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Big data and public health
Published in Sridhar Venkatapuram, Alex Broadbent, The Routledge Handbook of Philosophy of Public Health, 2023
However, some argue that implementing big data techniques in public health exacerbates disparities instead of dissolving them, due to problems in the techniques like algorithmic bias, along with how the techniques are used in practice. Consider the use of commercial algorithms to determine who is selected for hospitals’ high-risk care management programs. These algorithms are designed to predict which patients are most at risk for poor health outcomes, based on those patients’ current health information. Those identified as most at risk are enrolled in care management programs, providing them with extra care that has been associated with improved outcomes. The health information of around 200,000,000 people in the United States is analyzed by these risk prediction algorithms every year. One of the most widely used of these algorithms was implemented such that everyone classified above the 97th percentile for health risks was automatically eligible for a care management program. A recent study found that the Black patients in the automatically eligible group had, on average, 26.3% more chronic illnesses than the White patients in the automatically eligible group. This disparity was traced to the algorithm’s incorporation of patients’ healthcare costs as predictors of health risks: for any given severity of health risks, Black patients receive less expensive care than White patients. Resolving this disparity increased the proportion of Black patients within the automatically eligible group from 17.7% to 46.5% (Obermeyer et al. 2019).
Introduction
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
Federalist vs antifederalist analytics and what we have learned from the United States? This series of chapters will review state responses to the pandemic, provide the local flavor & richness of data analytics and summarize how health systems were affected. Each contributing author brings to bear their professional experience and area of subject matter expertise to the discussion. For example, those that are in academia discuss the value of analytics from the research and teaching point of view. Others discuss healthcare disparity and the impact of the pandemic on discrete populations and their access to health services. Health system executives and physicians provide a perspective on how the pandemic strained hospital resources and affected care. We present case studies from states around the Union to provide some level of context of how regional responses led to lessons learned from each part of the country. Attempting to provide a sample from each CDC Census region, we review lessons from Alabama, California, Colorado, Illinois, Florida, New York, Tennessee and Texas (see Figure I.1).
Local groups in shaping the advocacy of population health
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
Chesney P.Y. Wong, Fiona C.M. Yuen, Percy W.T. Ho
An increasing number of international organisations, including WHO, and countries have recognised the importance of reducing health inequalities to improve health outcomes. They are putting efforts in narrowing the social and health disparity. For example, the WHO Regional Office for the Americas has been promoting health equity in the region (Marmot, 2011). Local groups should carry out a sustainable health educational programme by collaborating with different stakeholders like the government, schools and community to enhance health literacy, especially within the low socioeconomic groups. This is an effective way to strengthen self-empowerment in self-care and the management of complex medical decisions (Gwynn et al., 2016; Kjærgård et al., 2014).
Understanding the determinants of circadian health disparities and cardiovascular disease
Published in Chronobiology International, 2023
Dayna A. Johnson, Philip Cheng, Maya FarrHenderson, Kristen Knutson
In this paper, we present the current scientific evidence on racial/ethnic disparities in circadian and cardiovascular health. Disparities in this context relate to inequities between groups such as race or ethnicity that are preventable and unfair/unjust (McGuire et al. 2006). We adopt the definition of Duran et al. that defines a health disparity as “a health difference that adversely affects defined disadvantaged populations, based on one or more health outcomes” (Duran and Perez-Stable 2019). Further, we are defining race as a social (not genetic) construct that is a proxy for experiences of racism. Race as a social construct has biological consequences that result from socio-economic and environmental factors that are differentially experienced across racial/ethnic groups as a result of historical and contemporary forms of discriminatory practices as well as policies on the basis of race/ethnicity (Smedley and Smedley 2005). This paper will utilize a socio-ecological approach, which takes into account the complex interplay between individual, relationship, community, and societal-level factors to the discussion racial/ethnic disparities in CVD and circadian health.
Institutional racism: a discursive paper
Published in Contemporary Nurse, 2022
Departing from the policymaking aspect of institutional racism, denial of, or a lack of access to treatments for First Nation Peoples are also prominent issues that stem from the existing prejudices within the healthcare system. Institutional racism may present itself as a lack of culturally appropriate practice and ignorance of Indigenous concepts of health and wellbeing from the system and health care professionals. For example, Moore et al. (2014) discovered in their cohort study that Indigenous Australians receive fewer cancer treatments, have more comorbidities, and are diagnosed at a later stage than non-Indigenous Australians. They concluded that inherent racism, and social and cultural differences between patients and healthcare providers, were the compounding factors for such disparity. As a result, these patients would have a significantly poorer cancer survival rate, especially in the first year after diagnosis. Furthermore, Reilly et al. (2018) also highlighted overt racism and mistrust of the health system as the main barriers for Indigenous Peoples in accessing health services during cancer care. She drew on stories of participants who had experienced racist remarks during their health journey and found that many would not speak up to avoid confrontation. Thus, institutional racism is playing a major role in preventing First Nation Peoples from accessing vital care and leading to poorer health outcomes.
Characteristics of Aboriginal and Torres Strait Islander smokers exposed to anti-smoking marketing in South Australia
Published in Journal of Communication in Healthcare, 2022
Joshua Trigg, Damien Shen, Julia Morris, Jason Blunt
Smoking continues to be disproportionately prevalent among Aboriginal and Torres Strait Islander Australian peoples (hereafter, Indigenous Australians). Recent data show that 39% of Indigenous Australians aged over 15 years are smoking daily, compared to 14% of non-Indigenous Australians [1], and that the former are 2.7 times more likely to begin smoking than non-Indigenous Australians [2]. This has contributed to a national prevalence gap of approximately 30% between 1995 and 2014 [1]. Health risk disparity is further compounded by social determinants such as socioeconomic disadvantage and discrimination [3]. Indigenous Australians may also struggle more with cessation attempts, as social exposure to smoking is associated with a lower likelihood of successful quitting [4]. These issues underscore the ongoing need for community-based support initiatives for smoking cessation, and for effective social campaigning to promote quit supports and services to Indigenous Australians interested in accessing them.