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1.
ASAIO J ; 68(9): 1105-1106, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35920754

Assuntos
Chicago , Illinois
2.
Am J Public Health ; 112(9): 1265-1268, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35797501

RESUMO

The US justice system unfairly targets youths of color; systemic reform plus interventions to keep youths out of the justice system are needed. The Juvenile Justice Collaborative provided care coordination and wraparound services to adolescents in a diversion program from 2017 to 2019 in Cook County, Illinois. Youths showed increased strengths and decreased needs by program's end. Youths who successfully completed the program showed reduced recidivism compared with nonprogram youths. Community-based alternatives to incarceration may decrease life disruption, promote positive health and social outcomes, and reduce further justice involvement. (Am J Public Health. 2022;112(9):1265-1268. https://doi.org/10.2105/AJPH.2022.306946).


Assuntos
Delinquência Juvenil , Reincidência , Adolescente , Humanos , Illinois , Delinquência Juvenil/prevenção & controle
3.
PLoS One ; 17(7): e0270404, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35895722

RESUMO

Accomplishing the goals outlined in "Ending the HIV (Human Immunodeficiency Virus) Epidemic: A Plan for America Initiative" will require properly estimating and increasing access to HIV testing, treatment, and prevention services. In this research, a computational spatial method for estimating access was applied to measure distance to services from all points of a city or state while considering the size of the population in need for services as well as both driving and public transportation. Specifically, this study employed the enhanced two-step floating catchment area (E2SFCA) method to measure spatial accessibility to HIV testing, treatment (i.e., Ryan White HIV/AIDS program), and prevention (i.e., Pre-Exposure Prophylaxis [PrEP]) services. The method considered the spatial location of MSM (Men Who have Sex with Men), PLWH (People Living with HIV), and the general adult population 15-64 depending on what HIV services the U.S. Centers for Disease Control (CDC) recommends for each group. The study delineated service- and population-specific accessibility maps, demonstrating the method's utility by analyzing data corresponding to the city of Chicago and the state of Illinois. Findings indicated health disparities in the south and the northwest of Chicago and particular areas in Illinois, as well as unique health disparities for public transportation compared to driving. The methodology details and computer code are shared for use in research and public policy.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Adulto , Chicago/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Teste de HIV , Acesso aos Serviços de Saúde , Homossexualidade Masculina , Humanos , Illinois , Masculino , Estados Unidos/epidemiologia
4.
Ann Epidemiol ; 73: 30-37, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35718099

RESUMO

PURPOSE: We examined how longitudinal changes and inter-community differences of food insecurity rates were associated with child maltreatment report (CMR) rates at the zip code level. We assessed these associations overall, by urbanicity, and within subgroups of age, sex, and maltreatment type. METHODS: We used Illinois statewide zip code-level data from 2011 to 2018. We measured CMR rates based on Illinois child protective services records and food insecurity rates from Feeding America's Map the Meal Gap. We conducted spatial linear modeling to account for spatial dependence with controls for various socioeconomic, demographic, care burden, and instability conditions of communities. RESULTS: Both longitudinal changes and inter-community differences of food insecurity rates were significantly associated with increased CMR rates overall and within all subgroups. These associations were significant among all large urban, small urban, and rural areas, while longitudinal changes of food insecurity rates had significantly stronger associations among small urban areas compared with other areas. CONCLUSIONS: Communities experiencing higher food insecurity had higher CMR rates. Increases in food insecurity over time were associated with increases in CMR rates. These associations were reproduced within subgroups of child age, sex, maltreatment type, and urbanicity. Attention and collaborative efforts are warranted for high food insecure communities.


Assuntos
Maus-Tratos Infantis , Insegurança Alimentar , Criança , Abastecimento de Alimentos , Humanos , Illinois/epidemiologia , Fatores Socioeconômicos
6.
J Gerontol Nurs ; 48(6): 26-32, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35648581

RESUMO

Fall risk assessment is a complex phenomenon involving several risk factors, including an individual's balance and mobility status, chronic health conditions, visual impairment, hearing deficits, environmental hazards (e.g., loose rugs, clutter), and being homebound or semi-homebound. Comprehensive fall risk assessment is the cornerstone of fall prevention in older adults throughout the community. The current study was based on secondary data and sought to examine variables associated with death due to accidental fall in a rural, midwestern county in Illinois, and to heighten awareness for consistent screening and risk assessment in older adults residing in the community. Results illustrated that among community-dwelling older adults with accidental falls, blunt injury or subdural hematoma had significantly fewer days until death than a fracture. [Journal of Gerontological Nursing, 48(6), 26-32.].


Assuntos
Acidentes por Quedas , Vida Independente , Acidentes por Quedas/prevenção & controle , Idoso , Doença Crônica , Humanos , Illinois , Medição de Risco , Fatores de Risco
7.
Contraception ; 114: 54-57, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35568088

RESUMO

OBJECTIVES: Beginning January 1, 2018, Illinois House Bill 40 (HB40) requires Medicaid coverage of induced abortion. The objective of this study was to describe the impact of HB40 on gestational age at time of induced abortion at a single academic medical center in Chicago, IL. STUDY DESIGN: We used Current Procedural Terminology (CPT) codes to identify patients who induced abortion one year before (2016) and one year immediately after (2018) HB40 implementation. We collected demographic and clinical information from the electronic medical record. We used ANOVA and Chi-square tests to evaluate differences in gestational age and patient characteristics before and after the policy change. RESULTS: Patient characteristics and indication for induced abortion before (N = 274) and after (N= 249) HB40 were similar. The mean gestational age of induced abortion was higher after HB40 (83.3 days ± 38.9 days vs 91.6 days ± 38.0 days, p = 0.01). While not statistically significant, the proportion of second trimester (>14 weeks) induced abortions increased (32.8% vs 40.6%, p = 0.07). After HB40, a smaller proportion of patients paid out-of-pocket for abortion care (2.4% vs 40.5%, p < 0.001) and more patients had an abortion with sedation (37.3% vs 49.8%, p = 0.007). CONCLUSIONS: After passage of HB40, the gestational age at time of induced abortion increased by a median of eight days, access to abortion care was less costly to patients and more procedures were completed with sedation. To further the impact of HB40, increased awareness of expanded coverage continues to be essential. IMPLICATIONS: With Medicaid coverage of induced abortion in Illinois, out-of-pocket cost decreased and sedation use increased in our academic medical center. To further the impact of HB40, increased awareness of expanded coverage continues to be essential.


Assuntos
Aborto Induzido , Medicaid , Chicago , Feminino , Humanos , Illinois , Gravidez , Segundo Trimestre da Gravidez , Estados Unidos
8.
Emerg Infect Dis ; 28(6): 1281-1283, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35608888

RESUMO

Bars and restaurants are high-risk settings for SARS-CoV-2 transmission. A multistate outbreak after a bar gathering in Chicago, Illinois, USA, highlights Omicron variant transmissibility, the value of local genomic surveillance and interstate coordination, vaccination value, and the potential for rapid transmission of a novel variant across multiple states after 1 event.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Chicago/epidemiologia , Surtos de Doenças , Humanos , Illinois/epidemiologia , SARS-CoV-2/genética
9.
Cancer Control ; 29: 10732748221105310, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35632990

RESUMO

OBJECTIVE: To conduct a needs assessment for lay health workers and non-physician healthcare professionals [i.e., community health workers (CHW) and lung health professionals who spend more time face-to-face with tobacco-related disparity populations] to describe current gaps in tobacco cessation practices and knowledge. METHODS: A 46-item needs assessment survey was developed to understand knowledge, practices, and confidence about tobacco cessation among non-physician health professionals in a large, urban city in the U.S. Participants, recruited from local community-based organizations and email listservs, completed the online or paper survey, which included a 10-item investigator-initiated tobacco knowledge questionnaire. RESULTS: About 61.5% of participants (N = 53) asked each client/patient about tobacco use at initial visit, 41.8% reported extreme likelihood of discussing tobacco during a visit, and 43.1% reported addressing tobacco use directly. Despite assisting with cessation, tobacco-related knowledge and confidence was low, with respondents scoring an average of 4.08 out of 10 (SD = 2.21) on the tobacco knowledge questionnaire. CONCLUSION: There was a clear lack of knowledge about tobacco cessation in the U.S. among non-physician healthcare professionals. These professionals could benefit from trainings that are relevant to their model of care and better equip them to assist the disparity populations that they serve.


Assuntos
Uso de Tabaco , Tabaco , Chicago , Atenção à Saúde , Humanos , Illinois
10.
JAMA Netw Open ; 5(5): e2214753, 2022 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-35622360

RESUMO

Importance: There has been large geographic inequity in vaccination coverage across Chicago, Illinois, with higher vaccination rates in zip codes with residents who predominantly have high incomes and are White. Objective: To determine the association between inequitable zip code-level vaccination coverage and COVID-19 mortality in Chicago. Design, Setting, and Participants: This retrospective cohort study used Chicago Department of Public Health vaccination and mortality data and Cook County Medical Examiner mortality data from March 1, 2020, through November 6, 2021, to assess the association of COVID-19 mortality with zip code-level vaccination rates. Data were analyzed from June 1, 2021, to April 13, 2022. Exposures: Zip code-level first-dose vaccination rates before the Alpha and Delta waves of COVID-19. Main Outcomes and Measures: The primary outcome was deaths from COVID-19 during the Alpha and Delta waves. The association of a marginal increase in zip code-level vaccination rate with weekly mortality rates was estimated with a mixed-effects Poisson regression model, and the total number of preventable deaths in the least vaccinated quartile of zip codes was estimated with a linear difference-in-difference design. Results: The study population was 2 686 355 Chicago residents in 52 zip codes (median [IQR] age 34 [32-38] years; 1 378 658 [51%] women; 773 938 Hispanic residents [29%]; 783 916 non-Hispanic Black residents [29%]; 894 555 non-Hispanic White residents [33%]). Among residents in the least vaccinated quartile, 80% were non-Hispanic Black, compared with 8% of residents identifying as non-Hispanic Black in the most vaccinated quartile (P < .001). After controlling for age distribution and recovery from COVID-19, a 10-percentage point increase in zip code-level vaccination 6 weeks before the peak of the Alpha wave was associated with a 39% lower relative risk of death from COVID-19 (incidence rate ratio [IRR], 0.61 [95% CI, 0.52-0.72]). A 10-percentage point increase in zip code vaccination rate 6 weeks before the peak of the Delta wave was associated with a 24% lower relative risk of death (IRR, 0.76 [95% CI, 0.66-0.87]). The difference-in-difference estimate was that 119 Alpha wave deaths (72% [95% CI, 63%-81%]) and 108 Delta wave deaths (75% [95% CI, 66%-84%]) might have been prevented in the least vaccinated quartile of zip codes if it had had the vaccination coverage of the most vaccinated quartile. Conclusions and Relevance: These findings suggest that low zip code-level vaccination rates in Chicago were associated with more deaths during the Alpha and Delta waves of COVID-19 and that inequitable vaccination coverage exacerbated existing racial and ethnic disparities in COVID-19 deaths.


Assuntos
COVID-19 , Adulto , COVID-19/prevenção & controle , Chicago/epidemiologia , Feminino , Humanos , Illinois/epidemiologia , Lactente , Masculino , Estudos Retrospectivos , Vacinação
11.
PLoS One ; 17(5): e0268317, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35576226

RESUMO

Early data from the COVID-19 pandemic suggests that the disease has had a disproportionate impact on communities of color with higher infection and mortality rates within those communities. This study used demographic data from the 2018 US census estimates, mortality data from the Cook County Medical Examiner's office, and testing results from the Illinois Department of Public Health to perform bivariate and multivariate regression analyses to explore the role race plays in COVID-19 outcomes at the individual and community levels. We used the ZCTA Social Deprivation Index (SDI), a measure of ZCTA area level deprivation based on seven demographic characteristics to quantify the socio-economic variation in health outcomes and levels of disadvantage across ZCTAs. Principal findings showed that: 1) while Black individuals make up 22% of Cook County's population, they account for 28% of the county's COVID-19 related deaths; 2) the average age of death from COVID-19 is seven years younger for Non-White compared with White decedents; 3) residents of Minority ZCTA areas were 1.02 times as likely to test positive for COVID-19, (Incidence Rate Ratio (IRR) 1.02, [95% CI 0.95, 1.10]); 1.77 times as likely to die (IRR 1.77, [95% CI 1.17, 2.66]); and were 1.15 times as likely to be tested (IRR 1.15, [95% CI 0.99, 1.33]). There are notable differences in COVID-19 related outcomes between racial and ethnic groups at individual and community levels. This study illustrates the health disparities and underlying systemic inequalities experienced by communities of color.


Assuntos
COVID-19 , COVID-19/epidemiologia , Criança , Etnicidade , Disparidades nos Níveis de Saúde , Humanos , Illinois/epidemiologia , Pandemias , Estudos Retrospectivos
12.
Artigo em Inglês | MEDLINE | ID: mdl-35564507

RESUMO

Temporary staffing has an increasing role in world economies, contracting workers and dispatching them to work for leasing employers within countries and across borders. Using Illinois as a case study, co-authors have undertaken investigations to understand the occupational health, safety, and well-being challenges for workers hired through temporary staffing companies; to determine knowledge and attitudes of temp workers and temp staffing employers; and to assess temporary staffing at a community level. Temporary staffing workers in Illinois tend to be people of color who are employed in the most hazardous sectors of the economy. They have a higher rate of injury, are compensated less, and often lose their jobs when injured. Laws allow for ambiguity of responsibility for training, reporting, and compensation between the staffing agency and host employers. Our findings illustrate the ways in which principles of fairness and equity are violated in temporary staffing. Shared responsibility for reporting injuries, providing workers' compensation insurance, and training workers should be mandated in law and required in contractual language between temporary staffing and host/contracting employers. Monitoring, enforcement, and adjustment of the law based on experience are required to "promote inclusive and sustainable economic growth, employment and decent work for all.


Assuntos
Equidade em Saúde , Saúde do Trabalhador , Traumatismos Ocupacionais , Humanos , Illinois , Justiça Social , Indenização aos Trabalhadores , Recursos Humanos
13.
Cancer ; 128(15): 2865-2870, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35607821

RESUMO

Comprehensive biomarker testing has become the standard of care for informing the choice of the most appropriate targeted therapy for many patients with advanced cancer. Despite evidence demonstrating the need for comprehensive biomarker testing to enable the selection of appropriate targeted therapies and immunotherapy, the incorporation of biomarker testing into clinical practice lags behind recommendations in National Comprehensive Cancer Network guidelines. Coverage policy differences across insurance health plans have limited the accessibility of comprehensive biomarker testing largely to patients whose insurance covers the recommended testing or those who can pay for the testing, and this has contributed to health disparities. Furthermore, even when insurance coverage exists for recommended biomarker testing, patients may incur burdensome out-of-pocket costs depending on their insurance plan benefits, which may also create barriers to testing. Prior authorization for biomarker testing for some patients can add an administrative burden and may delay testing and thus treatment if it is not done in a timely manner. Recently, three states (Illinois, Louisiana, and California) passed laws designed to improve access to biomarker testing at the state level. However, there is variability among these laws in terms of the population affected, the stage of cancer, and whether the coverage of testing is mandated, or the legislation addresses only prior authorization. Advocacy efforts by patient advocates, health care professionals, and professional societies are imperative at the state level to further improve coverage for and access to appropriate biomarker testing.


Assuntos
Gastos em Saúde , Cobertura do Seguro , Biomarcadores , Humanos , Illinois , Louisiana , Estados Unidos
14.
Sci Rep ; 12(1): 6888, 2022 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477968

RESUMO

Epizootic hemorrhagic disease (EHD) and bluetongue (BT) are vector-borne viral diseases that affect wild and domestic ruminants. Clinical signs of EHD and BT are similar; thus, the syndrome is referred to as hemorrhagic disease (HD). Syndromic surveillance and virus detection in North America reveal a northern expansion of HD. High mortalities at northern latitudes suggest recent incursions of HD viruses into northern geographic areas. We evaluated the occurrence of HD in wild Illinois white-tailed deer from 1982 to 2019. Our retrospective space-time analysis identified high-rate clusters of HD cases from 2006 to 2019. The pattern of northward expansion indicates changes in virus-host-vector interactions. Serological evidence from harvested deer revealed prior infection with BTV. However, BTV was not detected from virus isolation in dead deer sampled during outbreaks. Our findings suggest the value of capturing the precise geographic location of outbreaks, the importance of virus isolation to confirm the cause of an outbreak, and the importance of expanding HD surveillance to hunter-harvested wild white-tailed deer. Similarly, it assists in predicting future outbreaks, allowing for targeted disease and vector surveillance, helping wildlife agencies communicate with the public the cause of mortality events and viral hemorrhagic disease outcomes at local and regional scales.


Assuntos
Vírus Bluetongue , Bluetongue , Cervos , Vírus da Doença Hemorrágica Epizoótica , Transtornos Hemorrágicos , Infecções por Reoviridae , Doenças Transmitidas por Vetores , Animais , Illinois/epidemiologia , Infecções por Reoviridae/epidemiologia , Infecções por Reoviridae/veterinária , Estudos Retrospectivos , Ovinos
15.
PLoS One ; 17(4): e0266219, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35377916

RESUMO

Beekeepers regularly employ management practices to mitigate losses during the winter, often considered the most difficult time during a colony life cycle. Management recommendations involving covering or wrapping hives in insulation during winter have a long history; over 100 years ago, most recommendations for overwintering in cold climates involved heavy insulation wraps or moving hives indoors. These recommendations began to change in the mid-20th century, but hive covers are still considered useful and are described in contemporary beekeeping manuals and cooperative extension materials. However, most of the data supporting their use is published primarily in non-peer reviewed trade journals and was collected >40 years ago. In this time, the beekeeping environment has changed substantially, with new pressures from pathogens, agrochemicals, and land use changes. Here, we provide an update to the historical literature, reporting a randomized experiment testing the effectiveness of a common honey bee hive cover system across eight apiaries in central Illinois, USA, a temperate region dominated by conventional annual agriculture. We found that, when other recommended overwintering preparations are performed, covered colonies consumed less food stores and survived better than uncovered controls (22.5% higher survival). This study highlights the value of hive covers, even in an area not subject to extremely cold winter conditions, and these data can aid the production of evidence-based extension recommendations for beekeepers.


Assuntos
Criação de Abelhas , Urticária , Animais , Abelhas , Illinois , Estações do Ano
16.
Eval Program Plann ; 92: 102077, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35378411

RESUMO

Government partnerships with community-based and healthcare organizations have historically increased the impact of public health programs. In order to strengthen and expand the Illinois Asthma Partnership (IAP), external evaluators determined the degree to which local rates of Pediatric Asthma Related Emergency Department (PARED) visits aligned with local hospital Community Health Needs Assessments (CHNA), asthma prioritization, and IAP engagement. The majority of counties with high PARED rates also had high levels of concentrated disadvantage. Combining these data enabled identification of 15 out of 102 counties where PARED visits were high and the program was not engaged. In these counties, there was an opportunity for the IAP to assist. Potential actions in these counties could include identification of a local asthma champion and development of a new program, actions to raise community awareness of asthma, and engagement with health care community leaders to discuss perceptions of need and competing priorities. This study provided a unique and cost-effective way of utilizing easily accessible data in order to plan the expansion of the IAP.


Assuntos
Asma , Serviço Hospitalar de Emergência , Asma/prevenção & controle , Criança , Atenção à Saúde , Humanos , Illinois , Avaliação de Programas e Projetos de Saúde
17.
Public Health Nurs ; 39(5): 1034-1040, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35352391

RESUMO

The COVID 19 epidemic disrupted every aspect of American life and imposed severe trauma as a result of lockdown, fears of disease or death, separation from and death of loved ones, and daily media coverage of the unfolding pandemic. The following case report describes the experiences of the Vaccine Brigade, a group of Public Health Nurses (PHNs) and other professionals, mostly retired, who organized themselves to provide assistance with vaccine administration in the city of Chicago and Cook County, Illinois. The report describes the founding of their organization in February, 2021 and their work to support vaccine administration in communities of color and other underserved communities. This case report presents a successful model of volunteerism, built on foundational principals of collective decision making, democracy and social justice. Its members developed existing social networks and skills they had learned during their careers as PHNs and activists to create a functional organization that could assist with the task of getting shots into arms.


Assuntos
COVID-19 , Vacinas , COVID-19/prevenção & controle , Chicago , Controle de Doenças Transmissíveis , Humanos , Illinois , Estados Unidos
18.
J Environ Qual ; 51(3): 389-398, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35322433

RESUMO

There are few peer-reviewed studies documenting saturated buffer annual nitrate (NO3 ) removal or that have assessed the federal practice standard design criteria. Drainage flow, NO3 , and dissolved reactive phosphorus (DRP) were monitored at three saturated buffers in Illinois, USA, for a combined 10 site-years. Nitrate loss reduction averaged 48 ± 19% with removals of 3.5-25.2 kg NO3 -N ha-1 annually. Median DRP concentrations at all sampling locations were at the analytical detection limit of 0.01 mg L-1 . The current design paradigm (i.e., USDA practice standard) prescribes there should be no flow bypassing the saturated buffer at flow rates that are ≤5% of the peak drainage system flow rate. The drainage coefficient-based and Manning's equation-based peak flow estimates were higher and lower, respectively, than the observed annual peaks in all years. This illustrated inherent uncertainty introduced early in the design process, which can be further compounded by dynamic in-buffer hydrology. The percentage of the observed peak flow rate at which bypass initiated ranged across an order of magnitude between sites (4.4-8.1% of peak flow rate at one site and 42-49% of peak at another) despite the buffers providing relatively similar NO3 removal. Bypass at one site (SB2) was related to the concept of "antecedent buffer capacity filled," which was defined as the 5-d average water depth in the middle control structure chamber expressed as a relative percentage of the bypass stop log height. This design flow analysis serves as a call to further evaluate predictive relationships and design models for edge-of-field practices.


Core Ideas Three saturated buffers in Illinois provided an ≈50% annual reduction in NO3 load. Observed peak flow rates differed from estimation methods used for design purposes. Two sites had relatively similar nitrate removals but different bypass trends. "Antecedent buffer capacity filled" was the water depth in the middle chamber as a percent of stop log height.


Assuntos
Monitoramento Ambiental , Nitratos , Agricultura , Hidrologia , Illinois , Nitratos/análise , Nitrogênio/análise , Fósforo/análise
19.
Am J Public Health ; 112(5): 795-802, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35324258

RESUMO

Objectives. To examine gun violence with respect to hospital visits for treatment of intentional assault gunshot wounds (IGWs). Methods. IGW-coded visits among residents of Cook County, Illinois, were matched to census zip code tabulation areas (ZCTAs) to map changes in IGW visit frequencies between 2018 and 2020. Patient characteristics were compared across years, and Poisson regression models for the likelihood of an inpatient admission or in-hospital death were estimated. Results. Over the study period, Cook County residents made 7122 IGW-coded hospital visits to 89 Illinois hospitals, resulting in $342 million in charges and 24 894 hospital days. The number of visits almost doubled between 2018 and 2020, from 1553 to 3031; 6 ZCTAs had increases of more than 60 visits. Approximately one third of patients with a visit were admitted, and 6.5% died. Conclusions. Hospital statistics do not include the full toll of nonfatal gun injuries or the costs of related community-level trauma. The health care system remains crucial in implementing epidemiological approaches to violence prevention. Addressing the national spike in shootings will require large investments in community economic development and a professional public safety workforce. (Am J Public Health. 2022;112(5):795-802. https://doi.org/10.2105/AJPH.2022.306747).


Assuntos
Violência com Arma de Fogo , Ferimentos por Arma de Fogo , Mortalidade Hospitalar , Hospitais , Humanos , Illinois/epidemiologia , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/prevenção & controle
20.
BMC Health Serv Res ; 22(1): 413, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35351132

RESUMO

BACKGROUND: Many people seeking abortion encounter financial difficulties that delay or prevent them from accessing care. Although some patients qualify for Medicaid (a public program that can help cover health care costs), laws in some states restrict the use of Medicaid for abortion care. In 2017, Illinois passed House Bill 40 (HB-40), which allowed patients with Medicaid to receive coverage for their abortion. This study aimed to understand how HB-40 affected abortion affordability from the perspectives of individuals that work directly or indirectly with abortion patients or facilities providing abortion care. METHODS: We conducted interviews with clinicians and administrators from facilities that provided abortion services; staff from organizations that provided resources to abortion providers or patients; and individuals at organizations involved in the passage and/or implementation of HB-40. Interviews were audio-recorded and transcribed. We created codes based on the interview guides, coded each transcript using the web application Dedoose, and summarized findings by code. RESULTS: Interviews were conducted with 38 participants. Participants reflected that HB-40 seemed to remove a significant financial barrier for Medicaid recipients and improve the experience for patients seeking abortion care. Participants also described how the law led to a shift in resource allocation, allowing financial support to be directed towards uninsured patients. Some participants thought HB-40 might contribute to a reduction in abortion stigma. Despite the perceived positive impacts of the law, participants noted a lack of public knowledge about HB-40, as well as confusing or cumbersome insurance-related processes, could diminish the law's impact. Participants also highlighted persisting barriers to abortion utilization for minors, recent and undocumented immigrants, and people residing in rural areas, even after the passage of HB-40. CONCLUSIONS: HB-40 was perceived to improve the affordability of abortion. However, participants identified additional obstacles to abortion care in Illinois that weakened the impact of HB-40 for patients and required further action, Findings suggest that policymakers must also consider how insurance coverage can be disrupted by other legal barriers for historically excluded populations and ensure clear information on Medicaid enrollment and abortion coverage is widely disseminated.


Assuntos
Aborto Induzido , Medicaid , Feminino , Acesso aos Serviços de Saúde , Humanos , Illinois , Cobertura do Seguro , Gravidez , Estados Unidos
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