Journal Of Health And Human Services Administration[JOURNAL]
Sun
200 papers
The road to empowerment: a historical perspective on the medicalization of disability.
Hayes J, Hannold EL
J Health Hum Serv Adm · 2007 · PMID 18236708
The aims of this paper are to analyze the role of medical and health professions in creating and establishing the disability category. We also explore how the diagnosis, measurement, and treatment of disability have cont...
The aims of this paper are to analyze the role of medical and health professions in creating and establishing the disability category. We also explore how the diagnosis, measurement, and treatment of disability have contributed to stigmatization and promoted social, political and economic inequality. Theories from a variety of disciplines are used to examine the ways that medicine and the health-related professions have contributed to the oppression of people with disabilities, including the maintenance of a 'medical/knowledge power differential,' reinforcement of the 'sick role,' and objectification of people with disabilities. We also explore opportunities for empowerment versus 'sick role' status. The medical and health professions are uniquely positioned to promote the empowerment of people with disabilities as active partners in their own health care. Replacing the biomedical model of disability with a socio-political model that prioritizes disease/health care management, wellness and prevention of further disability as opposed to treatments aimed at curing disability could facilitate the empowerment process.
The impact of having a young child with disabilities on maternal labor supply by race and marital status.
Wehby GL, Ohsfeldt RL
J Health Hum Serv Adm · 2007 · PMID 18236707
Data from the National Maternal and Infant Health Survey (NMIHS) with the three-year follow-up survey data were used to assess the impact of having a young child with disabilities on maternal labor supply. The oversampli...
Data from the National Maternal and Infant Health Survey (NMIHS) with the three-year follow-up survey data were used to assess the impact of having a young child with disabilities on maternal labor supply. The oversampling of low birth-weight and African-American births in NMIHS provides a larger proportion of disabled children and a bigger sample of black mothers than available in data used in prior studies. The empirical analyses examined the impact of child disability on maternal employment participation and conditional intensity by race and marital status using alternative measures of disability based on occurrence of specific health conditions as well as activity performance and general development. Exogeneity of activity-based disability measures was tested using health conditions as instruments and instrumental variable models were used to estimate their impacts on maternal labor supply. The results indicated that activity-based measures are endogenous for black single and white married mothers. Model results suggested large reductions in likelihood of employment participation of black single as well as white single and married mothers. Work intensity of employed black single mothers was also substantially reduced by child disability. Overall, no consistent effects of child disability were observed for black married mothers.
How well are we doing addressing disability in America? Examining the status of adults with chronic disabling conditions, 1995 and 2005.
Bolin JN
J Health Hum Serv Adm · 2007 · PMID 18236706
Despite laws like the Americans with Disabilities Act (ADA), (1992), and The Ticket to Work Act, (TTWA), (2001), working age adults who develop chronic disabling conditions often find themselves faced with a choice of le...
Despite laws like the Americans with Disabilities Act (ADA), (1992), and The Ticket to Work Act, (TTWA), (2001), working age adults who develop chronic disabling conditions often find themselves faced with a choice of leaving the labor market in order to qualify for public health insurance or continuing to work, often on a "hit and miss" basis, disqualifying them from employee health benefits. Federal and state policy makers continue to struggle to find solutions addressing the needs of working age adults with disabling conditions and illnesses. In this study we examine the work status of working age adults using two National Health Interview Surveys conducted a decade apart (1995 & 2005) to investigate and compare adults who have chronic, disabling conditions and self-reported rates of work. Specifically, this research investigates whether reported work activity among working age adults who report chronic health conditions has improved in the decade between 1995 and 2005. The effects of racial/ethnic differences, age, and region of residence on one's work status are also examined.
Disability in Alzheimer's disease: causes, consequences, and economic considerations.
Demakis GJ
J Health Hum Serv Adm · 2007 · PMID 18236705
This literature review broadly examines disability in Alzheimer's disease (AD). The paper addresses the various types of disability in AD, as well as the presumed causes and the economic and social costs of such disabili...
This literature review broadly examines disability in Alzheimer's disease (AD). The paper addresses the various types of disability in AD, as well as the presumed causes and the economic and social costs of such disability. The influence of various types of treatment of disability, particularly pharmacological is addressed, as are directions for future research.
