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Bridging the Rural-Urban Divide: Addressing Barriers to Health Services in the Rural USA and Mexico

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Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden

Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden of disease is greater in rural areas, as well as rates of physical injury. There are many intersecting influencing factors including, but not limited to, barriers to access needed healthcare, issues regarding the quality of healthcare provided, the ability to pay for healthcare and other socioeconomic considerations are both causes and consequences of poor health and healthcare access.
The health disparities between rural and urban communities in the United States are not uniquely American. This rural-urban divide in health outcomes is present across the world and, closer to home, across North America. In addition to reviewing the current literature surrounding barriers to health and healthcare access in the United States, we will also use southern neighbor Mexico’s history and their pursuit of rural equity (universally and in health/healthcare access) to contrast initiatives that the U.S. has attempted, with the intent of exploring new theories of rural healthcare provision. By combining the history of social medicine in Mexico with literature on barriers to healthcare access, I hope to highlight areas of innovation and improvement in the American health care delivery system.
The purpose of this paper is to review the current literature regarding health disparities among rural Americans, possible causes of such disparities and current strategies to improve health, healthcare access and healthcare quality in rural America in order to recommend the most effective, practical solutions to improve rural mortality, morbidity and quality of life.

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2019-05

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A Quantitative Review and Analysis over the Quality of Care and Biases Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ+) Community Receive in Healthcare

Description

Populations in the United States and globally struggle to receive equal and affordable access to healthcare, this is no secret. However there are several minority and underprivileged groups within the population that experience disproportionate quality of healthcare when compared to

Populations in the United States and globally struggle to receive equal and affordable access to healthcare, this is no secret. However there are several minority and underprivileged groups within the population that experience disproportionate quality of healthcare when compared to their cis-gendered heterosexual counterparts.
Individuals that align and identify themselves as part of the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ+) Community, often face discrimination and bias from within the healthcare system that prevent them from receiving adequate patient knowledge, tailored and beneficial healthcare, as well as social support when seeking treatment for conditions that may at times, be more persistent within the community. Examples of these holes within the healthcare system include a lack of culturally competent and appropriate care for those in the community, access to affordable treatments, and other unique health needs.
Consequently, as a minority group these members face social and environmental factors that contribute to their overall wellbeing and health, and therefore training and education need to be implemented for future and current healthcare providers to assess, recognize and acknowledge these varying factors and how they contribute to a patient’s overall wellbeing.

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2020-05

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The Impact of Incarceration on the Health of Female Inmates

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The purpose of this study was to evaluate how incarceration impacts the health of female inmates. Healthcare professionals and employees at the Riverside Correctional Facility, a women’s prison in Philadelphia, Pennsylvania, were interviewed in order to ascertain their perspective on

The purpose of this study was to evaluate how incarceration impacts the health of female inmates. Healthcare professionals and employees at the Riverside Correctional Facility, a women’s prison in Philadelphia, Pennsylvania, were interviewed in order to ascertain their perspective on the health of the female inmates they serve. A total of six employees, identified as “respondents” were interviewed and, in addition to these interviews, a tour of the facility was provided. This study used a phenomenological design and the results were analyzed through grounded theory, in which responses were broken down into several codes and themes were then identified from those codes. The analysis of the interviews found that healthcare, empowerment, and drug use were the main themes identified in relation to the health impacts of incarcerated women. The healthcare provided at the facility has a significant impact on the health of the inmates, because most of the inmates struggle with some form of health issue, such as a mental illness, untreated malady, or drug dependency. Empowerment was found to be the most important factor in motivating women to obtain an education, employment skills, and employment once they reenter society. All respondents identified drug use as the most profound health issue at the facility, in addition to acting as the largest barrier for women to successfully reenter society and attain stable employment.

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2020-05

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The Evolution of Medicine: Predictions for the Future of Emergency Medicine

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Medicine is evolving at an accelerating rate. The needs of the future in medicine are different than the needs of today. With many possible outcomes for the future of medicine, researchers and physicians have tried to predict the future for

Medicine is evolving at an accelerating rate. The needs of the future in medicine are different than the needs of today. With many possible outcomes for the future of medicine, researchers and physicians have tried to predict the future for particular fields. As new healthcare workers enter the medical field, their training must be tailored to provide the best education to prepare healthcare workers for their careers. Therefore, it is imperative to take a closer look into the future in order to better decide how to train doctors, nurses, PA’s, etc. effectively to provide the best care possible.

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2020-05

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Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

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Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.

