Medicine and Health Commons^™

The Influence Of Patient-Centeredness On Minority And Socioeconomically-Disadvantaged Patients’ Trust In Their Physicians: An Evidence-Based Structural Equation Modeling Investigation, Stephen J. Aragon, Sylvia A. Flack, Cecil A. Holland, Racquel R. Ingram, Michael L. Clements

Journal of Health Disparities Research and Practice

The purpose of this investigation was to determine the effect of physician patient-centeredness on patient trust across randomly selected groups of patients from an inner city medical practice serving a preponderance of minority and socioeconomically-disadvantaged patients.

METHODS: A two-factor multigroup structural equation modeling design was employed, with randomly selected test (N = 300) and cross-validation (N = 300) samples of medical practice patients. Equality constraints were established to test the invariance of effects across groups. The model was compared to its unconstrained counterpart to further test its trustworthiness. An additional 5,000 nonparametric bootstrapped samples for each group were generated to …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

Cumulative Risk And A Call For Action In Environmental Justice Communities, H. P. Hynes, Russ Lopez

Journal of Health Disparities Research and Practice

Health disparities, social inequalities, and environmental injustice cumulatively affect individual and community vulnerability and overall health; yet health researchers, social scientists and environmental scientists generally study them separately. Cumulative risk assessment in poor, racially segregated, economically isolated and medically underserved communities needs to account for their multiple layers of vulnerability, including greater susceptibility, greater exposure, less preparedness to cope, and less ability to recover in the face of exposure. Recommendations for evidence-based action in environmental justice communities include: reducing pollution in communities of highest burden; building on community resources; redressing inequality when doing community-based research; and creating a screening framework …

Differential Effects Of Race And Poverty On Ambulatory Care Sensitive Conditions, Farrukh B. Hakeem, Daniel L. Howard, Timothy S. Carey, Yhenneko J. Taylor

Journal of Health Disparities Research and Practice

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in …