Project MUSE®: Journal of Health Care for the Poor and Underserved - Latest Articles
https://muse.jhu.edu/journal/278
Project MUSE®: Latest articles in Journal of Health Care for the Poor and Underserved.daily12026-05-14T00:00:00-05:00text/htmlen-USVol. 1 (1990) through current issueLatest Articles: Journal of Health Care for the Poor and UnderservedTWOProject MUSE®Journal of Health Care for the Poor and Underserved1548-68691049-2089Latest articles in Journal of Health Care for the Poor and Underserved. Feed provided by Project MUSE®Strategic Investment and Systemic Return: Building on 60 Years of the Community Health Center Movement
https://muse.jhu.edu/article/982953
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As the community health center (CHC) movement marks its 60th anniversary, its evolution offers critical lessons in the strategic value of sustained federal, state, and private investment in community-based primary care infrastructure. What began in 1965 as two demonstration projects has become the nation’s largest primary care network, serving more than 34 million patients across 17,000 communities. This column examines how strategic support through national and state-wide organizations has strengthened operations, improved outcomes, and generated measurable returns on investment, positioning CHCs as essential assets within the U.S. health care system.The CHC program emerged in 1965 as a part of national strategy
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallStrategic Investment and Systemic Return: Building on 60 Years of the Community Health Center Movement2026-02-13text/htmlen-USStrategic Investment and Systemic Return: Building on 60 Years of the Community Health Center Movement2026-02-132026TWOProject MUSE®357182026-05-14T00:00:00-05:002026-02-13New Editorial Board and Black History Month
https://muse.jhu.edu/article/982951
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Greetings from ice-bound Nashville! As the new year commences, the Journal announces the formation of a new Editorial Board, with 15 voting and two nonvoting members. Board members have all contributed significantly to the Journal, primarily as reviewers, but also as authors and representatives of our sponsor institution, Meharry Medical College, and two affiliated organizations, the Association of Clinicians for the Underserved (ACU) and the National Association of Community Health Centers (NACHC). The full list of the JHCPU Editorial Board for 2026–2027 is:H. Nelson Aguila, DVM
Acting Director Center to Reduce Cancer Health Disparities
National Cancer Institute
National Institutes of HealthLeah Alexander, PhD
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallNew Editorial Board and Black History Month2026-02-13text/htmlen-USNew Editorial Board and Black History Month2026-02-132026TWOProject MUSE®81352026-05-14T00:00:00-05:002026-02-13A Roadmap for the Health Workforce Revisited: New Recommendations to Ensure the Continuing Impact of the National Health Service Corps
https://muse.jhu.edu/article/982952
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In 2022, the National Health Service Corps (NHSC) celebrated its 50th anniversary. A crucial workforce program offering loan repayment assistance to incentivize clinicians to serve in Health Professional Shortage Areas (HPSAs), the NHSC in 2026 has a 54-year legacy of success in helping to build healthier communities. The scope of the Corps’ impact is both national—nearly 18.9 million patients at more than 8,400 service sites depend on care from 18,000 Corps clinicians in 20251—and personal—as reflected in the powerful testimonies of Corps members and the patients they have cared for.2Four years on from its 50th anniversary, the need for the Corps has grown only more acute, yet its funding has not kept pace with
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallA Roadmap for the Health Workforce Revisited: New Recommendations to Ensure the Continuing Impact of the National Health Service Corps2026-02-13text/htmlen-USA Roadmap for the Health Workforce Revisited: New Recommendations to Ensure the Continuing Impact of the National Health Service Corps2026-02-132026TWOProject MUSE®215612026-05-14T00:00:00-05:002026-02-13The Association between Structural Racism and Infant Mortality: A Systematic Review
https://muse.jhu.edu/article/982954
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Infant mortality—defined as the death of an infant before their first birthday1—is a key indicator of population health, broadly reflecting maternal health, environmental context, and access to health care.2 Although infant mortality rates (IMR) are decreasing globally, they remain high in some countries including the United States (U.S.) where much of this research has been undertaken.3 For example, in 2022 the IMR in the U.S. was 5.6 deaths per 1,000 live births compared with an average 4.0 deaths per 1,000 live births among Organization for Economic Cooperation and Development countries.4 Additionally, infants in some racial groups have higher infant mortality than others. For example, in the U.S. in 2022, the
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallThe Association between Structural Racism and Infant Mortality: A Systematic Review2026-02-13text/htmlen-USThe Association between Structural Racism and Infant Mortality: A Systematic Review2026-02-132026TWOProject MUSE®2066242026-05-14T00:00:00-05:002026-02-13Maternal Serum Hemoglobin Levels Relative to Anemia Interventions in the COVID-19 Era: A Systematic Review and Meta-Analysis
