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American Journal of Public Health Apr 2017To examine whether access to housing assistance is associated with better health among low-income adults.
OBJECTIVES
To examine whether access to housing assistance is associated with better health among low-income adults.
METHODS
We used National Health Interview Survey data (1999-2012) linked to US Department of Housing and Urban Development (HUD) administrative records (1999-2014) to examine differences in reported fair or poor health and psychological distress. We used multivariable models to compare those currently receiving HUD housing assistance (public housing, housing choice vouchers, and multifamily housing) with those who will receive housing assistance within 2 years (the average duration of HUD waitlists) to account for selection into HUD assistance.
RESULTS
We found reduced odds of fair or poor health for current public housing (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.57, 0.97) and multifamily housing (OR = 0.75; 95% CI = 0.60, 0.95) residents compared with future residents. Public housing residents also had reduced odds of psychological distress (OR = 0.59; 95% CI = 0.40, 0.86). These differences were not mediated by neighborhood-level characteristics, and we did not find any health benefits for current housing choice voucher recipients.
CONCLUSIONS
Housing assistance is associated with improved health and psychological well-being for individuals entering public housing and multifamily housing programs.
Topics: Adult; Female; Health Status; Humans; Male; Middle Aged; Poverty Areas; Public Assistance; Public Housing; Stress, Psychological; United States
PubMed: 28207335
DOI: 10.2105/AJPH.2016.303649 -
Medical Gas Research 2020
Review
Topics: Antioxidants; Clostridiales; Humans; Hydrogen; Insurance, Health; Mitochondria; National Health Programs; Organization and Administration; Patient Care; Public Assistance; Reactive Oxygen Species; United States; United States Dept. of Health and Human Services
PubMed: 33004714
DOI: 10.4103/2045-9912.296045 -
Academic Pediatrics Mar 2020Financial stress is the root cause of many adverse health outcomes among poor and low-income children and their families, yet few clinical interventions have been... (Review)
Review
Financial stress is the root cause of many adverse health outcomes among poor and low-income children and their families, yet few clinical interventions have been developed to improve health by directly addressing patient and family finances. Medical-Financial Partnerships (MFPs) are novel cross-sector collaborations in which health care systems and financial service organizations work collaboratively to improve health by reducing patient financial stress, primarily in low-income communities. Financial services provided by MFPs include individually tailored financial coaching, free tax preparation, budgeting, debt reduction, savings support, and job assistance, among others. MFPs have been shown to improve finances and, in the few existing studies available, health outcomes. We describe the rationale for MFPs and examine 8 established MFPs providing financial services under 1 of 3 models: full-scope on-site service partnerships; targeted on-site service partnerships; and partnerships facilitating referral to off-site financial services. The services MFPs provide complement clinical social risk screening and navigation programs by preventing or repairing common financial problems that would otherwise lead to poverty-related social needs, such as food and housing insecurity. We identify common themes, as well as unique strengths and solutions to a variety of implementation challenges MFPs commonly encounter. Given that the financial circumstances and health outcomes of socially marginalized patients and families are closely linked, MFPs represent a promising and feasible cross-sector service delivery approach and a new model for upstream health care to promote synergistic financial well-being and health improvement.
Topics: Banking, Personal; Budgets; Delivery of Health Care; Economic Status; Financial Stress; Humans; Income; Mentoring; Motivational Interviewing; Poverty; Primary Health Care; Public Assistance; Referral and Consultation; Social Determinants of Health; Social Work; Taxes
PubMed: 31618676
DOI: 10.1016/j.acap.2019.10.001 -
Nutrients May 2022Increased fruit and vegetable (FV) intake is associated with decreased risk of nutrition-related chronic diseases. Sociodemographic disparities in FV intake indicate the... (Review)
Review
Increased fruit and vegetable (FV) intake is associated with decreased risk of nutrition-related chronic diseases. Sociodemographic disparities in FV intake indicate the need for strategies that promote equitable access to FVs. The United States Department of Agriculture's Gus Schumacher Nutrition Incentive Program (GusNIP) supports state and local programs that offer nutrition incentives (NIs) that subsidize purchase of FVs for people participating in the Supplemental Nutrition Assistance Program (SNAP). While a growing body of research indicates NIs are effective, the pathways through which GusNIP achieves its results have not been adequately described. We used an equity-focused, participatory process to develop a retrospective Theory of Change (TOC) to address this gap. We reviewed key program documents; conducted a targeted NI literature review; and engaged GusNIP partners, practitioners, and participants through interviews, workshops, and focus groups in TOC development. The resulting TOC describes how GusNIP achieves its long-term outcomes of increased participant FV purchases and intake and food security and community economic benefits. GusNIP provides NIs and promotes their use, helps local food retailers develop the capacity to sell FVs and accept NIs in accessible and welcoming venues, and supports local farmers to supply FVs to food retailers. The TOC is a framework for understanding how GusNIP works and a tool for improving and expanding the program.
