Barrett, The Honors College Thesis/Creative Project Collection

The social determinants of health (SDOH) represent factors that impact the health and effectiveness/compliance of a treatment plan for a patient. The SDOH include such factors as economic stability, education, home and community context, access to healthcare, neighborhood and built environment, and personal behavior. The purpose of this study is to determine the extent of collection and integration of SDOH into clinical practice, and the usefulness of this information in medical decision making. Following a thorough literature review, an online survey was deployed to physicians and administrators around the country, with the aim of answering the following questions: 1) Do provider practices collect information on a patient's social determinants of health? 2) If yes, how is that information being used, if at all? 3) If not, what is preventing them from doing so? 4) Do the answers to questions 1-3 differ based on the type of payment model (Fee-for-Service or Capitation) to which the practice is subject? The results of the study suggest that fee-for-service payment environments present less incentive to use a patient's SDOH in medical decision making.

There is a lot of variation in health outcomes when it comes to individual states in America. Some states, such as Hawaii, have the life expectancy equivalent to that of developed countries, whereas states like Mississippi have the life expectancy equivalent to that of third world countries. This raised the questions of which states are doing well in health and why, and if their health has to do with their performance in the primary, secondary, tertiary, and/or quaternary prevention levels. The purpose of this research was to investigate if there is a correlation between performance in any of the prevention levels and the overall health status of a state, and if there is, which prevention level would be most beneficial for states to prioritize. The hypothesis of this research was: states that prioritized primary and secondary levels of prevention would have better health than states that prioritized tertiary and quaternary levels of prevention, since basic health measures contribute more to health outcomes than advanced medicine. To investigate this question, indicators were chosen to derive the ranking of each state in health and each of the four prevention levels. Six states were then chosen to represent the high, average, and low health statuses respectively. The six states were ranked for all indicators, and the data was analyzed and compared to determine a potential relationship between the prevention level rankings and the overarching health ranking. It was found that there is a correlation between performance in the primary and secondary prevention levels and a state’s overall health status, whereas there was no such correlation for the tertiary and quaternary levels. A model for health was proposed for states looking to improve their health status, which was to invest in primary prevention, followed by secondary, tertiary, then quaternary prevention and only moving to the next prevention level once the previous level reached a satisfactory threshold.

What is being done to promote cultural sensitivity in healthcare settings? To find answers and solutions to the widespread deficit of cultural competence in the health care industry, this case study interviews a varied sample of five physicians consisting of three men and two women in clinical, academic, and administrative positions. The hypothesis was physicians do not receive cultural sensitivity training in medical school and as a result, they have to find other ways to learn about the cultures of their patients. None of the participants had received formal cultural competency training in medical school and all of them found methods to improve their cultural literacy. The study uncovered the cultural training physicians do receive is sporadic and inconsistent, which can cause some disconnect between education and real-life clinical practice. Many solutions to improve cultural competency in health care delivery are presented. The results of this exploratory research should be used to inspire future conversations about cultural competency in health care as well as the creation of support and educational services and materials to medical students and health care workers on improving cultural sensitivity in clinical practice.

As 2020 unfolded, a new headline began taking over front pages: “COVID-19”. In the months that followed, waves of fear, sorrow, isolation, and grief gripped the population in the viruses’ wake. We have all heard it, we have all felt it, indeed because we were all there. Trailing a few months behind those initial headlines, more followed that only served to breed misinformation and ludicrous theories. Even with study after study, quality, scientific data about this new virus could not come fast enough. There was somehow both too much information and also not enough. We were scrambling to process the abundance of raw numbers into some semblance of an explanation. After those first few months of the pandemic, patterns in the research are beginning to emerge. These horrific patterns tell much more than just the pathology of COVID-19. As the number of sick, surviving, and deceased patients began to accumulate, it became clear that some populations were left devastated, while others seemed unscathed. The reasons for these patterns were present long before the COVID-19 Pandemic. Disparities in health care were highlighted by the pandemic – not caused by it. The roots of these disparities lie in the five Social Determinants of Health (SDOH): (1) economic stability, (2) neighborhood and built environment, (3) education, (4) social and community context, and (5) health and health care. Minority populations, namely Black Americans, Hispanic Americans, Native Americans, and Pacific Islanders consistently have higher diagnosis rates and poorer patient outcomes compared to their White American and Asian American counterparts. This is partly because minority populations tend to have jobs that pay lower, increase exposure risk, and provide little healthcare. When unemployment increased in the wake of the pandemic, minorities were the first to lose their jobs and their health insurance. In addition, these populations tend to live in densely populated neighborhoods, where social isolation is harder. Higher poverty rates encourage work DISPROPORTIONATE EFFECTS OF COVID-19 ON MINORITY POPULATIONS 3 rather than education, often perpetuating the cycle. The recent racial history and current aggressions towards minority people might produce a social attitude against healthcare Health care itself can be expensive, hard to find, and/or tied to employment, leading to poorly controlled comorbidities, which exacerbate poor patient outcomes in the case of COVID-19 infection. The healthcare delivery system plays little part in the SDOH, instead, public policy must be called to reform in order to fix these issues.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.