https://muse.jhu.edu/article/982955
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Maternal anemia remains a significant global health issue, particularly in low- and lower-middle-income countries, affecting approximately 37% of pregnant women aged 15–49 years, which is over 30 million worldwide.1 It is linked to adverse maternal and birth outcomes such as premature birth, low birth weight, and maternal mortality.2 Limited access to prenatal care and insufficient resources often hinder effective screening and treatment efforts.3–5The COVID-19 pandemic disrupted maternal health services.6,7 Lockdowns and fears of infection led to missed prenatal visits,8 compounding the risk for pregnant women, who are more susceptible to severe COVID-related symptoms than their non-pregnant counterparts.9Key
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallMaternal Serum Hemoglobin Levels Relative to Anemia Interventions in the COVID-19 Era: A Systematic Review and Meta-Analysis2026-02-13text/htmlen-USMaternal Serum Hemoglobin Levels Relative to Anemia Interventions in the COVID-19 Era: A Systematic Review and Meta-Analysis2026-02-132026TWOProject MUSE®1378972026-05-14T00:00:00-05:002026-02-13Unveiling the Impact: A Scoping Review of the COVID-19 Pandemic’s Effects on Low-Income Populations in Canada
https://muse.jhu.edu/article/982956
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The COVID-19 pandemic posed a public health crisis globally and both highlighted and exacerbated existing social and economic disparities within society. The COVID-19 pandemic and its associated public health restrictions, such as mandated social distancing and the closure of retail establishments, have negatively affected the lives of individuals across various socioeconomic strata.1 Enforced social isolation, the cessation of communal activities, and economic losses have adversely affected health outcomes.2 There were also reports of heightened anxiety, fear, panic, and psychological distress during the pandemic.3,4 While some authors attributed these mental and emotional outcomes to the observed morbidity and
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallUnveiling the Impact: A Scoping Review of the COVID-19 Pandemic’s Effects on Low-Income Populations in Canada2026-02-13text/htmlen-USUnveiling the Impact: A Scoping Review of the COVID-19 Pandemic’s Effects on Low-Income Populations in Canada2026-02-132026TWOProject MUSE®1736522026-05-14T00:00:00-05:002026-02-13The Impact of the COVID-19 Pandemic on Community Health Centers in Canada and the United States: A Scoping Review
https://muse.jhu.edu/article/982957
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Community health centers (CHCs) are essential components of primary care and safety-net systems in the United States and Canada, providing comprehensive, accessible and coordinated community-based primary care for vulnerable people in their communities. They play a critical role in equitably addressing the health needs of diverse communities, particularly underserved, marginalized and racialized groups – with a strong focus on addressing social determinants of health.1–3The roots of CHCs in the U.S. can be traced back to the mid-1960s, in which federally funded “Neighborhood Health Centers” were launched under President Johnson’s War on Poverty.2 The earliest CHC model in Canada is Winnipeg’s Mount Carmel Clinic
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallThe Impact of the COVID-19 Pandemic on Community Health Centers in Canada and the United States: A Scoping Review2026-02-13text/htmlen-USThe Impact of the COVID-19 Pandemic on Community Health Centers in Canada and the United States: A Scoping Review2026-02-132026TWOProject MUSE®2588092026-05-14T00:00:00-05:002026-02-13Examining Associations between COVID-19 Distress, Multilevel Resilience, and HIV Viral Suppression among African American/Black Adults in the Southeastern United States
https://muse.jhu.edu/article/982958
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African American/Black people living with HIV (PLWH) in the Southeastern United States (U.S.) face disparities in HIV outcomes compared with White PLWH, including decreased rates of HIV viral suppression.1 These disparities have been driven by structural and other factors, such as racism, poverty, inconsistent HIV-care funding, and low health literacy, for example.2–4 These are pre-existing burdens that African American/Black PLWH of the Southeastern U.S. carried into the COVID-19 pandemic.5,6COVID-19 increased economic and mental distress across African American/Black communities and disrupted HIV care in the Southeastern U.S.5,7 A lack of resources to cope with these adversities, along with disruptions to HIV
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallExamining Associations between COVID-19 Distress, Multilevel Resilience, and HIV Viral Suppression among African American/Black Adults in the Southeastern United States2026-02-13text/htmlen-USExamining Associations between COVID-19 Distress, Multilevel Resilience, and HIV Viral Suppression among African American/Black Adults in the Southeastern United States2026-02-132026TWOProject MUSE®921412026-05-14T00:00:00-05:002026-02-13Investigating the Moderating Role of Food Security on Group Session Attendance of an HIV/STI Intervention for Black Women Under Community Supervision