Working age Medicare beneficiaries with disabilities: population characteristics and policy considerations.
Kennedy J, Tuleu IB
J Health Hum Serv Adm · 2007 · PMID 18236704
Compared to older beneficiaries, disabled workers who become eligible for Medicare 25 months after they are deemed eligible for Social Security Disability Insurance (SSDI), receive little research attention or policy con...
Compared to older beneficiaries, disabled workers who become eligible for Medicare 25 months after they are deemed eligible for Social Security Disability Insurance (SSDI), receive little research attention or policy consideration. This is unfortunate, because of the special medical and vocational needs, high healthcare costs, and rapid growth of this population. Although disabled workers comprise only 14.1% of the total Medicare population, they account for about 17% ($71.6 billion) of total program expenditures. This review article finds that disabled workers are a medically heterogeneous population, with relatively high rates of psychiatric and cognitive conditions. Poor health, low incomes, and lack of access to affordable supplemental coverage make this group particularly vulnerable to program limitations and policy changes. Coverage gaps and co-payments may limit access to critical health services, including preventive services, rehabilitation, adaptive technology, personal assistance, and prescription drugs. Access to stable and affordable health insurance coverage is an essential part of return to work programming for SSDI beneficiaries.
Quality of life in people with multiple sclerosis: data from the Sonya Slifka Longitudinal Multiple Sclerosis Study.
Wu N, Minden SL, Hoaglin DC … +2 more , Hadden L, Frankel D
J Health Hum Serv Adm · 2007 · PMID 18236703
Current knowledge about the health-related quality of life (HRQoL) experienced by people with multiple sclerosis (MS) is limited. We compared item and component scale scores on the Medical Outcomes Short Form 12 (SF-12)...
Current knowledge about the health-related quality of life (HRQoL) experienced by people with multiple sclerosis (MS) is limited. We compared item and component scale scores on the Medical Outcomes Short Form 12 (SF-12) of 2,109 people with MS to U.S. norms and published data on persons with other medical conditions. We also built regression models for SF-12-derived mental (MCS) and physical component scale (PCS) scores. Seventy-five percent of the sample had been diagnosed with MS for over 5 years, and one-half to two-thirds received help with at least one activity of daily living (ADL) or instrumental activity of daily living (IADL), respectively. The mean PCS score was 36.2 (Standard Error: 0.27), significantly lower by 14 points than the U.S. population norm and by 4-12 points than mean scores for individuals with diabetes, congestive heart failure, myocardial infarction, hypertension or depression. The mean MCS score was 49.2 (Standard Error: 0.25), significantly lower than the norm for the U.S. population and the mean scores for the chronic condition groups except congestive heart failure and depression. We identified several demographic, disease, and health services factors that were significantly related to quality of life and highlighted a number of areas for improvement. We concluded that the quality of the lives of people with MS could be enhanced by removing barriers to MS care, general health care, and mental health care; meeting needs for help with activities of daily living and instrumental activities of daily living; supporting employment; and improving access to disease modifying agents and symptomatic treatments.
Terrorism and emergent challenges in public health.
O'Boyle I, Johnson JA, Simms M … +1 more , Metzroth R
J Health Hum Serv Adm · 2008 · PMID 18236702
The authors explore the complexity of challenges facing the public health community in an era increasingly defined by terrorism. The public health and associated political structure in this country has much to do to bett...
The authors explore the complexity of challenges facing the public health community in an era increasingly defined by terrorism. The public health and associated political structure in this country has much to do to better coordinate its' efforts in an effective way. Solutions will ultimately come from partnerships between government agencies, community organizations, the business community, and international interests.
Evaluating heart disease presciptions-filled as a proxy for heart disease prevalence rates.
Cossman RE, Cossman JS, James WL … +5 more , Blanchard T, Thomas RK, Pol LG, Cosby AG, Mirvis DM
J Health Hum Serv Adm · 2008 · PMID 18236701
Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective healt...
Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective health care interventions. We use heart disease drug prescriptions-filled as a proxy measure for prevalence of heart disease. We test the correlation to the Behavioral Risk Factor Surveillance System (BRFSS) and find positive, statistically significant correlations. Next we illustrate the geographic patterns revealed using the county-level prevalence estimate maps. This information can be used to provide a better understanding of sub-state variations in disease patterns and subsequently target the delivery of health resources to small areas in need.
