Using Social Indicators to Describe Neighborhood-Level Disparities in Adolescent Health in Baltimore City Circa 2017.

PURPOSE: The purpose of this study was to use social indicators to compare adolescent health disparities across neighborhoods in Baltimore, Maryland, circa 2017. Neighborhoods heavily influence adolescent health outcomes. Baltimore remains a hypersegregated city along racial boundaries with a recently growing population of Latino immigrant youth. This segregation may promulgate adolescent health disparities, yet the magnitude of needs and how they may differ among Baltimore's minoritized adolescents remain unknown. METHODS: The most predominantly white, black, and Latino neighborhoods in Baltimore were analyzed across six indicators relevant to adolescent health: teen birth rate, high school achievement, poverty, health insurance, youth mortality rate, and lead paint violation rate. The indicators were used to create a composite adolescent deprivation index. Measures of absolute and relative disparity were then calculated between white, black, and Latino neighborhood clusters. RESULTS: Both black and Latino neighborhoods had similar adolescent deprivation relative to white neighborhoods. Latino neighborhoods had the highest teen birth rate and children without health insurance. Black neighborhoods had the lowest educational achievement and the highest poverty, youth mortality, and lead paint violation rate. CONCLUSIONS: The overall magnitude of social deprivation is similar across communities of color in Baltimore. However, black adolescents tend to live in neighborhoods with greater physical deprivation and youth mortality that limits within-group bonding capacity, whereas Latino adolescents tend to live in neighborhoods with limited health and social resources that prevent between-group bridging capacity. These indicators thus orient policies and programs to promote differential asset-based strategies for positive youth development.

Mental Health Needs of an Emerging Latino Community.

Over the last decade, Baltimore has become a non-traditional sanctuary city, receiving an unprecedented influx of Latino immigrants, mostly from Central America's Northern Triangle, who are often fleeing violence in their home countries. This study explored the nature and frequency of healthcare utilization for mental health problems among uninsured/uninsurable Latinos who received outpatient care between 2012 and 2015 through an academic hospital-affiliated program that covers primary and specialty services to uninsured patients without regard to documentation status. Encounters for mental health disorders were the most common category, accounting for 14.88% of all visits. Mood (78%) and anxiety disorders (16%) were the most prevalent mental health diagnoses. The most frequent reason to seek care was symptom, signs, and ill-defined conditions (37.47%), and within this subgroup, pain was the leading cause of seeking care (88%), which may indicate high rates of somatization of mental health distress. This study presents a unique opportunity to explore the burden and nature of mental health needs among a population for which healthcare information is rarely attainable and highlights the need for culturally competent screening mechanisms and interventions to address the stressors faced by emergent communities.

Potential Role of Cost and Quality of Life in Treatment Decisions for Arthritis-Related Knee Pain in African American and Latina Women.

OBJECTIVE: The present study was undertaken to investigate whether Latina and African American women with arthritis-related knee pain and primary care providers who treat them believe their treatment decisions would benefit from having more information about the impact of treatment on their quality of life, medical care costs, and work productivity. METHODS: We conducted 4 focus groups of Latina and African American women over age 45 years who had knee pain. We also conducted 2 focus groups with primary care providers who treated Latina and African American women for knee pain. The participants were recruited from the community. They were asked their opinions about a decision tool that presented information on a range of treatment options and their impacts on quality of life, medical care costs, and work productivity. They were asked whether providing this information would help them make better treatment decisions. We analyzed the focus group transcripts using ATLAS.ti. RESULTS: We found that minority women and primary care providers endorsed the use of a decision-making tool that provided information of the impact of treatment on quality of life, medical care costs, and work productivity. Providers felt that patients would benefit from having the additional information but were concerned about its complexity and some patients' ability to comprehend the information. CONCLUSION: Latina and African American women could make more informed treatment decisions for their knee pain using a decision-making tool that provides them with significant information about how various treatment options may impact their quality of life, medical care costs, and workforce productivity.

Testimonios, A Mental Health Support Group for Latino Immigrants in an Emergent Latino Community.

Latino immigrants face many stressors before, during, and after migration to the U.S., but there are few mental health services available to help them cope with this transition. We established free group sessions moderated by bilingual therapists to address the unmet mental health needs of Latino immigrants.

Modelo de tamizaje, atención y monitoreo de la salud mental para adultos en casos de desastre / Model for adult mental health screening, treatment, and monitoring in disasters

Resumen Los desastres afectan a todos los miembros de una comunidad; sin embargo, no todos reaccionan de la misma forma. Por ello, resulta esencial identificar quiénes requieren intervenciones especializadas, así como establecer mecanismos de referencia y atención adecuados para los diferentes servicios de salud mental. Los autores sintetizan recomendaciones de intervenciones basadas en evidencia para informar los esfuerzos de atención a la salud mental para poblaciones expuestas a desastres, específicamente respecto al proceso de tamizaje, referencia y atención psicológica. Asimismo, proponen un modelo comprensivo y de acción coordinada, que utilice los servicios e infraestructura ya existentes, con el objetivo de incentivar tanto la colaboración interinstitucional a futuro, como una mayor profesionalización de la salud mental pública en México.

Abstract: Disasters affect all members of a community; however, not all react in the same way. It is therefore essential to identify those who require specialized interventions, and establish appropriate referral and treatment pathways for different mental health services. Authors synthesize recommendations from evidence-based interventions to inform mental health care efforts for populations exposed to disasters, specifically in relation to screening, referral and psychological treatment. The authors propose a comprehensive model of coordinated efforts that uses existing services and infrastructure. This aims to incentivize future inter-institutional collaboration and a greater professionalization of public mental health in México.