https://muse.jhu.edu/article/982959
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In the United States, approximately 3.745 million adults are in community supervision programs (CSPs), which include parole, probation, and alternative-to-incarceration (ATI) programs.1 Due to structural racism in the criminal legal system (e.g., racialized drug laws),2–4 CSPs have a disproportionately high proportion of Black adults (30% of the CSP population, but only 13% of the U.S. adult population).5 Black women in CSPs face higher rates of sexually transmitted infections (STIs), including HIV, when compared with White men in CSPs,5 yet interventions tailored to this group are lacking. Black women in CSPs also report low levels of condom use as well as food and housing insecurity, extreme poverty and
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallInvestigating the Moderating Role of Food Security on Group Session Attendance of an HIV/STI Intervention for Black Women Under Community Supervision2026-02-13text/htmlen-USInvestigating the Moderating Role of Food Security on Group Session Attendance of an HIV/STI Intervention for Black Women Under Community Supervision2026-02-132026TWOProject MUSE®794212026-05-14T00:00:00-05:002026-02-13Doubling of New Hepatitis C Virus Infections in South Dakota American Indian Reservation Counties since 2020
https://muse.jhu.edu/article/982960
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Infections by hepatitis C virus (HCV) can result in liver failure, liver cancer, and death.1 American Indian and Alaska Native (AIAN) individuals experience the highest rate of HCV infection among racial groups in the U.S., with an annual rate of 105 reported infections per 100,000 individuals compared with 24 per 100,000 individuals among the U.S. population.1 The highest rate of regional liver-related mortality among AIAN individuals occurs in the Northern Plains.2 Within the Northern Plains, South Dakota is home to several of the nation’s largest American Indian reservations,3 and the South Dakota Department of Health (SDDOH) mandates reporting of HCV cases by health care providers and regional laboratories, and
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallDoubling of New Hepatitis C Virus Infections in South Dakota American Indian Reservation Counties since 20202026-02-13text/htmlen-USDoubling of New Hepatitis C Virus Infections in South Dakota American Indian Reservation Counties since 20202026-02-132026TWOProject MUSE®293422026-05-14T00:00:00-05:002026-02-13Healing Together: Advocating for Community Mental Health Through Restorative Circles in Low-Income Latine and Pre-Columbian Indigenous Immigrant Communities
https://muse.jhu.edu/article/982961
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Immigrants, especially those from low-income backgrounds and racially and ethnically marginalized communities have endured significant physical and psychological trauma due to diverse factors including forced displacement, economic hardship, and systemic discrimination.1 Traumatic experiences, including adversity, both income-based and racial and ethnic discrimination, and cultural erasure, can be cumulative and are associated with diminished life satisfaction; 2 they can also increase risk for mental health conditions, including depression, anxiety disorders, substance abuse, post-traumatic stress disorder (PTSD), and complex-PTSD (c-PTSD).2,3Significant drivers of psychological trauma in immigrant communities are
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallHealing Together: Advocating for Community Mental Health Through Restorative Circles in Low-Income Latine and Pre-Columbian Indigenous Immigrant Communities2026-02-13text/htmlen-USHealing Together: Advocating for Community Mental Health Through Restorative Circles in Low-Income Latine and Pre-Columbian Indigenous Immigrant Communities2026-02-132026TWOProject MUSE®1304292026-05-14T00:00:00-05:002026-02-13Use of Quantitative Pre-admission Criteria to Predict Academic Difficulty in a Physical Therapy Program at a Historically Black University
https://muse.jhu.edu/article/982962
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The lack of diversity among health care providers may be a contributing factor in disparities in health outcomes for minority patients.1 Increasing the numbers of minority health care providers has been suggested as a means of reducing health disparities and decreasing provider bias toward minority patients. The physical therapy profession has historically faced the challenge of lack of racial and ethnic diversity. In 2023 the Bureau of Labor Statics reported that 86.5% of physical therapists self-reported as White, 5.0% as Black or African American, 6.0% as Hispanic or Latino, and 5.2% as Asian.2 The 2020 census reported the United States population percentage as: 58% White, 13% Black or African American, 20%
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallUse of Quantitative Pre-admission Criteria to Predict Academic Difficulty in a Physical Therapy Program at a Historically Black University2026-02-13text/htmlen-USUse of Quantitative Pre-admission Criteria to Predict Academic Difficulty in a Physical Therapy Program at a Historically Black University2026-02-132026TWOProject MUSE®952222026-05-14T00:00:00-05:002026-02-13Racial Income Inequality and COVID-19 Burden in Louisiana: A Spatial Analysis of Public Health Disparities
https://muse.jhu.edu/article/982963
