Family structure differences in health care utilization among U.S. children

This study explores the relationship between family structure and children's access to health care using data from the 2001-2003 waves of the child sample files from the U.S. National Health Interview Survey. Specifically, we investigate the extent to which family structure types predict children's utilization of preventive health care, and barriers to care. We then explore whether observed differences across family structures can be attributed to differences in demographic characteristics, socioeconomic status (SES), and child health status. Using logistic regression models, we document substantial variation in health care usage and barriers to health care across a variety of family structures. Of note is the finding that the children of single mothers demonstrate extremely different patterns of health care access than do the children of single fathers, and the importance of SES as a risk factor for diminished levels of access to health care varies by family type. SES plays a major role in mediating the relationship between access to care for children in single mother and cohabiting families (when contrasted against children in two married parent families), but less of a role for children living with stepparents, a single father, or with parents and other relatives.     

Self-rated health among U.S. adolescents

PurposeThis article investigates the meaning of subjective health assessments for younger respondents by examining the temporal stability of self-rated health (SRH) among adolescents. Two competing understandings of SRH are tested: SRH as a spontaneous health assessment or as an enduring self-concept.MethodsUsing data from two waves of the National Longitudinal Study of Adolescent Health (n = 13,511), an intra-class correlation coefficient and a weighted Kappa estimate are calculated to assess the test-retest reliability for SRH. Self-rated health (T2) is then modeled as a function of SRH (T1), physical health (T1), and mental health (T1), and changes in physical and mental health (T2–T1).ResultsSRH is found to be moderately stable over repeated observations (K = .40; ρ = .55) among adolescents. Findings from multivariate analyses suggest that SRH (T2) is largely determined by SRH (T1) and less so by changes in physical or psychological health status (T2-T1).ConclusionsSRH among adolescents is in part a spontaneous health assessment but it is best understood as an enduring self-concept.     

Psychocultural influences on health care acceptability among elderly U.S. Pacific Islanders

There is widespread recognition of the influence of ethnic variation on immigrant response to health care services, but far less is known about source of variation among nonimmigrant ethnic enclaves. Pacific Islander populations under U.S. administration for more than a century illustrate the potential influences of cultural factors on health care. Focus groups among elderly Samoan, Native Hawaiian, and Chamorro residents of southern California in 2002 found ethnic variation in such characteristics as expectations of publicly financed health care and in the willingness to discuss alternative sources of help with clinicians. These variations appear influenced by the colonial health care experience of these U.S. territories and, in the case of Samoan women, in distinctive perceptions of the role of prayer and traditional healing methods in care. Such psychocultural factors appear more potent than English language proficiency as an influence on the acceptability of health care among Pacific Islander elders.     

Overcoming disparities in U.S. health care

Disparities in U.S. health care result from a complex mixture of systemic quality and access problems intertwined with historic injury. The many dimensions of health disparities include race, ethnicity, socioeconomic status, and geography. It is critically important for policymakers to define the problem correctly so that our solutions address their intended goal-health security for all regardless of socioeconomic characteristics. Further, U.S. efforts to eliminate disparities must also be part of a broader effort to transform health care and thus must focus, first and foremost, on improving the quality of care delivered to the individual patient.     

Prevalence and correlates of depressive symptoms among older U.S. adults

Using data from telephone interviews conducted during 1985, we investigated the prevalence and correlates of depressive symptoms in a national probability sample of 1,232 noninstitutionalized U.S. residents 65 years of age and older. The association between depressive symptoms and personal attributes, personal resources, illness behavior, life events, and self-reported health was examined through chi-square and logistic regression analyses. We measured depressive symptoms with the Center for Epidemiologic Studies--Depression (CES-D) scale using a score of 16 or greater as an indication of high depressive symptoms. Prevalence of high depressive symptoms was 9.9% in the total sample. For black males the prevalence of depressive symptoms was 7.4%, and for white males it was 6.8%. For black females the prevalence of depressive symptoms was 20.8%, while for white females it was 11.5%. In the regression analysis, female gender, single marital status, poor self-reported assessment of health, illness behavior, and a low number of club/organization memberships were significantly associated with high depressive symptoms. In comparison to respondents reporting good to excellent health, those reporting poor to fair health were almost four times more likely to report a high number of depressive symptoms (odds ratio = 3.97).     

Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers

IntroductionDuring the 2018–2019 influenza season, vaccination coverage among U.S. children was 62.6%. The purpose of this study was to estimate the prevalence of influenza vaccinations among pediatric patients seen in U.S. health centers, and to explore potential disparities in vaccination coverage among subpopulations. Funded by the Health Resources and Services Administration (HRSA) within the U.S. Department of Health and Human Services, these health centers provide primary and preventive care to underserved and vulnerable individuals and families in order to reduce health disparities based on economic, geographic, or cultural barriers.MethodsCross-sectional data, analyzed in 2019, came from the most recent waves of the Health Center Patient Survey (2009, 2014). The sample consisted of children ages 2–17 years receiving care from HRSA-funded health centers. The outcome of interest was self- or parent-reported receipt of influenza vaccine in the past year. Multivariable logistic regression was used to estimate the adjusted prevalence rate ratios for the association between demographic characteristics (age, sex, race/ethnicity, poverty level, urban/rural residence, geographic region), health-related variables (receipt of well-child check-up, asthma diagnosis), and influenza vaccination.ResultsInfluenza vaccination coverage among pediatric health center patients increased from 46.6% in 2009 to 67.8% in 2014. In the adjusted model for 2014, there were few statistically significant differences in vaccination coverage among subpopulation groups, however American Indian/Alaska Native children had 31% increased vaccination coverage compared with non-Hispanic White children (aPRR: 1.31, 95% CI: 1.02–1.60) and children living in the South had 26% decreased vaccination coverage compared with those living in the Northeast (aPRR: 0.74, 95% CI: 0.54–0.93).ConclusionsInfluenza vaccination coverage among pediatric health center patients in 2014 exceeded the national average (as of 2018–2019), and few differences were found among at-risk subpopulations. HRSA-funded health centers are well-positioned to further increase the vaccination rate among children living in underserved communities.     

Trends in U.S. health care spending, 2001

U.S. health care spending grew 8.7 percent to $5,035 per capita in 2001. Total public funding continued to accelerate, increasing 9.4 percent and exceeding private funding growth by 1.2 percentage points. This acceleration was due in part to increased Medicaid spending in the midst of a recession and payment increases for Medicare providers. Prompted by sluggish economic growth and by faster-paced health spending, health spending's share of GDP spiked 0.8 percentage points in 2001 to 14.1 percent.     

Globalization of U.S. health care services: assessment and implementation

Globalization has become a commonly used term to describe the manner in which organizations in many industries have spread their operations and management to foreign countries. As the trend toward a global economy progresses, more and more industries, including health care, are looking to capitalize on its possible benefits. This article examines globalization in other industries and applies the tools used elsewhere to U.S. health care organizations.     

U.S. consumers attitudes toward farm animal cloning

In January 2008, the United States Food and Drug Administration concluded “meat and milk from cattle, swine, and goat clones or their offspring are as safe to eat as food we eat from those species now” (U.S. FDA, 2010). However, cloning remains a very controversial topic. A web-based survey administered by Knowledge Networks was used to determine U.S. consumers’ awareness of and attitudes toward meat and milk from cloned cattle. Findings reveal consumers do not differentiate much between products from cloned animals and products from non-cloned animals. Overall consumers are concerned that animal cloning is an unnatural process and that it will lead to human cloning.