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1.
Article in English | MEDLINE | ID: mdl-36834442

ABSTRACT

Smart community enables a sustainable and livable community future, in which residents' demands play an important role in its success. Though great efforts have been made to encourage residents' participation in the implementation of smart communities, inefficient service supply still exists. Thus, this study aimed to classify residents' demands for community services in smart communities and to explore relevant influencing factors based on the developed conceptual framework. Data from 221 respondents in Xuzhou city of China were analyzed by using binary logistic regression. The results indicated that more than 70% of respondents had demands for all community services in smart communities. Moreover, the demands were influenced by distinct factors, including sociodemographic characteristics, living characteristics, economic characteristics, and individual attitude characteristics. The types of community services in smart communities are clarified and fresh insights are provided into associated factors related to residents' demands for these services in this study, through which enhanced provision of community services and effective implementation of smart communities can be achieved.


Subject(s)
Contract Services , Social Welfare , China , Logistic Models , Surveys and Questionnaires
2.
Soc Sci Res ; 110: 102839, 2023 02.
Article in English | MEDLINE | ID: mdl-36796999

ABSTRACT

Institutions of the welfare state are supposed to function in accordance with normative principles of redistributive justice, which should guide not only the allocation but also the withdrawal of resources. Our study examines justice assessments of sanctions for unemployed individuals receiving welfare benefits, a much-discussed variant of benefit withdrawal. We present results from a factorial survey that asked German citizens to indicate which sanction they would perceive as just under different scenarios. In particular, we look at different kinds of deviant behavior on the part of the unemployed job seeker, which allows for a broad picture concerning potential sanction-triggering events. The findings show that the extent of sanctions perceived as just varies considerably across scenarios. Respondents would impose more sanctions on men, repeaters, and young people. Moreover, they have a clear picture of the severity of the deviant behavior.


Subject(s)
Social Welfare , Unemployment , Male , Humans , Adolescent , Social Justice
3.
Health Care Manage Rev ; 48(2): 130-139, 2023.
Article in English | MEDLINE | ID: mdl-36728459

ABSTRACT

BACKGROUND: Collaboration between clinical and community-based social service organizations is increasingly seen as vital for preventing and managing chronic diseases but has been challenging to establish and sustain. PURPOSE: The aim of this study was to identify organizational barriers and facilitators for clinic-community collaboration. METHODOLOGY/APPROACH: We employed multiple methods to study a national sample of nonprofit community-based organizations that each collaborated with local clinical organizations for diabetes prevention in the United States. We used qualitative data collected longitudinally through 65 semistructured interviews from 2016 to 2017 at seven of these organizations and their clinical collaborators to understand their relationships. We employed survey data ( N = 247 with 73% response rate) to measure and explore relationships among qualitatively identified themes and collaboration performance. RESULTS: We documented three levels of organizational challenges to community-clinic collaboration. Interorganizational challenges pertain to facing only weakly aligned interests across organizations. Interpersonal challenges pertain to misperceptions and miscommunications that occur as frontline employees from differing organizations seek to work together. Task-related challenges pertain to the inadequacy of current processes to effectively link services across clinical and community settings. We found that bridging leadership , provisional teamwork, and learning processes helped to overcome these challenges by enabling iterative progress. Follow-up national survey results indicated that these facilitators were significantly associated with collaboration performance. CONCLUSIONS: Because community-clinic collaboration presents substantial interorganizational, interpersonal, and task-related challenges, financial incentives alone are likely insufficient for success. PRACTICE IMPLICATIONS: Resources that help develop capacity to work across community and clinical settings may be vital and warrant dedicated funding.


Subject(s)
Organizations, Nonprofit , Social Welfare , Humans , United States , Communication , Leadership , Learning
5.
BMC Med Educ ; 23(1): 59, 2023 Jan 25.
Article in English | MEDLINE | ID: mdl-36698101

ABSTRACT

BACKGROUND: This study aimed to observe the impact of service learning on the attitude of senior dental students toward community service. METHODS: A cross-sectional survey-based was conducted and recruited a total of 120 senior students of Dentistry Taibah University that were enrolled in a clinical service-learning course using convenience sampling. The attitude of dental college students toward community service based on the model of helping behavior by Schwartz was evaluated through Community Service Attitude Scale (CSAS). The data was collected using the same questionnaires for the pre-test and post-test. Data were analyzed by using SPSS 25. A repeated-measures mixed-model ANOVA was used to test the changes across pre-and post-test. RESULTS: A total of 96 students completed the first survey, making a response rate of 80%, and 78 among them completed the second survey as well, making a response rate of 81%. Significant change (P < 0.0001) in ANOVA indicated that there was an overall change in attitude.  CONCLUSIONS: It can be concluded that community-based service-learning positively impacts the attitude of last year's dental students toward understanding needs at the community level and the attitude to help in providing dental care at the community level.


