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Pipas CF, Chaabo H, Brown Speights JS. How to ACE Daily Stressors in Medical Practice. Fam Pract Manag 2024; 31:12-16. [PMID: 38194305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
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Vilme H, Duke NN, Dokurugu Y, Akin-Odanye EO, Paul CJ, Kaninjing E, López IA, Matsouaka R, Brown Speights JS, De Leon J, Sauls DL, Ndip RN, Amissah F, Bosworth H, Warren CL, Muiruri C. Food insecurity among university students in the United States amidst the COVID-19 pandemic. J Am Coll Health 2022:1-6. [PMID: 35816732 DOI: 10.1080/07448481.2022.2082840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 04/20/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study reports on food insecurity (FI) amidst the COVID-19 pandemic. PARTICIPANTS AND METHODS College students in four regions of the US completed the two-item validated Hunger Vital Sign™ screening tool on Qualtrics. RESULTS FI increased significantly after March 2020 among US students (worry about food running out: 25% to 35%; food did not last: 17% to 21%) with significant regional increase in the Midwest and South. An adjusted multivariable logistic regression model indicated students that ran out of food were significantly at greater odds of experiencing hardship with paying bills (AOR: 5.59, 95% CI =3.90-8.06). CONCLUSIONS The findings identified an increase in the prevalence of FI among college students during the pandemic. Suggestions of how to address FI are discussed.
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Affiliation(s)
- Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Naomi N Duke
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Department of Sociology, Duke University, Durham, NC, USA
| | - Yussif Dokurugu
- Institute of Global Health, Inc. 603 MLK Jr. Blvd, Tallahassee, FL, USA
| | | | - Christopher J Paul
- Department of Public Administration, North Carolina Central University, Durham, NC, USA
| | - Ernest Kaninjing
- School of Health and Human Performance, Georgia College, Milledgeville, GA
| | - Ivette A López
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
- Utah Area Health Education Centers, University of Utah, Salt Lake City, UT, USA
| | - Roland Matsouaka
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University, Durham, NC
| | - Joedrecka S Brown Speights
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Jessica De Leon
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Derrick L Sauls
- Department of Public Health and Exercise Science, Saint Augustine's University, Raleigh, NC, USA
| | - Roland N Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Felix Amissah
- Department of Pharmaceutical Sciences, College of Pharmacy, Ferris State University, Big Rapids, Michigan, USA
| | - Hayden Bosworth
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Durham VA Health Care System, Health Services Research and Development, Durham, NC, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC, USA
| | - Carol L Warren
- Department of Interprofessional Education, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Charles Muiruri
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Vilme H, Akin-Odanye EO, Sauls DL, De Leon J, Paul C, Brown Speights JS, White-Means S, Amissah F, Ndip RN, Dokurugu YM, Bosworth HB, Avorgbedor F, López IA. A Social-Ecological Exploration of College and University Students’ COVID-19 Infection Preventive Behaviors. American Journal of Health Education 2022. [DOI: 10.1080/19325037.2022.2071361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Hayden B. Bosworth
- Duke University
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)
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Deichen Hansen ME, James BA, Sakinah I, Brown Speights JS, Rust G. Traversing Traditions: Prenatal Care and Birthing Practice Preferences Among Black Women in North Florida. Ethn Dis 2021; 31:227-234. [PMID: 33883863 DOI: 10.18865/ed.31.2.227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Our goal was to explore prenatal practices and birthing experiences among Black women living in an urban North Florida community. Design Non-random qualitative study. Setting Private spaces at a convenient location selected by the participant. Participants Eleven Black women, aged 25-36 years, who were either pregnant or had given birth at least once in the past five years in North Florida. Methods Semi-structured interviews were completed in July 2017, followed by thematic analysis of interview transcripts. Results Four main themes emerged: a) decision-making strategies for employing alternative childbirth preparation (ie, midwives, birthing centers, and doulas); b) having access to formal community resources to support their desired approaches to perinatal care; c) seeking advice from women with similar perspectives on birthing and parenting; and d) being confident in one's decisions. Despite seeking to incorporate "alternative" methods into their birthing plans, the majority of our participants ultimately delivered in-hospital. Conclusions Preliminary results suggest that culturally relevant and patient-centered decision-making might enhance Black women's perinatal experience although further research is needed to see if these findings are generalizable to a heterogenous US Black population. Implications for childbirth educators and health care professionals include: 1) recognizing the importance of racially and professionally diverse staffing in obstetric care practices; 2) empowering patients to communicate and achieve their childbirth desires; 3) ensuring an environment that is not only free of discrimination and disrespect, but that embodies respect (as perceived by patients of varied racial backgrounds) and cultural competence; and, 4) providing access to education and care outside of traditional work hours.
