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1.
MMWR Morb Mortal Wkly Rep ; 69(17): 523-526, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32352954

RESUMEN

On March 30, 2020, Public Health - Seattle and King County (PHSKC) was notified of a confirmed case of coronavirus disease 2019 (COVID-19) in a resident of a homeless shelter and day center (shelter A). Residents from two other homeless shelters (B and C) used shelter A's day center services. Testing for SARS-CoV-2, the virus that causes COVID-19, was offered to available residents and staff members at the three shelters during March 30-April 1, 2020. Among the 181 persons tested, 19 (10.5%) had positive test results (15 residents and four staff members). On April 1, PHSKC and CDC collaborated to conduct site assessments and symptom screening, isolate ill residents and staff members, reinforce infection prevention and control practices, provide face masks, and advise on sheltering-in-place. Repeat testing was offered April 7-8 to all residents and staff members who were not tested initially or who had negative test results. Among the 118 persons tested in the second round of testing, 18 (15.3%) had positive test results (16 residents and two staff members). In addition to the 31 residents and six staff members identified through testing at the shelters, two additional cases in residents were identified during separate symptom screening events, and four were identified after two residents and two staff members independently sought health care. In total, COVID-19 was diagnosed in 35 of 195 (18%) residents and eight of 38 (21%) staff members who received testing at the shelter or were evaluated elsewhere. COVID-19 can spread quickly in homeless shelters; rapid interventions including testing and isolation to identify cases and minimize transmission are necessary. CDC recommends that homeless service providers implement appropriate infection control practices, apply physical distancing measures including ensuring resident's heads are at least 6 feet (2 meters) apart while sleeping, and promote use of cloth face coverings among all residents (1).


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Personas sin Hogar/estadística & datos numéricos , Vivienda/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Washingtón/epidemiología
2.
MMWR Morb Mortal Wkly Rep ; 69(17): 521-522, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32352957

RESUMEN

In the United States, approximately 1.4 million persons access emergency shelter or transitional housing each year (1). These settings can pose risks for communicable disease spread. In late March and early April 2020, public health teams responded to clusters (two or more cases in the preceding 2 weeks) of coronavirus disease 2019 (COVID-19) in residents and staff members from five homeless shelters in Boston, Massachusetts (one shelter); San Francisco, California (one); and Seattle, Washington (three). The investigations were performed in coordination with academic partners, health care providers, and homeless service providers. Investigations included reverse transcription-polymerase chain reaction testing at commercial and public health laboratories for SARS-CoV-2, the virus that causes COVID-19, over approximately 1-2 weeks for residents and staff members at the five shelters. During the same period, the team in Seattle, Washington, also tested residents and staff members at 12 shelters where a single case in each had been identified. In Atlanta, Georgia, a team proactively tested residents and staff members at two shelters with no known COVID-19 cases in the preceding 2 weeks. In each city, the objective was to test all shelter residents and staff members at each assessed facility, irrespective of symptoms. Persons who tested positive were transported to hospitals or predesignated community isolation areas.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Personas sin Hogar/estadística & datos numéricos , Vivienda/estadística & datos numéricos , Neumonía Viral/epidemiología , Boston/epidemiología , Ciudades , Georgia/epidemiología , Humanos , Pandemias , Prevalencia , San Francisco/epidemiología , Washingtón/epidemiología
7.
Acta Med Port ; 33(4): 229-236, 2020 Apr 01.
Artículo en Portugués | MEDLINE | ID: mdl-32238236

RESUMEN

INTRODUCTION: Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman's role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life. MATERIAL AND METHODS: In order to characterise the country's situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.


Asunto(s)
Consumo de Bebidas Alcohólicas/prevención & control , Trastornos Relacionados con Sustancias/prevención & control , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Causas de Muerte , Estudios Transversales , Características Culturales , Recolección de Datos , Bases de Datos Factuales/normas , Composición Familiar , Femenino , Encuestas Epidemiológicas , Vivienda/normas , Humanos , Esperanza de Vida , Masculino , Salud Pública , Santo Tomé y Príncipe , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
8.
J Environ Manage ; 262: 110301, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32250785

RESUMEN

Previous studies of the residents' willingness to pay (WTP) for air quality improvement are likely suffering various endogeneity biases. Exploiting the unique opportunity of a recent quasi-experiment operation of the world's first SFT (Smog Free Tower) in China's northwestern city Xi'an, this paper reliably calibrates local residents' WTP for less exposure to haze by analyzing the price responses of housings in the neighborhoods of SFT. The hedonic regression is applied in the DID (difference-in-difference) setting, with further assistances of the PSM (propensity score matching) method, quantile regression and placebo test. The regression results consistently suggest that housing price responded positively to the installment of the SFT, and the impact estimates are closely centered around 4%. The study also indicates high-priced housings response much more to the operation of the SFT than cheap-priced housings, suggesting uneven distribution of welfare gains of air quality improvement. A cost-benefit analysis of the SFT project indicates that the economic benefits of this project far outweigh the costs involved. The paper concludes with discussions of policy implications of this paper for environment governance.


Asunto(s)
Contaminación del Aire , China , Ciudades , Vivienda , Características de la Residencia
9.
Psychiatry Res ; 288: 112945, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32302813

RESUMEN

BACKGROUND: Insufficient housing quality is associated with stress and mental health impacts. Crowding, pollution, noise, inadequate lighting, lack of access to green spaces, and other environmental factors associated with slums can exacerbate mental health disorders, including depression, anxiety, violence, and other forms of social dysfunction. METHOD: The studies were identified using large-sized newspapers with international circulation. RESULTS: Experts say that people who sleep in shelters or on the streets already have lower life expectancy, suffer from addiction, and have underlying health conditions that put them at greater risk should they develop the virus. There are just so many competing and unmet needs, which makes it much harder for homeless to contend with all of this. If exposed, people experiencing homelessness might be more susceptible to illness or death due to the prevalence of underlying physical and mental medical conditions and a lack of reliable and affordable health care. Nevertheless, without an urgent solution, people experiencing homelessness will remain in limbo. CONCLUSIONS: Many people living on the streets already have a diminished health condition, higher rates of chronic illnesses or compromised immune systems, all of which are risk factors for developing a more serious manifestation of the coronavirus infection. Those suffering from mental illness may have difficulty in recognizing and responding to the threat of infection. Homeless people have less access to health care providers who could otherwise order diagnostic testing and, if confirmed, isolate them from others in coordination with local health departments.


Asunto(s)
Infecciones por Coronavirus , Accesibilidad a los Servicios de Salud , Personas sin Hogar , Trastornos Mentales , Pandemias , Neumonía Viral , Poblaciones Vulnerables , Trastornos de Ansiedad , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/transmisión , Femenino , Personas sin Hogar/psicología , Vivienda , Humanos , Masculino , Salud Mental , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Neumonía Viral/transmisión , Factores de Riesgo
10.
PLoS Negl Trop Dis ; 14(3): e0008132, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32150578

RESUMEN

Visceral leishmaniasis (VL) in Nepal is found in 61 out of 75 districts including areas previously listed as non- endemic. This study focused on the role of housing conditions and its immediate environment in VL transmission, to limit future transmissions, ensure sustainable vector control and support the VL elimination program. The objective was to explore the risk factors in rural housing-and land lot typologies contributing to clinical VL occurrence and transmission. Housing structures and land lots were examined based on characteristics as risk factors of VL transmission in a case-control analysis. VL cases from 2013-2017 were identified based on the existing database from the Epidemiology and Disease Control Division and District Public Health Office from the plain Terai area (Morang, and Saptari districts) and hilly area (Palpa district) of Nepal. Two hundred and three built environments were analyzed (66 cases and 137 controls). Inferential statistics and logistic regression analysis were performed to determine the association of risk factors with VL. The risk factors with the highest odds of VL were: bamboo walls (adjusted odds ratio (AOR)- 8.1, 95% CI 2.40-27.63, p = 0.001), walls made of leaves/branches (AOR- 3.0, 95% CI 0.84-10.93, p = 0.090), cracks in bedroom walls (AOR- 2.9, 95% CI 0.93-9.19, p = 0.065), and placing sacks near sleeping areas (AOR- 19.2, 95% CI 4.06-90.46, p <0.001). Significant outdoor factors were: lots with Kadam trees (AOR- 12.7, 95% CI 3.28-49.09, p <0.001), open ground-outdoor toilets (AOR- 9.3, 95% CI 2.14-369.85, p = 0.003), moisture in outdoor toilet sheds (AOR- 18.09, 95% CI 7.25-451.01, p = 0.002), nearby- open land (AOR- 36.8, 95% CI 3.14-430.98, p = 0.004), moisture inside animal sheds (AOR- 6.9, 95% CI 1.82-26.66, p = 0.005), and surrounding animals/animals wastes particularly goats (AOR- 3.5, 95% CI 1.09-10.94, p = 0.036). Certain housing and surrounding environmental conditions and characteristics are risk factors for VL. Hence, elimination and educational programs should include the focus on housing improvement and avoidance of risk factors. Longitudinal interventional studies are required to document temporal relationships and whether interventions on these factors will have an impact on Leishmania transmission or burden.


Asunto(s)
Transmisión de Enfermedad Infecciosa , Ambiente , Vivienda , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/transmisión , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Nepal/epidemiología , Factores de Riesgo
11.
Clin Ter ; 171(2): e97-e100, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32141478

RESUMEN

The Italian Law n. 9/2012 provided the Italian Regions with a new decisional role by demanding the management/rehabilitation of prisoners judged as partially/fully mentally ill to care and protection delivered by the psychiatric services of the Regional Health Service. Healthcare has to be guaranteed by the so-called High-Security Forensic Psychiatry Residences (Italian: Residenze per l'Esecuzione delle Misure di Sicurezza: REMS) and by community mental health centres. Ensuring patients' and professionals' health and safety is a complex issue which requires effective strategies to cope with several structural, technological, and organisational problems. The present paper summarises the historical evolution of the Italian laws towards the development of the High-Security Forensic Psychiatry Residences in Italy, focusing specifically on the Tuscany Region situation. The paper also presents the key issues emerging after the implementation of the Law 81/2014 which complemented the Law 9/2012. Since these reforms included the need for assessing to what extent the patient may be considered as a danger to society and for ensuring the safety of National Health Service (NHS) professionals, they underscored the importance of a preventive use of specific clinical governance tools aimed to reduce risk of adverse events. The present work has the strength of proposing a new, evidence-based scientific approach to the implementation of assessment and care pathways in High-Security Forensic Psychiatry Residences.


Asunto(s)
Psiquiatría Forense/legislación & jurisprudencia , Personal de Salud , Prisioneros , Medidas de Seguridad , Psiquiatría Forense/historia , Historia del Siglo XXI , Hospitales Psiquiátricos , Vivienda , Humanos , Italia , Gestión de Riesgos
13.
PLoS One ; 15(2): e0228598, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32109247

RESUMEN

Since the real estate market reform in 1998, China's house prices have been rising. High housing prices have exerted negative impacts on labour mobility, the investment environment and resident consumption, all of which may affect the overall resource allocation efficiency and the improvement of the global value chain position of China's manufacturing industry. However, there is little research on the mechanism of the impact of housing prices on the status of manufacturing global value chain. Based on the matching data of China and the OECD-TiVA from 2005 to 2016, the parallel multiple mediator model is adopted to empirically test the transmission mechanism of housing price fluctuation on the global value chain position of China's manufacturing industry in this study using human capital level, resident consumption level, resident consumption structure, and R&D investment level as the mediating variables. This article finds that although housing price fluctuations do not have a direct impact on the global value chain position of the manufacturing industry, human capital level and resident consumption structure do have positive and negative mediating effects, respectively. Finally, we put forward some suggestions to promote the global value chain position of China's manufacturing industry, which provides useful reference for policy makers.


Asunto(s)
Costos y Análisis de Costo , Vivienda/economía , Modelos Económicos , China , Industria de la Construcción/economía , Factores Socioeconómicos
14.
PLoS One ; 15(2): e0228273, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32023292

RESUMEN

Over the last two decades, private renting has undergone a major revival in the UK, more than doubling its share within the housing system. Young adults increasingly remain in the sector into their 30s, giving rise to the term 'Generation Rent'. Using data from the UK's Family Resources Survey, this article shows how reliance on the sector varies by poverty status, particularly for young adults and children. In 2017/18, 42 per cent of adults under 40 in low-income poverty lived in private renting, compared with just 26 per cent of non-poor. This is almost double the proportion of 20 years earlier. Private renting is now home to more poor adults under 40 than owner occupation and social renting combined. In addition, one in three children in poverty (36 per cent) now lives in private renting, three times the level of 20 years ago. For both adults and children, rates are even higher in London and the South. Although rates of increase have slowed in recent years, this dramatic shift in the housing circumstances of those in poverty has a number of implications for housing and social policy which have not yet been sufficiently recognised.


Asunto(s)
Vivienda/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Adolescente , Estudios Transversales , Bases de Datos Factuales , Vivienda/economía , Humanos , Reino Unido , Adulto Joven
15.
N Z Med J ; 133(1510): 23-34, 2020 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-32078598

RESUMEN

AIM: To explore associations between tenure and the health service use of older New Zealanders. METHODS: Analysis of pooled data for adults aged 55+ from three New Zealand Health Surveys (2013/14, 2014/15, 2015/16) comparing owner-occupiers, private renters and public renters. RESULTS: Public renters, and in some age groups private renters, reported more visits to the GP and a higher proportion reported using a public hospital service in the last year. Renters were less likely than owner-occupiers to have used some privately paid services (visiting a dental health worker or optician). Renters averaged lower co-payments for their last GP visit, but financial barriers to accessing a GP, after-hours medical centre use and not collecting prescriptions were more likely to be reported by renters than owner-occupiers-particularly those that rent publicly. CONCLUSIONS: New Zealanders are simultaneously living longer while having declining opportunities to enter home ownership. Older renters are more likely to live in poorer health and, overall, are more likely to use some (public) health services than owner-occupiers yet are more likely to have unmet health needs. The increasing reliance on renting among older people has implications for population health and wellbeing, health service delivery and transitions to residential care.


Asunto(s)
Utilización de Instalaciones y Servicios/estadística & datos numéricos , Estado de Salud , Vivienda/estadística & datos numéricos , Propiedad/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Utilización de Instalaciones y Servicios/economía , Femenino , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Vivienda/economía , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Propiedad/economía , Autoinforme
16.
PLoS One ; 15(2): e0229385, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32106225

RESUMEN

Stigma and discrimination toward individuals experiencing homelessness and mental disorders remain pervasive across societies. However, there are few longitudinal studies of stigma and discrimination among homeless adults with mental illness. This study aimed to identify the two-year group trajectories of stigma and discrimination and examine the predictive role of mental health characteristics among 414 homeless adults with mental illness participating in the extended follow-up phase of the Toronto At Home/Chez Soi (AH/CS) randomized trial site. Mental health-related perceived stigma and discrimination were measured at baseline, one, and two years using validated scales. Group-based-trajectory modelling was used to identify stigma and discrimination group trajectory memberships and the effect of the Housing First treatment (rent supplements and mental health support services) vs treatment as usual on these trajectories. The associations between mental health-related characteristics and trajectory group memberships were also assessed using multinomial logistic regression. Over two-years, three group trajectories of stigma and discrimination were identified. For discrimination, participants followed a low, moderate, or increasingly high discrimination group trajectory, while for stigma, participants followed a low, moderate or high stigma group trajectory. The Housing First treatment had no significant effect on discrimination or stigma trajectories groups. For the discrimination trajectories, major depressive episode, mood disorder with psychotic features, alcohol abuse, suicidality, severity of mental health symptoms, and substance use severity in the previous year were predictors of moderate and increasingly high discrimination trajectories. History of discrimination within healthcare setting was also positively associated with following a moderate or high discrimination trajectory. For the stigma trajectories, substance dependence, high mental health symptoms severity, substance use severity, and discrimination experiences within healthcare settings were the main predictors for the moderate trajectory group; while substance dependence, suicidality, mental health symptom severity, substance use severity and discrimination experiences within health care setting were also positive predictors for the high stigma trajectory group. Ethno-racial status modified the association between having a major depression episode, alcohol dependence, and the likelihood of being a member of the high stigma trajectory group. This study showed that adults experiencing mental illness and homelessness followed distinct stigma and discrimination group trajectories based on their mental health-problems. There is an urgent need to increase focus on strategies and policies to reduce stigma and discrimination in this population.


Asunto(s)
Personas sin Hogar/psicología , Trastornos Mentales/psicología , Servicios de Salud Mental/normas , Salud Mental , Discriminación Social/estadística & datos numéricos , Problemas Sociales/estadística & datos numéricos , Estigma Social , Adulto , Femenino , Personas sin Hogar/estadística & datos numéricos , Vivienda , Humanos , Masculino , Trastornos Mentales/fisiopatología
18.
PLoS One ; 15(2): e0229363, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092129

