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Jain N, Kourampi I, Umar TP, Almansoor ZR, Anand A, Ur Rehman ME, Jain S, Reinis A. Global population surpasses eight billion: Are we ready for the next billion? AIMS Public Health 2023; 10:849-866. [PMID: 38187896 PMCID: PMC10764969 DOI: 10.3934/publichealth.2023056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 01/09/2024] Open
Abstract
In November 2022, the global population had officially crossed eight billion. It has long been recognized that socioeconomic or health-related problems in the community always accompany an uncontrolled population expansion. International calls have been made regarding lack of universal health coverage, an insufficient supply of healthcare providers, the burden of noncommunicable disease, population aging and the difficulty in obtaining safe drinking water and food. The present health policy paper discusses how to conquer these crowded world issues, including (1) promoting government and international organization participation in providing appropriate infrastructure, funding and distribution to assist people's health and well-being; (2) shifting health program towards a more preventive approach and (3) reducing inequalities, particularly for the marginalized, isolated and underrepresented population. These fundamental principles of health policy delivery as a response to an increasingly crowded world and its challenges are crucial for reducing the burden associated with excessive healthcare costs, decreased productivity and deteriorating environmental quality.
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Affiliation(s)
- Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, 16 Dzirciema street, Riga, Latvia, LV-1007
| | - Islam Kourampi
- Department of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, Athens, Greece, 11527
| | - Tungki Pratama Umar
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, United Kingdom
- Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia 30128
| | - Zahra Rose Almansoor
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Ayush Anand
- BP Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal
| | | | - Shivani Jain
- Department of Oral and Maxillofacial Surgery, Genesis Institute of Dental Sciences & Research, Ferozepur-Moga Road, Ferozepur, Punjab, India 152002
| | - Aigars Reinis
- Department of Biology and Microbiology, Riga Stradinš University, 16 Dzirciema street, Riga, Latvia, LV-1007
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Li K, Chen H, Tan Z, Yin X, Gong Y, Jiang N, Yang F. Job satisfaction and its related factors among emergency department physicians in China. Front Public Health 2022; 10:925686. [PMID: 35937259 PMCID: PMC9354402 DOI: 10.3389/fpubh.2022.925686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundJob satisfaction is recognized as an important factor affecting the performance and quality of medical services of emergency department physicians. However, little is known about the status of job satisfaction among emergency department physicians in China. This study aimed to explore the current level of job satisfaction and its associated factors among emergency department physicians in China.MethodsA nationwide cross-sectional survey was conducted in China from July to August 2018. A total of 10,457 emergency department physicians completed the questionnaire. The structured online questionnaire collected information on socio-demographic characteristics, work-related factors, work-family conflict, and job satisfaction. Student's t-test or ANOVA were used to compare the job satisfaction scores in different characters. The generalized linear model was used to investigate the related factors of job satisfaction among emergency department physicians.ResultsThe respondents' job satisfaction average score was 12.2 ± 3.6, of which 42.01% were satisfied of which the job. The results showed that emergency department physicians over 41 years old, with a higher income and working in central and western regions were positively associated with job satisfaction. In contrast, bachelor degree and above, fixed posts, long years of service, a high frequency of night shift, perceived shortage of physicians, perceived medical errors, and higher work-family conflict scores were negatively correlated with job satisfaction among emergency department physicians.ConclusionJob satisfaction of emergency department physicians in China is low. It is suggested that hospital administrators could improve the job satisfaction of emergency department physicians by establishing an acceptable shift system, ensuring adequate emergency department staffing, increasing their income appropriately and alleviating work-family conflict.
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Affiliation(s)
- Kang Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmei Chen
- School of Nursing, Wuchang University of Technology, Wuhan, China
| | - Zhen Tan
- Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Nan Jiang
| | - Fengjie Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Fengjie Yang
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Letterie MC, Patrick SW, Halvorson AE, Dupont WD, Carroll KN, Zickafoose JS, Williams SE. Factors Associated With Parental COVID-19 Vaccination Acceptance. Clin Pediatr (Phila) 2022; 61:393-401. [PMID: 35350918 DOI: 10.1177/00099228221084829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As the coronavirus pandemic continues to impact families and children, understanding parental attitudes and likely acceptance of the COVID-19 vaccine is essential. We conducted a statewide survey with a representative sample of parents in Tennessee focused on COVID-19 and influenza vaccine acceptance and perspectives. Data from 1066 parents were analyzed using weighted survey methods to generalize results to the state of Tennessee. About 53% of parents reported a likelihood to vaccinate their children against COVID-19, and 45% were likely to vaccinate their child against COVID-19 and influenza. Female parents were less likely to vaccinate their children against COVID-19, but the strongest predictor of likely COVID-19 vaccine acceptance was influenza vaccine acceptance (adjusted odds ratio = 5.46; 95% confidence interval: 3.20-9.30). Parental acceptance of COVID-19 vaccines for children is closely tied to influenza vaccine acceptance. Public health approaches to maximize vaccine uptake could focus on children who have not been receiving influenza vaccines.
