1
|
Kerker BD, Barajas-Gonzalez RG, Rojas NM, Norton JM, Brotman LM. Enhancing immigrant families' mental health through the promotion of structural and community-based support. Front Public Health 2024; 12:1382600. [PMID: 38751580 PMCID: PMC11094290 DOI: 10.3389/fpubh.2024.1382600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Immigrant communities in the United States are diverse and have many assets. Yet, they often experience stressors that can undermine the mental health of residents. To fully promote mental health and well-being among immigrant communities, it is important to emphasize population-level policies and practices that may serve to mitigate stress and prevent mental health disorders. In this paper, we describe the stressors and stress experienced by immigrant families, using Sunset Park, Brooklyn as an example. We discuss ways to build structures and policies in support of equitable environments that promote mental health at the population level and enable families and their children to thrive.
Collapse
Affiliation(s)
- Bonnie D. Kerker
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Natalia M. Rojas
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Jennifer M. Norton
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Laurie M. Brotman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States
| |
Collapse
|
2
|
Camacho-Rivera M, Haile K, Pareek E, D'Angelo D, Gany F, Maglione F, Jack K, Cather A, Phillips E. The Influence of the COVID 19 Pandemic on Food Insecurity Among Cancer Survivors Across New York State. J Community Health 2024:10.1007/s10900-024-01358-1. [PMID: 38683277 DOI: 10.1007/s10900-024-01358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 05/01/2024]
Abstract
People surviving cancer represent a particularly vulnerable population who are at a higher risk for food insecurity (FI) due to the adverse short- and long-term effects of cancer treatment. This analysis examines the influence of the COVID-19 pandemic on the prevalence of FI among cancer survivors across New York State (NYS). Data from the 2019 and 2021 NYS Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of FI. Multivariable logistic regression was used to explore socioeconomic determinants of FI. Among cancer survivors, FI varied geographically with a higher prevalence in New York City compared to the rest of the state (ROS) prior to (25.3% vs. 13.8%; p = .0025) and during the pandemic (27.35% vs. 18.52%; p = 0.0206). In the adjusted logistic regression model, pre-pandemic FI was associated with non-White race (OR 2.30 [CI 1.16-4.56]), household income <$15,000 (OR 22.67 [CI 6.39-80.43]) or $15,000 to less than <$25,000 (OR 22.99 [CI 6.85-77.12]), and more co-morbidities (OR 1.39 [CI 1.09-1.77]). During the pandemic, the association of FI with non-White race (OR 1.76 [CI 0.98-3.16]) was attenuated but remained significant for low household income and more co-morbidities. FI was newly associated with being out of work for less than one year (OR 6.36 [CI 1.80-22.54] and having one (OR 4.42 [CI 1.77-11.07]) or two or more children in the household (OR 4.54 [CI 1.78-11.63]). Our findings highlight geographic inequities and key determinants of FI among cancer survivors that are amendable to correction by public health and social policies, for which several were momentarily implemented during the pandemic.
Collapse
Affiliation(s)
- Marlene Camacho-Rivera
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Katherine Haile
- Bureau of Chronic Disease Evaluation and Research, New York State Department of Health, Albany, NY, USA
| | - Eshani Pareek
- Weill Cornell Medicine Division of Biostatistics, Population Health Sciences, New York, NY, USA
| | - Debra D'Angelo
- Weill Cornell Medicine Division of Biostatistics, Population Health Sciences, New York, NY, USA
| | - Francesca Gany
- Immigrant Health & Cancer Disparities Service, Department of Psychiatry & Behavioral Sciences, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Francesca Maglione
- Department of Food and Nutrition, NewYork-Presbyterian/Weill-Cornell Medical Center, New York, NY, USA
| | - Kellie Jack
- Sandra and Edward Meyer Cancer Center, Office of Community Outreach and Engagement, Weill Cornell Medicine, New York, NY, USA
| | - Alexina Cather
- Wellness in the Schools, New York, NY, USA
- Center for Food as Medicine, New York, NY, USA
| | - Erica Phillips
- Sandra and Edward Meyer Cancer Center, Office of Community Outreach and Engagement, Weill Cornell Medicine, New York, NY, USA.
