Healthcare Cost Burden and Self-Reported Frequency of Depressive/Anxious Feelings in Older Adults.

Using the 2018-2021 National Health Interview Survey data, we examined the associations between healthcare cost burden and depressive/anxious feelings in older adults. Nearly12% reported healthcare cost burden and 18% daily/weekly depressive/anxious feelings. Healthcare cost burden was higher among women, racial/ethnic minorities, those with chronic illnesses, mobility impairment, and those with Medicare Part D, but lower among individuals with Medicare-Medicaid dual eligibility, Medicare Advantage, VA/military insurance, and private insurance. Daily/weekly depressive/anxious feelings was higher among healthcare cost burden reporters. The COVID-19 pandemic-related medical care access problems were also associated with a higher risk of reporting healthcare cost burden and depression/anxiety.

Insights, beliefs, and myths surrounding tuberculosis among pulmonary patients with delayed healthcare access in a high-burden TB state in Nigeria - a qualitative inquiry.

Introduction: Nigeria grapples with a substantial burden of tuberculosis (TB), particularly in Oyo State, designated as a high-burden State for TB. Effectively addressing this persistent health challenge necessitates more than just medical interventions; it requires a profound understanding of the diverse insights, beliefs, and myths held by TB patients. Methods: This qualitative study explores the perspectives of pulmonary TB patients with delayed healthcare access in Oyo State, Nigeria, focusing on their beliefs, and conceptions. In-depth interviews were conducted with 25 TB patients and 20 healthcare providers. Results: Thematic analysis of patients' responses revealed a complex interplay between cultural, spiritual, and biomedical insights. These challenges questioned the germ theory, associating TB with witchcraft and spiritual attacks. Beliefs in hereditary transmission, links between tobacco use and health outcomes, and uncertainties about infection nature underscored disparities influenced by socio-economic factors. Insights into transmission ideas, preventive measures, and treatment beliefs highlighted a blend of culturally influenced and scientifically supported strategies. Healthcare providers' insights emphasized the necessity for targeted health education. Discussion: These findings contribute to a nuanced understanding of TB perceptions, emphasizing the importance of culturally sensitive interventions to enhance awareness and promote timely and accurate health-seeking behaviors.

Experiences of delay-causing obstacles and mental health at the time of abortion seeking.

Objectives: The delays and challenges people encounter when seeking abortion are well-documented, but their psychological implications are understudied. Aiming to fill this gap, we explored the associations between experiences of delay-causing obstacles to abortion care and adverse mental health symptoms among individuals seeking abortion care. Study design: In 2019, we surveyed 784 people (of 1092 approached) ages 15-45 accessing abortion care in four clinics in abortion-supportive states: California, Illinois, and New Mexico. We conducted multivariable Poisson regressions to examine associations between experiencing delay-causing obstacles to abortion care and stress, anxiety, and depression at the abortion appointment. We also used Poisson regression to examine whether some individuals are more likely to experience delay-causing obstacles than others. Results: Three in five participants (58%) experienced delay-causing obstacles when accessing abortion care. The most prevalent obstacles were cost-related (45%), followed by access-related (43%), and travel time-related (35%) delays. In adjusted analyses, experiencing any type of delay-causing obstacle to abortion care was significantly associated with more symptoms of stress, anxiety, and depression and higher risk of anxiety and depressive disorders. Participants were more likely to experience delay-causing obstacles if they traveled from another state or over 100 miles to reach the clinic, sought abortion beyond 13 weeks gestation, lacked money for unexpected expenses, and found it difficult to pay for the abortion. Conclusion: Abortion is a time-sensitive healthcare, but most individuals are forced to delay care due to various obstacles that may have a negative impact on their psychological well-being. Implications: Obstacles causing delays in accessing abortion care may contribute to elevated symptoms of stress, anxiety, and depression and higher risk of anxiety and depressive disorders for abortion patients. As restrictive policies increase, delays are likely to worsen, potentially leading to psychological harm for people seeking abortion.