Journal of health care for the poor and underserved
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Several recent studies have shown that the racial disparities in U. S. mortality nearly disappear in prisons. We review the social determinants of the recent epidemic of incarceration, especially the war on drugs, and describe inmate morbidity and mortality within the context of U. ⋯ Incarceration provides an important public health opportunity to address health disparities by accessing a high-need, medically-underserved, largely non-White population, but it has also been associated with poor long-term health outcomes. Viewing incarceration within the context of community health and community life shows that the more equitable mortality rates among inmates are not evidence of the beneficial effects of incarceration so much as an indictment of disparities in the community at large. Because people of color are incarcerated far more frequently than Whites, the experience may ultimately exacerbate rather than mitigate health disparities.
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J Health Care Poor Underserved · Nov 2012
Medicaid transformed: why ACA opponents should keep expanded Medicaid.
The next potential disaster facing the Affordable Care Act (ACA) is the November 2012 elections: Its opponents, who promise to "repeal and replace," may gain sufficient control of the federal government in 2013 to carry out their pledge. This commentary aims to promote understanding of the fundamental transformation that the ACA makes in Medicaid and to urge ACA opponents desiring some health reform after repeal to let the ACA's Medicaid provisions stand. ⋯ The ACA transforms Medicaid into a universal means-tested entitlement for anyone below 138 percent FPL. The conclusion explains why ACA opponents should retain its Medicaid provisions.
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J Health Care Poor Underserved · Nov 2012
Cancer prevention in the 21st century: the Preventorium concept.
The Cancer Preventorium model described here has proven successful in targeting the Hispanic population of a large metropolitan area in the United States to change the point of contact within the health care system from patients with advanced conditions seeking treatment to those screened while presumably healthy to detect disease early.
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J Health Care Poor Underserved · Aug 2012
Multicenter StudyCombating slavery in the 21st century: the role of emergency medicine.
Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. ⋯ After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.