EUROPEAN JOURNAL OF ENVIRONMENT AND PUBLIC HEALTH

Volume 3, Issue 2, 2019

Research Article
Factors Associated with Emergency Departments in Utilization of Health Services among Minorities who are Enrolled in Medicare
European Journal of Environment and Public Health, 2019, 3(2), em0026, https://doi.org/10.29333/ejeph/5852
ABSTRACT: This research was conducted to determine if there is a difference among Medicare and/or Medicaid enrolled patients, based on age, gender and provider diagnosis. The research was conducted using data from the The National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS was designed to collect data on the utilization and provision of ambulatory care services in hospital emergency and outpatient departments and ambulatory surgery locations. Findings are based on a national sample of visits to the emergency departments, outpatient departments, and ambulatory surgery locations of non-institutional general and short hospital stays. The research indicated that there are slightly significant differences between male and female total observations. There are a total of 2471 (53.881%) females compared to 1855 (40.449%) males for initial visits between the two sexes. For follow-up visits, about 138 (3.009%) are female compared to 122 (2.660%) for males. When looking at the differences between the races, there was a significant difference between white and black. For initial visits, there were 3536 (77.104%) among whites compared to 646 (14.086%) for blacks; others or unknown was 144 (3.140%). Also, there were significant differences for follow-up visits between the two races. About 218 (4.754%) are white compared to only 36 (.0785%) for black; other race or unknown was only 6 (0.131%).
Research Article
eHealth: The Mainstay of Healthcare Delivery in the 21st Century
European Journal of Environment and Public Health, 2019, 3(2), em0027, https://doi.org/10.29333/ejeph/5853
ABSTRACT: The demand and cost of healthcare are on the rise, but it is still important to optimize the care of all patients, while containing the cost of healthcare. There is an increasing need to develop systems that deliver good-quality health care and are cost-effective, especially in developing countries. Due to technological advancements, new healthcare delivery models are being developed to improve healthcare accessibility, especially to distant areas and for emergencies. One of these models of healthcare delivery is eHealth. There is a wide variability in the scope and focus of eHealth. eHealth is an umbrella term that includes telemedicine, mHealth, telecare, ePublic health, eMental health or telehealth. Artificial satellites, internet, mobile communication and cloud communication are some of the several ways that have been identified to be used for providing eHealth services, all with their benefits and applications. The use of eHealth in the delivery of healthcare has a wide range of identified benefits for the service users (clients and patients) and service providers (health professionals). Various barriers to healthcare delivery are set to be broken by the optimal utilization of eHealth. In spite of all these benefits, eHealth is not without its potential risks and challenges. To improve the viability of eHealth in the market and increase its use globally, authors therefore recommend that the risks have to be minimized and barriers lifted.
Research Article
Cultural Competency-Related Content among Florida Colleges of Pharmacy Curricula
European Journal of Environment and Public Health, 2019, 3(2), em0028, https://doi.org/10.29333/ejeph/5867
ABSTRACT: Objective. Assess cultural competency-related content in Pharmacy curricula among Colleges/Schools of Pharmacy in the state of FL.
Methods. Content analysis was used to examine PharmD course descriptions among 5 FL accredited Colleges of Pharmacy. All course descriptions were obtained through the institutes’ websites and the Florida Department of Education’s Statewide Course Numbering System. The text query analysis gathered and compared key terms among all universities using QSR NVivo11 software. In addition, the association between the number of courses with cultural competency-related content for each PharmD program and each class year were examined.
Results. Cultural competency related content differed by PharmD programs and class years. Only first-year (P1) pharmacy students showed significant differences in exposure to courses with cultural competency-related content.
Conclusion. This study implies PharmD education curricula needs to incorporate more exposure to cultural competency-related content within Pharmacy programs. Implementing cultural competence training would equip pharmacists in delivering competent care to vulnerable patient populations.
Research Article
Physiological Risk Profiles and Allostatic Load: Using Latent Profile Analysis to Examine Socioeconomic Differences in Physiological Patterns of Risk
European Journal of Environment and Public Health, 2019, 3(2), em0029, https://doi.org/10.29333/ejeph/5870
ABSTRACT: Purpose. The current study sought to expand implications of physiological weathering through the application of latent profile analysis to stress biomarkers to address limitations of traditional allostatic load calculations.
Methods. Latent profile analysis was applied biomarkers used in traditional allostatic load metrics to identify physiological risk profiles in the 2007-20010 National Health and Nutritional and Examination Survey. Multinomial logistic regression was used to determine the probability of risk profiles by race/ethnicity, age, gender, and poverty income ratio (PIR). Mean allostatic load score was assessed across each risk profile.
Results. Latent profile analysis identified four distinct profiles labeled low risk, inflammatory risk, cardiovascular risk, and hypertension risk. Race, age, and gender significantly increased odds of exhibiting a risk profile. Compared to Whites, Hispanics had significant higher odds of inflammatory (OR=1.43, 95% CI [1.06-1.92]) and cardiovascular risk profiles (OR=1.63, 95% CI [1.09-2.43]) while Blacks had higher odds of inflammatory (OR=1.76 95% CI [1.25-2.47]), cardiovascular (OR=2.12, 95% CI, [1.39-3.27]) and hypertension risk profiles (OR= 1.78, 95% CI [1.21-2.59]). Females held significant greater odds of all risk categories except hypertension in which they held the lowest odds (OR= .19, 95% CI [.14-.25]). Mean allostatic load scores were highest in the inflammatory (M=3.99, SD=1.66) and cardiovascular risk profiles (M=4.4, SD=1.84).
Conclusions. Employing latent profile analysis may expand traditional allostatic load methodology by identifying physiological risk patterns among those who experience allostatic load early in life. This may be useful for examining how cultural specific interventions may reduce cardiovascular risk among those exhibiting physiological risk profiles.
Research Article
Asbestos: A Silent Potent Killer
European Journal of Environment and Public Health, 2019, 3(2), em0030, https://doi.org/10.29333/ejeph/5906
ABSTRACT: Asbestos is a general name given to a group of carcinogenic and genotoxic fibrous silicate minerals that have been of commercial values over the years. They include chrysolite, amosite, crocidolite, tremolite, actinolite and anthrophylite. Because of their special properties such as flexibility, tensile length, heat stability and resistivity to chemical, electrical, thermal and biological attacks, asbestos fibres have been used as components of several construction, building and automotive materials. This materials when disturbed, during home redecoration, demolition, renovation and automobiles repairs, release asbestos fibres into the atmosphere leading to both residential and occupational exposure. Measured concentration of fibres has been found to be higher in urban areas (especially those in close proximity with asbestos industries which may include mining and demolition sites) than in rural areas. Several studies have linked asbestos exposure to several serious health challenges such as lung cancer, mesothelioma, asbestosis, and other respiratory diseases. Although the main mechanisms through which asbestos can lead to diseases are not fully understood, three hypotheses have been made. These include alterations at the chromosomal level, activation of oncogenes, loss of tumour suppressor genes, alterations in cellular signal transduction pathways, generation of reactive oxygen and nitrogen species, and direct mechanical damage to cells from asbestos fibres. This article reviews briefly the ways by which the general public (occupational and non-occupational) can be exposed to asbestos and its most recent pathogenic mechanisms leading to malignant and non-malignant disease conditions.
Research Article
Association between Health Insurance and Obesity among Adolescents
European Journal of Environment and Public Health, 2019, 3(2), em0031, https://doi.org/10.29333/ejeph/5929
ABSTRACT: Background: Childhood obesity has become a vast concern among public health professionals. The Centers for Disease Control and Prevention reported that childhood obesity has a lasting effect on a child’s health and well-being. Research has found that 40% of Mississippi youth are obese and have a possibility of carrying the obesity into adulthood. Availability of health insurance greatly impact human health. Researchers suggest that children benefit from public and private insurance. The purpose of this study was to investigate an association between health insurance and obesity among adolescents in Hinds County, Mississippi.
Method: A cross-sectional study was administered to 36 parents of adolescents in Hinds County at the Metrocenter Mall and the Boys and Girls Club to determine whether adolescents have health insurance coverage. A descriptive statistic was conducted to describe the characteristics of the sample. Gender differences of BMI were examined using a t-test. Chi-square was used to show an association between obesity status and healthcare utilization. The statistical software that was used to analyze the data was Statistical Package for the Social Sciences (SPSS).
Results: There was no significant difference in insurance utilization and obesity rate was (p=0.125). 100% of participants with private insurance utilized their insurance while only 87% of participants utilized public insurance (p=0.056).
Conclusion: Based on this research, findings indicate that the majority of the adolescents have both public and private insurance. Parents are utilizing health insurance services for their adolescents. The prevalence of childhood obesity was significantly small. Healthcare utilization among obese adolescents was relatively small.