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Articles 2131 - 2160 of 2413
Full-Text Articles in Public Health
Involving Men To Improve Maternal And Newborn Health: A Systematic Review Of The Effectiveness Of Interventions, Mariam Tokhi, Liz Comrie-Thomson, Jessica Davis, Anayda Portela, Matthew Chersich, Stanley Luchters
Involving Men To Improve Maternal And Newborn Health: A Systematic Review Of The Effectiveness Of Interventions, Mariam Tokhi, Liz Comrie-Thomson, Jessica Davis, Anayda Portela, Matthew Chersich, Stanley Luchters
Population Health, East Africa
Background: Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low- and middle-income countries. Previous reviews have identified male involvement as a promising intervention, but with a complex evidence base and limited direct evidence of effectiveness for mortality and morbidity outcomes.
Objective: To determine the effect of interventions to engage men during pregnancy, childbirth and infancy on mortality and morbidity, as well as effects on mechanisms by which male involvement is hypothesised to influence mortality and morbidity outcomes: home care practices, care-seeking, and couple relationships. …
Understanding Perceptions Of Child Maltreatment Risk: A Qualitative Study Of Early Head Start Home Visitors, Alayna Schreier, Kelsey Mccoy, Mary F. Flood, Brian Wilcox, David J. Hansen
Understanding Perceptions Of Child Maltreatment Risk: A Qualitative Study Of Early Head Start Home Visitors, Alayna Schreier, Kelsey Mccoy, Mary F. Flood, Brian Wilcox, David J. Hansen
Department of Psychology: Faculty Publications
Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment. Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience maltreatment by identifying characteristics and behaviors of children, caregivers, families, and environments that are of concern. However, research has demonstrated that home visitors are often ill-equipped to identify and address risk factors such as parental mental health concerns, substance abuse, and domestic violence. Further, little is known about how home visitors understand and perceive risk for maltreatment and identify vulnerable families. The study sought to identify …
Paleoparasitology And Pathoecology In Russia: Investigations And Perspectives, Sergey Slepchenko, Karl Reinhard
Paleoparasitology And Pathoecology In Russia: Investigations And Perspectives, Sergey Slepchenko, Karl Reinhard
Karl Reinhard Publications
Russia, both as the USSR and the Russian federation, provided a source of parasitological theory for decades. A key figure in Russian parasitology was Yevgeny Pavlovsky. He developed the nidus concept, the conceptual basis for the field of pathoecology. He also coined the term “paleoparasitology.” Pathoecology is a foundation concept in archaeological parasitology. Paleoparasitology, as defined by Pavlovsky, is an avenue for understanding of host parasite evolution over very long time periods. These contributions are not fully recognized internationally. Similarly, the long history of Russian paleontological and archaeological investigations are not fully known. Most recently, discoveries from archaeological sites show …
The Paleoepidemiology Of Enterobius Vermicularis (Nemata: Oxyuridae) Among The Loma San Gabriel At La Cueva De Los Muertos Chiquitos (600–800 Ce), Rio Zape Valley, Durango, Mexico, Johnica J. Morrow, Karl Reinhard
The Paleoepidemiology Of Enterobius Vermicularis (Nemata: Oxyuridae) Among The Loma San Gabriel At La Cueva De Los Muertos Chiquitos (600–800 Ce), Rio Zape Valley, Durango, Mexico, Johnica J. Morrow, Karl Reinhard
Karl Reinhard Publications
