Note from the Editor

25 years of JHCPU

Let the trumpets sound! 25 years ago, the Journal of Health Care for the Poor and Underserved published its first issue, and the Journal has been in continuous publication as a peer-reviewed record of the health of underserved populations in North America and beyond ever since. The brainchild of Dr. David Satcher, then the President of Meharry Medical College (the nation’s oldest historically Black medical school, having been founded in 1876), the Journal has thrived through decades of shifting economic and political winds. This issue opens with a set of essays by people who have played important roles in the history of JHCPU and the cause of social justice as it relates to health.

Accompanying this issue is a special supplement on the implementation of broad sections of the U.S. Patient Protection and Affordable Care Act of 2010 (popularly known as Obamacare and abbreviated as ACA), much of it just happening as this issue goes to press. The supplement delves into the changes associated with health reform in an array of states around the country. Its Guest Editors are Dr. Claudia Baquet of the University Of Maryland School of Medicine and The Honorable Thomas (“Mac”) Middleton, Chairman of the Maryland State Senate Finance Committee. The supplement includes a tribute to Dr. Satcher as well as his Preface.

Federal Health Reform

The regular issue of the Journal also includes a section on health reform in the United States, as seems inevitable given the historic and rapidly evolving nature of this reform in the present decade. Block and colleagues write about the importance of building primary care capacity in the U.S., a need made much more pressing given the expanded coverage under the ACA. Another team, led by Nicole Jepeal, writes about the need to educate community health care workers about health reform in order to foster engagement in safety-net settings.

Two additional Commentaries appear in this section. The first, by Chen, Weider, Konopka, and Danis digs into the important provision regarding meaningful use of electronic health records in federal legislation. The authors examine the use of socioeconomic status (SES) indicators in an array of research and policy documents, and argue that adding an income question is the best choice for reflecting SES in electronic health records. Finally, Shah, Heisler, and Davis take up the challenge laid down by Jepeal to integrate community health workers substantively in health care teams in safety-net settings. They identify four specific opportunities for doing this in the context of the ACA.

Schiefelbein and colleagues look into the use of health information exchange data to estimate the risk of emergency department or inpatient visits by vulnerable patients. These groups were at increased risk: homeless, disabled, and severe behavioral health patients were all at risk of increased ED use; behavioral health, near elderly, and disabled patients were at greater risk for inpatient visits. The authors conclude by calling for improved primary care services, for mental as well as physical health, to improve the functioning of the health care system, progress made more likely by the ACA.

International Health and Immigrant Health

Poverty blindness is a phrase coined by William Ventres (of the University of El Salvador) and Geoff Gusoff in their Commentary, reminding us of the need to attend to the fact of poverty in our communities both large and small — unacknowledged, as it often is, poverty will always remain unaddressed. In the international/immigrant section of this issue, we read of populations in the U.S. and other countries, including Trinidad, Malawi, Nigeria, and (especially) Kenya.

A team from the University of Nigeria, Enugu State and others from Ebonyi State led by Obiekwe Okoye report on pediatric ocular trauma and the high incidence of ocular injuries, many from farm work, in a rural area of southeastern Nigeria. Also studying a population in southeastern Nigeria, Paul Odinka and colleagues from the University of Nigeria, Enugu State and others from Benue State and Anambra State report on treatment delay by 367 people with schizophrenia seen at a psychiatric hospital. About 76% of the sample had...