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1.
Infection ; 2022 Sep 27.
Article in English | MEDLINE | ID: covidwho-2048641

ABSTRACT

INTRODUCTION: Objectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A/B/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia/gonorrhea and syphilis infections were assessed. METHODS: Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019-12/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs). RESULTS: 4620 PrEP users were included: 99.2% male, median age 38 years (IQR 32-45), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451 days (IQR 357-488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078/100py (95% CI 0.029-0.208). For two, suboptimal adherence was reported and in the third case, suboptimal adherence and resistance to emtricitabine were observed. One infection was likely acquired before PrEP start. Incidence rates were 21.6/100py for chlamydia, 23.7/100py for gonorrhea, 10.1/100py for syphilis and 55.4/100py for any STI and decreased significantly during the observation period. 65.5% of syphilis, 55.6% of chlamydia and 50.1% of gonorrhea cases were detected by screening of asymptomatic individuals. In a multivariable analysis among MSM younger age, PrEP start before health insurance coverage and daily PrEP were associated with greater risk for chlamydia/gonorrhea. Symptom triggered testing and a history of STI were associated with a higher risk for chlamydia/gonorrhea and syphilis. A significantly lower risk for chlamydia/gonorrhea and syphilis was found for observations during the COVID-19 pandemic period. CONCLUSIONS: We found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV infection and decreasing incidence rates of STIs were found in this cohort of PrEP users. The results were influenced by the SARS-CoV-2 pandemic. Rollout of PrEP covered by health insurance should be continued to prevent HIV infections. Increased PrEP availability to people at risk of HIV infection through the elimination of barriers requires further attention. Investigation and monitoring with a longer follow-up would be of value.

2.
Journal of Corporation Law ; 47(3):817-841, 2022.
Article in English | ProQuest Central | ID: covidwho-2046444

ABSTRACT

[...]this Note supports the use of a co/reinsurance policy that protects insurers and insured businesses alike. A. The Current State of the COVID-19 Crisis At the time of writing, the impacts and effects of COVID-19 are ongoing.6 However, the pandemic's effects on New York, particularly New York City (NYC), cannot be overstated.7 While the impacts of COVID-19 are diffuse and variable, almost every effect arising from this pandemic implicates the insurance industry in one way or another, and early estimates indicate insurance claims will total in the billions of dollars.8 In an effort to shore up costs for businesses and the resulting employment impacts of the pandemic, the United States Federal Government (USFG) passed the $2.2 trillion Coronavirus Aid, Relief, and Economic Security Act (CARES Act).9 While the CARES Act did not explicitly target the insurance industry for relief, additional pieces of legislation were introduced that could have impacted the industry early on.10 At the state level, Governor Cuomo officially declared a Disaster Emergency in New York on March 7, 2020.11 As of December 2020, there have been 87 continuations and amendments to the declared Disaster Emergency.12 Of the various measures Governor Cuomo enacted, the most significant for the present study are the non-essential business closure and stay-at-home orders, which ordered many business closures and obliged the population to avoid leaving their homes.13 By September 2020, New York had already seen 6,000 businesses close and a 40% increase in bankruptcy filings.14 In May 2020, Governor Cuomo announced a phased reopening scheme, New York Forward, in which restrictions were linked to local infection rates.15 As New York and the rest of the country began to emerge from what has been the worst of the pandemic so far, hundreds of businesses looked to their insurance policies to mitigate their losses, many insurance companies rejected their claims, and litigation ensued.16 New York courts construe insurance coverage for business losses stringently, and the U.S. District Court for the Southern District of New York has already rejected a business policyholder's request for an injunction, pending the lawsuit result, that would require the insurer to pay most of the amount claimed.17 While the suits are just beginning, the insurance industry will likely see changes of the scale it has not seen since the 9/11 terrorist attacks.18 Estimates put the total national cost of 9/11 between $50 and $100 billion.19 By contrast, the COVID-19 pandemic is estimated to cost the nation tens of trillions of dollars.20 To understand where the legal environment is headed, it is first necessary to understand the current legal environment surrounding BI insurance in New York. "22 Typically, BI is not a separate insurance policy, but rather BI is a supplemental endorsement to a policyholder's property insurance.23 Unlike standard general liability insurance policies, BI supplements do not have standardized language and often contain language that is unique to the specific insurer and industry.24 As a part of commercial property insurance, BI is offered either as an all-risk policy or a named-perils policy.25 Under an all-risk policy, the policyholder may recover for all losses resulting from any cause barring their express exclusion in the policy.26 Alternatively, a named-peril policy only covers a policyholder's losses for specific causes of loss expressly named in the policy.27 Although BI contains the word "interruption," more often than not, the interruption must precipitate from actual property damage or loss.28 1. The second element, loss of covered property, refers to physical losses of, or damage to, commercial or personal property within or touching commercial real estate listed in the policy.35 This element typically addresses what commercial or personal "property" is covered by the terms of the policy, as property is increasingly digital or otherwise intangible by its nature.36 Barring indeterminate language or language to the contrary, New York typically requires physical property damage.37 This element will be of particular importance, as many all-risk policies explicitly exclude viral or bacterial causes of loss, many named peril policies do not name pandemics, and in any event, physical damage may be difficult if not impossible to prove for COVID-19-related business losses.38 While causal links between each element are a requirement, the third element most expressly requires causal analysis to prove the cause of the covered property loss results in an interruption of business.39 Beyond the issue of proving the causal relationship between the damaged and/or lost property and interruption of business, policyholders will frequently be required to prove that the level of interruption experienced rises to the level described by the policy's language.40 As a result, BI can come off as a misnomer because business is

