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Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
As the US population ages, public health agencies must examine better ways to measure the impact of adverse health outcome on a population. Many reports have asserted that more adverse health events occur in Appalachia. However, few studies have assessed the quality of life and burden of disease on those residing in Appalachia. Therefore, the overall aim of this dissertation was to assess the health status, burden of disease, and quality of life in Appalachia using available data and improved health outcome assessment measures. For this dissertation, 3 secondary data sources collected by the State of Tennessee and the National Center for Health Statistics (NCHS) were used. These data were used to calculate the index of disparity and absolute and relative disparity measures within the study area of 8 Appalachian counties in upper east Tennessee. Vital statistics data for the selected area were also used to calculate Disability Adjusted Life Years (DALYs) by gender for all cause mortality and stroke mortality. The Behavior Risk Factor Surveillance System (BRFSS) data were used for prevalence data and to determine what factors impact Health Related Quality of Life (HRQOL) within the study area. The Index of disparity (ID) for all cause mortality for the study area found that disparity is greatest in stroke mortality for the study area and TN and the least for all cause mortality and the US. The highest numbers of DALYs was found in the 45-59 age group for the Appalachian study population. Finally, the mean general health status did not vary significantly by gender; however, predictors of reporting excellent to good health status did vary based on gender. Predictors of fair to poor general health status were found to be low income, having diabetes, or having had a stroke or heart attack. The results within this dissertation are intended to assist health professionals with the creation of health interventions and policy development within the Appalachian area. This disse.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
As the US population ages, public health agencies must examine better ways to measure the impact of adverse health outcome on a population. Many reports have asserted that more adverse health events occur in Appalachia. However, few studies have assessed the quality of life and burden of disease on those residing in Appalachia. Therefore, the overall aim of this dissertation was to assess the health status, burden of disease, and quality of life in Appalachia using available data and improved health outcome assessment measures. For this dissertation, 3 secondary data sources collected by the State of Tennessee and the National Center for Health Statistics (NCHS) were used. These data were used to calculate the index of disparity and absolute and relative disparity measures within the study area of 8 Appalachian counties in upper east Tennessee. Vital statistics data for the selected area were also used to calculate Disability Adjusted Life Years (DALYs) by gender for all cause mortality and stroke mortality. The Behavior Risk Factor Surveillance System (BRFSS) data were used for prevalence data and to determine what factors impact Health Related Quality of Life (HRQOL) within the study area. The Index of disparity (ID) for all cause mortality for the study area found that disparity is greatest in stroke mortality for the study area and TN and the least for all cause mortality and the US. The highest numbers of DALYs was found in the 45-59 age group for the Appalachian study population. Finally, the mean general health status did not vary significantly by gender; however, predictors of reporting excellent to good health status did vary based on gender. Predictors of fair to poor general health status were found to be low income, having diabetes, or having had a stroke or heart attack. The results within this dissertation are intended to assist health professionals with the creation of health interventions and policy development within the Appalachian area. This disse.
Author: Robert L. Ludke Publisher: University Press of Kentucky ISBN: 0813140420 Category : Health & Fitness Languages : en Pages : 400
Book Description
Appalachians have been characterized as a population with numerous disparities in health and limited access to medical services and infrastructures, leading to inaccurate generalizations that inhibit their healthcare progress. Appalachians face significant challenges in obtaining effective care, and the public lacks information about both their healthcare needs and about the resources communities have developed to meet those needs. In Appalachian Health and Well-Being, editors Robert L. Ludke and Phillip J. Obermiller bring together leading researchers and practitioners to provide a much-needed compilation of data- and research-driven perspectives, broadening our understanding of strategies to decrease the health inequalities affecting both rural and urban Appalachians. The contributors propose specific recommendations for necessary research, suggest practical solutions for health policy, and present best practices models for effective health intervention. This in-depth analysis offers new insights for students, health practitioners, and policy makers, promoting a greater understanding of the factors affecting Appalachian health and effective responses to those needs.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309452961 Category : Medical Languages : en Pages : 583
Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Author: Michele Morrone Publisher: Ohio University Press ISBN: 0821440772 Category : Social Science Languages : en Pages : 260
Book Description
In Ailing in Place, Michele Morrone explores the relationship between environmental conditions in Appalachia and health outcomes that are too often ascribed to individual choices only. She applies quantitative data to observations from environmental health professionals to frame the ways in which the environment, as a social determinant of health, leads to health disparities in Appalachian communities. These examples—these stories of place—trace the impacts of water quality, waste disposal, and natural resource extraction on the health and quality of life of Appalachian people. Public health is inextricably linked to place. Environmental conditions such as contaminated water, unsafe food, and polluted air are as important as culture, community, and landscape in characterizing a place and determining the health outcomes of the people who live there. In some places, the state of the environment is a consequence of historical activities related to natural resources and cultural practices. In others, political decisions to achieve short-term economic objectives are made with little consideration of long-term public health consequences.
