Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status

Becker, Gay; Gates, Rahima Jan; Newsom, E.

doi:10.2105/ajph.94.12.2066

Cited by 102 publications

(105 citation statements)

References 26 publications

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“…Future research should measure other sources of support that may have cultural relevance, such as churches and barber shops, particularly among black men. 20,21 Other barriers not studied here may also contribute to racial disparities in completing pre-transplantation evaluations such as logistical barriers (distance from diagnostic testing centers, limited clinical office hours), perceived disrespect in interactions with medical providers and staff that may impede pursuing evaluations, and patients' cultural or religious beliefs. [22][23][24] Finally, whereas our overall sample size was substantial, the numbers of patients in the race and gender strata were smaller, and survey item-nonresponse gave us limited precision, especially for multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

Promoting Access to Renal Transplantation: The Role of Social Support Networks in Completing Pre-transplant Evaluations

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Promoting Access to Renal Transplantation: The Role of Social Support Networks in Completing Pre-transplant Evaluations

et al. 2008

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“…Those who lack adequate access to health care are not able to manage their chronic disease as well as those with consistent access to a regular source of care. 61,62 Because they are under-or uninsured they may not have a regular physician and thus receive inconsistent care with poor follow-up for health concerns and treatments. 38,63 These disadvantages are compounded by the trend that lowincome, uninsured people often have less healthrelated knowledge, which impairs their ability to seek care when necessary and ask appropriate questions.…”

Section: Discussionmentioning

confidence: 99%

The Health Status of Patients of a Student-Run Free Medical Clinic in Inner-City Buffalo, NY

Cadzow¹,

Servoss²,

Fox³

2007

The Journal of the American Board of Family Medicine

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Methods: Clinic staff asked patients to fill out a Health Risk Assessment questionnaire that addressed their chronic disease and illness history, mental health, social support, substance use, income, education, and housing. Through statistical analysis of 469 anonymous patient questionnaires, we identified prevalent health conditions in this patient population and compared these rates to regional and national data.Results: Of those patients 20 years of age and older, 70% earned less than US $10,000 a year. The rates of obesity, hypertension, asthma, diabetes, anxiety, and depression were higher in this population than in the Buffalo, NY, region and the general United States population. Conclusion:The data reflect the health disparity experienced by low-income minority populations in the United States and emphasize a need to plan additional services that target hypertension, heart disease, obesity, diabetes, and mental health disorders such as anxiety and depression. When it comes to health, the United States ranks 24th among 191 nations.1 The United Kingdom, Canada, and Japan, to name a few, have higher health rankings, higher life expectancies, lower infant mortality rates, and lower health expense per capita. 1,2 These nations provide health care coverage universally, whereas 46.6 million United States residents (15.9%) are without health insurance.3 This is equivalent to more than 2 times the population of New York state. 4 Among the uninsured, African-Americans are disproportionately represented, with 19.6% lacking health insurance. 5Social safety net services such as Medicaid and Medicare provide free or reduced-cost insurance to some people who lack employment, are disabled, or whose jobs do not provide health insurance. There are many other people, though, who exceed the income limits to receive free health care coverage but make an insufficient income to pay out-of-pocket for their health insurance. 6 Among those uninsured, nearly 70% come from a family with at least one full-time worker. 5,7 Twenty-eight percent of the uninsured are parttime workers.5,7 Free clinics across the UnitedStates have functioned to partially patch this hole in the safety net by providing care to the underand uninsured. 8,9 Free medical clinics are typically staffed by volunteer physicians, nurse practitioners, and nurses, and often also include a dental care component. Most offer standard triage care and physical exams; some offer services such as screening for sexually transmitted diseases. The importance of free medical clinics as part of the health care safety net was underscored by a survey of 106 free clinics in the Midwestern United States that showed they cared for over 200,000 patients in a single year. Recently, free medical clinics have been established by students in medical schools or by the schools themselves. Student-run clinics operate with a variety of underserved populations, including migrant workers, rural Appalachian communities, and the homeless.11-13 Some student initiatives take place outside of the cli...

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“…A global consensus has emerged that self-management plays an important role in the care of chronic diseases [9]. Diabetes self-management is a process in which the knowledge, skills, and abilities required for a patient to adequately manage his or her condition are facilitated [10].…”

Section: Introductionmentioning

confidence: 99%

Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes

et al. 2016

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OBJECTIVES:Diabetes is a major public health problem that is approaching epidemic proportions globally. Diabetes self-management can reduce complications and mortality in type 2 diabetic patients. The purpose of this study was to examine associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. METHODS:In this cross-sectional study, 562 Iranian patients older than 30 years of age with type 2 diabetes who received treatment at the Diabetes Research Center of the Endocrinology and Metabolism Research Institute of the Tehran University of Medical Sciences were identified. The participants were enrolled and completed questionnaires between January and April 2014. Patients' diabetes self-management was assessed as an independent variable by using the Diabetes Self-Management Questionnaire translated into Persian. The outcomes were the microvascular complications of diabetes (retinopathy, nephropathy, and neuropathy), identified from the clinical records of each patient. A multiple logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between diabetes self-management and the microvascular complications of type 2 diabetes, adjusting for potential confounders. RESULTS:After adjusting for potential confounders, a significant association was found between the diabetes self-management sum scale and neuropathy (adjusted OR, 0.64; 95% CI, 0.45 to 0.92, p= 0.01). Additionally, weak evidence was found of an association between the sum scale score of diabetes self-management and nephropathy (adjusted OR, 0.71; 95% CI, 0.47 to 1.05, p= 0.09). CONCLUSIONS:Among patients with type 2 diabetes, a lower diabetes self-management score was associated with higher rates of nephropathy and neuropathy.

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Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status

Cited by 102 publications

References 26 publications

Promoting Access to Renal Transplantation: The Role of Social Support Networks in Completing Pre-transplant Evaluations

Promoting Access to Renal Transplantation: The Role of Social Support Networks in Completing Pre-transplant Evaluations

The Health Status of Patients of a Student-Run Free Medical Clinic in Inner-City Buffalo, NY

Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes

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