (29%), issues regarding the management of the health system (49%), the values of health promotion/prevention (59%), consideration of the underserved, disadvantaged or vulnerable populations in the society (62%), the socioeconomic statuses of patients (54%), ethnicity (54%) and cost-effectiveness (65%). There was variability in integrating the social accountability values in case scenarios across different units which are based on organ system. ConclusionMedical educators can use this valuable data to calibrate their curriculum content, especially when using a problem-based learning curriculum to integrate the values of social accountability such as relevance, quality, equity and cost-effectiveness to train the future generation of healthcare providers to be ready to address the ever-changing and diverse needs of the societies.

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Rethinking the Leading Health Indicators for Healthy People 2030

Cited by 11 publications

References 1 publication

A Census Tract–Level Examination of Differences in Social Determinants of Health Among People With HIV, by Race/Ethnicity and Geography, United States and Puerto Rico, 2017

A Census Tract–Level Examination of Differences in Social Determinants of Health Among People With HIV, by Race/Ethnicity and Geography, United States and Puerto Rico, 2017

Association of Race and Ethnicity on the Management of Acute Non−ST‐Segment Elevation Myocardial Infarction

Title Evaluation of the Integration of Social Accountability Values into Medical Education using a Problem-Based Learning Curriculum

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