National Healthcare Quality and Disparities Report
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- Access to Care (5)
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- Children's Health Insurance Program (CHIP) (1)
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- Dental and Oral Health (1)
- Depression (1)
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- Disabilities (1)
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- (-) Low-Income (40)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 40 Research Studies DisplayedGoff SL, Mazor KM, Guhn-Knight H
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
The authors sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. They found that pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Guhn-Knight H .
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
J Racial Ethn Health Disparities 2017 Dec;4(6):1051-60. doi: 10.1007/s40615-016-0309-x.
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Keywords: Access to Care, Quality of Care, Low-Income, Children/Adolescents, Racial and Ethnic Minorities
Selden TM, Lipton BJ, Decker SL
AHRQ Author: Selden TM, Lipton BJ, Decker SL
Medicaid expansion and marketplace eligibility both increased coverage, with trade-offs in access, affordability.
The researchers found that as of 2015, adults with incomes of 100-138 percent of the federal poverty level had experienced large declines in uninsurance rates in both expansion and nonexpansion states. Adults in expansion and nonexpansion states also experienced similar increases in having a usual source of care and primary care visits, and similar reductions in delayed receipt of medical care due to cost.
AHRQ-authored.
Citation: Selden TM, Lipton BJ, Decker SL .
Medicaid expansion and marketplace eligibility both increased coverage, with trade-offs in access, affordability.
Health Aff 2017 Dec;36(12):2069-77. doi: 10.1377/hlthaff.2017.0830.
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Keywords: Access to Care, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Magnusson DM, Minkovitz CS, Kuhlthau KA
AHRQ Author: Mistry KB
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
This study sought to understand the role of health beliefs in shaping maternal decisions regarding help-seeking for children with developmental delay (DD) and explore differences between African American and Hispanic mothers. Five major themes emerged describing the role of maternal health beliefs in shaping key stages of the help-seeking pathway for children with DD. Differences between African American and Hispanic mothers are also described.
AHRQ-authored.
Citation: Magnusson DM, Minkovitz CS, Kuhlthau KA .
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
Pediatrics 2017 Nov;140(5):pii: e20172059. doi: 10.1542/peds.2017-2059.
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Keywords: Children/Adolescents, Shared Decision Making, Disabilities, Low-Income, Racial and Ethnic Minorities
Lines LM, Rosen AB, Ash AS
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
Much of emergency department (ED) use is avoidable, and high-quality primary care can reduce it, but performance measures related to ED use may be inadequately risk-adjusted. To explore associations between ED use and neighborhood poverty, a secondary analysis of Massachusetts managed care network data, 2009-2011, was conducted.
AHRQ-funded; HS022194.
Citation: Lines LM, Rosen AB, Ash AS .
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
J Health Care Poor Underserved 2017;28(4):1487-508. doi: 10.1353/hpu.2017.0129..
Keywords: Emergency Department, Low-Income, Social Determinants of Health, Healthcare Utilization
Xavier Moore J, Donnelly JP, Griffin R
Community characteristics and regional variations in sepsis.
This study aimed to determine the influence of community characteristics upon regional variations in sepsis incidence and case fatality. The study concluded that regional variations in sepsis incidence may be partly explained by community poverty. Other community characteristics do not explain regional variations in sepsis incidence or case fatality.
AHRQ-funded; HS013852.
Citation: Xavier Moore J, Donnelly JP, Griffin R .
Community characteristics and regional variations in sepsis.
Int J Epidemiol 2017 Oct 1;46(5):1607-17. doi: 10.1093/ije/dyx099..
Keywords: Disparities, Low-Income, Mortality, Sepsis, Social Determinants of Health
Kangovi S, Mitra N, Grande D
Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial.
The researchers sought to determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. They concluded that a standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems.
AHRQ-funded; HS021706.
Citation: Kangovi S, Mitra N, Grande D .
Community health worker support for disadvantaged patients with multiple chronic diseases: a randomized clinical trial.
Am J Public Health 2017 Oct;107(10):1660-67. doi: 10.2105/ajph.2017.303985.