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COVID-19 outcomes varied widely between countries, but the United States led the world in the number of COVID-19 cases and deaths.1 While factors such as age and existing health conditions represented recognized risk factors for cases, hospitalizations, and deaths, social factors also played a crucial role in shaping health outcomes in the United States.1–2 In particular, the Centers for Disease Control and Prevention has reported significant racial disparities in the prevalence of COVID-19 and the outcomes related to the disease.3–4 Black, Latino, and Native American communities are among the groups that have experienced disproportionate impacts of COVID-19.4 For instance, the COVID-19 hospitalization rate for the
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallRacial Income Inequality and COVID-19 Burden in Louisiana: A Spatial Analysis of Public Health Disparities2026-02-13text/htmlen-USRacial Income Inequality and COVID-19 Burden in Louisiana: A Spatial Analysis of Public Health Disparities2026-02-132026TWOProject MUSE®1207692026-05-14T00:00:00-05:002026-02-13Medicaid Expansion and Payday Lending: Evidence from Louisiana
https://muse.jhu.edu/article/982964
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In July 2016, Louisiana expanded Medicaid eligibility under the Patient Protection and Affordable Care Act (ACA) to include adults with incomes up to 138% of the federal poverty level. Several studies have documented the relationship between ACA Medicaid expansion and financial well-being and have concluded that increased access to Medicaid coverage contributed to fewer unpaid medical bills and medical debt sent to collection agencies; fewer bankruptcy filings, rent payment delinquencies, and evictions; and improved credit scores.1–7 Less is known, however, about the relationship between Medicaid expansion and short-term debt obligations, such as payday loans, which are frequently used by populations targeted by
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallMedicaid Expansion and Payday Lending: Evidence from Louisiana2026-02-13text/htmlen-USMedicaid Expansion and Payday Lending: Evidence from Louisiana2026-02-132026TWOProject MUSE®620112026-05-14T00:00:00-05:002026-02-13Take-Up of Marketplace Coverage Increased After Enhanced Premium Subsidies
https://muse.jhu.edu/article/982965
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Affordability of health insurance is a longstanding policy challenge in the United States. In response to this challenge, the Affordable Care Act (ACA) introduced premium tax credits to reduce the cost of health insurance by specifying percentages of income that qualifying individuals would be required to pay to enroll in a benchmark plan.1 In the context of the Marketplaces, the affordability of premiums has been a particular concern for middle-class families who historically were not eligible for premium subsidies.2 In March of 2021, the American Rescue Plan Act (ARPA) increased subsidies to purchase Marketplace health coverage. The Inflation Reduction Act (IRA) of 2022 extended the ARPA subsidies until the end
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallTake-Up of Marketplace Coverage Increased After Enhanced Premium Subsidies2026-02-13text/htmlen-USTake-Up of Marketplace Coverage Increased After Enhanced Premium Subsidies2026-02-132026TWOProject MUSE®766322026-05-14T00:00:00-05:002026-02-13Independent Relationship between Incarceration Factors and Glycemic Control in African Americans with Criminal Legal Involvement and Type 2 Diabetes
https://muse.jhu.edu/article/982966
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Diabetes affects 38.4 million people in the United States, with a notable rise in prevalence from 7.4% in 2015 to 11.6% in 2021.1,2 Poorly controlled diabetes can lead to complications including kidney disease, blindness, stroke, and cardiovascular issues.1–4 Despite an overall decline in diabetes-related mortality, a diagnosis of diabetes continues to confer two-to threefold increase in all-cause mortality risk.1,2 This has implications for health equity, with African American patients with diabetes experiencing higher rates of complications1,2 such as increased lower extremity amputations and a twofold greater likelihood of death compared with White patients with diabetes.1,2There is also a significant disparity
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallIndependent Relationship between Incarceration Factors and Glycemic Control in African Americans with Criminal Legal Involvement and Type 2 Diabetes2026-02-13text/htmlen-USIndependent Relationship between Incarceration Factors and Glycemic Control in African Americans with Criminal Legal Involvement and Type 2 Diabetes2026-02-132026TWOProject MUSE®1021332026-05-14T00:00:00-05:002026-02-13Health Care Utilization among Young Adults: Associations with Historic Redlining
https://muse.jhu.edu/article/982967
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Homeownership rates declined rapidly in the United States (U.S.) during the Great Depression. Between 1928 and 1933, home construction plummeted roughly 90% and foreclosures skyrocketed nearly 300%.1 To rescue imperiled real estate markets from total collapse, the Roosevelt administration established the Home Owners’ Loan Corporation (HOLC) in 1933.2 Among other responsibilities, the HOLC was required to forecast the perceived risk of investing in certain neighborhoods. This mandate led to systematized appraisal schemes using “residential security” maps of over 239 major cities.3 These maps used hierarchical letter and color grades. Areas deemed “most desirable” and on the rise were scored A and marked in green
