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Medical-Legal Partnerships: Reducing Health Disparities by Disrupting Cumulative Disadvantages Faced by Vulnerable Colorado Families

机译:医疗法律合作伙伴关系:通过破坏科罗拉多州脆弱家庭的累积不利条件来减少健康差距

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摘要

In Colorado, low-income and minority children live shorter and less healthy lives than wealthier and white children. Data on childhood asthma, obesity, and infant mortality disparities are disheartening. For example, although Colorado has the 5th lowest infant mortality rate nationally, Colorado's black infants die nearly three times more often than the state's white infants; Latino infants are 70% more likely to die during their first year than whites. Data from 2015 not only show the immunization rate for Colorado toddlers continued a troubling downward trend so that Colorado children rank 30th in the nation, but a research collaborative between the University of Colorado School of Medicine and Children's Hospital Colorado reported that "[s]ignificant disparities exist in vaccination delivery by age group..., race/ethnicity, and socioeconomic status.";This dissertation presents a study premised on the understanding that the inequitable distribution of access to important social determinants of health is an underlying cause of these health disparities among Colorado children. The study examines the impact of medical-legal partnerships (MLPs), an intervention designed to equalize access to preventive medical care, decent housing, and other social determinants in order to disrupt the fundamental association between poverty, minority race and ethnicity status, and poor health. MLPs are an innovative health delivery model that integrate lawyers into clinical delivery teams to help equalize vulnerable patients' access to the social determinants of health that are guaranteed by law. The MLP studied here operated between 2009 and 2013 between Children's Hospital of Colorado, Colorado Legal Services, and a law school program called the Colorado Health Equity Project. This study retrospectively analyzed quantitative medical and qualitative legal data to examine whether MLP services improved children's health and social outcomes by reducing upstream social risk factors that could decrease health disparities over the life course. Specifically, this study analyzed the MLPs impact on young children's vaccination compliance and access to better neighborhood resources due to upward residential mobility. Although this MLP did not have a statistically significant impact on either outcome of interest, the methodology developed here suggested a relationship between MLPs and other health outcomes that warrants further study.
机译:在科罗拉多州,低收入和少数族裔的孩子比富裕和白人的孩子寿命短,健康状况差。有关儿童哮喘,肥胖和婴儿死亡率差异的数据令人沮丧。例如,尽管科罗拉多州的婴儿死亡率在全美排名第五,但科罗拉多州的黑人婴儿的死亡率是该州白人婴儿的近三倍。拉丁美洲婴儿在第一年死亡的可能性比白人高70%。 2015年的数据不仅表明科罗拉多州幼儿的免疫接种率继续呈令人不安的下降趋势,以至于科罗拉多州儿童在全美排名第30位,而且科罗拉多大学医学院与儿童医院之间的一项研究合作报告说:“在按年龄段,种族/民族和社会经济地位分列的疫苗接种工作上存在差异。”;本论文提出了一项研究,其前提是,获得健康的重要社会决定因素的机会分配不均是造成这些健康的根本原因科罗拉多州儿童之间的差异。该研究考察了医疗法律伙伴关系(MLP)的影响,该干预旨在使获得预防性医疗,平等住房和其他社会决定因素的机会均等,从而破坏贫困,少数民族和种族地位与贫困之间的基本联系。健康。 MLP是一种创新的医疗服务提供模式,可将律师纳入临床医疗服务团队,以帮助弱势患者获得法律保障的健康社会决定因素。在这里研究的MLP在2009年至2013年之间由科罗拉多州儿童医院,科罗拉多州法律服务部和一个名为科罗拉多州健康公平项目的法学院计划进行运作。这项研究回顾性分析了定量医学和定性法律数据,以检查MLP服务是否通过减少上游社会风险因素来改善儿童的健康和社会成果,而这些风险因素可能会减少一生中的健康差异。具体来说,本研究分析了MLP对年幼儿童疫苗接种依从性的影响,以及由于居民流动性的提高而获得了更好的社区资源。尽管该MLP对任何一种感兴趣的结局均没有统计学上的显着影响,但此处开发的方法表明MLP与其他健康结局之间的关系值得进一步研究。

著录项

  • 作者

    Matthew, Dayna Bowen.;

  • 作者单位

    University of Colorado at Denver.;

  • 授予单位 University of Colorado at Denver.;
  • 学科 Sociology.;Health care management.;Health sciences.;Law.
  • 学位 Ph.D.
  • 年度 2018
  • 页码 204 p.
  • 总页数 204
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 石油、天然气工业;
  • 关键词

  • 入库时间 2022-08-17 11:52:58

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