Subject(s)
Attitude of Health Personnel , Social Welfare , Students, Dental , Humans , Attitude , Cross-Sectional Studies , Learning
6.
Inquiry ; 60: 469580231152078, 2023.
Article in English | MEDLINE | ID: mdl-36718520

ABSTRACT

The welfare state is facing complex challenges. Social innovation is considered as the solution to social challenges and so-called wicked problems, problems in the welfare state that are important, but difficult to solve. This implies being willing to take the risk that is involved when being innovative. A discussion of how different kinds of social innovations carry various risks and how some of these can be prevented, is still limited. This article looks at experiences from previous social innovations and ask what we can learn from them. It elaborates on why social innovation is challenging and what we can do to reduce the risk of failure. The research question is: What risks are at stake in different social innovations, and how can these be prevented? The article highlights risks and issues associated with social or collaborative innovation related to welfare services. It is theoretical and based on innovation theory and previous research, with examples from Norwegian welfare services. The purpose is to explore challenges and risks involved in 4 stereotype versions of social innovation as a result of crossing 2 dimensions of social innovation described above: (a) the degree of novelty and (b) who has initiated the innovation. The article enlightens some aspects of the implementation phase that are important to be aware of if we want to minimize the risk of failure. This concerns the importance of creating a common understanding of the innovation and reflecting on the need for extra resources.


Subject(s)
Social Welfare , Humans
7.
Article in English | MEDLINE | ID: mdl-36613211

ABSTRACT

Critical perspectives and practices are fundamental to social work, yet there are only scarce examples of direct critical practice in public social services, and even fewer empirical evaluations of their outcomes for service users and social workers. This article presents a rapid evidence review of 25 evaluation studies of five programs that operate in the social services departments in Israel according to the principles of the Poverty-Aware Paradigm (PAP). The PAP is a critical paradigm for direct social work practice with people living in poverty that was implemented in the welfare services by the Ministry of Welfare, targeting over 14,000 service users. The evaluation studies we reviewed encompass an overall quantitative sample of 4612 service users and 1363 professionals, and a qualitative sample of 420 service users and 424 professionals. The findings present: (1) the program's outcomes for service users in terms of relationship with social workers, financial circumstances, family relations, and children's safety; and (2) the program's impact on social workers' attitudes and practices. Finally, we discuss the lessons learned regarding social workers' role in combatting poverty, the construction of success in interventions with people in poverty, and the article's limitations.


Subject(s)
Social Work , Social Workers , Child , Humans , Israel , Poverty , Social Welfare
8.
J Environ Manage ; 330: 117157, 2023 Mar 15.
Article in English | MEDLINE | ID: mdl-36608608

ABSTRACT

In countries that promote further EV diffusion, battery swapping opens up a market outlet for time-sensitive consumers as well as another green policy channel. To better understand this phenomenon from the perspective of policy-making, this study establishes a Hotelling model of a competitive market comprising a battery swapping service provider and a charging service provider. The analyses of three scenarios, no subsidization, consumer subsidization, and provider subsidization, reveal how to maximize social welfare. Considering subsidy amount, consumer time preferences, service time, and operating costs, the findings provide valuable insights for policymakers. Whereas incentive programs are generally helpful for battery swapping development and social welfare improvement, it is more effective to subsidize service providers than end consumers. Considering subsidy opportunity cost, it is necessary to control incentive amount and make continuous adjustments to promote battery swapping services without harming charging services.


Subject(s)
Motivation , Policy , Social Welfare , Consumer Behavior , Electric Power Supplies
9.
Health Aff (Millwood) ; 41(12): 1744-1753, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36469816

ABSTRACT

The Temporary Assistance for Needy Families (TANF) program, which was established in 1996 and renewed in 2005, constituted a major reform of the US welfare system. Since its renewal, few studies have examined its effects on children. We used instrumental variables, two-way fixed effects, and event studies to examine the associations between state-level TANF policies, Child Protective Services involvement, and foster care placement during the period 2004-16. We found that each additional TANF policy that restricted access to benefits was associated with a 13 percent reduction in TANF caseloads. Using TANF policies as an instrument, we found that increases in TANF caseloads were associated with significant reductions in numbers of neglect victims and foster care placements. In two-way fixed effects models, restrictions on TANF access were associated with more than forty-four additional neglect victims per 100,000 child population and between nineteen and twenty-two additional children per 100,000 placed in foster care. Our findings suggest that additional research using data that capture the nuances of maltreatment should be used to investigate the relationships among TANF policies, child maltreatment, and foster care placement.