Topics: Food Assistance; Food Supply; Humans; Motivation; Poverty; Retrospective Studies; United States
PubMed: 35631159
DOI: 10.3390/nu14102018 -
Annals of Epidemiology Feb 2017We examined if receipt of public assistance during childhood lowered risk for hypertension by mid-life in a cohort of African Americans in the Southeastern United States.
PURPOSE
We examined if receipt of public assistance during childhood lowered risk for hypertension by mid-life in a cohort of African Americans in the Southeastern United States.
METHODS
We used multiple logistic regression models to assess the relationship between receipt of public assistance during childhood and adult hypertension among 405 male and 737 female adult participants enrolled between 1988 and 2001 in the Pitt County Study, a community-based prospective cohort study of African Americans in North Carolina. Statistical analyses were adjusted for child and adult sociodemographic measures as well as adult psychosocial and lifestyle factors.
RESULTS
Women who grew up in economically disadvantaged families and who received public assistance during childhood had a 66% decreased odds of hypertension by mid-life compared with women similarly disadvantaged in childhood but who did not receive public assistance, odds ratio = 0.34; 95% confidence interval: 0.14-0.83. No association was observed for African American men.
CONCLUSIONS
Receipt of anti-poverty federal assistance during childhood was associated with reduced risk for hypertension by mid-life among African American women. It is possible that social expenditures on public assistance programs for families in need could produce long-term health benefits for children.
Topics: Adolescent; Adult; Black or African American; Aged; Aged, 80 and over; Child; Child, Preschool; Cohort Studies; Female; Humans; Hypertension; Infant; Infant, Newborn; Logistic Models; Male; Middle Aged; North Carolina; Odds Ratio; Poverty; Prospective Studies; Public Assistance; Socioeconomic Factors; Young Adult
PubMed: 28094118
DOI: 10.1016/j.annepidem.2016.11.012 -
JAMA Pediatrics Jun 2020Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma...
IMPORTANCE
Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes.
OBJECTIVES
To examine whether participation in the US Department of Housing and Urban Development's (HUD) rental assistance programs is associated with childhood asthma outcomes and to examine whether associations varied by program type (public housing, multifamily housing, or housing choice vouchers).
DESIGN, SETTING, AND PARTICIPANTS
This survey study used data from the nationally representative National Health Interview Survey linked to administrative housing assistance records from January 1, 1999, to December 31, 2014. A total of 2992 children aged 0 to 17 years who were currently receiving rental assistance or would enter a rental assistance program within 2 years of survey interview were included. Data analysis was performed from January 15, 2018, to August 31, 2019.
EXPOSURES
Participation in rental assistance provided by HUD.
MAIN OUTCOMES AND MEASURES
Ever been diagnosed with asthma, 12-month history of asthma attack, and 12-month history of visiting an emergency department for the treatment of asthma among program participants vs those waiting to enter a program. Overall participation was examined, and participation in public or multifamily housing was compared with participation in housing choice vouchers.
RESULTS
This study included 2992 children who were currently participating in a HUD program or would enter a program within 2 years. Among children with an asthma attack in the past year, participation in a rental assistance program was associated with a reduced use of emergency departments for asthma of 18.2 percentage points (95% CI, -29.7 to -6.6 percentage points). Associations were only found after entrance into a program, suggesting that they were not confounded by time-varying factors. Statistically significant results were found for participation in public or multifamily housing (percentage point change, -36.6; 95% CI, -54.8 to -18.4) but not housing choice vouchers (percentage point change, -7.2; 95% CI, -24.6 to 10.3). No statistically significant evidence of changes in asthma attacks was found (percentage point change, -2.7; 95% CI, -12.3 to 7.0 percentage points). Results for asthma diagnosis were smaller and only significant at the 10% level (-4.3; 95% CI, -8.8 to 0.2 percentage points).
CONCLUSIONS AND RELEVANCE
Among children with a recent asthma attack, rental assistance was associated with less emergency department use. These results may have important implications for the well-being of low-income families and health care system costs.
Topics: Adolescent; Asthma; Child; Child, Preschool; Emergency Service, Hospital; Female; Health Status; Health Surveys; Humans; Infant; Male; Public Assistance; United States
PubMed: 32150240
DOI: 10.1001/jamapediatrics.2019.6242 -
International Journal of Environmental... May 2023A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service... (Review)
Review
Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage: A Literature Review of International Organizations.