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallHealth Care Utilization among Young Adults: Associations with Historic Redlining2026-02-13text/htmlen-USHealth Care Utilization among Young Adults: Associations with Historic Redlining2026-02-132026TWOProject MUSE®1463512026-05-14T00:00:00-05:002026-02-13A Cross-Sectional Study of Women’s Cervical Cancer Knowledge and Acceptance of Human Papillomavirus Vaccination in Makeni, Sierra Leone
https://muse.jhu.edu/article/982968
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In recent decades, the human papillomavirus (HPV) has become a major focus of improving health care and health outcomes in low- and middle-income countries (LMIC).1 The human papillomavirus is a sexually transmitted infection (STI) that affects both males and females occurring mostly among adolescents and women under the age of 25.2 Of the world’s eight billion people, approximately three out of four will contract HPV within their lifetime, with 42.2% of infections occurring in LMICs. 2,3 While nine of 10 infections resolve within two years, untreated cases may cause complications such as genital warts and cancer.4 In fact, untreated HPV is associated with 99% of all cervical cancer cases.5 Although HPV infection
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallA Cross-Sectional Study of Women’s Cervical Cancer Knowledge and Acceptance of Human Papillomavirus Vaccination in Makeni, Sierra Leone2026-02-13text/htmlen-USA Cross-Sectional Study of Women’s Cervical Cancer Knowledge and Acceptance of Human Papillomavirus Vaccination in Makeni, Sierra Leone2026-02-132026TWOProject MUSE®1035662026-05-14T00:00:00-05:002026-02-13Real-World Impact of Weekly Dulaglutide and Semaglutide on Hba1c and Weight in a Predominantly Underrepresented Demographic
https://muse.jhu.edu/article/982969
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Diabetes mellitus is a globally prevalent disease, and it affects approximately 37 million Americans, with 90–95% of these individuals diagnosed with type 2 diabetes mellitus (T2DM).1 Current treatment guidelines emphasize a patient-centered approach to therapy selection for T2DM, taking into account factors such as glycemic efficacy, comorbidities, impact on weight, and potential adverse effects.2,3 Among the recommended therapies, glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have emerged as first-line options. The 2025 American Diabetes Association (ADA) Standards of Medical Care endorse three GLP-1 RAs—subcutaneous semaglutide, dulaglutide, and liraglutide—for glycemic management, particularly in
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallReal-World Impact of Weekly Dulaglutide and Semaglutide on Hba1c and Weight in a Predominantly Underrepresented Demographic2026-02-13text/htmlen-USReal-World Impact of Weekly Dulaglutide and Semaglutide on Hba1c and Weight in a Predominantly Underrepresented Demographic2026-02-132026TWOProject MUSE®1120562026-05-14T00:00:00-05:002026-02-13Expectant Fathers’ Intentions for Infant Involvement: Role of Knowledge, Self-Efficacy, and Beliefs
https://muse.jhu.edu/article/982970
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Engaging expectant fathers during the perinatal period has been shown to improve infant health outcomes and parental well-being.1–3 While several studies have explored the impact of father involvement during pregnancy, childbirth, and infancy,4 few studies have examined expectant fathers’ intentions to care for their infant, let alone their confidence to do so.5 Gaining a better understanding of expectant fathers’ perspectives about their intentions and confidence (i.e., self-efficacy) to care for an infant (e.g., feed, diaper, soothe) can help support strategies to enhance father involvement during the perinatal period. This is especially relevant for lower-income fathers who report having unmet needs regarding
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallExpectant Fathers’ Intentions for Infant Involvement: Role of Knowledge, Self-Efficacy, and Beliefs2026-02-13text/htmlen-USExpectant Fathers’ Intentions for Infant Involvement: Role of Knowledge, Self-Efficacy, and Beliefs2026-02-132026TWOProject MUSE®1431602026-05-14T00:00:00-05:002026-02-13Housing Status and Overall Survival in People with Lung Cancer: Utilization of a Housing Insecurity Screening and Referring Program
https://muse.jhu.edu/article/982971
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Analyzing health disparities in terms of social determinants of health (SDOH), defined as the economic and environmental conditions under which people are born, live, work, and age that affect health, well-being, and quality of life, has become a focal point for U.S. health policy.1,2 Housing insecurity, a SDOH, encompasses various challenges including high costs, instability, frequent moves, poor living conditions, and unsafe neighborhoods.3 These housing-related issues can influence and be influenced by cancer across the entire continuum from prevention and screening to diagnosis, treatment, and survivorship.4–6 Positive findings demonstrating the effect of SDOH screening interventions on process measures (e.g.