Health implications of physical activity in individuals with spinal cord injury: a literature review.
Fernhall B, Heffernan K, Jae SY … +1 more , Hedrick B
J Health Hum Serv Adm · 2008 · PMID 18236700
Physical activity has demonstrated beneficial effects on health and longevity in the general population, and physically active individuals are at lower risk for many chronic diseases compared to their sedentary peers. In...
Physical activity has demonstrated beneficial effects on health and longevity in the general population, and physically active individuals are at lower risk for many chronic diseases compared to their sedentary peers. Individuals with disabilities in general are less active than individuals without disabilities, but it is still unknown if physical activity confers the same level of risk reduction in populations with as without disabilities. Individuals with spinal cord injury (SCI) have among the lowest levels of physical activity participation compared to other populations. They also demonstrate early onset of cardiovascular disease and other chronic diseases. This literature review discusses evidence for the potential benefits of physical activity in persons with SCI and provides a summary of pertinent studies to date. Although being physically active and physically fit appears to be associated with several health benefits in persons with SCI, most studies are small and little longitudinal evidence exists. Future studies will be needed to address this need.
Outsourcing veterans for long-term care: comparison of community and state veterans' nursing homes.
Laberge A, Weech-Maldonado R, Johnson CE … +2 more , Jia H, Dewald L
J Health Hum Serv Adm · 2008 · PMID 18236699
This study compares the characteristics of state veterans' nursing homes and community nursing homes with VA per-diem residentes between 1999 - 2002. A structure, process, and outcome model was used to examine whether th...
This study compares the characteristics of state veterans' nursing homes and community nursing homes with VA per-diem residentes between 1999 - 2002. A structure, process, and outcome model was used to examine whether there was any difference in the multi-dimensional quality measures among the three types of community nursing homes (for profit, not-for-profit, and government) and state veterans' nursing homes. For profit community nursing homes were less likely to achieve nurse staffing standards while government facilities were more likely to achieve CNA staffing standards when compared to the state veterans' homes. All community nursing homes had a lower prevelance of tube feeds and catheterization when compared to state veterans' nursing homes. Only government community nursing homes had significantly lower quality of life deficiencies and pressure sore prevelance when compared to state veterans' nursing homes. Vigilant monitoring of all long-term care facilities utilized by veterans is needed.
Weight counseling for elderly patients in primary care: how often and how much time.
Tai-Seale T, Tai-Seale M, Zhang W
J Health Hum Serv Adm · 2008 · PMID 18236698
Some 20 million Americans over the age of 60 will soon be obese. As a result, they will likely suffer lower life-expectancy, higher disability, and higher health care costs. How much time do physicians spend with elders,...
Some 20 million Americans over the age of 60 will soon be obese. As a result, they will likely suffer lower life-expectancy, higher disability, and higher health care costs. How much time do physicians spend with elders, especially obese elders, in helping them plan weight loss? This study, which analyzed 352 videotaped visits with elderly patients and their provider, has found that only a third of the visibly obese patients were counseled, and that the average time spent discussing the subject--if discussed--was 103 seconds. This is probably less than a fifth of the time needed to adequately counsel patients about weight loss. In addition, the study has found that both provider and patient characteristics determine if and how long discussion lasts.
Advance directives for health care among older community residents.
McAuley WJ, McCutcheon ME, Travis SS
J Health Hum Serv Adm · 2008 · PMID 18236697
Advance directives (ADs) for healthcare are useful planning tools for older people. In addition, the utilization of ADs is important for health and human services planners, administrators, and policy makers to understand...
Advance directives (ADs) for healthcare are useful planning tools for older people. In addition, the utilization of ADs is important for health and human services planners, administrators, and policy makers to understand because whether or not people have an AD, and what types of ADs they have can dramatically influence the treatment trajectories and the well-being of older people who can longer make decisions for themselves. Using telephone survey data with a random sample of Oklahoma residents age 60 and older, we examined the prevalence of four measures of AD use. Prior to the implementation of this survey in 2002, the Oklahoma Aging Services Division was very active in promoting two types of AD---the living will and the durable power of attorney for healthcare. More than half of those interviewed had a living will, two-fifths had a durable power of attorney for healthcare, and one-third had both ADs. Older age and higher levels of education were consistently associated with having ADs.