A wider range of social protection services, including social insurance and social assistance, are gaining global attention as a key driver of improved health service coverage and financial protection among vulnerable populations. However, only a few studies have investigated the associations between social protection and universal health coverage (UHC). Therefore, we conducted a literature review on relevant international organizations with respect to this topic. We found that many international organizations consider the wide range of social protection services, including social insurance and social assistance, essential for achieving UHC in 2030. In specific health programs, social protection is considered an important service to promote health service access and financial protection, especially among vulnerable populations. However, discussions about social protection for achieving UHC are not given high priority in the World Health Organization. Currently, the coverage of social protection services is low among vulnerable populations in low- and middle-income countries. To address this issue, we employed the metrics recommended by the migrant integration policy index (MIPEX). Based on our findings, a conceptual framework was developed. We expect this framework to lead synergy between social protection and health systems around the globe, resulting in healthy ageing.
Topics: Humans; Universal Health Insurance; Health Promotion; Health Services Accessibility; Public Policy; Medical Assistance
PubMed: 37174271
DOI: 10.3390/ijerph20095754 -
Journal of Epidemiology and Community... Apr 2022Recognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes...
Prevalence of type 2 diabetes by age, sex and geographical area among two million public assistance recipients in Japan: a cross-sectional study using a nationally representative claims database.
BACKGROUND
Recognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes (T2D) for public assistance recipients (PAR) in 2018. However, evidence of the T2D prevalence among PAR is lacking. We aimed to estimate T2D prevalence by age and sex among PAR, compared with the prevalence among health insurance enrollees (HIE). Additionally, regional differences in T2D prevalence among PAR were examined.
METHODS
This was a cross-sectional study using 1-month health insurance claims of both PAR and HIE. The Fact-finding Survey data on Medical Assistance and the National Database of Health Insurance Claims data were used. T2D prevalence among PAR and HIE were assessed by age and sex, respectively. Moreover, to examine regional differences in T2D prevalence of inpatients and outpatients among PAR, T2D crude prevalence and age-standardised prevalence were calculated by prefecture. Multilevel logistic regression analysis was also conducted at the city level.
RESULTS
T2D crude prevalence was 7.7% in PAR (inpatients and outpatients). Among outpatients, the prevalence was 7.5% in PAR and 4.1% in HIE, respectively. The mean crude prevalence and age-standardised prevalence of T2D (inpatients and outpatients) among 47 prefectures were 7.8% and 3.9%, respectively. In the city-level analysis, the OR for the prevalence of T2D by region ranged from 0.31 to 1.51.
CONCLUSION
The prevalence of T2D among PAR was higher than HIE and there were regional differences in the prevalence of PAR. Measures to prevent the progression of diabetes among PAR by region are needed.
Topics: Cross-Sectional Studies; Diabetes Mellitus, Type 2; Humans; Japan; Prevalence; Public Assistance
PubMed: 34711673
DOI: 10.1136/jech-2020-216158 -
American Journal of Public Health Oct 2022To examine the effects of childhood participation in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women,...
To examine the effects of childhood participation in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on adult food security in the United States. We used data from the 1984 to 2019 waves of the Panel Study of Income Dynamics to follow a balanced panel of 1406 individuals from birth through ages 20 to 36 years. We measured food insecurity from 1999 to 2003 and 2015 to 2019 among those who resided in low-income households during childhood. Twenty-eight percent of individuals who resided in low-income households during childhood exhibited improved food security status from childhood to adulthood. Those who participated in SNAP and WIC during childhood had 4.16-fold higher odds (95% confidence interval [CI] = 1.91, 9.03) of being more food secure than those who were eligible for but did not receive SNAP or WIC, and those who participated in SNAP alone had 3.28-fold higher odds (95% CI = 1.56, 6.88). Participation in social safety net programs such as SNAP and WIC during childhood helps to improve food security across the life course. Our findings add evidence regarding the long-term benefits of participation in SNAP and WIC during childhood. (. 2022;112(10):1498-1506. https://doi.org/10.2105/AJPH.2022.306967).
Topics: Adolescent; Adult; Child; Dietary Supplements; Female; Food Assistance; Food Security; Food Supply; Humans; Infant; Poverty; United States; Young Adult
PubMed: 35981276
DOI: 10.2105/AJPH.2022.306967 -
Annals of Global Health 2023It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent...
It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent pandemics and the rise in violence in medical settings, one is compelled to question whether their health and safety are sufficient for a robust healthcare system. This is important because protecting and promoting the health, safety, and well-being of health workers will improve the quality of patient care and increase the resilience of health services in the face of outbreaks and public health emergencies. We thus strive to answer this question and suggest potential remedies to this growing public health issue.
Topics: Humans; Disease Outbreaks; Government Programs; Health Personnel; Health Workforce; Medical Assistance
PubMed: 37692379
DOI: 10.5334/aogh.4167