Subject(s)
Child Abuse , Child Protective Services , Child , Humans , United States , Social Welfare , Foster Home Care , Family , Child Abuse/prevention & control , Policy , Child Welfare
10.
Health Aff (Millwood) ; 41(12): 1735-1743, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36469821

ABSTRACT

Temporary Assistance for Needy Families (TANF) is a federal cash welfare program for low-income, working families with children in the United States that requires participation with child support enforcement, if one parent is noncustodial, to receive the cash benefit. Cash assistance has been linked to improved child health and academic achievement, but sanctions to benefits can increase health risks. Our community-engaged, mixed-methods research project sought to identify barriers to TANF among families with young children in Illinois. In this study we analyzed TANF sanctions related to child support enforcement, using analysis of TANF administrative data and semistructured interviews with TANF customers. We conducted logistic regression and Fisher's test to explore demographic differences in sanctioning and sanction types. Black families were 111 percent more likely than White families to receive at least one sanction in 2018-19. Black families who were enrolled in TANF received more sanctions for child support noncompliance (2018: 42 percent; 2019: 50 percent) than White families (2018: 30 percent; 2019: 34 percent). Mothers who were survivors of intimate partner violence voiced particular challenges with child support compliance. Policy recommendations include shifting to alternative cash assistance models and removing pass-through funding so that families receive the full child support benefit.


Subject(s)
Child Custody , Poverty , Child , United States , Humans , Child, Preschool , Social Control, Formal , Illinois , Logistic Models , Public Assistance , Social Welfare
11.
Article in English | MEDLINE | ID: mdl-36497519

ABSTRACT

A growing research agenda shows the importance of local welfare systems in understanding socio-spatial inequalities in health. Welfare services provided by local governments overlap with those provided by other levels of government. Thus, differences in the provision of welfare services between municipalities could explain differences in residents' health, moderating the magnitude of health inequalities if local governments deploy actions capable of positively influencing the social determinants of health. This article attempts to analyse this idea in the Spanish case, exploring the influence of local policies according to the orientation of municipal spending on three indicators of the population's health status: self-perceived health, healthy practices and activity limitations due to health problems. A multilevel cross-sectional study was designed using information from two waves of the 2006-2007 and 2011-2012 National Health Survey for the population aged 15 years and older (N = 31,378) residing in Spanish municipalities of 20,000 inhabitants or over (N = 373). The results show that the magnitude of inequalities in self-perceived health, in the adoption of healthy practices and in daily activity limitations by social class are smaller as municipalities" spending was oriented towards policy areas considered as redistributive. Therefore, the proposed institutional overlap thesis could help understand the role of subnational governments on the magnitude of health inequalities, as well as in comparative analysis between countries with institutional systems in which local governments have a greater or lesser capacity to provide welfare services.


Subject(s)
Local Government , Social Welfare , Cross-Sectional Studies , Social Class , Health Status , Socioeconomic Factors , Health Status Disparities
13.
Notas enferm. (Córdoba) ; 23(40): 13-26, dic.2022.
Article in Spanish | LILACS, BDENF, BINACIS, UNISALUD | ID: biblio-1401325

ABSTRACT

La OMS declaró en el año 2020 estado de pandemia con la llegada del COVID-19, el virus no hizo distinción sin embargo la población adulta mayor fue la más propensas al contagio. Los adultos mayores bajo los lineamientos sanitarios fueron considerados población vulnerable y las directrices como el confinamiento y el distanciamiento social provocó algunas implicancias en su salud y bienestar social. El trabajo tuvo como objeto realizar un análisis descriptivo a partir de la mirada que tuvieron los adultos mayores sobre la desigualdad, incertidumbre y oportunidades durante el confinamiento y el distanciamiento social de la pandemia en la ciudad de Catamarca. Se tomó como parámetros de análisis las variables sexo, edad, situación socio-económico y estado de salud físico y emocional. La estrategia metodológica fue cuantitativa con un enfoque mixto (cuantitativo-cualitativo), la muestra de estudios es intencional no probabilística, en la cual participaron adultos mayores; y se utilizó como técnica de recopilación de datos la encuesta de elaboración propia. Como resultado, se observó que durante el confinamiento por la pandemia del COVID-19, si bien los adultos mayores sintieron temor al virus, el cual fue por etapas, pero por medio de diferentes mecanismos pudieron superar la situación y levantar el ánimo participando de diferentes actividades integrales. La investigación permitió concluir que la situación socioeconómica marco un parámetro de acceso/des-acceso para obtener los recursos, pero las estructuras socio-familiares como factores de contención social, económica y de salud fueron determinantes para superar problemas socio-sanitarios durante el confinamiento y el distanciamiento social[AU]