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Affiliation(s)
- Megan E Deichen Hansen
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
| | - Brittny A James
- Frederick D. Patterson Research Institute, United Negro College Fund, Atlanta, GA
| | - Inam Sakinah
- Rollins School of Public Health, Emory University, Atlanta, GA
| | - Joedrecka S Brown Speights
- Department of Family Medicine and Rural Health, College of Medicine, Florida State University, Tallahassee, FL
| | - George Rust
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
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Anim TE, Rust G, Strong C, Brown Speights JS. Population Based Health Care. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Brown Speights JS, Goldfarb SS, Levine RS, Rust G. Racial Equality in Infant Outcomes: A Call to Action. Am J Public Health 2019; 109:666-668. [PMID: 30969840 DOI: 10.2105/ajph.2019.305028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Joedrecka S Brown Speights
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee. Samantha S. Goldfarb is with the Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. George Rust is with the Center for Medicine and Public Health, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
| | - Samantha S Goldfarb
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee. Samantha S. Goldfarb is with the Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. George Rust is with the Center for Medicine and Public Health, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
| | - Robert S Levine
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee. Samantha S. Goldfarb is with the Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. George Rust is with the Center for Medicine and Public Health, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
| | - George Rust
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee. Samantha S. Goldfarb is with the Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. George Rust is with the Center for Medicine and Public Health, Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
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White-Davis T, Edgoose J, Brown Speights JS, Fraser K, Ring JM, Guh J, Saba GW. Authors’ Reply “Racism Education is Needed at All Levels of Training”. Fam Med 2018; 50:712. [DOI: 10.22454/fammed.2018.819419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Tanya White-Davis
- Department of Family and Social Medicine, Montefiore Medical Center-Albert Einstein College of Medicine, Bronx, NY
| | - Jennifer Edgoose
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Joedrecka S. Brown Speights
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL
| | - Kathryn Fraser
- Halifax Health Family Medicine Residency Program, Daytona Beach, FL
| | | | - Jessica Guh
- Swedish Family Medicine Residency, Cherry Hill, Family Medicine Residency Network at University of Washington, Seattle, WA
| | - George W. Saba
- Department of Family and Community Medicine, University of California San Francisco
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Goldfarb SS, Houser K, Wells BA, Brown Speights JS, Beitsch L, Rust G. Pockets of progress amidst persistent racial disparities in low birthweight rates. PLoS One 2018; 13:e0201658. [PMID: 30063767 PMCID: PMC6067759 DOI: 10.1371/journal.pone.0201658] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 07/19/2018] [Indexed: 01/10/2023] Open
Abstract
Racial disparities persist in adverse perinatal outcomes such as preterm birth, low birthweight (LBW), and infant mortality across the U.S. Although pervasive, these disparities are not universal. Some communities have experienced significant improvements in black (or African American) birth outcomes, both in absolute rates and in rate ratios relative to whites. This study assessed county-level progress on trends in black and white LBW rates as an indicator of progress toward more equal birth outcomes for black infants. County-level LBW data were obtained from the 2003 to 2013 U.S. Natality files. Black LBW rates, black-white rate ratios and percent differences over time were calculated. Trend lines were first assessed for significant differences in slope (i.e., converging, diverging, or parallel trend lines). For counties with parallel trend lines, intercepts were tested for statistically significant differences (sustained equality vs. persistent disparities). To assess progress, black LBW rates were compared to white LBW rates, and the trend lines were tested for significant decline. Each county's progress toward black-white equality was ultimately categorized into five possible trend patterns (n = 408): (1) converging LBW rates with reductions in the black LBW rate (decreasing disparities, n = 4, 1%); (2) converging LBW rates due to worsening white LBW rates (n = 5, 1%); (3) diverging LBW rates (increasing disparities, n = 9, 2%); (4) parallel LBW rates (persistent disparities, n = 373, 91%); and (5) overlapping trend lines (sustained equality, n = 18, 4%). Only four counties demonstrated improvement toward equality with decreasing black LBW rates. There is significant county-level variation in progress toward racial equality in adverse birth outcomes such as low birthweight. Still, some communities are demonstrating that more equitable outcomes are possible. Further research is needed in these positive exemplar communities to identify what works in accelerating progress toward more equal birth outcomes.