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Keywords: Chronic Conditions, Community-Based Practice, Low-Income, Patient-Centered Outcomes Research
Louisias M, Phipatanakul W
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
The authors review current understanding of the epidemiology and etiology of disparities in asthma. They also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors.
AHRQ-funded; HS022986.
Citation: Louisias M, Phipatanakul W .
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
Curr Allergy Asthma Rep 2017 Sep 15;17(10):68. doi: 10.1007/s11882-017-0734-x.
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Keywords: Asthma, Children/Adolescents, Low-Income, Racial and Ethnic Minorities, Vulnerable Populations
Hudson JL, Moriya AS
AHRQ Author: Hudson JL, Moriya AS
Medicaid expansion for adults had measurable 'welcome mat' effects on their children.
This study used data from the 2013-15 American Community Survey to provide the first national-level (analytical) estimates of welcome-mat effects on children's coverage post Affordable Care Act (ACA). It estimated that 710,000 low-income children gained coverage through these effects. The study was also the first to show a link between parents' eligibility for Medicaid and welcome-mat effects for their children under the ACA.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
Medicaid expansion for adults had measurable 'welcome mat' effects on their children.
Health Aff 2017 Sep;36(9):1643-51. doi: 10.1377/hlthaff.2017.0347.
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Keywords: Children/Adolescents, Health Insurance, Policy, Low-Income
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Heintzman J, Bailey SR, DeVoe J
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
This study compared the insurance status of low-income patients served in 23 community health centers (CHCs) in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion in 2014. It found that among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos.
AHRQ-funded; HS021522; HS024270.
Citation: Heintzman J, Bailey SR, DeVoe J .
In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.
J Racial Ethn Health Disparities 2017 Jun;4(3):329-36. doi: 10.1007/s40615-016-0232-1.
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Keywords: Disparities, Health Insurance, Policy, Low-Income, Racial and Ethnic Minorities
Sommers BD, Maylone B, Blendon RJ
Three-year impacts of the Affordable Care Act: improved medical care and health among low-income adults.
Using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage, researchers found that by the end of 2016 the uninsurance rate in the two expansion states had dropped by more than 20 percentage points relative to the nonexpansion state.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Blendon RJ .
Three-year impacts of the Affordable Care Act: improved medical care and health among low-income adults.
Health Aff 2017 Jun;36(6):1119-28. doi: 10.1377/hlthaff.2017.0293.
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Keywords: Policy, Low-Income, Access to Care, Health Insurance, Uninsured
Decker SL, Lipton BJ, Sommers BD
AHRQ Author: Decker SL, Lipton BJ
Medicaid expansion coverage effects grew in 2015 with continued improvements in coverage quality.
The researchers used detailed federal survey data through 2015 to analyze recent changes in coverage for low-income adults after the expansion associated with the Affordable Care Act's (ACA's) Medicaid expansion in 2014. They found that the uninsurance rate fell in both expansion and nonexpansion states but that it fell significantly more in expansion states.
AHRQ-authored; AHRQ-funded; HS021291.
Citation: Decker SL, Lipton BJ, Sommers BD .
Medicaid expansion coverage effects grew in 2015 with continued improvements in coverage quality.
Health Aff 2017 May;36(5):819-25. doi: 10.1377/hlthaff.2016.1462.
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Keywords: Medicaid, Low-Income, Health Insurance, Uninsured, Policy
Heerman WJ, Taylor JL, Wallston KA
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
The study’s objective was to measure the associations between parenting self-efficacy, parent depressive symptoms, and preschool child behaviors that support healthy growth. It found that in this minority population, higher parenting self-efficacy was associated with longer child sleep and fewer meals in front of the TV, but parent depressive symptoms mitigated that protective effect for child sleep duration.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Taylor JL, Wallston KA .
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
Matern Child Health J 2017 May;21(5):1156-65. doi: 10.1007/s10995-016-2214-7.
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Keywords: Children/Adolescents, Family Health and History, Depression, Racial and Ethnic Minorities, Low-Income
Burgette JM, Preisser JS, Jr., Weinberger M
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
The researchers examined the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. They concluded that EHS participation increases dental care use among disadvantaged young children.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Jr., Weinberger M .
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
Am J Public Health 2017 Apr;107(4):614-20. doi: 10.2105/ajph.2016.303621.