One hundred coprolites excavated from La Cueva de los Muertos Chiquitos (600–800 CE) in the Rio Zape Valley of present-day Durango, Mexico, were examined for the presence of helminth eggs utilizing standard archaeoparasitological techniques. Eggs of the human pinworm (Enterobius vermicularis) were recovered from 34 of the 100 coprolites examined. Eggs of parasites were photographed and measured before egg concentration values were calculated for each positive sample. Egg concentration values demonstrated an overdispersed pattern of distribution among the samples (66% uninfected, 25% less than 100 eggs/g, 8% between 100 and 500 eggs/g, and 1% more than 500 eggs/g). …
Taphonomic Considerations On Pinworm Prevalence In Three Ancestral Puebloan Latrines, Morgana Camacho, Alena M. Iñiguez, Karl Reinhard
Taphonomic Considerations On Pinworm Prevalence In Three Ancestral Puebloan Latrines, Morgana Camacho, Alena M. Iñiguez, Karl Reinhard
Karl Reinhard Publications
For archaeological studies it is always necessary to consider taphonomic factors that could have influenced in ancient material preservation. Parasite eggs are usually highly degraded in ancient sites dated from all periods of time and taphonomic factors are mentioned to explain absence and low quantity of eggs found. In this study, we compare parasite egg recovery of three Great House latrines: two from Aztec Ruins (Rooms 219 and 225) and one from Salmon Ruins. We compared through statistical regression the recovery of eggs with the abundance of two classes of decomposers: mites and nematodes. These microorganisms have relation with nematode …
New Evidence Of Ancient Parasitism Among Late Archaic And Ancestral Puebloan Residents Of Chaco Canyon, Rachel E. Paseka, Carrie C. Heitman, Karl Reinhard
New Evidence Of Ancient Parasitism Among Late Archaic And Ancestral Puebloan Residents Of Chaco Canyon, Rachel E. Paseka, Carrie C. Heitman, Karl Reinhard
Karl Reinhard Publications
Archaeoparasitology provides a unique perspective on the health and habits of ancient cultures through the identification of parasite remains in archaeological materials. We identified eggs of the human whipworm, Trichuris trichiura, in coprolites recovered from Late Archaic (1926–1751 cal. BCE) and Ancestral Puebloan (1039–1163 cal. CE) sites in Chaco Canyon, New Mexico. Our findings represent the earliest record of T. trichiura in North America, the first record of the species from Chaco Canyon, and the first record of a macroparasite from a Late Archaic site (Atlatl Cave) on the Colorado Plateau. T. trichiura is common in the …
Autologous Bone Flap Resorption Years After Subtemporal Craniotomy, John Oladapo Obafunwa, Emily E. Hammerl, David Jaskierny, Livia A. Taylor, Lynette Russell, Karl Reinhard
Autologous Bone Flap Resorption Years After Subtemporal Craniotomy, John Oladapo Obafunwa, Emily E. Hammerl, David Jaskierny, Livia A. Taylor, Lynette Russell, Karl Reinhard
Karl Reinhard Publications
In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury. Death was variously attributed to craniocerebral …
Does Insulin Therapy Matter? Determinants Of Diabetes Care Outcomes, Jennifer A. Andersen, Larry Gibbs
Does Insulin Therapy Matter? Determinants Of Diabetes Care Outcomes, Jennifer A. Andersen, Larry Gibbs
Department of Sociology: Faculty Publications
Objective: To evaluate adherence to care standards for people with diabetes (PWDs) on insulin therapy versus PWDs who are not on insulin therapy, controlling for social determinants.
Research design and methods: Utilizing the United States 2015 Behavioral Risk Factor Surveillance System Survey, this study used logistic regression analyses to estimate differences in self-care behaviors, healthcare provider quality of care, and diabetic complications for individuals on insulin therapy and individuals not on insulin therapy.
