Women's health issues : official publication of the Jacobs Institute of Women's Health
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Womens Health Issues · Sep 2020
Changes in Incidents and Payment Methods for Intimate Partner Violence Related Injuries in Women Residing in the United States, 2002 to 2015.
Violence in interpersonal relationships is a substantial health and social problem in the United States and is associated with a myriad of immediate and long-term physical, behavioral, and neurocognitive impairments. The present study sought to determine the incidence of U.S. emergency department (ED)-attended intimate partner violence (IPV) from 2002 to 2015 and examine the differences in payment sources before and after implementation of the Affordable Care Act. ⋯ The increase in the percentage of IPV-related ED claims paid by private insurance suggests that the Affordable Care Act may have increased women's willingness and ability to seek medical attention for IPV-related injuries and disclose IPV as the source of injuries.
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Womens Health Issues · Jul 2020
An Analysis of Payment Mix Patterns of Preterm Births in a Post-Affordable Care Act Insurance Market: Implications for the Medicaid Program.
The United States has a relatively high preterm birth rate compared with other developed nations. Before the enactment of the Affordable Care Act in 2010, many women at risk of a preterm birth were not able to access affordable health insurance or a wide array of preventive and maternity care services needed before, during, and after pregnancy. The various health insurance market reforms and coverage expansions contained in the Affordable Care Act sought in part to address these problems. This analysis aims to describe changes in the patterns of payer mix of preterm births in the context of a post-Affordable Care Act insurance market, explore possible factors for the observed changes, and discuss some of the implications for the Medicaid program. ⋯ After the 2010 reforms, Medicaid remained a constant source of coverage for the most vulnerable women in society when faced with the high cost of a preterm birth. Nationwide, of the 64 million women ages 15 to 44, 4% gained PHI (directly purchased or employer sponsored) and another 4% Medicaid, with a concomitant 8% decrease in uninsured women of reproductive age between 2013 and 2017. More research is needed to conclude with certainty that the reforms worked as intended, but the important role of Medicaid as a financial safety net is undeniable.
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Womens Health Issues · May 2020
Perceptions, Characteristics, and Behaviors of Cigarette and Electronic Cigarette Use among Pregnant Smokers.
Smoking during pregnancy is a primary risk factor for adverse perinatal outcomes. Although electronic cigarette (e-cigarette) use has increased, reasons for and behaviors of use are not fully understood. The purpose of this study, composed exclusively of pregnant current smokers, was to describe perceptions of health risks associated with e-cigarette use among pregnant women, describe the use patterns of pregnant dual users (defined as those who simultaneously use conventional/combustible cigarettes and e-cigarettes), and examine smoking-related behaviors between conventional-only (defined as those smoking combustible cigarettes but not e-cigarettes) and dual users. ⋯ Characterizing perceptions and behaviors of e-cigarette use during pregnancy is foundational for future research to explore the association between product use and maternal and infant outcomes.
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Womens Health Issues · Mar 2020
Gynecologic Care for Women With Physical Disabilities: A Qualitative Study of Patients and Providers.
Women with physical disabilities have unmet gynecologic care needs, including disparities in cancer screening and contraceptive care, when compared with women without physical disabilities. Our objective was to qualitatively assess provider and patient perspectives regarding barriers to gynecologic health care for women with physical disabilities. ⋯ Providers were motivated to provide quality care for women with disabilities, but encountered systems and training barriers. Patients and providers had concordant impressions of barriers that influenced equitable and patient-centered care, with structural barriers, including a lack of accessible space, closely related to perceptions of health care inequity between women with and without physical disabilities.
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Womens Health Issues · May 2019
Comparative StudyForeign-Born Hispanic Women's Health Patterns in Allostatic Load Converge to U.S.-Born Hispanic Women at a Slower Tempo Compared With Men.
We investigated the patterns of foreign-born Hispanic health convergence to U.S.-born Hispanics using an allostatic load index, a subjective biological risk health profile, and we explored whether the health convergence patterns differ by sex. ⋯ Foreign-born Hispanics are healthier than their U.S.-born counterparts, providing support for the healthy migrant hypothesis. This relatively better health of foreign-born Hispanics disappears with a longer duration in the United States, providing support for the health convergence hypothesis, but is most noticeable for men. Foreign-born Hispanic women converge to U.S.-born Hispanic women's health status at a slower tempo, compared with foreign-born Hispanic men.