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallHousing Status and Overall Survival in People with Lung Cancer: Utilization of a Housing Insecurity Screening and Referring Program2026-02-13text/htmlen-USHousing Status and Overall Survival in People with Lung Cancer: Utilization of a Housing Insecurity Screening and Referring Program2026-02-132026TWOProject MUSE®771182026-05-14T00:00:00-05:002026-02-13From Food to Finances: Early Phase Qualitative Evaluation of a Novel Resource-Coaching Program
https://muse.jhu.edu/article/982972
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In the United States (U.S.), 37.9 million people live in poverty, and over 90 million live below 200% of the poverty line, a threshold which still often requires significant public and community support services. These households are more likely to experience adverse health outcomes and to have lower lifetime economic mobility, and children in these households are more likely to have lower educational attainment and lifetime earnings compared with higher-income households.1 People in households with low income face numerous challenges related to acquiring needed resources to achieve economic, housing, health, and food security, which are linked to health disparities such as a greater burden of chronic disease.2
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallFrom Food to Finances: Early Phase Qualitative Evaluation of a Novel Resource-Coaching Program2026-02-13text/htmlen-USFrom Food to Finances: Early Phase Qualitative Evaluation of a Novel Resource-Coaching Program2026-02-132026TWOProject MUSE®933432026-05-14T00:00:00-05:002026-02-13Evidence of Implicit Bias Against People Experiencing Homelessness Among Emergency Medical Services Providers
https://muse.jhu.edu/article/982973
<p></p>
Research indicates that the negative attitudes and stereotypes held by health care providers toward patient groups can play a role in creating and perpetuating disparities in the health outcomes of minoritized patients.1–2 The concept of “implicit bias” refers to automatic associations that people make between social groups (e.g., “Hispanic,” “transgender,” “elderly”) and certain traits (e.g., “non-adherent”) or evaluations (e.g., “bad”).3 These associations occur so quickly that they can influence judgment and behavior outside of conscious awareness.4 Using computer reaction-time tasks, researchers show that health care providers tend to quickly link minoritized racial and ethnic groups; people with obesity;
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallEvidence of Implicit Bias Against People Experiencing Homelessness Among Emergency Medical Services Providers2026-02-13text/htmlen-USEvidence of Implicit Bias Against People Experiencing Homelessness Among Emergency Medical Services Providers2026-02-132026TWOProject MUSE®984912026-05-14T00:00:00-05:002026-02-13Patient-Centered Communication and Intention to Recommend a Safety Net Primary Care Clinic in the United States
https://muse.jhu.edu/article/982974
<p></p>
Delivery of health care services is “fundamentally a communicative enterprise,”1[p.286] and the way providers interact with patients can improve or worsen the health and well-being of their patients. Thus, effective provider communication plays a critical role in improving quality of health care delivery.2 Patient-centered communication (PCC) is defined as provider interactions with patients that improve patients’ understanding of clinical information (e.g., using simple language and terminology), in which the provider is empathetic and attentively listening to patients, and in which the provider encourages greater patient involvement in treatment decision-making.3Patient-centered communication in outpatient
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallPatient-Centered Communication and Intention to Recommend a Safety Net Primary Care Clinic in the United States2026-02-13text/htmlen-USPatient-Centered Communication and Intention to Recommend a Safety Net Primary Care Clinic in the United States2026-02-132026TWOProject MUSE®1016802026-05-14T00:00:00-05:002026-02-13Prioritizing the Health of Underserved Communities in Prenatal Genetics
https://muse.jhu.edu/article/982975
<p></p>
Prenatal genetic screening using cell-free DNA (cfDNA) has become increasingly common since its 2011 introduction. The technology uses fragments of DNA found in maternal serum to identify quantitative differences that may indicate the presence of fetal aneuploidy or a genetic condition caused by microdeletion. Advocates for the technology argue that it offers a higher specificity and sensitivity over traditional aneuploidy screening methods and allows for screening for previously unscreened conditions such as microdeletions.1,2 Some estimates place the use of cfDNA screening in approximately 25–50% of the approximately 3.6 million pregnancies per year in the U.S.3 However, its clinical integration has not been