Providing appropriate services to individuals in the community: a preliminary case-mix for model allocating personal care services.
Phillips CD, Dyer J, Janousek V … +2 more , Halperin L, Hawes C
J Health Hum Serv Adm · 2008 · PMID 18236696
Personal care services are often provided to clients in community settings through highly discretionary processes. Such processes provide little guidance for caseworkers concerning how public resources should be allocate...
Personal care services are often provided to clients in community settings through highly discretionary processes. Such processes provide little guidance for caseworkers concerning how public resources should be allocated. The results of such processes almost guarantee that individuals with very similar needs will receive very different levels of care resources. Such disparities in treatment open the door to inequity and ineffectiveness. One way to address this problem is through case-mix classification systems that allocate hours of care according to client needs. This paper outlines the preliminary steps taken by one state in its movement toward such a system.
Urban/rural differences in access and barriers to health care for people with multiple sclerosis.
Buchanan RJ, Stuifbergen A, Chakravorty BJ … +3 more , Wang S, Zhu L, Kim M
J Health Hum Serv Adm · 2006 · PMID 17571473
CONTEXT: People living in rural areas face barriers when seeking health care, often experiencing difficulties accessing health providers or facilities. Little is known about barriers to the use of health care confronting...
CONTEXT: People living in rural areas face barriers when seeking health care, often experiencing difficulties accessing health providers or facilities. Little is known about barriers to the use of health care confronting people with multiple sclerosis (MS) in rural areas. PURPOSE: To identify any rural/urban differences in access and barriers to health services, including MS-focused care, among people with MS. METHODS: The data were collected in a survey of 1,518 people with MS living in all 50 States. The study included three geographic subgroups: urban areas; adjacent rural areas; and more remote rural areas. FINDINGS: We found significant rural/urban differences in access and barriers to care among people with MS, especially for MS-focused care. Significantly smaller proportions of people with MS from adjacent and more remote rural areas reported no difficulty getting MS-related care than their urban counterparts. CONCLUSIONS: Greater difficulty accessing MS-related care experienced by people with MS in rural areas has negative implications for the quality of the MS care they receive.
The development of the U.S. Health Care System and the contemporary role of the public health department.
Grott CJ
J Health Hum Serv Adm · 2006 · PMID 17571472
The absence of national health care reform and the growing number of uninsured individuals in the United States have prompted states to develop plans to provide medical care for the low income and the indigent. Many loca...
The absence of national health care reform and the growing number of uninsured individuals in the United States have prompted states to develop plans to provide medical care for the low income and the indigent. Many local health departments are not only responsible for the core public health functions; but they are increasingly called upon to provide person health care services for those who cannot afford it. This article chronicles the development of the health care system in the United States and describes the contemporary role of the local public health department.
Faith-based versus secular providers of social services--differences in what, how, and where.
Graddy EA, Ye K
J Health Hum Serv Adm · 2006 · PMID 17571471
Recent public policies have promoted an increased role for faith-based organizations in the delivery of publicly supported services. Yet, there is little information on how service delivery by faith-based and secular pro...
Recent public policies have promoted an increased role for faith-based organizations in the delivery of publicly supported services. Yet, there is little information on how service delivery by faith-based and secular providers might differ. This study seeks a better understanding of role differences by analyzing the broad context of social service delivery patterns in Los Angeles County. We find important differences. Faith-based organizations are much more concentrated in their service offerings than their secular counterparts. However, they play an important role through their emphasis on transitional assistance, their multi-service orientation, and their reliance on interventions that utilize their unique strengths. Secular nonprofit and public providers, in contrast, offer a much more comprehensive set of services. The results suggest that faith-based organizations have a modest and focused role in social service delivery, but one that is complementary to the efforts of secular providers.
The emergency department and victims of sexual violence: an assessment of preparedness to help.
Plichta SB, Vandecar-Burdin T, Odor RK … +2 more , Reams S, Zhang Y
J Health Hum Serv Adm · 2006 · PMID 17571470
The Emergency Department (ED) is a key source of care for victims of sexual violence but there is little information available about the extent to which EDs are prepared to provide this care. This study examines the stru...
