Medicine and Health Commons^™

The Weight Of The Interaction: An Exploration Of Fat Women's Experiences In Healthcare Settings, Danielle Snow

Masters Theses

Despite making up a large portion of the United States population, fat people are stigmatized, discriminated against, and treated as deviant. Though there is a large body of interdisciplinary literature on obesity and health, and a large body of sociological literature on stigma, there is little literature on fat stigma. Thus, using a Goffman’s stigma theory with the added contribution of Foucault’s concept the medical gaze and medical anthropological concept delegitimization, this qualitative thesis explores the health care experiences of 13 White and 2 Black fat women in the U.S. First, context for fatness and health is explored within chapter …

The Financial Implications Of The Chinese Healthcare System, Lilly Schneider, Chi Hung Kenneth Leung

DU Undergraduate Research Journal Archive

In 1949 one of the world’s most powerful and influential countries was born: The People’s Republic of China. Perhaps the greatest challenge the country has consistently faced since its inception has been ensuring a fiscally sound healthcare system. Today, China has the world’s largest population and a rapidly aging society with 330 million citizens over the age of 65 projected by 2050- nearly the same size as the total U.S. population. Living standards across China have been drastically increasing in recent decades and the Chinese people are desiring better, higher quality healthcare to complement their new lifestyles. With this desire …

Barriers To Relational Continuity Of Care For Undergraduate College Students In Southeastern South Dakota, Laura E. Nelson

Honors Thesis

In health care, the patient’s relationship with his or her provider serves as a foundation upon which health care decisions are guided and health outcomes are addressed. Relational continuity of care refers to the presence of a sustained (long-term) relationship between a primary care provider (PCP) and a patient. Such continuity of care has been linked with improved health outcomes, reduced mortality, lower health care costs, increased patient satisfaction, and increased delivery of preventative services. Relational continuity of care tends to be low amongst young adults, especially college students. The reasons for this – and the salient barriers to relational …

Trans Men’S Access To Knowledgeable Providers And Their Experiences In Health Care Settings: Differences By Demographics, Mental Health, And Degree Of Being “Out” To Providers, Kristie L. Seelman, Shanna K. Kattari, Penny Harvey, Matthew Bakko

SW Publications

Transgender adults face a health care system rife with stigma, including a lack of culturally responsive providers and high likelihood of discrimination and mistreatment. However, there is a gap in knowledge about trans men—those assigned a female sex at birth who identify as men or as transmasculine—including subgroups, such as trans men of color. Using data from the U.S. Transgender Survey, the largest transgender survey conducted in the United States, this study analyzes whether trans men’s access to knowledgeable providers and their experiences of mistreatment in health care were related to demographic and mental health characteristics and degree of being …

Mlk Book Read 2019 (Research Materials), Holy Cross Libraries

Library Resources for Campus Events

A bibliography of resources available through the Holy Cross Libraries which provide additional information related to the MLK Winter Book Read, based on the best-seller “Brother, I'm Dying" by Edwidge Danticat.

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Gender Nonconforming, Transgender, And Transsexual Patient Navigation Of The American Health Care System: Locating A Primary Care Provider, Justin M. Vinneau

Theses and Dissertations

This study explores the experiences of gender nonconforming (GNC), transgender, and transsexual (trans) people in the search for a primary care provider in the United States. The current body of literature on transgender health often discusses HIV rates, substance use, mental health/suicide, and few studies have studies primary care seeking behaviors; this study seeks to provide new insight into the primary care (pcp) seeking behaviors of GNC and trans people. The primary theoretical perspectives utilized in this study were West and Zimmerman’s (1987) “Doing Gender” and the Health Beliefs Mode (Ayers et al., 2007; Connor and Norman, 2005; Green and …

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

Timothy D. Lytton

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Bridging The Gap: The St. Cloud Somali Community’S View Of Illness And Disease In A Western Society & Its Effects On Patient Care, Jeffry J. Anderson, Sinloria C. Macrae, Katee A. Meckeler, Jennifer N. Yang, Sheng Xiong

Celebrating Scholarship & Creativity Day (2011-2017)