3.
Academy of Marketing Studies Journal ; 26(S3), 2022.
Article in English | ProQuest Central | ID: covidwho-2045182

ABSTRACT

In the economic development of a nation, banks occupy an important place. Commercial banks as financial institutions have also emerged as significant sources of funds to industry by virtue of which they constitute an important element of the institutional structure of the capital market in India. Banks assist the establishment and development of well-economic infrastructure for better living standards and are a good source for the procurement of credit to vulnerable groups. They initiated varied financial products and services for inclusive growth at affordable costs. The main purpose of the study is to identify the specific role played by commercial banks in India for achieving financial inclusion. In this research, Firstly, the authors will talk about the significance of financial inclusion in detail;later, the focal point is on the initiatives and role of commercial banks to achieve financial inclusion. The study is based on a systematic review of the literature. The researchers have reviewed the literature of the last decade to realize the financial inclusion growth through the banks. A longitudinal manner literature review has been carried out. The findings of this review paper suggested that various significant contributions rendered by the Indian banking sector towards inclusive growth and to the unbanked populace are Bank branch penetration, Setting up of BC/BF outlets to a large extent, no-frill accounts opening with nil or no balance, Expansion of ATM density in rural and semi-rural areas, Rendering flexible credit facility to MSMEs, SHGs and Villagers to make them economically strong, the introduction of technology-based initiatives such as online banking, Mobile banking, telebanking, Kiosks, and smart cards, simplified KYC norms, distributing General credit cards and Kisan credit cards, and enhancing the financial literacy among the public. The study also concentrates on the performance of banks for financial inclusion before and after the adoption of ICT technology in India.

4.
Journal of Risk and Financial Management ; 15(8):333, 2022.
Article in English | ProQuest Central | ID: covidwho-2023839

ABSTRACT

With the increased availability of community care to veterans from the VA MISSION Act, policymakers and providers need to understand how older veterans are insured, particularly before Medicare eligibility at age 65. Using data from 1996 to 2018, this study examines the insurance patterns of veterans prior to the expansion of access to community care through the VA and compares those patterns to nonveterans. This study finds that veterans are more likely to have insurance than nonveterans and that they are less likely to rely on Medicaid and Medicare before age 65. Regression estimates also suggest that veterans with at least some college education are less likely to have private insurance and are more likely to be uninsured than nonveterans with the same educational attainment.

