Medicine and Health Sciences Commons^™

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

A Unique Hiv Harm Reduction Perspective From Costa Rica: Hogar De La Esperanza An Ethnographic Case Study And Comparative Examination Of Approach To Hiv Treatment Between The United States And Costa Rica, Kim Marie Day

Theses and Graduate Projects

This case study presents a real, currently operational scenario of harm reduction in action in Costa Rica, focusing on its success and the challenges faced by healthcare professionals, the experiences of those who live at Hogar de la Esperanza, and the implications for healthcare policies and interventions in the United States. By examining this specific case of a Costa Rican community-based HIV treatment model, the aim of this ethnographic report is to shed light on the complexities and factors contributing to the success or failure of harm reduction treatment strategies within the United States and what can be learned by …

Community And Social Context: An Important Social Determinant Of Cardiovascular Disease., Rahul Singh, Zulqarnain Javed, Tamer Yahya, Javier Valero-Elizondo, Isaac Acquah, Adnan A. Hyder, Muhammad Haisum Maqsood, Zahir Amin, Sadeer Al-Kindi, Miguel Cainzos-Achirica, Khurram Nasir

Global Health Faculty Publications

No abstract provided.

Limitations And Consequences Of Migrant And Refugee Healthcare- An Analysis Of The Current State Of Migrant Health, Meghan Herilla

Senior Theses

Migrants and refugees are an often-neglected specialized population in the field of healthcare, although making up over 14% of the world’s population.

The following paper examines the current state of migrant healthcare, including but not limited to ease of access, quality of care, and the accompanying stigmatization of immigrants in general. It then analyzes current policies, both national and global, influencing the healthcare of immigrants in both the United States and abroad. Finally, a comparison of migrant healthcare in the United States versus Thailand shows how the current U.S. healthcare system can be improved to better accommodate migrants and refugees. …

Transition In Occupations Of Refugees During Resettlement, Jacqueline-Elizabeth Cantrell, Kimberley K. Banuelos, Adam Chan, Jennifer H. Daine

Occupational Therapy | Graduate Capstone Projects

Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only …

Indigenous Adolescent Girls’ Empowerment Network (Imagen): Adapting The Girl Roster™ For Lakota Communities, Kelly Hallman, Stephanie Martinez

Poverty, Gender, and Youth

This brief reports on a first-of-a-kind meeting between the Population Council’s GIRLCenter and organizations such as the White Buffalo Calf Woman Society (WBCWS) that work locally with Native American communities to understand the specific needs of adolescent girls in Indian Country. This followed an inaugural meeting of the Indigenous Adolescent Girls’ Empowerment Network (IMAGEN) with its wealth of insight concerning the needs of the Native communities they serve, and the GIRL Center’s myriad programmatic tools and resources that have been tried and tested in global settings for several decades. The IMAGEN Approach is an adaptable process that links these two …

Swedish Social Welfare And Its Application To American Welfare Systems, Ben Wilson Galloway

Graduate Theses and Dissertations

Swedish Social Welfare and its Application to American Welfare Systems concerns itself with the issue of determining the origins of the modern Swedish social welfare system. Additionally, the causes behind the formation of the system are evaluated for their relevancy concerning the formation of the American welfare system. Multiple areas of study are considered, including racial impacts, economic factors, sociological impactors, and demographic variables.

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Among African Medical Schools Catalyzed By The Medical Education Partnership Initiative., Zohray M. Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Miliard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Health Policy and Management Faculty Publications

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

Better Colon Cancer Care For Extremely Poor Canadian Women Compared With American Women, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Sundus Haji-Jama, Eric J. Holowaty, Caroline Hamm, Sindu M. Kanjeekal, Fraces C. Wright, Madhan K. Balagurusamy, Nancy L. Richter

Social Work Publications

Extremely poor Canadian women were recently observed to be largely advantaged on most aspects of breast cancer care as compared with similarly poor, but much less adequately insured, women in the United States. This historical study systematically replicated the protective effects of single- versus multipayer health care by comparing colon cancer care among cohorts of extremely poor women in California and Ontario between 1996 and 2011. The Canadian women were again observed to have been largely advantaged. They were more likely to have received indicated surgery and chemotherapy, and their wait times for care were significantly shorter. Consequently, the Canadian …

Agenda: 2012 Energy Justice Conference And Technology Exposition, University Of Colorado Boulder. Center For Energy & Environmental Security, University Of Colorado Boulder. Colorado European Union Center Of Excellence, University Of Colorado Boulder. Presidents Leadership Institute

2012 Energy Justice Conference and Technology Exposition (September 17-18)

Co-sponsored with the Colorado European Union Center of Excellence and the Presidents Leadership Institute at the University of Colorado Boulder.

The ability to harness energy is fundamental to economic and social development. Worldwide, almost 3 billion people have little or no access to beneficial energy resources for cooking, heating, water sanitation, illumination, transportation, or basic mechanical needs. Energy poverty exacerbates ill health and economic hardship, and reduces educational opportunities, particularly for women and children. Specifically, access to efficient and affordable energy services is a prerequisite for achieving the Millennium Development Goal (MDG) relating to poverty eradication.

In response, the UN …

The Clinical Gaze In The Practice Of Migrant Health: Indigenous Mexican Migrants In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep …

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Parce Qu'ils Sont Plus Pres Sol: L'Invisibilisation De La Souffrance Sociale Des Cueilleurs De Baies, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

An Ethnographic Study Of The Social Context Of Migrant Health In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

Background

Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care.

Methods and Findings

This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm …

Are Differences In Exposure To A Multicomponent School-Based Intervention Associated With Varying Dietary Outcomes In Adolescents?, Amanda S. Birnbaum, Leslie A. Lytle, Mary Story, Cheryl L. Perry, David M. Murray

Department of Public Health Scholarship and Creative Works

Multicomponent interventions are recommended for health behavior change among adolescents. However, it is difficult to disentangle the effects of multiple intervention components. This article reports outcomes associated with varying levels of exposure to a school-based nutrition intervention, Teens Eating for Energy and Nutrition at School (TEENS). Four incremental exposureswere possible: (1) control group, (2) school environment interventions only, (3) classroom plus environment interventions, and (4) peer leaders plus classroom plus environment interventions. Patterns suggesting dose response were observed, with peer leaders reporting the largest increases in fruit, vegetable, and lower fat food consumption. Students exposed to classroom plus environment interventions …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior., Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago.

METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey.

RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …