Assuntos
Diabetes Mellitus Tipo 2 , Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon , Alocação de Recursos para a Atenção à Saúde , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Peptídeo 1 Semelhante ao Glucagon/agonistas , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Alocação de Recursos para a Atenção à Saúde/ética , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/estatística & dados numéricos , Receptores dos Hormônios Gastrointestinais/agonistas , Populações Vulneráveis/estatística & dados numéricos , Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon/provisão & distribuição , Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon/uso terapêuticoRESUMO
PURPOSE OF REVIEW: We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/or deliver services in community settings. We examine literature in seven topic areas: collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention. We adapt the social-ecological model for health promotion and provide a framework for understanding the actions of community interventions. RECENT FINDINGS: There are recent examples of effective interventions in each topic area. The majority of interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors. Findings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health. There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels. Studies indicate the importance of ongoing resources and training to maintain long-term outcomes, explicit attention to ethics and processes to foster equitable partnerships, and policy reform to support sustainable healthcare-community collaborations.
Assuntos
Medicina Comunitária , Promoção da Saúde , Saúde Mental , Meio Social , Humanos , Transtornos Psicóticos/prevenção & controle , Transtornos Psicóticos/terapia , Instituições AcadêmicasAssuntos
Medicina , Racismo , Negro ou Afro-Americano , Humanos , Racismo/economia , Impostos , Estados Unidos , População BrancaRESUMO
This study compares postgraduate trainee racial, ethnic, and gender representation and faculty compensation for 21 clinical specialties using 2015-2022 data.
Assuntos
Docentes de Medicina , Internato e Residência , Medicina , Salários e Benefícios , Humanos , Docentes , Docentes de Medicina/economia , Docentes de Medicina/estatística & dados numéricos , Medicina/estatística & dados numéricos , Grupos Minoritários/educação , Grupos Raciais/educação , Grupos Raciais/estatística & dados numéricos , Estados Unidos , Fatores Sexuais , Salários e Benefícios/economia , Salários e Benefícios/estatística & dados numéricos , Masculino , Feminino , Educação de Pós-Graduação em Medicina/economia , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/economia , Internato e Residência/estatística & dados numéricos , Economia Médica/estatística & dados numéricos , Etnicidade/estatística & dados numéricosRESUMO
This perspectives article considers the potential implications an affirmative action ban would have on patient care in the US. A physician's race and ethnicity are among the strongest predictors of specialty choice and whether or not a physician cares for Medicaid and uninsured populations. Taking this into account, research suggests that an affirmative action ban in university admissions would sharply reduce the supply of primary care physicians to Medicaid and uninsured populations over the coming decade. Our article compares current conditions to the potential effect of an affirmative action ban by projecting how many future medical students will become primary care physicians for Medicaid and uninsured patients by 2025. Based on previous evidence and current medical student training patterns, we project that a ban could deny primary care access for 1.25 million of our nation's most vulnerable patients, considerably worsening existing healthcare disparities. More broadly, we argue that the effects of eliminating affirmative action would be fundamentally contrary to the Association of American Medical Colleges' stated goal of medical education-"to improve the health of all."
Assuntos
Diversidade Cultural , Pessoal de Saúde/tendências , Política de Saúde/tendências , Grupos Minoritários , Educação Médica/legislação & jurisprudência , Educação Médica/tendências , Pessoal de Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Humanos , Grupos Minoritários/legislação & jurisprudência , Médicos/legislação & jurisprudência , Médicos/tendências , Critérios de Admissão Escolar/tendências , Estudantes de Medicina/legislação & jurisprudência , Estados Unidos/etnologiaRESUMO
Long-standing challenges facing the mental health system require more effective strategies to furnish a workforce whose diversity matches an increasingly diverse population. Current and former system leaders can offer expert guidance informed by their experiences and perspectives. Their professional journeys to leadership in this area provide context and unique insight into issues of justice, including workforce diversity, equity, and inclusion in psychiatry. These experts agree that significant policy changes are needed to improve psychiatric workforce diversity and that implementing change will require that disparate groups together to achieve this goal. Financial considerations must be included in policy and advocacy.
Assuntos
Psiquiatria , Humanos , Saúde Mental , Recursos HumanosRESUMO
Long-standing challenges facing the mental health system require more effective strategies to furnish a workforce whose diversity matches an increasingly diverse population. Current and former system leaders can offer expert guidance informed by their experiences and perspectives. Their professional journeys to leadership in this area provide context and unique insight into issues of justice, including workforce diversity, equity, and inclusion in psychiatry. These experts agree that significant policy changes are needed to improve psychiatric workforce diversity and that implementing change will require that disparate groups together to achieve this goal. Financial considerations must be included in policy and advocacy.
Assuntos
Psiquiatria , Humanos , Liderança , Inquéritos e Questionários , Recursos HumanosRESUMO
(Reprinted with permission from Current Psychiatry Reports (2020) 21: 35).
RESUMO
This JAMA Forum discusses the US Supreme Court's ruling on affirmative action in the context of the potential harms to access to care, quality of care, and leadership for the health care system.