In this ethnographic study, we looked at how the Somali people view illness and disease in a Western society. In addition, we looked at how differing views and cultural practices affected their treatment and interpretation of Western medicine. Due to the ongoing increase of Somali people in the United States, this topic is important in showcasing the difficulties that newcomers face when it comes to medicine and how these experiences shape their view of Western medicine. These difficulties include language barriers and cultural differences. Our main focus was on the St. Cloud area due to its close proximity to the …

The Reverberating Risk Of Long-Term Care, Allison K. Hoffman

All Faculty Scholarship

The Fiftieth Anniversary of Medicare and Medicaid offers an opportunity to reflect on how American social policy has conceived of the problem of long-term care. In this essay, based on a longer forthcoming article, I argue that current policies adopt too narrow a conception of long-term care risk, by focusing on the effect of serious illness and disability on people who need care and not on the friends and family who often provide it. I propose a more complete view of long-term care risk that acknowledges how illness and disability reverberates through communities, posing insecurity for people beyond those in …

Worlds Of Connection: A Hermeneutic Formulation Of The Interdisciplinary Relational Model Of Care, Susana Lauraine Mccune

Antioch University Full-Text Dissertations & Theses

Despite a general agreement across health care disciplines that Advanced Care Planning (ACP) and Advanced Directives (ADs) add important elements to a patient's end-of-life care desires, and can inform their loved ones and advocates, help create ease of mind, and enhance quality of care, they continue to remain significantly underused. More than half of Americans transition to chronic and terminal illness without having completed them. The aim of this study was to increase the frequency and enhance the quality of communication about Advance Directives and Advance Care Planning within the clinical relationship. The resulting Interdisciplinary Relational Model of Care (IRMOC) …

The State Of The Science Of Health And Wellness For Adults With Intellectual And Developmental Disabilities, Lynda Lahti Anderson, Kathy Humphries, Suzanne Mcdermott, Beth Marks, Jasmina Sisirak, Sheryl Larson

Rural Institute Journal Articles

Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater …

Adherence Among Women With Hiv Infection In Puerto Rico, Desiree Ciambrone, Helen Loewenthal, Lauri Bazerman, Carmen Zorilla, Brenda Urbina, Jennifer Mitty

Desiree A Ciambrone

Women are the fastest growing segment of the adult population acquiring HIV, and most women infected with HIV are in their reproductive years. The success of HAART is highly dependent upon the ability and willingness of the individual to adhere to complex antiretroviral regimens. Improved adherence among HIV-infected pregnant women will delay disease progression in the mother and should also reduce HIV transmission to the baby. Modified directly observed therapy (MDOT), may benefit this population. MDOT has been shown to be an acceptable and feasible intervention among HIV substance users; however, no-one has yet evaluated the use of MDOT in …

Free Clinics And The Uninsured: The Need For Remote Area Medical In Central Appalachia After Health Reform., James W. Watson

Electronic Theses and Dissertations

In 2008, the election of President Barack Obama brought health care to the forefront of national discussions and led to the passage of the Patient Protection and Affordable Care Act (ACA). The legislation changed the rules of health care delivery in the United States, but the ACA did not do one fundamental thing: It did not end the need for many of the nation's most needy patients to seek free medical care from groups such as Remote Area Medical (RAM).

A mobile clinic, RAM brings together volunteer dentists, physicians, nurses, and other professionals as well as support staff for multi-day …

Cultural Definitions Of Health Care: A Case Study Of Burmese Refugees, Marielena Rose White

Undergraduate Honors Thesis Collection

As a result of ongoing civil war and civil unrest in the Southeast Asian country of Myanmar, every year the United States accepts increasing numbers of refugees from Burma of which there is a population of significance within the greater Indianapolis area. When considering options for health care, Burmese refugees may opt for self care as opposed to care from a health care professional as a result of clashing cultural factors or fears of the unknown.

