Social Work Commons^™

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 …

Breast Cancer Among Women Living In Poverty: Better Care In Canada Than In The United States, Kevin M. Gorey, Nancy L. Richter, Isaac N. Luginaah, Caroline Hamm, Eric J. Holowaty, Guangyong Zou, Madhan K. Balagurusamy

Social Work Publications

This historical study estimated the protective effects of a universally accessible, single-payer health care system versus a multipayer system that leaves many uninsured or underinsured by comparing breast cancer care of women living in high-poverty neighborhoods in Ontario and California between 1996 and 2011. Women in Canada experienced better care, particularly as compared with women who were inadequately insured in the United States. Women in Canada were diagnosed earlier (rate ratio [RR] = 1.12) and enjoyed better access to breast conserving surgery (RR = 1.48), radiation (RR = 1.60), and hormone therapies (RR = 1.78). Women living in high-poverty Canadian …

Multiplicative Disadvantage Of Being An Unmarried And Inadequately Insured Woman Living In Poverty With Colon Cancer: Historical Cohort Exploration In California, Naomi R. Levitz, Sundus Haji-Jama, Tonya Munro, Kevin M. Gorey

Social Work Publications

Background: Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. Methods: California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5–29%) or low poverty (<5% poor). Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. Results: A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. Conclusions: The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as future reforms of the American health care system are considered.

Children's Experiences Of Companion Animal Maltreatment In Households Characterized By Intimate Partner Violence, Shelby Elaine Mcdonald, Elizabeth A. Collins, Nicole Nicotera, Tina O. Hageman, Frank R. Ascione, James Herbert Williams, Sandra A. Graham-Bermann

Social Work Publications

Cruelty toward companion animals is a well-documented, coercive tactic used by abusive partners to intimidate and control their intimate partners. Experiences of co-occurring violence are common for children living in families with intimate partner violence (IPV) and surveys show that more than half are also exposed to abuse of their pets. Given children's relationships with their pets, witnessing such abuse may be traumatic for them. Yet little is known about the prevalence and significance of this issue for children. The present study examines the experiences of children in families with co-occurring pet abuse and IPV. Using qualitative methods, 58 children …

Hispanic Subgroups, Acculturation, And Substance Abuse Treatment Outcomes, Karen G. Chartier, Tom Carmody, Maleeha Akhtar, Mary B. Stebbins, Scott T. Walters, Diane Warden

Social Work Publications

This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n = 34), Mexican American (n = 209), Puerto Rican (n = 78), and other Hispanic American (n = 54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home …

Explaining The Frequency Of Alcohol Consumption In A Conflict Zone: Jews And Palestinians In Israel, Zohar Massey, Karen G. Chartier, Mary B. Stebbins, Daphna Canetti, Stevan E. Hobfoll, Brian J. Hall, Kerem Shuval

Social Work Publications

Experiencing stress and exposure to terrorism may have an adverse effect on health risk behaviors. Few studies have examined alcohol use among adults living in Israel under chronic, stressful terrorism-related conditions. In this study, we examined the relationships of demographics, past stressful events, and terrorism exposure to the frequency of alcohol use and the mediating roles of depressive and post-traumatic stress disorder (PTSD) symptoms. We used three waves of data from a 2007–2008 nationally representative sample of Jewish and Palestinian adults in Israel. We assessed past stressful events, in addition to direct and indirect exposures to terrorism. Results indicated that …

Comorbidities And Race/Ethnicity Among Adults With Stimulant Use Disorders In Residential Treatment, Katherine Sanchez, Karen G. Chartier, Tracy L. Greer, Robrina Walker, Thomas Carmody, Chad D. Rethorst

Social Work Publications

Comorbid physical and mental health problems are associated with poorer substance abuse treatment outcomes; however, little is known about these conditions among stimulant abusers at treatment entry. This study compared racial and ethnic groups on baseline measures of drug use patterns, comorbid physical and mental health disorders, quality of life, and daily functioning among cocaine and stimulant abusing/dependent patients. Baseline data from a multi-site randomized clinical trial of vigorous exercise as a treatment strategy for a diverse population of stimulant abusers (N = 290) were analyzed. Significant differences between groups were found on drug use characteristics, stimulant use disorders, …

Men And Women From The Stride Clinical Trial: An Assessment Of Stimulant Abstinence Symptom Severity At Residential Treatment Entry, Karen G. Chartier, Katherine Sanchez, Therese K. Killeen, Allison Burrow, Thomas Carmody, Tracy L. Greer, Madhukar H. Trivedi

Social Work Publications

Background and Objectives

Gender‐specific factors associated with stimulant abstinence severity were examined in a stimulant abusing or dependent residential treatment sample (N = 302).

Method

Bivariate statistics tested gender differences in stimulant abstinence symptoms, measured by participant‐reported experiences of early withdrawal. Multivariate linear regression examined gender and other predictors of stimulant abstinence symptom severity.

Results

Women compared to men reported greater stimulant abstinence symptom severity. Anxiety disorders and individual anxiety‐related abstinence symptoms accounted for this difference. African American race/ethnicity was predictive of lower stimulant abstinence severity.

Discussion and Conclusions

Women were more sensitive to anxiety‐related stimulant withdrawal symptoms.

Scientific …

Delinquency And Crime Prevention: Overview Of Research Comparing Treatment Foster Care And Group Care, Gershon K. Osei, Kevin M. Gorey, Debra M. Hernandez Jozefowicz

Social Work Publications

Background: Evidence of treatment foster care (TFC) and group care’s (GC) potential to prevent delinquency and crime has been developing.

Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have greater impacts than larger homes with a meta-analytic update.

Methods: Research literatures were searched to 2015. Five systematic reviews were selected that included seven independent studies that compared delinquency or crime outcomes among youths ages 10–18. A similar search augmented by author and bibliographic searches identified six additional studies with an …

Perceptions Of Social Support Among Canadian-Born And Non- Canadian-Born Parents Of Children With Developmental Disabilities, Irene Carter, Wansoo Park, Stephanie J. Craig

Social Work Publications

No abstract provided.