Results: PWDs on insulin therapy are more likely to adhere to self-care measures (self-glucose checks [OR: 7.57], self-foot checks [OR: 1.27], diabetes class participation [OR: 1.96]), adherence …
The Role Of Family Structure In The Abuse Of Children, Ramona Okonya
The Role Of Family Structure In The Abuse Of Children, Ramona Okonya
Walden Dissertations and Doctoral Studies
Every year, about 1 million children are abused in the United States and an average of 4.5 of those children die daily at the hands of caretakers, parents, relatives, or friends. Using the ecological model as a guide, the purpose of this study was to investigate the relationship between family structure and specific types of child maltreatment utilizing cases from an agency in Montgomery, Alabama, in 2012-2013. Approximately 727 cases of child maltreatment were reviewed. Logistic regression results indicate married and common law families' children are 1.83 times more likely to experience sexual abuse than the reference category (single) (OR= …
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson
Walden Dissertations and Doctoral Studies
Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …
Changes In Beliefs About Aggression In Baton Rouge Youth Peace Olympics Participants, Shonta Manuel
Changes In Beliefs About Aggression In Baton Rouge Youth Peace Olympics Participants, Shonta Manuel
Walden Dissertations and Doctoral Studies
Youth violence in the Baton Rouge inner-city area continues to create heightened concerns for the communities as well as the financial and healthcare systems. Even though violence prevention programs are in place in the area, no decline has been recorded in those who are being affected by violence. Due to lack of research in this field, a need for a sound research study exists to understand how Youth Peace Olympics (YPO) community-based program may be related to changes in attitudes about aggression and violence. A correlational cross-sectional research design was used to evaluate participants' beliefs about aggression, measured using the …
Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright
Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright
Walden Dissertations and Doctoral Studies
Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …
Etiology Of Water Quality Perceptions And Beverage Preferences Of Black Children And Adolescents, Forkpayea K. Johnson
Etiology Of Water Quality Perceptions And Beverage Preferences Of Black Children And Adolescents, Forkpayea K. Johnson
Walden Dissertations and Doctoral Studies
The purpose of this phenomenological qualitative study was to examine the etiology of water quality perceptions and beverage preferences of Black children and adolescents, which addressed a current gap in the literature on this topic. This study was guided by Festinger's social comparison theory, which supports the notion that children and adolescents' perceptions and preferences are influenced by their social network and those with whom they have a close association. In this study, children and adolescents' water quality perceptions were examined as well as the development and factors affecting those perceptions. Whether social factors such as peer or parental influence …
Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner
Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner
Walden Dissertations and Doctoral Studies
Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …
Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina
Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina
Walden Dissertations and Doctoral Studies
The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …
Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah
Influence Of An Educational Program On Opioid Drug Abuse, Gloria Nkiru Nnah
Walden Dissertations and Doctoral Studies
Prescription opioid abuse in the United States is an alarming health issue. In 2015, approximately 2 million people abused prescription opioids, and 12 million individuals misused their prescription opioid pain relievers. The percentage of individuals who died as a result of opiate abuse increased from 22% in 2013 to 76% in 2014. The purpose of this project was to evaluate the influence of an inner-city drug treatment (DTBF) program on opioid users' behavior. The practice question addressed whether knowledge of signs and symptoms of opioid withdrawal obtained from the DTBF program resulted in a significant behavioral change in opioid use …
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie
Walden Dissertations and Doctoral Studies
Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …
Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave
Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave
Walden Dissertations and Doctoral Studies
Diabetes has quickly become an epidemic in the United States and affects all genders and races. Some ethnic groups are at greater risk for being diagnosed and face devastating health consequences due to poor diabetes self-management. Diabetes self-management education (DSME) is considered to be a positive step toward patient self-efficacy and diabetes management. The benefits of diabetes self-management education can only be realized if patients diagnosed with diabetes not only enroll, but complete the program. The purpose of this research study was to investigate the association between race and gender and dropout rates among participants enrolled in a DSME program. …
Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton
Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton
Walden Dissertations and Doctoral Studies
Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …
Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister
Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister
Walden Dissertations and Doctoral Studies