This study aims to uncover how members of the Chin ethnic group have been challenged or confronted by the social, cultural, and political institutions …

Stigmatization As A Social Control Mechanism For Persons Living With Hiv And Aids, Judy E. Mill, Nancy Edwards, Randy C. Jackson, Lynne Maclean, Jean Chaw-Kant

Aboriginal Policy Research Consortium International (APRCi)

Stigmatization contributes to inequity by marginalizing persons living with HIV and AIDS (PHAs). In this study we examined the stigmatizing practices in health care settings from the perspectives of PHAs and health care providers (HCPs). A qualitative design, using a participatory action research approach, was used. Interviews and focus groups were completed with 16 aboriginal and 17 nonaboriginal individuals living with HIV (APHAs and PHAs) and 27 HCPs in Ottawa and Edmonton, Canada. We present findings to support the premise that stigmatization can be used as a social control mechanism with PHAs. Participants described both active and passive social control …

Performance Measures And Pilot Evaluation Of Georgia’S Medical Assistance Program For Population Below The Poverty Line, Tamar Chitashvili

Muskie School Capstones and Dissertations

In recent years the Georgian health care system has been undergoing fundamental reforms aimed at improving the population’s health status by increasing financial and geographic access to high-quality health care. To address limited financial access to health services of the poor, and protect them from catastrophic expenditures associated with illnesses and improve equity, the government restructured the centralized, financially and administratively unsustainable social security system, with a liberal welfare system focusing on providing a safety net for the poor.

Allowing Patients To Waive The Right To Sue For Medical Malpractice: A Response To Thaler And Sunstein, Tom Baker, Timothy D. Lytton

All Faculty Scholarship

This essay critically evaluates Richard Thaler and Cass Sunstein’s proposal to allow patients to prospectively waive their rights to bring a malpractice claim, presented in their recent, much acclaimed book, Nudge: Improving Decisions about Health, Wealth and Happiness. We show that the behavioral insights that undergird Nudge do not support the waiver proposal. In addition, we demonstrate that Thaler and Sunstein have not provided a persuasive cost-benefit justification for the proposal. Finally, we argue that their liberty-based defense of waivers rests on misleading analogies and polemical rhetoric that ignore the liberty and other interests served by patients’ tort law rights. …

Scaling Up, Lourdes Hernández-Cordero, Susan P. Sturm, Kathleen Klink, Allan J. Formicola

Faculty Scholarship

Moments of crisis require big, bold ideas. In this chapter we will zoom out of our close examination of the Northern Manhattan Community Voices Collaborative experience to propose ways to scale up the things that worked for us in order to make them applicable at a national level. With this chapter we honor the intent of the W. K. Kellogg Foundation in its support of learning laboratories across the nation. Our goal is to contribute to the collective dialogue on how to improve the health care system. Specifically, we propose that making a healthier nation and reducing health care costs …

Physician Sovereignty: The Dangerous Persistence Of An Obsolete Idea, David M. Lawrence

Center for Policy Research

The heart of the model is this: to quote Pogo, "We have met the enemy and it is us." We doctors are the problem, not because we are venal or self-serving or insulated from reality. Far from it. Most of us are hard-working, dedicated professionals. We are the problem, though, because of the way our profession developed in the 20th century. This model is no longer appropriate for what lies ahead. The notion of the sovereign physician comes from Paul Starr's 1982 work, "The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a …

Emergency Department Utilization Among Victims And Offenders Involved In Non-Lethal Violence, Jerry Daday, Lisa M. Broidy, Cameron S. Crandall

Sociology Faculty Publications

The medical literature has focused on violent victimization as a public health concern, examining its correlates and evaluating intervention models. However, the emphasis on victimization in this literature overlooks the strong ties between victimization and offending risks outlined in the criminological literature, which may unnecessarily limit the scope of public health efforts to influence violence in our communities. This study examines whether the similarities observed in the criminological literature are evident in a health care setting. More specifically, do victims and offenders exhibit similar health care utilization patterns? We address this question by comparing the emergency department utilization records, criminal …

Puerto Ricans' Access To Health Care, Ralph Rivera

New England Journal of Public Policy

The shift toward cost containment in health policy over the past decade has had negative consequences for the most vulnerable populations in the country, namely, ethnic minorities, the poor, and the uninsured. The Puerto Rican population is significantly affected by this shift, yet little is known of their health care usage. This study investigates the extent to which Puerto Ricans' health care use is determined by the relationship between predisposing variables, enabling variables, need, and other contextual variables and probes the implications of the findings for health policy. The adult Puerto Rican subsample (n = 1598) of the Hispanic Health …