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Keywords: Children/Adolescents, Dental and Oral Health, Access to Care, Health Promotion, Low-Income
Berridge C
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
The researchers examined the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. They found that assumptions built into the technology about how older adults live presented a problem for many users who experience unwanted disruptions and threats to their behavioral autonomy. Also, the resident responses challenged the dominant image of residents as passive subjects of a passive monitoring system.
AHRQ-funded; HS000011.
Citation: Berridge C .
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
Ageing Soc 2017 Mar;37(3):537-60. doi: 10.1017/s0144686x15001269.
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Keywords: Caregiving, Elderly, Health Information Technology (HIT), Low-Income
Cole MB, Galarraga O, Wilson IB
At federally funded health centers, Medicaid expansion was associated with improved quality of care.
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. The researchers used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion States. Medicaid expansion was associated with improved quality for asthma treatment, Pap testing, body mass index assessment, and hypertension control.
AHRQ-funded; HS024652.
Citation: Cole MB, Galarraga O, Wilson IB .
At federally funded health centers, Medicaid expansion was associated with improved quality of care.
Health Aff 2017 Jan;36(1):40-48. doi: 10.1377/hlthaff.2016.0804.
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Keywords: Quality of Care, Policy, Uninsured, Low-Income, Access to Care
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Waehrer G, Deb P, Decker SL
AHRQ Author: Decker SL
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income). In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality.
AHRQ-authored.
Citation: Waehrer G, Deb P, Decker SL .
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Econ Hum Biol 2015 Dec;19:170-83. doi: 10.1016/j.ehb.2015.08.006..
Keywords: Nutrition, Social Determinants of Health, Low-Income, Vulnerable Populations
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Chao MT, Handley MA, Quan J
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
The authors identified sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Disclosure was associated with language concordance, physicians' interpersonal communication scores, shared decision making, and explanatory-type communication.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Chao MT, Handley MA, Quan J .
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
Patient Educ Couns 2015 Nov;98(11):1360-6. doi: 10.1016/j.pec.2015.06.011.
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Keywords: Low-Income, Diabetes, Complementary and Alternative Medicine, Racial and Ethnic Minorities, Healthcare Delivery
Kennedy-Hendricks A, Schwartz HL, Griffin BA
Health implications of social networks for children living in public housing.
This study sought to examine whether the health composition of the social networks of children living in subsidized housing differs from those living in public housing developments; and whether children's social network composition is associated with children's own health. The authors found no significant differences in the health characteristics of the social networks of children based on housing, but social network composition was significantly associated with several aspects of children's own health.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Schwartz HL, Griffin BA .
Health implications of social networks for children living in public housing.
Health Place 2015 Nov;36:145-51. doi: 10.1016/j.healthplace.2015.11.001.
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Keywords: Children/Adolescents, Health Status, Low-Income, Social Determinants of Health
Kennedy-Hendricks A, Schwartz H, Thornton RJ
Intergenerational social networks and health behaviors among children living in public housing.
The researchers investigated whether caretakers' social networks are linked with children's health status. They found that caretaker social networks are independently associated with certain aspects of child health, suggesting the importance of the broader social environment for low-income children's health.
AHRQ-funded; HS023009.
Citation: Kennedy-Hendricks A, Schwartz H, Thornton RJ .
Intergenerational social networks and health behaviors among children living in public housing.
Am J Public Health 2015 Nov;105(11):2291-7. doi: 10.2105/ajph.2015.302663.
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Keywords: Caregiving, Children/Adolescents, Family Health and History, Health Status, Low-Income
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Garcia Mosqueira A, Hua LM, Sommers BD
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
The researchers explored potential factors related to racial/ethnic differences in ACA enrollment - awareness of the law and receipt of application assistance such as navigator services. Their results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations to close existing disparities in coverage.
AHRQ-funded; HS021291.
Citation: Garcia Mosqueira A, Hua LM, Sommers BD .
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
Inquiry 2015 Oct 8;52. doi: 10.1177/0046958015609607.
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Keywords: Disparities, Health Insurance, Low-Income, Medicaid, Racial and Ethnic Minorities