Te WHO declared a state of pandemic in 2020 with the arrival of COVID-19, the virus made no distinction, however, the older adult population was the most prone to contagion. Older adults under the health guidelines were considered a vulnerable population and guidelines such as confnement and social distancing caused some implications for their health and social wellbeing. Te purpose of the work is to carry out a descriptive analysis based on the view that older adults had on inequality, uncertainty and opportunities during the confnement and social distancing of the pandemic in the city of Catamarca. Te variables sex, age, socio-economic situation and physical and emotional health status were taken as analysis parameters. Te methodological strategy is quantitative with a mixed approach (quantitative-qualitative), the study sample is intentional, non-probabilistic, in which adults participated; and the self-made survey was used as a data collection technique. As a result, it is observed that during the confnement due to the COVID-19 pandemic, although older adults felt fear of the virus, which was in stages, but through different mechanisms they were able to overcome the situation and lif their spirits by participating in different comprehensive activities. Te research allows us to conclude that the socioeconomic situation marks a parameter of access/deaccess to obtain the resources, but the socio-family structures as factors of social, economic and health containment were decisive in overcoming socio-sanitary problems during confnement and social distancing[AU]


A OMS declarou estado de pandemia em 2020 com a chegada do COVID-19, o vírus não fez distinção, porém, a população idosa foi a mais propensa ao contágio. Os idosos sob as diretrizes de saúde foram considerados uma população vulnerável e diretrizes como confnamento e distanciamento social causaram algumas implicações para sua saúde e bem-estar social. O objetivo do trabalho é realizar uma análise descritiva a partir da visão que os idosos tiveram sobre desigualdade, incerteza e oportunidades durante o confnamento e distanciamento social da pandemia na cidade de Catamarca. As variáveis sexo, idade, situação socioeconômica e estado de saúde física e emocional foram tomadas como parâmetros de análise. A estratégia metodológica é quantitativa com abordagem mista (quantitativa-qualitativa), a amostra do estudo é intencional, não probabilística, da qual participaram adultos; e como técnica de coleta de dados utilizou-se o questionário auto-feito. Como resultado, observa-se que durante o confnamento devido à pandemia do COVID-19, embora os idosos sentissem medo do vírus, que estava em etapas, mas por meio de diferentes mecanismos conseguiram superar a situação e elevar o ânimo participando de diferentes atividades abrangentes. A pesquisa permite concluir que a situação socioeconômica marca um parâmetro de acesso/desacesso para obtenção dos recursos, mas as estruturas sociofamiliares como fatores de contenção social, econômica e sanitária foram determinantes na superação de problemas sociossanitários durante o confnamento e distanciamento social[AU]


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Social Welfare , Socioeconomic Factors , Uncertainty , Vulnerable Populations , Fear , Pandemics , COVID-19 , Life Change Events
14.
Przegl Epidemiol ; 76(3): 336-351, 2022.
Article in English | MEDLINE | ID: mdl-36520081

ABSTRACT

INTRODUCTION: One of the decisive factors in maintaining good health and physical and mental fitness is proper nutrition. Its role becomes particularly important when a disease occurs, including chronic and mental illness. AIM OF THE STUDY: This study was aimed at investigating whether, and to what extent, it is feasible to conduct health-promoting nutritional education and to implement principles of correct nutrition in chronically mentally ill patients residing in a 24-h Social Welfare Home (SWH). MATERIAL AND METHODS: 52 people staying in the 24-hour SWH for chronically mentally ill participated in the study. Nutritional education was conducted by a dietitian with whom a psychologist, nurse and physiotherapist collaborated. Nutritional education was aimed at accepting changes in the way of nutrition by changing the composition otfthe diet and food preparation, changing eating behavior (throwing food under the table, taking food from other residents, etc.) and changing the structure of own purchases. RESULTS: One year after the correction of the diet and nutritional supervision, a statistically significant increase in the consumption of vegetables, fruit, cottage cheese, fish and vegetable fats and a decrease in the consumption of white wheat bread, rennet cheese, cold meats and sugar and sweets. In the assortment of women's own purchases, the amount of cold cuts, sweets and cakes decreased, and apples and dairy products appeared. In men, the amount of cold cuts, cheese, cakes and sweetened drinks decreased, and fruits and fermented milk drinks appeared. A significant reduction in the value of the glycemic load was found: 2nd breakfasts, snacks and the value of a 24-hour diet. CONCLUSIONS: It was found that multidirectional pro-health nutritional education of chronically mentally ill people is reflected in their nutritional behavior. The fact that the respondents are aware of the influence of the diet on their health also translates into a change in the range of their own purchases.


