1
|
Lee K. Racial Disparities in the Impact of Head Start on Health Outcomes Among Low-Income Head Start-Eligible Children and Parents. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01836-7. [PMID: 37930580 DOI: 10.1007/s40615-023-01836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
This study examined racial disparities in Head Start's impact on health outcomes for families with young children in poverty. Research questions were as follows: (a) are there racial disparities in health outcomes among low-income families? (b) Does Head Start participation promote better health outcomes? And (c) does Head Start's impact on health outcomes differ by race and ethnicity? Logistic regression analysis found that African American and Hispanic children experience lower health outcomes than their white peers, including lower rates of dental screening, more frequent injury-related care, lower overall health status, and lower rates of health insurance coverage. In comparison to White parents, African American and Hispanic parents reported lower levels of cigarette smoking. Children enrolled in Head Start received significantly more dental screening than their non-Head Start peers, regardless of race and ethnicity. The positive impacts of Head Start were particularly pronounced for African American and Hispanic children when compared to White children. Families that do not speak English as their primary language and those with lower household incomes experienced worse health outcomes. The positive impact of Head Start on the health outcomes of marginalized populations highlights the need for continued expansion of Head Start programs, as they strive to provide equal opportunities for improvements in academic, socio-emotional, and health outcomes for children and their parents in low-income households. The recruitment and enrollment process for Head Start should provide eligibility and application information in multiple languages for families in deep poverty.
Collapse
Affiliation(s)
- Kyunghee Lee
- School of Social Work, Michigan State University, 655 Auditorium Road, East Lansing, MI, 48824, USA.
| |
Collapse
|
2
|
Davis MA, Gichoya JW, Banerjee I, Sung D, Newsome J, Vey BL, Gerard R, Khan F, Zavaletta V, Mazaheri S, Heilbrun ME. Balancing the Scales: An Analysis of Social Determinants of Health, Radiology Report Acuity, and Radiology Staffing Models in an Academic Health System. J Am Coll Radiol 2022; 19:172-177. [PMID: 35033306 DOI: 10.1016/j.jacr.2021.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Social determinants of health, including race and insurance status, contribute to patient outcomes. In academic health systems, care is provided by a mix of trainees and faculty members. The optimal staffing ratio of trainees to faculty members (T/F) in radiology is unknown but may be related to the complexity of patients requiring care. Hospital characteristics, patient demographics, and radiology report findings may serve as markers of risk for poor outcomes because of patient complexity. METHODS Descriptive characteristics of each hospital in an urban five-hospital academic health system, including payer distribution and race, were collected. Radiology department T/F ratios were calculated. A natural language processing model was used to classify multimodal report findings into nonacute, acute, and critical, with report acuity calculated as the fraction of acute and critical findings. Patient race, payer type, T/F ratio, and report acuity score for hospital 1, a safety net hospital, were compared with these factors for hospitals 2 to 5. RESULTS The fraction of patients at hospital 1 who are Black (79%) and have Medicaid insurance (28%) is significantly higher than at hospitals 2 to 5 (P < .0001), with the exception of hospital 3 (80.1% black). The T/F ratio of 1.37 at hospital 1 as well as its report acuity (28.9%) were significantly higher (P < .0001 for both). CONCLUSIONS T/F ratio and report acuity are highest at hospital 1, which serves the most at-risk patient population. This suggests a potential overreliance on trainees at a site whose patients may require the greatest expertise to optimize care.
Collapse
Affiliation(s)
- Melissa A Davis
- Assistant Professor, Director of Quality, Emory University, School of Medicine, Atlanta, Georgia.
| | | | - Imon Banerjee
- Assistant Professor, Emory University, School of Medicine, Atlanta, Georgia
| | | | - Janice Newsome
- Associate Professor, Chief of Interventional Radiology, Emory University, School of Medicine, Atlanta, Georgia
| | - Brianna L Vey
- Resident, Emory University, School of Medicine, Atlanta, Georgia
| | - Roger Gerard
- Resident, Emory University, School of Medicine, Atlanta, Georgia
| | - Fiza Khan
- Resident, Emory University, School of Medicine, Atlanta, Georgia
| | - Vaz Zavaletta
- Fellow, Emory University, School of Medicine, Atlanta, Georgia
| | - Sina Mazaheri
- Resident, Emory University, School of Medicine, Atlanta, Georgia
| | - Marta E Heilbrun
- Associate Professor, Vice-Chair of Quality, Emory University, School of Medicine, Atlanta, Georgia
| |
Collapse
|