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Affiliation(s)
- Mia C Letterie
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen W Patrick
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, TN, USA
| | - Alese E Halvorson
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William D Dupont
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kecia N Carroll
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph S Zickafoose
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Mathematica, Nashville, TN, USA
| | - Sarah E Williams
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
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Association of Health Insurance Literacy with Health Care Utilization: a Systematic Review. J Gen Intern Med 2022; 37:375-389. [PMID: 34027605 PMCID: PMC8141365 DOI: 10.1007/s11606-021-06819-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Given increasing numbers of people experiencing transitions in health insurance due to declines in employer-sponsored insurance and changes in health policy, the understanding and application of health insurance terms and concepts (health insurance literacy) may be important for navigating use of health care. The study objective was to systematically review evidence on the relationship between health insurance literacy and health care utilization. METHODS Medline, SCOPUS, Web of Science, CINAHL, PsychInfo, Cochrane Library, and reference lists of published literature were searched in August 2019. Quantitative, qualitative, and intervention studies that assessed the association of health insurance literacy as the exposure and health care utilization as the outcome were identified, without language or date restrictions. Outcomes were independently assessed by 2-3 reviewers. RESULTS Twenty-one studies including a total of 62,416 subjects met inclusion criteria: three interventional trials, two mixed-methods studies, and sixteen cross-sectional studies. Ten of thirteen preventive care studies suggested that higher health insurance literacy was associated with greater utilization of primary care and other preventive services. Eight of nine studies of care avoidance demonstrated that individuals with lower health insurance literacy were more likely to delay or avoid care. A few studies had mixed results regarding the utilization of emergency department, inpatient, and surgical care. DISCUSSION The emerging literature in this area suggests that health insurance literacy is an important factor that can enable effective utilization of health care, including primary care and preventive services. However, the literature is limited by a paucity of studies using validated tools that broadly measure health insurance literacy (rather than testing knowledge of specific covered services). Improving health insurance literacy of the general public and increasing plain language communication of health insurance plan features at the point of health care navigation may encourage more effective and cost-conscious utilization.
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Wiltshire J, Liu E, Dean CA, Colato EG, Elder K. Health Insurance Literacy and Medical Debt in Middle-Age Americans. Health Lit Res Pract 2021; 5:e319-e332. [PMID: 34905430 PMCID: PMC8668166 DOI: 10.3928/24748307-20211102-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Health insurance literacy (HIL) may influence medical financial burden among people who are sick and the most vulnerable. OBJECTIVE This study examined the relationships between HIL, health insurance factors, and medical debt among middle-age Americans, a population with an increasing prevalence of illnesses. METHODS Linear and generalized linear regression analyses were conducted on data drawn from the 2015-2016 waves of the Health Reform Monitoring Survey, a national, internet-based sample of Americans age 18 to 64 years. The analytical sample included 8,042 people age 50 to 64 years. KEY RESULTS Adjusted mean HIL scores did not differ by private versus public insurance or by out-of-pocket costs. Mean HIL scores were lower with higher deductibles; however, differences in mean scores were small. Higher HIL was associated with lower medical debt (odds ratio = 0.97; 95% confidence interval [0.96, 0.98]), but at the highest HIL score, the risk of having medical debt was still 13.8%. Public coverage, higher annual deductibles, and out-of-pocket costs were associated with higher risks of having medical debt. CONCLUSIONS The findings suggest that HIL plays an important role in medical debt burden. However, with the shift toward high cost-sharing insurance plans, addressing health care affordability issues along with HIL are critical to eliminate medical debt problems. [HLRP: Health Literacy Research and Practice. 2021;5(4):e319-e332.] Plain Language Summary: Understanding and using health insurance (also defined as health insurance literacy) may influence the ability to pay medical bills among people who are sick and vulnerable. This study examined the relationships among health insurance literacy, health insurance factors, and difficulty paying medical bills (i.e., medical debt) in Americans age 50 to 64 years using data from the Health Reform Monitoring Survey. People with higher health insurance literacy reported lower medical debt. Type of insurance coverage did not influence medical debt. Those with annual deductibles and out-of-pocket health care costs were more likely to report having medical debt.