5.
Oncology Times ; 44(15):26-26, 2022.
Article in English | CINAHL | ID: covidwho-2018113
6.
Applied Radiology ; 51(5):14-17, 2022.
Article in English | CINAHL | ID: covidwho-2011190
7.
Cancer ; 128(20): 3727-3733, 2022 10.
Article in English | MEDLINE | ID: covidwho-1999841

ABSTRACT

BACKGROUND: Cancer survivors represent a population with high health care needs. If and how cancer survivors were affected by the first year of the coronavirus disease 2019 (COVID-19) pandemic are largely unknown. METHODS: Using data from the nationwide, population-based Behavioral Risk Factor Surveillance System (2017-2020), the authors investigated changes in health-related measures during the COVID-19 pandemic among cancer survivors and compared them with changes among adults without a cancer history in the United States. Sociodemographic and health-related measures such as insurance coverage, employment status, health behaviors, and health status were self-reported. Adjusted prevalence ratios of health-related measures in 2020 versus 2017-2019 were calculated with multivariable logistic regressions and stratified by age group (18-64 vs. ≥65 years). RESULTS: Among adults aged 18-64 years, the uninsured rate did not change significantly in 2020 despite increases in unemployment. The prevalence of unhealthy behaviors, such as insufficient sleep and smoking, decreased in 2020, and self-rated health improved, regardless of cancer history. Notably, declines in smoking were larger among cancer survivors than nonelderly adults without a cancer history. Few changes were observed for adults aged ≥65 years. CONCLUSIONS: Further research is needed to confirm the observed positive health behavior and health changes and to investigate the role of potential mechanisms, such as the national and regional policy responses to the pandemic regarding insurance coverage, unemployment benefits, and financial assistance. As polices related to the public health emergency expire, ongoing monitoring of longer term effects of the pandemic on cancer survivorship is warranted.


Subject(s)
COVID-19 , Cancer Survivors , Neoplasms , Adult , COVID-19/epidemiology , Humans , Insurance Coverage , Insurance, Health , Neoplasms/epidemiology , Pandemics , Self Report , United States/epidemiology
8.
American Journal of Pharmaceutical Education ; 86(5):372-373, 2022.
Article in English | ProQuest Central | ID: covidwho-1980297

ABSTRACT

During her time as Executive Vice President and CEO of AACP, the Journal has made major advances thanks in large partto Dr. Maine's enthusiastic, compassionate, and visionary leadership. [...]of Dr. Maine's passion for advancing pharmacy education globally, the Journal appointed its first international associate editor in 2008. In the last 20 years, her contributions included topics ranging from Medicare and prescription coverage to the importance of science in schools and colleges of pharmacy, to lessons learned about the power of collaboration during the COVID-19 pandemic, to pharmacists' roles and responsibilities in confronting systemic racism.3-7 The past and current AJPE editors, associate editors, editorial board members, authors, and reviewers have all benefited from Dr. Maine's commitment to ensure the continued success of the Journal.

9.
Journal of Financial Counseling and Planning ; 33(2):228-242, 2022.
Article in English | ProQuest Central | ID: covidwho-1933445

ABSTRACT

In this article, we projected household financial vulnerability in the COVID-19 pandemic. Using a nationally representative sample of households from the 2017 Panel Study of Income Dynamics (PSID), we analyzed potential changes in financial status in the pandemic resulting from loss of income and savings from discretionary consumption. We provided a ranking of household groups by their financial vulnerability and the first estimate of the number of households at various degrees of financial vulnerability. Our study showed that a substantial part of the universal stimulus payments was made to households that had sufficient income to cover basic needs and those saved by reducing discretionary expenses. For the most financially vulnerable, the first one-time stimulus payment was too little and too late to help with their financial difficulties. Our findings shed light on to whom and in what form the US government should direct financial assistance during the pandemic.

