Assessing the Impact of Health Policy Reforms on Vulnerable Populations: A Social Science Perspective

Through the view of social science, this study takes a critical look at how changes to health policy affect people who are already at risk. As countries around the world make big changes to their health care systems, it's important to figure out how these changes affect weak and marginalised groups. Our study uses a social science approach to look into how changing health policies affect the lives of disadvantaged groups by exploring the complex web of social, economic, and cultural factors that affect them. The method uses a mix of quantitative and qualitative data analysis, with conversations and focus group talks with people from a range of disadvantaged groups to get more in-depth ideas. Through a broad lens, we want to find out the complex ways that changes in health policy interact with social factors that affect health, affecting the availability, cost, and quality of healthcare for weak groups. Early results show that vulnerable groups bear an unfair amount of the load, showing differences in healthcare outcomes, hurdles to entry, and differences in healthcare service. The study also explores the role of social support networks, community engagement, and cultural competence in mitigating or exacerbating the effects of health policy reforms on vulnerable populations.The implications of this research extend beyond academia, offering practical insights for policymakers, healthcare professionals, and advocacy groups to formulate inclusive policies that address the unique needs of vulnerable populations. By fostering a deeper understanding of the social dynamics at play, this study contributes to the ongoing discourse on health equity and informs evidence-based interventions aimed at safeguarding the health and well-being of society's most marginalized members

Health Inequalities in Europe: Setting the Stage for Progressive Policy Action

While the health of Europeans has improved over recent years, differences by gender, birthplace, and/or socioeconomic background persist. This report maps the extent of such health inequalities, its determinants, and costs to society. The findings indicate that differences in health between and within countries are attributable not only to social and health policies, but also depend on economic policy and the social determinants of health. Thus, holistic policy interventions are required to tackle health inequalities

A Comprehensive Analysis on the Healthcare Systems in Latin America

This comprehensive report summarizes and analyzes the current state of healthcare in Latin America, specifically in the countries of Mexico, Brazil, the Northern Triangle (El Salvador, Guatemala, and Honduras), the Andean Region (Ecuador, Peru, and Bolivia) and the Rioplatense Region (Uruguay, and Argentina). Each country's healthcare system is examined in depth, in terms of health infrastructure, the healthcare providing industry, and the effects of healthcare on the countries' respective populations.Mosser, Michael W.International Relations and Global Studie

State of Health Equity Movement, 2011 Update Part C: Compendium of Recommendations DRA Project Report No. 11-03

State of Health Equity Movement, 2011 Update Part C: Compendium of Recommendations DRA Project Report No. 11-0

Healthcare not Handcuffs: Putting the Affordable Care Act to Work for Criminal Justice and Drug Policy Reform

The Affordable Care Act (ACA) sets the stage for a new health-oriented policy framework to address substance use and mental health disorders. By dramatically expanding and funding healthcare coverage to millions of currently uninsured people, the ACA represents a remarkable opportunity for criminal justice and drug policy reform advocates to advance efforts for policies promoting safe and healthy communities, without excessive reliance on the criminal justice solutions that have become so prevalent under the War on Drugs. This paper is intended as a starting framework for criminal justice and drug policy advocates to navigate the ACA, and to take advantage of the conceptual and practical opportunities it offers for shifting the conversation and the landscape. Part One of this paper describes some of the major provisions of the ACA relevant to our work: the health insurance requirement; the places many people will buy insurance, called health exchanges; Medicaid expansion; insurance coverage requirements for substance use and mental health disorders; and opportunities for improved models of coordinated care. Part Two of this paper outlines a series of practical recommendations, including program and policy examples and suggested action steps, across three broad categories: ensuring access to healthcare, leveraging the ACA to reduce incarceration, and moving from a criminilization-based drug policy approach to one rooted in health

A Qualitative Exploration to Understand Access to Pharmacy Medication Reviews: Views from Marginalized Patient Groups

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This research was led by the Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK.Background: Vulnerable patients from marginalized groups (e.g., people with disabilities, people experiencing homelessness, black and minority ethnic communities) experience higher rates of ill-health, inequitable access to healthcare and low engagement with screening services. Addressing these disparities and ensuring healthcare provision is impartial and fair is a priority for the United Kingdom (UK) healthcare system. Aim: Using Levesque’s access conceptual framework, this study explored the views of patients from marginalized groups, specifically on how access to pharmacy services could be improved and their experiences of receiving a medication review service. Method: Qualitative data were collected via semi-structured interviews on patient experiences of pharmacy services and how access to these could be improved (n = 10). Interviews of patients who had received a medication review from their pharmacist were also conducted (n = 10). Using an interpretivist approach, five ‘demand-side’ dimensions of Levesque’s access conceptual framework were explored (ability to perceive a need for medication support, their ability to seek this support, ability to reach the pharmacy, ability to pay and engage). Results: The findings exposed the medicine, health and social care challenges of vulnerable people and how these are often not being adequately managed or met. Using the access formwork, we unpack and demonstrate the significant challenges patients face accessing pharmacy support. Discussion: Pharmacy organizations need to pay attention to how patients perceive the need for pharmacy support and their ability to seek, reach and engage with this. Further training may be needed for community pharmacy staff to ensure services are made accessible, inclusive and culturally sensitive. Effective engagement strategies are needed to enable the provision of a flexible and adaptable service that delivers patient-centred care. Policy makers should seek to find ways to reconfigure services to ensure people from diverse backgrounds can access such services

Restoring Health to Health Reform: Integrating Medicine and Public Health to Advance the Population\u27s Wellbeing

The Patient Protection and Affordable Care Act is a major achievement in improving access to health care services. However, evidence indicates that the nation could achieve greater improvements in health outcomes, at a lower cost, by shifting its focus to public health. By focusing nearly exclusively on health care, policy makers have chronically starved public health of adequate and stable funding and political support. The lack of support for public health is exacerbated by the fact that health care and public health are generally conceptualized, organized, and funded as two separate systems. In order to maximize gains in health status and to spend scarce health resources most effectively, health care and public health should be treated as two interactive parts of a single, unified health system. The core purpose of health reform ought to be the improvement of the population’s health. We propose five criteria that would significantly advance this goal: prevention and wellness, human resources, a strong and sustainable health infrastructure, robust performance measurement, and reduction of health disparities. Although the Patient Protection and Affordable Care Act includes provisions addressing these criteria, population health is not a central focus of the reform. In order to guide health reform implementation and to inform future health reform efforts, we offer three major policy reforms: changing the environment to incentivize healthy behavioral choices, strengthening the public health infrastructure at the state and local levels, and developing a health-in-all policies strategy that would engage multiple agencies in improving health incomes. Adopting these reforms would facilitate integration and dramatically improve the population’s health, particularly when compared to the health gains likely to be realized from a continued focus on access to health care services

Socioeconomic Disparities in Health: A Symposium on the Relationships Between Poverty and Health

The disparities in health between the rich and poor are so striking, and the results so dire, that reducing the gap is an ethical imperative. A strong and consistent finding of epidemiological research is that socioeconomic status (SES) is correlated with morbidity, mortality, and functioning. SES is a complex combination of income, education, and occupation. Theorists posit that material disadvantage, diminished control over life\u27s circumstances, and lack of social acceptance all contribute to poor health outcomes. The relationship between SES and health often is referred to as a gradient because of the graded and continuous nature of the association; health differences are observed well into the middle ranges of SES. These empirical findings have persisted across time and cultures and remain viable today

The Impact of the Patient-Centered Medical Home on Health Disparities in Adults: A Systematic Review of the Evidence

Introduction: The objective of this study was to review the empirical evidence on Patient-Centered Medical Home (PCMH) impact on health disparities in adults. Methods: We searched PubMed, Scopus, and Google Scholar to identify studies on PCMH/health homes and health disparities published in English between January 1, 2009 and December 31, 2014. Articles met inclusion criteria if they investigated at least one component of PCMH or health homes in vulnerable populations, defined by PROGRESS-PLUS criteria, and reported differences in one of five clinical quality measures. Results: 964 articles were identified through database searching and subsequent snowballing. 60 articles underwent full text screening. Further review eliminated 56 studies. In the final 4 studies, PCMH interventions showed small improvements in health disparities. Discussion: The PCMH has been suggested as a model for improving health disparities. Given rapid implementation in underserved settings, stakeholders should better understand the impact of the PCMH on health disparities

Change, psychosocial stress and health in an era of globalization

In the last decades, globalization has produced an acceleration of social, economic and political changes worldwide. These changes had a number of positive effects including enhancing political freedom, living standards and health conditions. However, many of them have also produced adverse health consequences, especially when they have been implemented in a sudden, rapid and unexpected way. This is especially true among those populations whose ability to adjust to the new circumstances generated by rapid change was limited. The aim of the present research project was to examine the health consequences of rapid social, economic and political change following globalization as well as to investigate the role of psychosocial factors in explaining these relationships. A theoretical framework proposing major psychosocial pathways connecting rapid change with health-related outcomes has been developed. A series of case studies from countries affected by rapid change supported the hypothesized relationships included in the framework. Countries of interest were the former Soviet Union nations, China, Japan, Micronesia Islands, New Zealand, Australia, Canada, and the United States. The limited ability of certain populations to adjust to rapid changes induced by globalization as well as the pace of change of social, economic and political reforms are discussed