Subject(s)
Mentally Ill Persons , Female , Humans , Poland , Feeding Behavior , Nutritional Status , Diet , Social Welfare , Vegetables
15.
Article in English | MEDLINE | ID: mdl-36498349

ABSTRACT

Ecological welfare performance (EWP) is a necessary condition for achieving sustainable economic development and is a crucial initiative for resolving the dilemma of balancing economic development, social welfare, ecology, and the environment. This paper constructs and enhances a comprehensive evaluation system of ecological welfare performance (EWP) from an ecological value viewpoint for the purpose of making the results of the evaluation both comprehensive and objective. In the meantime, the Dagum Gini decomposition, kernel density, and the spatial Durbin model were initiated to measure and analyze urban EWP, which supplies new empirical results for studies on the dynamic evolution, regional differences and driving factors of urban EWP. The findings indicate the following: (1) In each spatial dimension, the urban EWP roughly demonstrates first a decreased and then an increased trend. There is a discrepancy in the east-central-west distribution of urban EWP in space, in which urban EWP in the east and west is larger than that in the central area. (2) For relative differences, intra-regional and inter-regional differences in urban EWP are significantly spatially uneven. Supervariable density is the main source of regional differences. For absolute differences, the EWP demonstrates a significant polarization effect. (3) The urban EWP does not have σ-convergence; nonetheless, it has spatial absolute ß-convergence and spatial conditional ß-convergence. (4) The urban EWP has a significant spatial correlation. Industrial structure, science and technology innovation, foreign investment, urbanization, government intervention, finance development, and environmental regulations all have influence effects and spatial effects on urban EWP; notwithstanding, the direction and magnitude of the effects vary across the different spatial dimensions.


Subject(s)
Economic Development , Urbanization , China , Industry , Social Welfare , Cities
16.
Article in English | MEDLINE | ID: mdl-36429352

ABSTRACT

This article aims to advance the discussion of government policies for improving women's work and family life. It focuses on exploring whether it is reasonable to expect that the supported adult worker model will play an important role in guiding governments to reduce the gender employment gap and, at the same time, increase women's resources for strengthening their control over family and work life. This model posits that governments should take a proactive approach to encouraging women to take part in formal employment, such as providing care support measures. To examine the impact of the model, this article develops an 'input adult worker model typology' and an 'output adult worker model typology' using cluster analysis of comparative data covering 15 countries. The findings show that it is important not to overestimate the impact of the supported adult worker model on reducing the gender employment gap or increasing women's control over their lives in most of the 15 countries. The evidence generated from these typologies highlights the difficulties involved in promoting women's welfare despite the use of the adult worker model as a substitute for the male-breadwinner model.


Subject(s)
Family Planning Policy , Adult , Male , Humans , Female , Employment , Government , Europe , Social Welfare
17.
Article in English | MEDLINE | ID: mdl-36429525

ABSTRACT

Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional "20 de Noviembre"-ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI95% 1.01-1.53] vs. +0.90 [OR = 1.90, CI95% 1.56-2.32] vs. 0.73 [OR = 1.73, CI95% 1.36-2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI95% 1.11-1.87] vs. +0.35 [OR = 1.35, CI95% 1.00-1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI95% 1.22-1.94] vs. +0.41 [OR = 1.41, CI95% 1.13-1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.