RESUMEN

Post-marital residence patterns are an important aspect of human social organization. However, identifying such patterns in prehistoric societies is challenging since they leave almost no direct traces in archaeological records. Cross-cultural researchers have attempted to identify correlates of post-marital residence through the statistical analysis of ethnographic data. Several studies have demonstrated that, in agricultural societies, large dwellings (over ca. 65 m2) are associated with matrilocality (spouse resides with or near the wife's family), whereas smaller dwellings are associated with patrilocality (spouse resides with or near the husband's family). In the present study, we tested the association between post-marital residence and dwelling size (average house floor area) using phylogenetic comparative methods and a global sample of 86 pre-industrial societies, 22 of which were matrilocal. Our analysis included the presence of agriculture, sedentism, and durability of house construction material as additional explanatory variables. The results confirm a strong association between matrilocality and dwelling size, although very large dwellings (over ca. 200 m2) were found to be associated with all types of post-marital residence. The best model combined dwelling size, post-marital residence pattern, and sedentism, the latter being the single best predictor of house size. The effect of agriculture on dwelling size becomes insignificant once the fixity of settlement is taken into account. Our results indicate that post-marital residence and house size evolve in a correlated fashion, namely that matrilocality is a predictable response to an increase in dwelling size. As such, we suggest that reliable inferences about the social organization of prehistoric societies can be made from archaeological records.


Asunto(s)
Arqueología , Composición Familiar , Vivienda , Matrimonio , Filogenia , Antropología , Demografía/historia , Composición Familiar/historia , Femenino , Historia Antigua , Vivienda/historia , Humanos , Masculino , Matrimonio/historia , Dinámica Poblacional/historia , Características de la Residencia/historia
19.
Chemosphere ; 247: 125987, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32069736

RESUMEN

Bisphenol analogs (BPs), as the industrial chemicals, are widely used in consumer products. Limited information exists regarding human exposure to BPs in university students in China. In this study, we detected concentrations of seven BPs, namely bisphenol A (BPA), bisphenol AF (BPAF), bisphenol P (BPP), bisphenol AP (BPAP), bisphenol Z (BPZ), bisphenol S (BPS), and bisphenol F (BPF), in paired urine (n = 160) and indoor dust samples (n = 40) from university students in South China. High detection rates and levels (median) was found in BPA in paired urine (99%, 3.57 ng/mL) and indoor dust (80%, 2.98 µg/g) samples, followed by BPS (88%, 0.24 ng/mL; 78%, 0.22 µg/g). These findings suggest that BPA remains the major BPs used in consumer products. A positive relationship between urinary ∑BPs (sum of six BPs) concentration and indoor dust was observed (r = 0.444, p < 0.01), indicated that exposure to non-dietary BPs may also be significant to human exposure. The median EDIurine values (ng/kg bw/day) of ∑BPs in males (119.6) were relatively higher than (p < 0.05) those in females (84.6). By contrast, the median EDIdust of BPs (except for BPAF) in dust form female dormitories were slightly higher than that in dust from male dormitories. Notably, BPF was the most ingested from indoor dust (dormitory dust). This study is the first time to document the occurrence of BPs in paired urine and indoor dust in university students from China.


Asunto(s)
Compuestos de Bencidrilo/análisis , Polvo/análisis , Fenoles/análisis , Estudiantes , Universidades , Compuestos de Bencidrilo/orina , China , Ciclohexanos/análisis , Femenino , Vivienda , Humanos , Masculino , Fenoles/orina , Factores Sexuales , Sulfonas/análisis
20.
Am J Public Health ; 110(4): 567-573, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32078348

RESUMEN

Objectives. To describe the types of social services provided at community health centers (CHCs), characteristics of CHCs providing these services, and the association between on-site provision and health care quality.Methods. We surveyed CHCs in 12 US states and the District of Columbia during summer 2017 (n = 208) to identify referral to and provision of services to address 8 social needs. Regression models estimated factors associated with the provision of social services by CHCs and the association between providing services and health care quality (an 8-item composite).Results. CHCs most often offered on-site assistance for needs related to food or nutrition (43%), interpersonal violence (32%), and housing (30%). Participation in projects with community-based organizations was associated with providing services on-site (odds ratio = 2.48; P = .018). On-site provision was associated with better performance on measures of health care quality (e.g., each additional social service was associated with a 4.3 percentage point increase in colorectal cancer screenings).Conclusions. Some CHCs provide social services on-site, and this was associated with better performance on measures of health care quality.Public Health Implications. Health care providers are increasingly seeking to identify and address patients' unmet social needs, and on-site provision of services is 1 strategy to consider.


Asunto(s)
Centros Comunitarios de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Servicio Social/estadística & datos numéricos , Centros Comunitarios de Salud/organización & administración , Violencia Doméstica , Abastecimiento de Alimentos , Vivienda , Humanos , Encuestas y Cuestionarios , Estados Unidos
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