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallPrioritizing the Health of Underserved Communities in Prenatal Genetics2026-02-13text/htmlen-USPrioritizing the Health of Underserved Communities in Prenatal Genetics2026-02-132026TWOProject MUSE®793612026-05-14T00:00:00-05:002026-02-13Standards of Care for Assaulted Patients in Custody
https://muse.jhu.edu/article/982976
<p></p>
“Why treat people and send them back to the conditions that made them sick?”Slumped on the stretcher, the patient clutched his black eye. “Please don’t send me back, doc,” he pleaded. “They’re just going to do it again.” He had just been sent from the county jail after a reported assault. Imaging showed no fracture, so we were preparing for medical discharge. However, his fear of future violence lingered and could certainly come true. For the non-incarcerated patients in the surrounding rooms, numerous interventions exist to promote patient safety: restraint orders, domestic violence shelters, social work.2 For patients who are incarcerated, medical treatment follows a different set of rules. There are limited
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallStandards of Care for Assaulted Patients in Custody2026-02-13text/htmlen-USStandards of Care for Assaulted Patients in Custody2026-02-132026TWOProject MUSE®479172026-05-14T00:00:00-05:002026-02-13The Community Health Centers at Sixty: As Essential as Ever
https://muse.jhu.edu/article/982977
<p></p>
The very first community health center (CHC) was established at Columbia Point in the Dorchester neighborhood of Boston, Massachusetts in December 1965.1 The brainchild of H. Jack Geiger, MD, and Count D. Gibson, Jr., MD, the Columbia Point Health Center constituted a demonstration project underwritten by the federal Office of Economic Opportunity, the lead agency in the Johnson administration’s War on Poverty.1 The Columbia Point CHC was followed in 1967 by a rural counterpart in Mound Bayou, Mississippi.1 In 1987, the Omnibus Budget Reconciliation Act [Public Law No. 100-203] created the designation of federally qualified health centers (FQHCs), and since then, more than 1,400 FQCHCs have been established
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallThe Community Health Centers at Sixty: As Essential as Ever2026-02-13text/htmlen-USThe Community Health Centers at Sixty: As Essential as Ever2026-02-132026TWOProject MUSE®204562026-05-14T00:00:00-05:002026-02-13Reverse Integration: Community-Based Breastfeeding Experts Integrated with Integrity into Traditional Clinical Prenatal Care
https://muse.jhu.edu/article/982978
<p></p>
Breastfeeding positively affects maternal and infant health,1 but rates of breastfeeding initiation and continuation are lower for Black mothers than for mothers belonging to other racial groups, resulting in poorer health outcomes.2 Research has shown that Black mothers have rates of intention to breastfeed similar to White mothers, suggesting barriers that contribute to lower initiation.3 These barriers include longstanding experiences of racism and discrimination that engenders Black mothers’ distrust of the health care system,4 including health care provider assumptions that Black women would not breastfeed, which affects the amount and quality of breastfeeding support a Black woman receives.4 Black mothers
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallReverse Integration: Community-Based Breastfeeding Experts Integrated with Integrity into Traditional Clinical Prenatal Care2026-02-13text/htmlen-USReverse Integration: Community-Based Breastfeeding Experts Integrated with Integrity into Traditional Clinical Prenatal Care2026-02-132026TWOProject MUSE®394572026-05-14T00:00:00-05:002026-02-13Training the Next Generation of Health Equity Leaders: Development and Implementation of the Boston Medical Center Executive Health Equity Fellowship
https://muse.jhu.edu/article/982979
<p></p>
Structural and institutional racism is ubiquitous in the U.S. health care system.1–5 Hospitals that serve populations that have been structurally marginalized and institutionally underserved, referred to as “essential hospitals,” are not immune to these pressures and may be uniquely positioned to understand, address, and dismantle many of the drivers of inequity that have led to our current system.6 Leaders and clinicians at these organizations frequently possess a deep understanding of and experience navigating the structural and social drivers of health, appreciation of the health system’s role in addressing these “upstream”7,8 drivers, and the management skills to catalyze and sustain health system