Subject(s)
COVID-19 , Humans , United States , Retrospective Studies , COVID-19/epidemiology , Mexico/epidemiology , Hospitalization , Social Welfare
18.
Article in English | MEDLINE | ID: mdl-36429997

ABSTRACT

This study explores how the services provided by different types of Chinese communities varied in their impact on the social involvement of residents during the COVID-19 pandemic. The literature revealed problems caused by travel restrictions, including using oversimplified measures for grassroots governance, which might result in decreased residents' social involvement during COVID-19. We argue that the services provided by "smart communities" in China not only adhered to the COVID-19 pandemic governance, but also promoted the social involvement of residents. Using a case study approach of the smart community Fang Xing and the traditional community Qili Tang, both of which are located in China, this article compared the traditional and smart community services based on 122 interviews with residents and frontline community staff members. The findings suggest that while the traditional community decreased the residents' social involvement by restricting certain services during the pandemic, the smart community was able to apply COVID-19 governance measures, considerably increasing the residents' social involvement. It offered an attractive option for residents to act as community service managers, and it prepared them for local-level pandemic governance. This study provides an understanding of the relationship between the community services and the residents' social involvement in terms of the community services. The smart community model can act as a reference for international community development during pandemic governance.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , China/epidemiology , Social Welfare
19.
Article in English | MEDLINE | ID: mdl-36430119

ABSTRACT

Home and community care is an important way to actively respond to population aging and to promote healthy aging. This study aims to estimate the effect of using home and community care services on the multidimensional health of older adults. We used data from the China Health and Retirement Longitudinal Study conducted in 2018 and relied mainly on the propensity score matching method for data analysis. The results showed that using home and community care increased the probability of maintaining and improving physical health by 2.9%, decreased the score of depression by 0.471, and improved the score of cognitive function by 0.704. Using home and community care also increased the probability of actively participating in life by 4.1% and elevated the score of life satisfaction by 0.088. The heterogeneity analysis showed that the use of home and community care had a significant effect on promoting all health indicators in rural older adults and a more obvious promoting effect on the social adaptation of urban older adults. Using home and community care significantly promoted the multidimensional health of people aged 60 to 79 years but had no impact among people aged ≥ 80 years. The use of home and community care significantly improved all health indicators in non-disabled older adults. Whereas, it only improved the levels of cognitive function and life satisfaction in disabled older people. Using this form of care significantly improved all health indicators in those with low socio-economic status, but it only had a partial positive effect on the multidimensional health of those with high socio-economic status. Our results are of importance to the government as they may be used to further improve the quality of home and community care services for the targeted older population.


Subject(s)
Disabled Persons , Social Welfare , Humans , Aged , Longitudinal Studies , China , Rural Population
20.
BMC Public Health ; 22(1): 2147, 2022 11 22.
Article in English | MEDLINE | ID: mdl-36419068

ABSTRACT

BACKGROUND: Low-income is one of the well-established determinants of people's health and health-related behavior, including susceptibility to the coronavirus disease 2019 (COVID-19) infection. Two social welfare services are available in Japan to support financial and medical care among low-income patients: Public Assistance (PA), which provide both minimum income and medical costs; and Free/Low-Cost Medical Care (FLCMC), wherein only medical costs were covered. In this study, changes in Health-Related Quality of Life (HRQOL) scores of low-income patients on PA and FLCMC, before and after COVID-19 pandemic, were described and compared against those that are not utilizing the said services (comparison group) to evaluate the contribution of social welfare services in protecting the HRQOL of the beneficiaries during the pandemic. METHODS: We used repeated cross-sectional data of adult beneficiaries of FLCMC and PA, as well as those without social welfare services, who regularly visit the Kamigyo clinic in Kyoto, Japan. We collected the data from 2018 and 2021 using a questionnaire on patients' socioeconomic attributes and the Japanese version of Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). The Japanese version of SF-12 can calculate the three components scores: physical health component summary (PCS), the mental health component summary (MCS), and the role-social component summary (RCS), which can be transformed to a 0-100 range scale with a mean of 50 and standard deviation of 10. RESULTS: Data of 200 and 174 beneficiaries in 2018 and 2021, respectively, were analyzed. Low-income patients on social welfare services had lower PCS, and RCS than the comparison group in both years. Multiple linear regression analyses with cluster-adjusted standard error estimator showed that the decline in MCS was significantly higher among FLCMC beneficiaries than in those without welfare services (Beta: -4.71, 95% Confidence Interval [CI]: -5.79 to -3.63, p < 0.01), and a decline in MCS among PA recipients was also observed (Beta: -4.27, 95% CI: -6.67 to -1.87 p = 0.02). CONCLUSIONS: Low-income beneficiaries of social welfare may have experienced mental health deterioration during the COVID-19 pandemic. To maintain healthy lives during the pandemic, additional support on mental health for low-income recipients of social welfare services may be required.


Subject(s)
COVID-19 , Pandemics , Adult , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Quality of Life , Japan/epidemiology , Social Welfare
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