The Emergency Department (ED) is a key source of care for victims of sexual violence but there is little information available about the extent to which EDs are prepared to provide this care. This study examines the structural and process factors that the ED has in place to assist victims. A survey of all 82 publicly accessible EDs in the Commonwealth of Virginia was conducted (RR 76%). In general, the EDs provide the recommended medical care to victims. However, at least half do not have the needed resources in place to effectively assist victims and most (80%) do not provide regular training to their medical staff about sexual violence. Further, almost one-quarter do not have a relationship with a local rape crisis center. It is recommended that each ED partner with local rape crisis centers to provide training to their staff and to ensure continuity of support for victims. It is also suggested that the state government explore ways in which a forensic (SANE) nurse be made available to every victim of sexual violence that presents to the ED for medical assistance. Ideally, each ED would become part of a community-wide Sexual Assault Response Team (SART) in order to provide comprehensive care to victims and thorough evidence collection and information to law enforcement.
Exploring assumptions about child neglect in relation to the broader field of child maltreatment.
Polonko KA
J Health Hum Serv Adm · 2006 · PMID 17571469
Research on child neglect is reviewed as it relates to common assumptions in the field, the broader context of research on child maltreatment and trends within the larger society. Overall, while child Research on child n...
Research on child neglect is reviewed as it relates to common assumptions in the field, the broader context of research on child maltreatment and trends within the larger society. Overall, while child Research on child neglect is reviewed as it relates to common assumptions in the field, the broader context of research on child maltreatment and trends within the larger society. Overall, while child neglect is the type of maltreatment most frequently reported to and acted on by official agencies, its proportion of all maltreatment in the general population is comparatively smaller. The issue.of "neglect of neglect" is placed within the larger framework of the low priority of research on child maltreatment in general. While research shows that all forms of child maltreatment are associated with devastating consequences for children, child physical neglect has the most profound effects on cognitive functioning and academic achievement, while child physical abuse has the most serious effects on aggression and subsequent violent behavior. Child emotional neglect, sexual and physical abuse have similarly grave effects on psychopathology, in contrast to child physical neglect which is associated with the least adverse consequences. These findings are discussed within the framework of research on the neurodevelopmental effects of child abuse and neglect. Research on the causes of child neglect, in particular as they relate to the perpetrators, points to a distressing "cycle of neglect." Finally, suggestions for breaking this cycle and keeping our children safe are discussed.
Restructuring the multi-professional organization: professional identity and adjustment to change in a public hospital.
Callan VJ, Gallois C, Mayhew MG … +3 more , Grice TA, Tluchowska M, Boyce R
J Health Hum Serv Adm · 2007 · PMID 17571468
The present study explored the multiple identities held by health professionals in a large public hospital that was experiencing organizational change that involved the transition from the traditional use of professional...
The present study explored the multiple identities held by health professionals in a large public hospital that was experiencing organizational change that involved the transition from the traditional use of professional hierarchies to the use of new clinical teams. Consistent with predictions from social identity theory and research, the results of an organization-wide survey (N = 615) reveal the protective role of identification with professional departments during change that threatened group status. Professional departments were the preferred target of identification of employees, and employees who preferred this target reported a stronger sense of identification. Also consistent with our predictions, employees who were members of higher status groups reported greater job satisfaction, higher levels of openness to organizational change, and reduced levels of change-related uncertainty. These results were more pronounced for employees who identified with their professional department. Implications for managing multiple identities during organizational transition are discussed.
Is fun for everyone? Personality differences in healthcare providers' attitudes toward fun.
Karl KA, Peluchette JV, Harland L
J Health Hum Serv Adm · 2007 · PMID 17571467
This study examines the role of personality (the Big Five dimensions) in attitudes towards fun and levels of experienced fun in the healthcare environment. Our results show that extraversion and agreeableness were positi...
This study examines the role of personality (the Big Five dimensions) in attitudes towards fun and levels of experienced fun in the healthcare environment. Our results show that extraversion and agreeableness were positively related to attitudes toward fun. Extraversion and emotional stability (low neuroticism) were positively related to the level of experienced fun. In general, our sample expressed positive attitudes regarding the appropriateness, salience, and consequences of having fun at work. Additionally, those who reported experiencing greater levels of workplace fun had significantly lower emotional exhaustion and emotional dissonance, as well as higher job satisfaction. Implications for healthcare institutions are discussed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe