Health Disparities Flashcards
Social Determinants of Health
- conditions in which people are born, grow, live, work, and age including the health system
- ultimately shaped by the distribution of money, power, and resources at global, national, and local levels
What are the social determinants of health?
Childhood development
education attainment and quality
employment status
occupation
food security
access to health services
housing
transporation
income
discrimination
Vulnerable Populations
- race/ethnicity
- socioeconomic status (income, education, occupation, wealth)
- gender
- age
- disability status
- geographic location
- sexual orientation
Health Outcomes are based on what two things?
balance of SDOH & Personal Characteristics
Effects of SDOH
- place patients in the flight or fight stress response all the time
Allostasis and Allostatic Load
Allostasis: extension of the concept of homeostasis and represents the adaptation process of the complex physiological system to physical, psychosocial and environmental challenges or stress
Allostatic Load: the long-term result of failed adaptation or allostasis, resulting in pathology and chronic illness.
Federal Poverty Guidelines
1: 14,580
2: 19,720
3: 24,860
4: 30,000
5: 35,140
6: 40,280
7: 45,420
8: 50,560
Health Disparity
- systematic
- differentiated by social position
differences in the incidence, prevalence, mortality, and burden of diseases that exist among specific population groups in the US
Health Care Disparity
- systematic
- differentiated by social position
- includes delivery and quality of care
differences in access to or availability of facilities and services that exist among specific population groups in the US
What two things lead to disparities?
SDOH & Vulnerable populations
Life expectancy
life expectancies for all genders and ethnicities have decreased especially after COVID-19
Life expectancy is a health disparity
Health Outcomes of Indiana Vs US
Increased:
- premature death
- poor/fair health
- adult smokers
- adult obesity
- physical inactivity
Decreased:
- Food Environment Index
- Access to exercise opportunities
- primary care physician ratio
What are safety organizations?
- providers that organize and deliver a significant level of healthcare and other services to uninsured, Medicaid, and other vulnerable patients
- work to fill in gaps
- free or fees on a sliding scale
- won’t turn patients away
How are safety organizations financed?
- federal/state funds
- foundations/charities
- private donors
- sliding scale revenues
- third party (medicaid, medicare)
Different Types of Safety Net Providers
- Federally Qualified Health Center (FQHC)
- FQHC Look Alike (not federally funded)
- Free Clinic (supported by private donors)
- Street Medicine
- Disproportionate Share Hospital
FQHC
- organizations that receive FEDERAL FUNDING from HRSA under the PHS Act Section 330
- must apply and be approved
FQHC Requirements
Location: medically underserved area
Services: primary care/preventative care (outpatient)
Community Board: mostly from community being served
Fees must be sliding scale based on income or waived if unable to pay
ongoing quality assurance program
governing board of directors
Characteristics of a Medically Underserved Area
low primary care providers
high infant mortality
high poverty
high elderly population
Resources to find FQHC
findahealthcenter.hrsa.gov
npidb.org
muafind.hrsa.gov
Public/Disproportionate Share Hospitals (DAH)
- disproportionate number of patients served are low income/uninsured
- states receive funds to cover the costs of DSH’s
Ex) Eskenazi Health
Accessing Medications for Uninsured/Low Income Patients
- 340 B Drug Pricing Program
- associated with FQHC
- in house pharmacy or contracted with chain/independent pharmacy to reduce costs - Medication Samples
- Patient Assistance Programs
- Discounted Prescription Programs sponsored by pharmacies
Patient Assistance Programs
- commonly sponsored by manufacturers
- eligibility criteria and drug availability vary (patients cant have insurance and must meet certain income guidelines)
- both brand and generic drugs availabile –> normally brand
- discount cards/coupons available
Examples of Patient Assistance Programs
Rx Assist
Rx Hope
Needy Meds
Medicine Assistance Tool
Advantages vs Disadvantages of Medication Samples
Advantages:
- opportunity to try new medication before filling full script
- no cost to clinic or patient
- used as bridge until insurance or PAP meds arrive
Disadvantages:
- may promote compliance to this med and discourage use of more appropriate meds
- sustainability concerns