10.
Obes Surg ; 32(9): 2994-3004, 2022 09.
Article in English | MEDLINE | ID: covidwho-1914009

ABSTRACT

BACKGROUND: On November 25, 2021, the IFSO-Asia-Pacific Chapter (IFSO-APC) Virtual Meeting 2021 was held online, and the representatives from the Asia-Pacific region presented 10 years of change in bariatric/metabolic surgery and the influence of COVID-19 in the special session of "IFSO-APC National Reports 2010-2020". We herein report the summarized data. METHODS: National bariatric/metabolic surgery data, which included the data of 2010 and 2020, were collected from the representatives using a questionnaire that consisted of 10 general questions. At the congress, the data were calculated and summarized. RESULTS: Thirteen of the 14 national societies responded to the survey. From 2010 to recent years, the populations of individuals with obesity (BMI ≥ 30 kg/m2) and individuals with diabetes both significantly increased. Eight countries and regions expanded the lower limit of criteria for bariatric surgery by 2-5 kg/m2 (BMI), and 5 countries newly established criteria for metabolic surgery in the last ten years. Sixty-nine percent of the countries currently run public health insurance systems, which doubled from 2010. The number of bariatric surgeons and institutions increased more than threefold from 2010. In 2010, 2019, and 2020, surgeons in IFSO-APC societies performed 18,280, 66,010, and 49,553 bariatric/metabolic surgeries, respectively. Due to the COVID pandemic, restriction policies significantly reduced access to surgery in South and Southeast Asian countries. The biggest changes included increased numbers of bariatric surgeons and institutions, operation numbers, public insurance coverage, raising awareness, and national registry systems. CONCLUSION: For the last 10 years, bariatric/metabolic surgery has rapidly grown in the Asia-Pacific region.


Subject(s)
Bariatric Surgery , Bariatrics , COVID-19 , Obesity, Morbid , Asia/epidemiology , COVID-19/epidemiology , Humans , Obesity, Morbid/surgery , Pandemics
11.
Generations Journal ; 45(2):1-12, 2021.
Article in English | ProQuest Central | ID: covidwho-1871952

ABSTRACT

Under Medicare, older Americans have access to government-subsidized health insurance to protect them from catastrophic healthcare costs and ensure access to needed care. And yet, one in ten Medicare beneficiaries report delaying care due to cost, and 6 percent report having problems paying medical bills. The health and economic impacts of the coronavirus pandemic have exacerbated issues of healthcare affordability for older adults, particularly those with low incomes. This article reviews the financial impact of gaps in the Medicare program, and proposals designed to meet Medicare beneficiaries' evolving needs.

12.
Healthcare ; 10(5):771, 2022.
Article in English | ProQuest Central | ID: covidwho-1871875

ABSTRACT

Background: To predict areas with a high concentration of long-term uninsured (LTU) and Emergency Department (ED) usage by uninsured patients in South Carolina. Methods: American Community Survey data was used to predict the concentration of LTU at the ZIP Code Tabulation Area (ZCTA) level. In a multivariate regression model, the LTU concentration was then modeled to predict ED visits by uninsured patients. ED data came from the restricted South Carolina Patient Encounter data with patients’ billing zip codes. A simulation was conducted to predict changes in the ED visit numbers and rates by uninsured patients if the LTU concentration was reduced to a lower level. Results: Overall, there was a positive relationship between ED visit rates by the uninsured patients and areas with higher concentrations of LTU. Our simulation model predicted that if the LTU concentration for each ZCTA was reduced to the lowest quintile, the ED visit rates by the uninsured would decrease significantly. The greatest reduction in the number of ED visits by the uninsured over a two-year period was for the following primary diagnoses: abdominal pain (15,751 visits), cellulitis and abscess (11,260 visits) and diseases for the teeth and supporting structures (10,525 visits). Conclusions: The provision of primary healthcare services to the LTU could help cut back inappropriate uses of ED resources and healthcare costs.