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Affiliation(s)
- Samantha S. Goldfarb
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - Kelsey Houser
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - Brittny A. Wells
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States of America
| | - Joedrecka S. Brown Speights
- Department of Family Medicine and Rural Health, College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - Les Beitsch
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, United States of America
- Center for Medicine and Public Health, College of Medicine, Florida State University, Tallahassee, FL, United States of America
| | - George Rust
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, United States of America
- Center for Medicine and Public Health, College of Medicine, Florida State University, Tallahassee, FL, United States of America
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Abstract
Background and Objectives: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities.
Methods: A multiracial, interdisciplinary team identified essential elements of teaching about racism. A 1.5-hour faculty development workshop consisted of a didactic presentation, a 3-minute video vignette depicting racial and gender microaggression within a hospital setting, small group discussion, large group debrief, and presentation of a toolkit.
Results: One hundred twenty diverse participants attended the workshop at the 2016 Society of Teachers of Family Medicine Annual Spring Conference. Qualitative information from small group facilitators and large group discussions identified some participants’ emotional reactions to the video including dismay, anger, fear, and shame. A pre/postsurvey (N=72) revealed significant changes in attitude and knowledge regarding issues of racism and in participants’ personal commitment to address them.
Discussion: Results suggest that this workshop changed knowledge and attitudes about racism and health inequities. Findings also suggest this workshop improved confidence in teaching learners to reduce racism in patient care. The authors recommend that curricula continue to be developed and disseminated nationally to equip faculty with the skills and teaching resources to effectively incorporate the discussion of racism into the education of health professionals.
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Affiliation(s)
- Tanya White-Davis
- Department of Family and Social Medicine, Montefiore Medical Center-Albert Einstein College of Medicine, Bronx, NY
| | - Jennifer Edgoose
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Joedrecka S. Brown Speights
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL
| | - Kathryn Fraser
- Halifax Health Family Medicine Residency Program, Daytona Beach, FL
| | | | - Jessica Guh
- Swedish Family Medicine Residency, Cherry Hill, Family Medicine Residency Network at University of Washington, Seattle, WA
| | - George W. Saba
- Department of Family and Community Medicine, University of California San Francisco
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Rust G, Brown Speights JS. Creating Health Equity Curricula. Fam Med 2018. [DOI: 10.22454/fammed.2018.397067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- George Rust
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine
| | - Joedrecka S. Brown Speights
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL
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Chen FM, Overstreet F, Cole AM, Kost A, Brown Speights JS. Racial and Ethnic Health Disparities Curricula in US Medical Schools: A CERA Study. PRiMER 2017; 1:6. [PMID: 32944692 DOI: 10.22454/primer.2017.1.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction Health disparities among African Americans are an historic and pervasive problem in US health care. We examined the presence, requirements, and content of curricula in US medical schools dedicated to racial and ethnic health disparities. Methods We conducted a national CERA survey of Family Medicine department chairs. Chairs were asked about disparities curricula in their institutions. Results Ninety-two percent reported that their medical school curriculum included focus on racial and ethnic disparities. However, many were dissatisfied with the content and quality of their curricular offerings. There were no significant departmental predictors of the quality of health disparities curricula. Conclusion The majority of medical schools address health disparities in their curricula, but optimally covering this important content remains a persistent challenge in medical school education.
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Affiliation(s)
- Frederick M Chen
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA
| | - Frederica Overstreet
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA
| | - Allison M Cole
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA
| | - Amanda Kost
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA
| | - Joedrecka S Brown Speights
- Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, FL
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Brown Speights JS, Nowakowski ACH, De Leon J, Mitchell MM, Simpson I. Engaging African American women in research: an approach to eliminate health disparities in the African American community. Fam Pract 2017; 34:322-329. [PMID: 28387794 DOI: 10.1093/fampra/cmx026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To explore the success of community-based participatory research [CBPR] in engaging African American women to achieve health equity by elucidating community, trust, communication and impact. Recommendations helpful for researchers interested in engaging communities to achieve health equity in the USA are included. INRODUCTION African American women experience health disparities of multifactorial etiology and are underrepresented in research. CBPR is a collaborative approach that incorporates perspectives, which address the intricate determinants of health and has been reported as an effective means to address health disparities. Yet, the science of CBPR seems elusive to researchers in the medical field. The opportunity exists to better understand and expand the use of the principles of engagement, replication, and sustainability in engaging African American women in health research. METHODS A variety of literature regarding engaging African American women in community-based participatory research was reviewed. RESULTS CBPR focused on robust engagement of marginalized groups continues to be validated as a vital approach to the elimination of disparities and improved health for all, especially ethnic and racial minority populations. However, limited evidence of focused engagement of African American women was found. Making specific outreach to African American women must be a community and patient engagement priority to achieve health equity. CONCLUSIONS Continued research is needed which specifically focuses on building and sustaining engagement with African American women and their communities. This research can transform healthcare access, experiences and outcomes by yielding actionable information about what African American women need and want to promote wellness for themselves and their communities.
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Affiliation(s)
- Joedrecka S Brown Speights
- Department of Family Medicine & Rural Health, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Alexandra C H Nowakowski
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Jessica De Leon
- Department of Family Medicine & Rural Health, Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Ivana Simpson
- Obstetrics and Gynecology Residency, University of Texas Health Sciences Center, Houston, TX, USA
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Rodgers DV, Wendling AL, Saba GW, Mahoney MR, Brown Speights JS. Preparing Family Physicians to Care for Underserved Populations: A Historical Perspective. Fam Med 2017; 49:304-310. [PMID: 28414410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Family physicians have been involved in the care of rural and urban underserved populations since the founding of the specialty. In the early 1970s family medicine training programs specifically focused on training residents to work with the underserved were established in both urban and rural settings. Key to the success of these programs has been a specific focus on improving access to care, understanding and eliminating health disparities, cultural competency and behavioral science training that recognizes the challenges often faced by patients and families living in poor rural and urban areas of the country. In keeping with a focus on the underserved, several urban underserved residencies also became national models for the provision of primary care to patients and families affected by HIV/AIDS. Family medicine training programs focused on the underserved have resulted in the development of a cohort of family physicians who care for those most in need in the United States. Despite these achievements, persistent challenges remain in providing adequate access to care for many living in rural and inner city settings. New strategies will need to be developed by family medicine programs and others to better meet these challenges.
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Affiliation(s)
- Denise V Rodgers
- Office of Interprofessional Programs, Rutgers Biomedical and Health Sciences
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Brown Speights JS, Goldfarb SS, Wells BA, Beitsch L, Levine RS, Rust G. State-Level Progress in Reducing the Black-White Infant Mortality Gap, United States, 1999-2013. Am J Public Health 2017; 107:775-782. [PMID: 28323476 DOI: 10.2105/ajph.2017.303689] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To assess state-level progress on eliminating racial disparities in infant mortality. METHODS Using linked infant birth-death files from 1999 to 2013, we calculated state-level 3-year rolling average infant mortality rates (IMRs) and Black-White IMR ratios. We also calculated percentage improvement and a projected year for achieving equality if current trend lines are sustained. RESULTS We found substantial state-level variation in Black IMRs (range = 6.6-13.8) and Black-White rate ratios (1.5-2.7), and also in percentage relative improvement in IMR (range = 2.7% to 36.5% improvement) and in Black-White rate ratios (from 11.7% relative worsening to 24.0% improvement). Thirteen states achieved statistically significant reductions in Black-White IMR disparities. Eliminating the Black-White IMR gap would have saved 64 876 babies during these 15 years. Eighteen states would achieve IMR racial equality by the year 2050 if current trends are sustained. CONCLUSIONS States are achieving varying levels of progress in reducing Black infant mortality and Black-White IMR disparities. Public Health Implications. Racial equality in infant survival is achievable, but will require shifting our focus to determinants of progress and strategies for success.
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Affiliation(s)
- Joedrecka S Brown Speights
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Samantha Sittig Goldfarb
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Brittny A Wells
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Leslie Beitsch
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Robert S Levine
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - George Rust
- Joedrecka S. Brown Speights is with the Department of Family Medicine and Rural Health, Florida State University (FSU) College of Medicine, Tallahassee. Samantha Sittig Goldfarb and Brittny A. Wells are with the Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Leslie Beitsch and George Rust are with the Center for Medicine and Public Health, and Department of Behavioral Sciences and Social Medicine, FSU College of Medicine. Robert S. Levine is with the Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
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