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2017-05

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Contributing Factors to the Patient Burden of Work

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Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient,

Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.

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2017-05

Let Food be Thy Medicine

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“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these

“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these conditions, especially when combined with medication and physical activity. Obesity is a condition that people worldwide struggle with. Adequate nutrition can play a major role in contributing to the prevention of and management of obesity not only through calorie and macronutrient intake but also by affecting hormonal and energy balances in the body. Recommended physical activity levels are included along with dietary
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.

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2019-05

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Accessibility to Information in the City of Phoenix Regarding Childhood Vaccinations: A Comparative Case Study

Description

The rate of vaccinations has been consistently decreasing in the past years in children of ages 0-18. Multiple factors and barriers contribute to these low rates. This comparative case study investigated the accessibility of information regarding childhood vaccinations to parents

The rate of vaccinations has been consistently decreasing in the past years in children of ages 0-18. Multiple factors and barriers contribute to these low rates. This comparative case study investigated the accessibility of information regarding childhood vaccinations to parents in areas with differing poverty levels in the greater Phoenix region, specifically in the West Valley, Downtown Phoenix, and the East Valley. Pediatric clinics, public elementary schools, and public libraries were visited in each area to assess how much information was available where. The analysis produced unexpected results: the West Valley, which had the highest poverty level, contained the most amount of accessible information for parents in many languages, while the East Valley, with a low poverty level, had almost no information accessible to parents of these children. Implications for future research, policy, and practice are discussed. Based on these unexpected results, one recommendation is to develop a pamphlet that could be distributed to these public places to raise awareness of the importance of vaccinations in children to parents.

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2020-05

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A Feminist Analysis on Biopolitical State Regulation of Refugee Women with Female Genital Cutting/Mutilation in the United States and France

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This thesis uses the Foucauldian model of the biopolitical state to explain the regulation of refugee women’s bodies who have undergone female genital cutting/mutilation (FGC/M). The main theoretical framework for this thesis is inspired by Dr. Khiara Bridges’ work:

This thesis uses the Foucauldian model of the biopolitical state to explain the regulation of refugee women’s bodies who have undergone female genital cutting/mutilation (FGC/M). The main theoretical framework for this thesis is inspired by Dr. Khiara Bridges’ work: Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization (2011). Her book explains how “material and societal conditions appear to affirm the veracity of race” (Bridges, 2011, 10). She describes pregnancy as a “racially salient event” that inevitably engages racial politics. In her book, she illustrates how the material body is the primary sign of racial difference (Bridges, 2011, 47). I argue that race and culture are inscribed in the body, and FGC/M is a physical representation of that inscription. As a result, a physical representation of racialization opens women with FGC/M to far more scrutiny and regulation. I define the United States and France as biopolitical states whose values and agendas regulate and police bodies to behave according to their norms. The value set that underlies the United States is predicated on principles of sovereignty, federalism, and an emphasis on a Puritanical work ethic where an individual must earn their benefits from the state. In France, however, there is less stigma surrounding social welfare but there is forced cultural assimilation that results in a singular, secular French identity. These value systems then inform the tools to police behavior. The tools, or systems, I have identified for this thesis are the adoption of human rights instruments into domestic law, refugee policy, healthcare systems, and regulation of women’s reproductive health. All of these macro-level systems then inform individual patient-provider relationships since those interactions are not independent of these systems. I argue that refugee women who have undergone FGC/M deviate from these prescribed norms and thus are subjugated to overwhelming biopolitical regulation.

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2020-05

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Cultural Aspects of Healthcare from an Alaska Native Perspective

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Healthcare encounters may often be experienced by patients as cultural experiences as much as they are medicinal, creating different expectations and perceptions for each individual seeking care. This project sought to understand the experiences that Alaska Natives have with healthcare

Healthcare encounters may often be experienced by patients as cultural experiences as much as they are medicinal, creating different expectations and perceptions for each individual seeking care. This project sought to understand the experiences that Alaska Natives have with healthcare and how those experiences influenced their care. It provided a small window into the cultural relevance to healthcare for Alaska Natives by conducting interviews with participants from Sitka, Alaska. Interviews addressed three topics (or themes): linguistic and communication barriers, culturally specific care associated with individual tribes and patient-provider relationships. Although these topics, within the context of healthcare, have been well studied under the Native American - Alaska Native demographic umbrella, few projects target Alaska Natives specifically. This project was developed to specifically spotlight Alaska Natives to gain an understanding of their healthcare experiences.

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2020-05