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA.
| |
Collapse
|
3
|
Miller J, Doucas A, Karra H, Thareja SK, Bowie O, Dong X, Terrell J, Hernandez S, Corujo-Ramirez AM, Xia N, Qi S, Huang CC, Lundh R, Young SA. Social determinants of health correlations and resource usefulness at a Milwaukee free clinic for uninsured individuals: A cross-sectional study. J Clin Transl Sci 2024; 8:e71. [PMID: 38690226 PMCID: PMC11058579 DOI: 10.1017/cts.2024.503] [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: 11/08/2023] [Revised: 02/16/2024] [Accepted: 03/14/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured population. Methods In this cross-sectional study, we screened adult patients without health insurance (N = 238) for nine traditional SDOH needs as well as their access to dental and mental health care between October 2021 and October 2022. Patients were surveyed at intervals greater than or equal to 30 days. We assessed correlations between SDOH needs and trends in patient-reported resource usefulness. Results Access to dental care (64.7%) and health insurance (51.3%) were the most frequently endorsed needs. We found significant correlations (P ≤ 0.05) between various SDOH needs. Notably, mental health access needs significantly correlated with dental (r = 0.41; 95% CI = 0.19, 0.63), medications (r = 0.51; 95% CI = 0.30, 0.72), utilities (r = 0.39; 95% CI = 0.17, 0.61), and food insecurity (r = 0.42; 95% CI = 0.19, 0.64). Food-housing (r = 0.55; 95% CI = 0.32, 0.78), housing-medications (r = 0.58; 95% CI = 0.35, 0.81), and medications-food (r = 0.53; 95% CI = 0.32, 0.74) were significantly correlated with each other. Longitudinal assessment of patient-reported usefulness informed changes in the resources offered. Conclusions Understanding prominent SDOH needs can inform resource offerings and interventions, addressing root causes that burden under-resourced patients. In this study, patient-reported data about resource usefulness prompted the curation of new resources and volunteer roles. This proof-of-concept study shows how longitudinally tracking SDOH needs at low-resource clinics can inform psychosocial resources.
Collapse
Affiliation(s)
- Jessica Miller
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Adrianna Doucas
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hamsitha Karra
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Suma K. Thareja
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Owen Bowie
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Xiaowei Dong
- Medical College of Wisconsin, Milwaukee, WI, USA
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jennifer Terrell
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Samuel Hernandez
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ana Mia Corujo-Ramirez
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nicole Xia
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sabrina Qi
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Chiang-Ching Huang
- Medical College of Wisconsin, Milwaukee, WI, USA
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rebecca Lundh
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Staci A. Young
- Medical College of Wisconsin, Milwaukee, WI, USA
- Saturday Clinic for the Uninsured, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
4
|
Odunyemi A, Sohrabi H, Alam K. The evolution of household forgone essential care and its determinants during the COVID-19 pandemic in Nigeria: A longitudinal analysis. PLoS One 2024; 19:e0296301. [PMID: 38564649 PMCID: PMC10986961 DOI: 10.1371/journal.pone.0296301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/09/2023] [Indexed: 04/04/2024] Open
Abstract
Apart from the morbidity and mortality, the Coronavirus disease 2019 (COVID-19) pandemic has increased the predisposition of households in Nigeria to forgone care, thereby increasing their vulnerability to adverse health consequences. Since there is no previous study in Nigeria on the evolution of pandemic-related forgone care and its drivers, our study assess the evolution of the problem using descriptive and nationally representative panel data analyses. We found about a 30% prevalence of forgone care during the lockdown, which declined progressively afterwards, dropping by 69.50 percentage points between April 2020 and April 2022. This decline produced a surge in households needing care