Note from the Editor
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Note from the Editor
As we move ahead into the brave new world of 2017 and beyond, we seek to advance the well-being of underserved populations by establishing the effectiveness of strategies for advancing health equity, baseline health studies in developing countries, and underserved patient perspectives on their health needs. Brief summaries of the papers in this issue appear below.
A supplement Guest Edited by Dr. Lorece Edwards (Morgan State University) and Dr. Ronald Braithwaite (Morehouse School of Medicine) and supported by the Substance Abuse and Mental Health Administration (SAMHSA) accompanies the regular issue. The supplement explores the connections among substance use and HIV-risk, particularly among students at minority-serving institutions. We are proud to be the forum for this important work. Citation: JHCPU 28.2 Suppl May 2017.
Part 1: What Works? Achieving Health Equity
In the summaries below, I have italicized the paper's answer to the question of how to advance the goal of health equity (editor's italics added).
Mattingly and colleagues argue in their commentary on hepatitis C treatment for the United States to revisit drug patent laws and other means that the federal government might employ to reduce the extremely high costs of the new direct-acting anti-viral agents that may provide a cure, and thus reduce the need for liver transplants.
Getrich's team conducted a qualitative study to describe the early ACA enrollment experiences of a range of health care providers in six immigrant-serving safety-net clinics in New Mexico. The authors emphasize the evident importance of using and funding concerted strategies for future enrollment of immigrant patients, such as featuring community health workers and leveraging trust for outreach.
Rosati and colleagues, studying rates of referral for diabetic retinopathy at a clinic in Spartanburg, South Carolina, underscore the importance of a standardized method to screen for retinopathy in the clinic.
Gibson and colleagues analyzed use of a long-serving mobile medical clinic (MMC) in New Haven, Connecticut. Patients being treated for opioid addiction were the most frequent users of the van; being foreign-born, injection drug use, and hypertension were also associated with increased use of the MMC. The authors conclude that, even as the ACA results in more Americans having health insurance, "MMCs will continue their role in assisting entry into continuous health care and offering low-threshold acute care for urban vulnerable populations."
Gunn and colleagues asked what patient navigator activities were associated with more timely diagnoses, conducting a controlled study. They conclude, "Content analysis revealed service provision directed at specific patients improved care while systems-focused activities did not." [End Page vii]
Haley and colleagues assessed strategies for improving population health—where that is understood as health outcomes for groups of individuals, and the distribution of outcomes within groups—across New York State community health centers (73% response rate). The authors conclude that "widespread improvements in population health may remain limited without an increase in dedicated funding to support community-based prevention strategies."
Wahle and colleagues analyzed data from hypertensive patients receiving care at an inter-professional student-run free clinic, which is open one day a week and is based in a high-poverty area of Indianapolis. Despite the challenge of extra risk factors in the population treated, the authors report that "records for patients with hypertension who used IUSOC as a regular provider of primary care compared favorably with national data."
Part 2: Epidemiology and Baseline Health in Developing Countries
Two of the three papers in this part are set in Nigeria, and both concern people with schizophrenia.
Afe and colleagues studied characteristics associated with intimate partner violence in women with schizophrenia in southern Nigeria.
Ezeme and colleagues aimed to identify clinical variables associated with response in patients with schizophrenia, and report that medication adherence, the presence or absence of associated conditions in the individual, and duration of untreated psychosis were all associated with the effectiveness of the medication regimen.
The third paper in this part, by Pettit and colleagues, is a needs assessment of three different communities in central Haiti. The greatest needs included clean water, sanitation, and health care, as well as education.