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallTraining the Next Generation of Health Equity Leaders: Development and Implementation of the Boston Medical Center Executive Health Equity Fellowship2026-02-13text/htmlen-USTraining the Next Generation of Health Equity Leaders: Development and Implementation of the Boston Medical Center Executive Health Equity Fellowship2026-02-132026TWOProject MUSE®499052026-05-14T00:00:00-05:002026-02-13Addressing Nutrition Insecurity Through a Social Determinants of Health Framework: Training Wisconsin Nutrition and Dietetics Professionals
https://muse.jhu.edu/article/982980
<p></p>
Food insecurity encompasses hunger and lack of consistent access to nutritious foods and is a critical social determinant of health (SDOH).1,2 Closely related, nutrition insecurity emphasizes both physical and economic access to food that supports health and prevents disease.3 Nutrition and dietetics (ND) professionals, including registered dietitians (RDs),4 and dietetics technicians registered (DTRs), support diverse populations (e.g., students, food pantry users, isolated seniors) affected by multiple intersecting SDOH, which affect dietary habits and overall health.The Wisconsin Academy of Nutrition and Dietetics (WAND) builds member capacity to recognize and address these issues through targeted advocacy
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallAddressing Nutrition Insecurity Through a Social Determinants of Health Framework: Training Wisconsin Nutrition and Dietetics Professionals2026-02-13text/htmlen-USAddressing Nutrition Insecurity Through a Social Determinants of Health Framework: Training Wisconsin Nutrition and Dietetics Professionals2026-02-132026TWOProject MUSE®456422026-05-14T00:00:00-05:002026-02-13MOWA Medical Hub: A Student-Run Free Clinic’s Approach to Meeting the Needs of an Underserved Community
https://muse.jhu.edu/article/982981
<p></p>
Indigenous peoples are communities with deep historical roots in pre-colonial societies who maintain distinct cultural traditions, social institutions, and ties to ancestral land.1 In the U.S., this primarily includes American Indian (AI), Alaska Native, Native Hawaiian, and Pacific Islander communities.2 Historically, Indigenous peoples in the U.S. have faced significant barriers to equitable health care, health education, and health-related resources, resulting in a lifespan nearly four to five and a half years shorter than the general U.S. population.2,3,4 One study reported a striking 22-year life expectancy gap between AI males in North Dakota and their White counterparts.2 In addition to reduced life
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallMOWA Medical Hub: A Student-Run Free Clinic’s Approach to Meeting the Needs of an Underserved Community2026-02-13text/htmlen-USMOWA Medical Hub: A Student-Run Free Clinic’s Approach to Meeting the Needs of an Underserved Community2026-02-132026TWOProject MUSE®347972026-05-14T00:00:00-05:002026-02-13COVID-19 Pandemic Density Hotel Initiative for People Experiencing Homelessness: New York City, 2020–2021
https://muse.jhu.edu/article/982982
<p></p>
We describe the COVID-19 pandemic density hotel initiative directed by the NYC [New York City] Department of Homeless Services (DHS). The NYC DHS is the nation’s largest municipal shelter system. Together with nonprofit partners, DHS’s mission is to prevent homelessness, address street homelessness, provide safe temporary shelter, and connect New Yorkers experiencing homelessness to stable housing.In addition to operating isolation and quarantine hotels, NYC used hotels to dedensify congregate shelters as part of a strategy to protect homeless individuals from COVID-19. The initiative was directed and overseen by DHS. Services in the hotels were provided by the same nonprofit homeless services providers that DHS
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Project MUSE®https://muse.jhu.edu/2026-05-14T00:00:00-05:00https://muse.jhu.edu/journal/278/image/coversmallCOVID-19 Pandemic Density Hotel Initiative for People Experiencing Homelessness: New York City, 2020–20212026-02-13text/htmlen-USCOVID-19 Pandemic Density Hotel Initiative for People Experiencing Homelessness: New York City, 2020–20212026-02-132026TWOProject MUSE®411592026-05-14T00:00:00-05:002026-02-13