Abstract
Universal Health Care: Will Colorado Lead the Way with Amendment 69?
Ricki Hadow, Colorado School of Public Health, Master's student; ColoradoCare, Special Operations1, Irene Aguilar, MD, Colorado State Senator, Co-author of ColoradoCare2, Lyn Gullette, Co-author of ColoradoCare2, Ivan Miller, Co-author of ColoradoCare2, Ralph Ogden, Co-author of ColoradoCare2 and William Semple, Co-author of ColoradoCare2
(1)Colorado School of Public Health, Aurora, CO, (2)ColoradoCare, Louisville, CO
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The U.S. is the only industrialized country that does not provide health care for all its citizens. All other developed countries guarantee their citizens full and equal access to health care. The Affordable Care Act has made significant progress in reducing the number of uninsured, yet 29 million Americans remain without health insurance. One provision in that law (µ1332) specifically encourages states to produce innovative health care proposals of their own.
Implementing that suggestion, a group of Coloradans created ColoradoCare, a plan to provide universal healthcare for Coloradans, with the idea that once one state has adopted such a system, others will follow, until universal health care becomes the law of the land. Because the Colorado legislature was unwilling to refer ColoradoCare to the ballot, the group decided to take ColoradoCare to the people as a citizens' initiative. Having received sufficient signatures to qualify for the November 2016 ballot, ColoradoCare, as Amendment 69, will now be put to a vote.
This presentation will: identify challenges in getting Amendment 69 on the ballot and provide details about the plan. We will present details on: how ColoradoCare would be financed, organized and run; how it would interact with existing federal programs (e.g., Medicare and Medicaid); what would be covered under the plan; and what the cost would be to a typical user of the system. Finally, the views of both proponents and opponents will be presented.
Provision of health care to the public Public health administration or related administration Public health or related laws, regulations, standards, or guidelines
Abstract
Better Together: Community Partnerships to Increase Equity in Access to Care for Public Housing Residents
Joy Oguntimein, MPH1 and Kristine Gonnella, MPH2
(1)North American Management, Alexandria, VA, (2)National Nurse-Led Care Consortium, Philadelphia, PA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Community partnerships can improve access to care for low-income and disadvantaged populations. Partnerships between Public Housing Authorities (PHAs) and Public Housing Primary Care Health Centers (PHPCs) are ideal for addressing causes of health inequities such as education, housing, neighborhood environment, and employment opportunities. We conducted in-depth interviews with 5 PHPCs and PHAs (n=13), which were selected by geographic region and documented success improving residents' access to care. Interviews were conducted with a semi-structured guide. Data were transcribed and analyzed by thematic analysis. Components of successful partnerships included shared goals related to improving care coordination, access, and delivery; continual resident engagement; and consistent assessment of initiatives. Additionally, PHPC-PHA partnerships encouraged community members to address social, structural, and physical environmental inequities through active involvement. Additionally, in each succesful partnership each partner contributed their expertise to understand and address an issue with holistic action that benefitted the community. Reported outcomes and benefits attributed to the PHA-PHPC partnerships included increased employment opportunities for residents; increased number of residents with health care coverage; improved community environment; and more partnerships with government agencies, nongovernmental organizations, and academic institutions. Collaborative partnerships are a prominent strategy for community health improvement. PHAs and PHPCs can align their agendas and work collaboratively to address the health of public housing residents. Future assessments of partnerships will explore best practices for expanding and sustaining partnerships.
Public health or related research
Abstract
Providing for All: The Sonoma County Farmworker Health Survey and Its Importance in Developing Strategies to Achieve Health Equity for the Remaining Uninsured
Brian Vaughn, MPH
Sonoma County, Santa Rosa, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction
The Sonoma County Farmworker Health Survey (FHS) was conducted to describe the health and well-being of adult farmworkers in Sonoma County, California, and to identify preventable health disparities for this population.
Methods
From September 2013 through January 2014, venue-based and convenience sampling were used to survey 293 farmworkers aged 18 years or older. Questions included self-rated general health, diabetes and hypertension, and body mass index. To identify disparities between surveyed farmworkers and Sonoma County residents overall, age-adjusted prevalence estimates were developed by using indirect standardization to the adult (18 years) Sonoma County sample from the California Health Interview Survey for 2011–2012.
Results
Surveyed farmworkers were mostly male (91%) and Latino or Hispanic (95%), and 54% had an educational attainment of 8th grade or less. Most (81%) farmworkers reported their families earned less than $30,000 in 2012. After adjusting for age, 30% of farmworkers had US-based health insurance as compared with the 86% of Sonoma County adults in 2011–2012 (P < .001), and 15% of farmworkers reported ever being diagnosed with diabetes after adjusting for age as compared with 5% of Sonoma County adults (P = .002). After adjusting for age, 44% of farmworkers reported poor or fair health in general as compared with 13% of Sonoma County adults (P < .001).
Conclusion
We identified significant health disparities between Sonoma County farmworkers and Sonoma County adults overall. Additional research and new health policies are necessary to eliminate these health disparities and to facilitate farmworker access to the health care system.
Advocacy for health and health education Biostatistics, economics Diversity and culture Epidemiology Program planning Public health or related public policy
Abstract
Determining Gaps at the Regional and Community Level in Healthcare Needs and Access: A Sub-County Deep-dive Analysis in San Diego County
Sanaa Abedin, MPH1, Leslie Ray, MPH, MPPA, MA1, Maria Pena, MPH1, Ryan Smith, MPH1, Isabel Corcos, PhD, MPH1, Amelia Kenner Brininger, MPH, CPH2, Joshua Smith, PhD, MPH1 and Barbara M. Stepanski, MPH1
(1)County of San Diego Health and Human Services Agency, San Diego, CA, (2)County of San Diego, San Diego, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: The uninsured population declined considerably under the Affordable Care Act (ACA). In California, the uninsured fell from 13.8% to 11.9% between 2013-14; whereas, San Diego County experienced a larger drop, from 15.3% to 10.7%. Identifying communities disproportionally affected by health coverage and access issues is an integral step to addressing health inequities at the sub-county level.
Objectives: The purpose of this analysis is to identify San Diego County communities with the highest percentage of uninsured and their characteristics, and areas with healthcare access issues during the 2014 enactment of the ACA.
Methods: This analysis utilized census-tract level data from the 2010-2014 American Community Survey with coverage type stratified by sociodemographic factors. Census-tract data was aggregated to 41 sub-regional areas (SRAs) and regions. The 2013-14 California Health Interview Survey was used to determine gaps in healthcare access, coverage and utilization.
Results: In 2014, National City and Central Region communities (all with lower socioeconomic status) had the largest uninsured population (ranging from 22.6%-30.0%). National City had the greatest population of uninsured children (17.8%) and adults, ages 18-24 and 45-64 (48.3% and 35.0%, respectively). Central Region had the largest population with no usual source of care (24.9%). South experienced the greatest decline in the uninsured (8.7%) and the second-largest increase in the percentage of individuals with no usual source of care (7.2%).
Conclusions: Determining which communities would benefit from enhanced coverage and healthcare access efforts is of paramount public health importance to ensure gaps in health coverage are addressed.
Conduct evaluation related to programs, research, and other areas of practice Provision of health care to the public Public health or related research