from about 35.00% in the early pandemic to greater than 50%, beginning in early 2021. The forgone care was primarily due to financial hindrances, movement restrictions, and supply-side disruptions. Household socioeconomic factors such as income loss had 2.74 [95%CI: 1.45-5.17] times higher odds of forgone care, job loss, food insecurity, and poverty were 87% (OR: 1.87 [95%CI: 1.25-2.79]), 60% (OR: 1.60 [95%CI: 1.12-2.31]) and 76% (OR: 1.76 [95%CI: 1.12-2.75]) more likely to predispose households to forgone care, respectively. Also, geographical location, such as the South-South zone, induced 1.98 [95%CI: 1.09-3.58] times higher odds of forgone care than North-Central. A married female household head increased the odds by 6.07 [95%CI: 1.72-21.47] times compared with an unmarried female head. However, having a married household head, social assistance, and North-East or North-West zone compared with North-Central increased the chance of accessing care by 69% (OR 0.31 [95%CI: 0.16-0.59]), 59%,(OR 0.41 [95%CI: 0.21-0.77]), 72% (OR 0.28 [95%CI: 0.15-0.53]) and 64% (OR 0.36 [95%CI: 0.20-0.65]), respectively. Non-communicable diseases, disability, old age, large household size and rural-urban location did not affect the forgone care. Our study highlights the need to strengthen Nigeria's health system, create policies to promote healthcare accessibility and prepare the country for future pandemic challenges.
Collapse
Affiliation(s)
- Adelakun Odunyemi
- Murdoch Business School, Murdoch University, Perth, Western Australia
- Hospitals’ Management Board, Alagbaka Estate, Akure, Ondo State, Nigeria
| | - Hamid Sohrabi
- Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
| | - Khurshid Alam
- Centre for Healthy Ageing, Murdoch University, Perth, Western Australia
| |
Collapse
|
5
|
Daundasekara SS, Marshall AN, Schuler BR, Testa A, Hernandez DC. Lower Perceived Neighborhood Collective Efficacy Indirectly Influences the Association Between Perceived Maternal Exposure to Community Violence and Household Food Insecurity. FAMILY & COMMUNITY HEALTH 2024; 47:117-129. [PMID: 38372329 PMCID: PMC10878717 DOI: 10.1097/fch.0000000000000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity. METHODS Mothers from the Future of Families and Child Wellbeing Study who completed phone surveys when the child was 3 (time 1, T1) and 5 years old (time 2, T2) were included (n = 2068). A covariate-adjusted structural equation model estimated direct and indirect effects of community violence exposure on household food insecurity. A covariate-adjusted multiple mediator model estimated the indirect effects of the 2 neighborhood collective efficacy subscales (informal social control; social cohesion and trust). RESULTS At T1, 40% of mothers reported community violence exposure; 15% experienced food insecurity at T2. Mean neighborhood collective efficacy (range 1-5) at T1 was 2.44 (SD = 0.94). Neighborhood collective efficacy indirectly influenced the association between community violence exposure and food insecurity (indirect effect = 0.022, 95% CI = 0.007 to 0.040). Only social cohesion and trust contributed independent variance to the indirect effect model (indirect effect = 0.028, 95% CI = 0.001 to 0.056). CONCLUSIONS Community-based efforts to reduce household food insecurity should emphasize building social cohesion and trust in communities experiencing violence.
Collapse
Affiliation(s)
- Sajeevika S Daundasekara
- Department of Food Science & Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka (Dr Daundasekara); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana (Dr Marshall); School of Social Work, Temple University, Philadelphia, Pennsylvania (Dr Schuler); Department of Management, Policy, & Community Health, School of Public Health San Antonio, The University of Texas Health Science Center at Houston, San Antonio (Dr Testa); and Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston (Dr Hernandez)
| | | | | | | | | |
Collapse
|
6
|
Abstract
This JAMA Forum discusses how physicians and health professionals can help patients by intervening when they observe harmful cycles in health and by encouraging virtuous or health-promoting cycles.
Collapse
Affiliation(s)
- Dave A Chokshi
- CUNY Graduate School of Public Health and Health Policy, New York, New York.,Grossman School of Medicine, New York University, New York, New York
| |
Collapse
|