13.
Risks ; 10(5):97, 2022.
Article in English | ProQuest Central | ID: covidwho-1871733

ABSTRACT

A lapsed policy is an insurance policy that has become inactive due to non-payment of premiums. The word “lapse” is an insurance topic that constantly evolves, proven by the recent increase in publications on this topic. The study explores the life insurance lapse decision through a comprehensive bibliometric analysis throughout the years, concentrating on publication trends;co-authorship networks among countries, authors, and scientific journals;and the field’s evolution. The research is based on the Scopus database. Ultimately, 178 documents were retrieved and analysed, demonstrating increased literature on insurance lapse from 1971 to 2021. The authors’ keyword co-occurrence network was also analysed for possible future directions of the field. Journals originating from the United Kingdom dominate the publication on life insurance lapsation. In contrast, an author from the United States is at the first rank in terms of the co-authorship network’s total link strength. The results may help researchers define the research objective and determine the aspects of the life insurance lapse for future research.

14.
Healthcare ; 10(5):915, 2022.
Article in English | ProQuest Central | ID: covidwho-1870629

ABSTRACT

Metropolitan Haifa, Israel, has three hospitals: Rambam Health Care Campus, Bnai Zion Medical Center, and Carmel Medical Center. In 2007–2014, the length of stay at RHCC’s emergency department increased, while the number of visits decreased. We ask whether the increase in LOS is associated with the falling numbers of visits to other EDs, whether an increase in LOS induces more referrals to competing hospitals in the metropolitan area, and whether it pays to be a crowded ED in mitigating moral hazard. Average LOS at Rambam climbed from 3.5 h in 2000–2007 to 6.4 in 2008–2018. While the number of visits to Rambam decreased significantly, those to Bnai Zion increased significantly and quite linearly. A one-way ANOVA test reveals a statistically significant difference among the three hospitals. In addition, Rambam was significantly different from Carmel but not from Bnai Zion. When LOS stabilized at Rambam from 2016 to 2018 and increased at Bnai Zion, referrals to Rambam went up again. Policymakers should instruct all hospitals to publish LOS data, regulate referrals to EDs, and find an optimal LOS that will reduce competition, non-urgent visits, and moral hazard.

15.
EuroMed Journal of Business ; 17(2):193-217, 2022.
Article in English | ProQuest Central | ID: covidwho-1853335

ABSTRACT

Purpose>In this paper, the authors assess the responsiveness of OOP healthcare expenditure to macro-fiscal factors, as well as to tax-based, SHI, mixed systems and voluntary PHI financing. Although the relationship between OOP expenditure, macroeconomy, aggregate public and PHI financing is well documented in the existing empirical literature, little is known for the impact of several macro-fiscal drivers and the existing health financing arrangements associated with voluntary PHI on OOP expenditure.Design/methodology/approach>The authors gather panel data by applying three official organizations’ databases. They elaborate static and dynamic panel data methodology to a dataset of 49 European and OECD countries from 2000 to 2015.Findings>The authors’ findings do not indicate a considerable impact of GDP growth and general government debt as a share of GDP on OOP payments. Unemployment rate presents as a positive driver of OOP payments in all three compulsory national health systems post to the 2008 economic crisis. OOP payments are significantly influenced by countries’ fiscal capacity to increase general government expenditure to GDP in SHI and mixed health systems. Additionally, study findings present that government health financing, irrespective of the different health systems structure characteristics, and OOP healthcare payments follow different directions. Voluntary PHI financing considerably counteracts OOP payments only in tax-based health systems.Practical implications>In the backdrop of a new economic crisis associated to the COVID-19 epidemic, health policy planners have to deal with the emerging unprecedented challenges in financing of health systems, especially for these economies that have to face the fiscal capacity constraints owing to the 2008 financial crisis and its severe recession.Originality/value>To the best of authors’ knowledge, there is no empirical consensus on the effects of macro-fiscal parameters, different compulsory health systems financing associated with the parallel voluntary PHI institution funding on OOP expenditure, for the majority of European and OECD settings.

