- Note from the Editor
In this, the second issue of JHCPU's 30th anniversary volume, readers will find an array of articles, with special attention paid to American Indians and Alaska Natives, Latinos on the U.S.-Mexico border (including in El Paso) and in Puerto Rico post-Hurricane Maria, and the providers of health care themselves. As always, we also keep a close eye on health policy and on epidemiology (especially as it relates to disparities among sub-populations) and on innovative models of care. As history has demonstrated with the special force of consistency, only when the health and health care issues of underserved populations appear front and center through prominent publications does the wheel turn further towards health justice.
Immediately following this Note, Frierson's column directs our attention to one of the earliest visionaries of health justice for Black Americans, Mrs. Lugenia Burns Hope (1874–1947), whose work creating community service organizations for the benefit of African Americans in her native Chicago, in Atlanta, and elsewhere, established a high bar of achievement for others who followed her. Her achievements and innovations as a social reformer left a blueprint drawn upon by Civil Rights leaders half a century later, the value of which persists to this day.
Frierson's column and the succeeding set of commentaries, reports, and literature review set the stage for our three large thematic sections, each comprising a set of empirical research papers: Health Policy; Epidemiology, Disparities, and Innovative Models of Care; and Health Care Providers across the Professions.
The four papers in this section bear on major contemporary themes in health policy in the U.S. Londhe and colleagues demonstrate that states that expanded Medicaid under the Affordable Care Act (ACA) experienced significantly reduced food insecurity in their populations during the succeeding months and years. Rosales and Calvo's research on Latino-serving mental health organizations also indirectly supports the ACA in that the ACA's envisioned expansion of community health centers would shore up the viability of the places (community health centers) where most Latinos seeking mental health care find it. Tapales and colleagues contribute to our understanding of immigrant health, specifically by identifying the best sources of information on the sexual and reproductive health of immigrants. Finally, Verevkina and colleagues focus on residents of four states in Appalachia, centering on colorectal cancer patients and their hospital choices—this paper is of special interest for those concerned with rural health. [End Page ix]
Epidemiology, Disparities, and Innovative Models of Care
What new information do this issue's papers in the area of epidemiology tell us? First, the very most common type of pancreatic cancer (pancreatic adenocarcinoma) affects Native Americans in New Mexico even more adversely than it affects non-Hispanic Whites and Hispanics: Native American patients (NAs) in the study conducted by Greenbaum et al. were offered chemotherapy less often than non-Hispanic White (nHWs) or Hispanic patients (Hs); a greater proportion of NAs than nHWs died within a month of diagnosis (25.8% vs. 7.5%); the proportion of NAs who survived for a year after diagnosis (26.2%) was barely more than half the proportion of nHWs (48.3%) who survived that long.
Johansson and colleagues demonstrate the importance and feasibility of adapting an existing cardiovascular disease (CVD) risk intervention to reach urban American Indians at risk for CVD. Zurovac and colleagues—concentrating on a large health care system in the Dakotas and rural Minnesota—demonstrate that patient outcomes improve when primary care practices integrate chronic illness care and behavioral health care (increasing the receipt of four recommended diabetes care processes by 8.6% and slowing the rate of increase of emergency department visits by 4.9%).
Spencer and colleagues, too, conducted research on embedding behavioral health care (in this case, child psychiatry consultation) in a primary care setting. Their patient population was urban and Latino. Their findings demonstrate that such embedding significantly improves engagement in care, and provide initial evidence that such pediatric psychiatric consultation is both feasible and helps to improve access to care. Also concentrating on an urban population (uninsured and underinsured women in New Jersey), Tsui...