Author: Rhoda H. Halperin Publisher: University of Texas Press ISBN: 0292746709 Category : Social Science Languages : en Pages : 200
Book Description
Rural Appalachians in Kentucky call it "The Kentucky Way"—making a living by doing many kinds of paid and unpaid work and sharing their resources within extended family networks. In fact, these strategies are practiced by rural people in many parts of the world, but they have not been studied extensively in the United States. In The Livelihood of Kin, Rhoda Halperin undertakes a detailed exploration of this complex, family-oriented economy, showing how it promotes economic well-being and a sense of identity for the people who follow it. Using actual life and work histories, Halperin shows how people make a living "in between" the cash economy of the city and the agricultural subsistence economy of the country. In regionally based, three-generation kin networks, family members work individually and jointly at many tasks: small-scale agricultural production, food processing and storage, odd jobs, selling used and new goods in marketplaces, and wage labor, much of which is temporary. People can make ends meet even in the face of job layoffs and declining crop subsidies. With these strategies people win a considerable degree of autonomy and control over their lives. Halperin also examines how such multiple livelihood strategies define individual identity by emphasizing a person’s role in the family network over an occupation. She reveals, through psychiatric case histories, what damage can result when individuals leave the family network for wage employment in the cities, as increasing urbanization has forced many people to do. While certainly of interest to scholars of Appalachian studies, this lively and readable study will also be important for economic anthropologists and urban and rural sociologists.
Author: National Research Council Publisher: National Academies Press ISBN: 0309182573 Category : Medical Languages : en Pages : 58
Book Description
The panel convened the Workshop on Improving Racial and Ethnic Data in Health to review information about current private-sector and state data collection practices in light of existing federal, state, and local regulations, laws, and requirements. The workshop presentations featured the perspectives of data users, health care providers, insurance plan representatives, state and local public health officials, and regulatory officials. Participants assessed policies, practices, barriers, and opportunities for collecting racial and ethnic data in their settings, and explored ways that private and state systems can be improved to address data needs. In preparation for the workshop, the panel commissioned four background papers to fill gaps in knowledge of private-sector and state government policies and practices and to address the importance of racial and ethnic data collection. The panel is also examining the role of socioeconomic status regarding health and health care disparities. However, the workshop intended to focus only on racial and ethnic data collection. The panel's final report will contain a full consideration of the collection of racial, ethnic, and socioeconomic status data.
Author: National Research Council Publisher: National Academies Press ISBN: 0309166136 Category : Medical Languages : en Pages : 310
Book Description
Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
The Internet offers potential for reducing professional isolation of Appalachian health care providers by enhancing access to medical information and facilitating contact with colleagues. However, there is a gap in the knowledge of current computer and Internet access in Appalachia, and in the technology-related behaviors and attitudes of health care professionals there. This study examined Internet-related access and behaviors of Appalachian family physicians and advanced practice nurses. A survey was mailed to 429 graduates of East Tennessee State Universityâs family medicine residency and advanced practice nursing programs currently in practice in southern and central Appalachia. Demographic information was collected from ETSU graduate records. The Dillman survey method included a pre-notice letter, two survey mailings, and post card and telephone follow-ups. Two hundred sixty-four providers (61.5%) returned surveys. Data were analyzed using SPSS. Respondents were similar to the total population in gender, provider discipline, age, and percentage in rural practice. Workplace computer access was common; 59.6% had sole access and 40.2% shared access. Internet access was: 82.7% broadband, 13.5% dial-up, and 2.4% no access. Although rural providers were more likely than urban to have slower dial-up access, they regularly used the Internet. Over 75% of providers accessed the Internet at home for work; 34% reported dial-up and 66% broadband home connection. Although 50% used the Internet for continuing education in 2004, most preferred in-person workshops or print-based modes of continuing education; 58.9% e-mailed daily and 80% accessed medical information via the Internet regularly. Other Internet uses included accessing online journals and patient information, receiving professional association updates, filing insurance, and writing prescriptions. The Internet is ubiquitous in Appalachia; health care providers access it for a variety of professional activities daily.
Author: F. Douglas Scutchfield Publisher: University Press of Kentucky ISBN: 0813155886 Category : Medical Languages : en Pages : 254
Book Description
Appalachian Health explores major challenges and opportunities for promoting the health and well-being of the people of Appalachia, a historically underserved population. It considers health's intersection with social, political, and economic factors to shed light on the trends affecting mortality and morbidity among the region's residents. Editors F. Douglas Scutchfield and Randy Wykoff have assembled high-profile experts working in academia, public health, and government to offer perspectives on a wide range of topics including health behaviors, environmental justice, and pandemic preparedness. This volume also provides updated data on issues such as opioid abuse, "deaths of despair," and the social determinants of health. Together, the contributors illuminate the complex health status of the region and offer evidence-based programs for addressing the health problems that have been identified.
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Author: Robert L. Ludke
Author: National Academies of Sciences, Engineering, and Medicine
Author: Michele Morrone
Author: Rhoda H. Halperin
Author: National Research Council
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Author: F. Douglas Scutchfield