Food service businesses in the United States have experienced millions of dollars in losses caused by foodborne illness outbreaks, which can lead to bankruptcy and business closures. More than 68% of all foodborne illness outbreaks occur in food service establishments. The purpose of this descriptive case study was to explore the strategies leaders of food service establishments use to implement food safety regulations. Force field analysis was the conceptual framework for this study. The population for the study consisted of 3 leaders of food service establishments located in the southeastern region of the United States. Data were collected using semistructured …
Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu
Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu
Walden Dissertations and Doctoral Studies
A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses …
Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett
Women's Experiences Using Health Facilities For Childbirth In South Sudan, Gillian Magda Garnett
Walden Dissertations and Doctoral Studies
There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women …
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston
Walden Dissertations and Doctoral Studies
Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …
Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings
Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings
Walden Dissertations and Doctoral Studies
In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …
Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna
Sport-Related Concussion And Lower Extremity Musculoskeletal Injuries In High School Athletes, Lisa Koperna
Walden Dissertations and Doctoral Studies
Sport-related injuries (SRI) can be foreseen and averted when mechanisms and risk factors are completely understood. An appreciation of the relationship between sport-related concussion (SRC) and lower extremity musculoskeletal injuries (LEMI) is emerging amid professional and collegiate athletes. However, findings of such a relationship in adults may not be generalizable to younger populations, and the literature has not addressed this relationship in adolescents. The purpose of this cross-sectional quantitative study was to examine the relationship between SRC and LEMI in high school athletes. The dynamic model of etiology in sport injury provided the study's conceptual framework. A de-identified secondary dataset …
Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster
Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster
Walden Dissertations and Doctoral Studies
Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …
Improving Fall Risk Assessment And Documentation: A Qi Project, Ashley N. Kohari
Improving Fall Risk Assessment And Documentation: A Qi Project, Ashley N. Kohari
DNP Projects
BACKGROUND: Unintentional falls commonly arise and can cause significant harm including fractures, head injuries, and death. Assessing each patient for falls and performing a fall risk assessment is recommended by the American Geriatrics Society and the Center for Disease Control and Prevention, and is mandated for institutional reimbursement. Fall risk assessment has been shown to decrease the rate of falls and healthcare costs.
PURPOSE: The purpose of this quality improvement project was to improve compliance for fall risk screening and documentation to meet MACRA requirements in a family medicine clinic.
OBJECTIVES: The objectives for this project were: 1. Conduct PDSA …
The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell
The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell
DNP Projects
BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.
PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.
METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …
A Process Improvement Project To Increase Referral And Documentation Rates For Diabetic Retinopathy Screening, Debra Ann Bryant Taylor
A Process Improvement Project To Increase Referral And Documentation Rates For Diabetic Retinopathy Screening, Debra Ann Bryant Taylor
DNP Projects
Abstract
Background: Approximately 5.3 million Americans, aged 18 and over, carry a diagnosis of diabetic retinopathy (DR). By the year 2050 this number is expected to triple without effective healthcare intervention. Approximately 4.8% of the global blindness is attributable to DR, a silent, progressive, microvascular complication of diabetes. Best practice dictates immediate screening at time of diagnosis of Type II Diabetes Mellitus (T2DM) and biennial screenings thereafter, yet this need is often unmet.
Purpose: This study is a continuation of a process put into place by Dr. Michelle Campbell in October 2017 at the Norton Community Medical Associates Mount Washington …
Coverage And Prior Authorization Policies For Medications For Opioid Use Disorder In Medicaid Managed Care, Michael S. Spencer, Karina L. Walters, Heidi L. Allen, Christina M. Andrews Ph.D., Audrey Begun, Teri Browne Ph.D., Msw, John D. Clapp, Diana Dinitto, Peter Maramaldi, Darrell P. Wheeler, Bradley J. Zebrack, Edwina Uehara
Coverage And Prior Authorization Policies For Medications For Opioid Use Disorder In Medicaid Managed Care, Michael S. Spencer, Karina L. Walters, Heidi L. Allen, Christina M. Andrews Ph.D., Audrey Begun, Teri Browne Ph.D., Msw, John D. Clapp, Diana Dinitto, Peter Maramaldi, Darrell P. Wheeler, Bradley J. Zebrack, Edwina Uehara
Faculty Publications
More than 60 million Americans experience devastating one-two punches to their health -- they have inadequate access to basic health care while also enduring the effects of discrimination, poverty, and dangerous environments that accelerate higher rates of illness. Innovative and evidence-based social strategies can improve health care and lead to broad gains in the health of our entire society.