16.
Nature ; 582(7812):321-323, 2020.
Article in English | ProQuest Central | ID: covidwho-1830010

ABSTRACT

Four emerge as very strong contenders: those of Germany, the Netherlands, Norway and Taiwan, each with laudable features such "Which country has the worst health care?" as broad choice, excellent coordination of long-term care and affordability. (Regarding universal coverage, Taiwan's system is similar to the United Kingdom's, with care paid for by a single public authority, and mandatory public health insurance;Norway uses a single-payer model with limited private insurance;and Germany and the Netherlands have universal coverage with mandatory basic private insurance.) It is noteworthy that the same four have so far been among the most successful in managing COVID-19. When I led a review in 2018-19 to help the UK National Health Service to plan its future workforce and directions, I learnt that it has a body, Health Education England, sible for education and training, that helps the service to adapt to major changes such as incorporating genomics, digital medicine and artificial intelligence into daily medical practice.

17.
Front Public Health ; 10: 738146, 2022.
Article in English | MEDLINE | ID: covidwho-1775967

ABSTRACT

China has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008-2018) data from Jiangsu province. Ordinary least squares and binary multivariate logistic regression of pooled cross-sectional data were carried out to evaluate the effect of universal health insurance coverage and other socioeconomic factors on the economic burden of disease. Total health expenses (THE) first increased and then decreased during the survey period while out-of-pocket health expenses (OOP) decreased except for urban residents, for whom OOP increased after 2013. Household catastrophic health expenditure (HCHE) was stable between 2008 and 2013 but increased after 2013. Social health insurance had a significant positive effect on the annual THE and OOP and a negative effect on HCHE, however, universal health insurance coverage could alleviated THE and the economic burden of disease on individuals (OOP) while it was insufficient to protect against the economic risk of diseases (HCHE), with greater benefits for urban as compared to rural residents. Other socioeconomic factors including age, marital status, education, income, and health status also influenced the economic burden of disease.


Subject(s)
State Medicine , China/epidemiology , Cost of Illness , Cross-Sectional Studies , Humans , Universal Health Insurance
18.
hfm (Healthcare Financial Management) ; 76(2):16-19, 2022.
Article in English | CINAHL | ID: covidwho-1762552

ABSTRACT

The article focuses on Strategies to provide care access and maximize reimbursement. Topics discussed include Efforts focus on eligibility, patient advocacy and finding alternative reimbursement sources to increase recovery, with many seeking help from a revenue cycle partner;and the Healthcare Financial Management Association (HFMA) conducted a survey at its 2021 Annual Conference.