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Affiliation(s)
- Jacqueline Wiltshire
- Address correspondence to Jacqueline Wiltshire, PD, MPH, College of Public Health, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC 56, Tampa, FL 33612;
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Wiltshire J, Garcia Colato E, Conner KO, Anderson E, Orban B. Health care Affordability and Associated Concerns Among Adults Aged 65 and above in Florida. J Appl Gerontol 2021; 41:1120-1130. [PMID: 34404255 DOI: 10.1177/07334648211039314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study assessed affordability of care in a diverse sample of Floridians aged ≥ 65 to ascertain concerns about health care costs. METHODS We surveyed 170 adults (40.6% white, 27.6% black, and 31.8% Hispanic) and conducted three race/ethnic-stratified focus groups (n = 27). RESULTS Most participants had Medicare (97.1%). Among whites, 11.6% reported problems paying medical bills in the past 12 months versus 14.9% of blacks and 24.1% of Hispanics. In addition, 13% of whites, 19.2% of blacks, and 20.4% of Hispanics reported not getting needed prescription drugs because of costs. The most frequently identified concerns from the focus groups were the cost of prescription drugs, out-of-pocket expenses, and medical billing. Concerns about medical billing included understanding bills, transparency, timely postings, and uncertainty about who to contact about problems. DISCUSSION Our findings suggest that practices that help older adults effectively manage medical bills and costs may alleviate their concerns and guard against financial burdens.
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Silvestri GA, Jemal A, Yabroff KR, Fedewa S, Sineshaw H. Cancer Outcomes Among Medicare Beneficiaries And Their Younger Uninsured Counterparts. Health Aff (Millwood) 2021; 40:754-762. [PMID: 33939501 DOI: 10.1377/hlthaff.2020.01839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Proposals for expanding Medicare insurance coverage to uninsured Americans approaching the Medicare eligibility age of sixty-five has been the subject of intense debate. We undertook this study to assess cancer survival differences between uninsured patients younger than age sixty-five and older Medicare beneficiaries by using data from the National Cancer Database from the period 2004-16. The main outcomes were survival at one, two, and five years for sixteen cancer types in 1,206,821 patients. We found that uninsured patients ages 60-64 were nearly twice as likely to present with late-stage disease and were significantly less likely to receive surgery, chemotherapy, or radiotherapy than Medicare beneficiaries ages 66-69, despite lower comorbidity among younger patients. Compared with older Medicare patients, younger uninsured patients had strikingly lower five-year survival across cancer types. For instance, five-year survival in younger uninsured patients with late-stage breast or prostate cancer was 5-17 percent lower than that among older Medicare patients. We conclude that survival after a diagnosis of cancer is considerably lower in younger uninsured patients than in older Medicare patients. Expanding comprehensive health insurance coverage to people approaching Medicare age eligibility may improve cancer outcomes in the US.
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Affiliation(s)
- Gerard A Silvestri
- Gerard A. Silvestri is the Hillenbrand Professor of Thoracic Oncology in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, in Charleston, South Carolina
| | - Ahmedin Jemal
- Ahmedin Jemal is senior vice president in the Surveillance and Health Equity Science Department, American Cancer Society, in Atlanta, Georgia
| | - K Robin Yabroff
- K. Robin Yabroff is a scientific vice president in the Surveillance and Health Equity Science Department, American Cancer Society
| | - Stacey Fedewa
- Stacey Fedewa is a scientific director in the Surveillance and Health Equity Science Department, American Cancer Society
| | - Helmneh Sineshaw
- Helmneh Sineshaw is principal scientist, Epidemiology-Oncology Core, at Merck Research Laboratories, in West Point, Pennsylvania. He was a senior scientist in the Surveillance and Health Services Research Department, American Cancer Society, when this work was conducted
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Factors Associated with Health Insurance Affordability Concerns Among U.S. Adults Age 50-64: a Cross-Sectional, Nationally Representative Study. J Gen Intern Med 2021; 36:546-548. [PMID: 32144696 PMCID: PMC7878644 DOI: 10.1007/s11606-020-05732-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/10/2020] [Indexed: 10/24/2022]
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