- Persistent communication inequalities limit racial/ethnic minority access to life‐saving health information and make them more vulnerable to the effects of misinformation.
- Establishing data collection systems that detect and track acute gaps in the supply and/or access of racial/ethnic minority groups to credible health information is long overdue.
- Public investments and support for minority‐serving media and community outlets are needed to close persistent gaps in access to credible health information.
Policy Points:
- Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector.
- This policy paradox persists during the implementation of the Affordable Care Act of 2010.
Context
For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox.Methods
This article explores the origin and persistence of the paradox using what many scholars call “interpretive social science.” This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality.Findings
A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness.Conclusions
The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox. 相似文献This paper focuses on the ways in which social context structures smokers’ views of, and reactions to, tobacco control. This exploratory study examined the interactions between tobacco control and smokers’ social contexts and how this may be contributing to inequalities in smoking. We found in our sample that higher socio-economic status (SES) smokers are more likely to positively respond and adapt to tobacco control messages and policies, viewing them for their future health betterment. Lower SES smokers in our study, on the other hand, are in conflict with tobacco control and feel intransigent with regard to the effects that tobacco control is having on their smoking. A better understanding of how social context structures people's perceptions of tobacco control may help us to understand why social inequalities in smoking are deepening, and potentially what can be done better in tobacco control to decrease them. 相似文献
Objective
Although a growing number of interventional studies on health literacy have been conducted recently, the majority were designed in clinical settings, focusing mainly on functional health literacy. This study evaluated a programme designed to improve health literacy in a community population, with a scope of going beyond functional health literacy.Methods
In collaboration with an Approved Specified Nonprofit organization (NPO), we evaluated a five‐session programme designed to provide basic knowledge on health‐care policy and systems, current issues in health care in Japan, patient roles and relationships with health‐care providers and interpersonal skills. In total, 67 of 81 programme participants agreed to participate in the study, and 54 returned the completed questionnaires at baseline and at follow‐up. Health literacy and trust in the medical profession were measured at baseline and at follow‐up. Participants’ learning through the programme was qualitatively analysed by thematic analysis.Results
Quantitative examinations of the changes in health literacy and degree of trust in medical professionals between the baseline and follow‐up suggested that health literacy significantly improved after implementing the programme. The thematic analysis of participants’ learning throughout the programme suggested that they not only acquired knowledge and skills but also experienced a shift in their beliefs and behaviours.Discussion
Providing individuals who are motivated to learn about health‐care systems and collaborate with health‐care providers with the necessary knowledge and skills may improve their health literacy, which could enable them to maintain and promote their health and that of their family and other people around them. 相似文献Methods: This study was a national survey to assess the perceptions of State Child Health Insurance Program (SCHIP) directors (N = 51) regarding schools assisting students in obtaining public health insurance. This study examined the perceived benefits of and barriers to working with school systems and the perceived benefits to schools in assisting students to enroll in SCHIPs and what SCHIP activities were actually being conducted with school systems.
Results: The majority (78%) of SCHIPs had been working with school systems for more than a year. Perceived benefits of working with schools were greater access to SCHIP-eligible children (75%), assistance with meeting mandates to cover all SCHIP-eligible children (65%), and greater ability of state agencies to identify SCHIP-eligible children (58%). A majority of the directors did not identify any of the potential barrier items. The directors cited the following benefits to schools in helping enroll students in public health insurance programs: reduces the number of students with untreated health problems (80%), reduces student absenteeism rates (68%), improves student attention and concentration during school (58%), and reduces the number of students being held back in school because of health problems (53%).
Discussion: The perceived benefits derived from schools assisting in enrolling eligible students into SCHIPs are congruent with the mission of schools. Schools need to become proactive in helping to establish a healthy student body, which is more likely to be an academically successful body. 相似文献