19.
J Ment Health Policy Econ ; 25(1):21-34, 2022.
Article in English | PubMed | ID: covidwho-1749581

ABSTRACT

BACKGROUND: Uncertainty around economic recovery from a pandemic, in addition to restrictions on mobility and socializing, can be isolating and stressful. While preventive measures, such as mask mandates, are expected to mitigate spread of the disease and lower concerns of future job loss, state- and local-level mandates could signal that infection rates are worse in the mandated areas and decrease consumer confidence and mobility. Thus, the association between mask mandates and psychological well-being is unclear. AIMS OF THE STUDY: Twenty-five states in the United States implemented statewide mask mandates early in the pandemic. This study seeks to examine the effect of mask mandates on self-reported job loss expectation and mental health. METHODS: This study analyzes U.S. Census Bureau's Household Pulse Survey data, collected between April 23rd and July 21st, 2020. Using a panel subset of the data, fixed effects models are estimated to understand statewide mask mandate's effect on psychological well-being over a twelve-week period while controlling for individual-level unobserved heterogeneity. All data are then state-aggregated, and fixed effects models are estimated to examine average differences in job loss expectation and mental health between mandate and non-mandate states. RESULTS: In the individual-level panel data, job loss expectation was lower by 1.1 percentage point by the second week of a statewide mask mandate and by 1.6 percentage point by the third week, compared to average job loss expectation in states without a mask mandate and to the mandate states before the policy implementation. Average job loss expectation was 6.5 percentage point lower by the twelfth week in the five states that were the first to implement statewide mask mandates. Mental health status improved steadily from the fourth week on in states with a mask mandate. Analysis of state-aggregated data indicates considerable variability and lack of uniformity in mask mandates' impact on job loss expectation and mental health status. DISCUSSION: Local-level mandates, such as those at the county-level, could not be identified in these data. The impact of a mask mandate could be underestimated when only state-level mandates are considered, and local regulations are excluded. This is a limitation of this study. IMPLICATIONS FOR HEALTH CARE PROVISION: The staggered state-by-state approach to implementing mask mandates and the considerable variability in enforcement of mask rules has possibly contributed to lack of uniformity and consistency in how mask mandates impact subjective psychological well-being. IMPLICATIONS FOR HEALTH POLICIES: The lack of statistically significant impact of statewide mask mandates on the two outcome variables in the state-aggregated data, and on long-run job loss expectation in the individual-level panel data, could be indicative of the complexities of effective science communication regarding behavioral recommendations to promote overall well-being. IMPLICATIONS FOR FURTHER RESEARCH: Multiple variants of SARS-CoV-2, the virus that causes COVID-19, has emerged around the world. Further research could more clearly assess the degree to which communicating public health implications of these variants has evolved, and whether it has elicited behavior change and affected psychological well-being.

20.
Health Serv Res ; 57 Suppl 1: 111-121, 2022 06.
Article in English | MEDLINE | ID: covidwho-1731059

ABSTRACT

OBJECTIVE: To assess and address through policy change the health-care needs of immigrant populations in Colorado. DATA SOURCES: Primary data were collected in two Colorado communities from June 2019 through December 2020. STUDY DESIGN: This work utilized a mixed-method, community power building approach to determine and meet health-care needs of immigrants, a marginalized population of mixed documentation status. Findings were then used to inform Emergency Medicaid (EM) expansion in Colorado. DATA COLLECTION: In-depth interviews were conducted in Spanish, English, and Somali with 47 immigrants in rural Morgan County in June-September 2019; findings were presented to the community for feedback in January-February 2020. In March-December 2020, 330 interviews were conducted in Spanish and English with 208 unique individuals in Morgan and Pueblo Counties by local community grassroots leaders via four rounds of a novel phone tree outreach method. Interviewees were identified through snowball sampling and direct outreach among individuals seeking immediate relief (i.e., food assistance). PRINCIPAL FINDINGS: Interviewees reported numerous barriers to health-care access, including discrimination and limited service hours and transportation options. Data also revealed a clear health insurance coverage gap among undocumented immigrants. These data were then presented to Colorado's Department of Health-Care Policy and Financing, ultimately contributing to securing EM expansion to this population to include COVID treatment, including respiratory therapies and outpatient follow-up appointments. Data-informed continued implementation advocacy to ensure the effectiveness of EM program expansion. CONCLUSIONS: Immigrants are particularly marginalized by the health-care system. Rapid data collection grounded in a community power-building approach produced data that directly informed state policy and an increased power base. This approach enables direct connection to immediate "downstream" needs in communities while simultaneously building collective systemic "upstream" analysis and capacity of community members and laying pathways to translation and implementation of research into policy.


Subject(s)
COVID-19 , Emigrants and Immigrants , Colorado , Health Services Accessibility , Humans , Medicaid , United States
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