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Introduction. Healthcare within the United States has been at the forefront of public discussion and political representation in recent years, particularly as it relates to healthcare access and barriers to said access. Focus has been placed on low-income groups that most generally represent the face of the average American, but this leaves the question: How are new Americans faring, and do their struggles match those faced by the rest of the country? The new Americans of Burlington, Vermont serve as a small window into a unique refugee population's experiences with healthcare in the United States. Methods. A focus group consisting of 8 women was hosted on-site at the Burlington Housing Authority Franklin Square apartments. Questions were designed to determine demographic data as well facilitate subjective discussion on participants' healthcare experiences. Translation services were provided by the resident manager. Results. Languages spoken were Mai Mai, Swahili, and English. Five major themes for healthcare access barriers were identified: language barriers, having children, transportation barriers, financial barriers, and a lack of preventative care. Sub- themes were also identified, which formed a taxonomy of barriers to healthcare access among the representative population. Discussion/Conclusions. The difficulties faced by new Americans are numerous and interrelated, leading to a perpetual cycle of insufficient healthcare. Throughout the discussion, the financial burden of healthcare was regularly raised as one of the most prominent issues faced. This concern matches with those found in similar, previous studies, that have analyzed the difficulties faced by the rest of America. ; https://scholarworks.uvm.edu/comphp_gallery/1254/thumbnail.jpg

AbstractLatinx children now live in a wider array of U.S. geographic areas than in the past, including both established and new areas of Latinx settlement. This geographic heterogeneity could be consequential for Latinx children's health care access, with prior research suggesting increased health access barriers for Latinx children in new versus established areas of settlement. Merging public-use county-level data with restricted individual-level health data from the National Health Interview Survey (2010–2014), we quantitatively examine how three health access indicators—health insurance coverage, delayed care, and usual place of care—differ among children (ages 4–17) in Latinx immigrant, Latinx U.S.-born, White U.S.-born, and Black U.S.-born families (n = 89,994) across established, fast-growing hub, new, and minor Latinx destination counties. We also examine the potential roles of local immigrant hostilities and health care resources in contributing to health access differences across destinations. In fully adjusted models, children in new destinations are less likely to have health insurance than peers in established destinations, and this disparity is even wider for Latinx children of immigrants. Adjusted model results also show that children in new destinations are more likely to have delayed care than those in established destinations, and children in these four groups in new destinations, fast-growing hubs, and minor destinations are more likely to have no usual place of care than peers in established destinations. Our results are consistent with prior work suggesting that more health care access barriers exist for children, particularly Latinx children of immigrants, in new versus established Latinx destinations.

AbstractThis article analyzes the link between men's and women's perceptions of health and the demand for health goods and services. The study examines access to the health care system in a community characterized by social and economic variance. The data have been taken from a health survey carried out in a suburb of the city of Zaragoza in Spain. The sample (1,032 people over the age of 15) was selected according to specifications of sex, age, and place of residence. The sample shows a confidence interval of 95.5 percent with a ±3 margin of error. Descriptive and inferential statistical techniques are used. Sex differences are reflected in social conditions, lifestyles, health perception, and health care behaviors. The research describes how differences in health attitudes can be contextualized by the neighborhood. The results of this type of research are essential for the design of preventive strategies that are better adapted to need.

The United States has a rich history of resettling refugees. The United States resettled hundreds of thousands of refugees at the conclusion of World War II, and has resettled more than 3 million refugees since 1975 (Refugee Council USA, 2016). A refugee is a forcibly displaced person who will not or cannot return to their country of origin because of fear of physical harm or persecution (United Nations, 1951). Refugees are distinct from other forms of immigrants in many ways: refugees do not choose their country for resettlement, they receive government assistance upon arrival, their residency and work permits are in effect indefinitely, and English-speaking ability does not play a part in the resettlement process. Because of the United States' open refugee resettlement policies, refugees make up an integral part of an ever-diversifying U.S. population, and will continue to do so for many years. Upon resettlement, refugees often lack access to basic social services, in particularly, to health care (Bulman and McCourt, 2002). The United States has generous policies to assist refugees when they arrive, but because of their ability to speak English and discrepancies in the cultural understanding of health care many of the services are underutilized (Finney Lamb & Smith, 2006; Lloyd 2014). Not only are refugees less able to access care, but they are more likely to have preexisting health conditions. For example, a survey of incoming refugees in Denmark found that 64% of newly-arrived refugees had one or more physical illnesses - and they did not even attempt to account for the incidence of mental illness (Kristensen and Mandrup, 2005). Research on refugee access to health care has been conducted predominantly in the United States, the United Kingdom, and Australia. The studies conducted outside of the United States can provide important insight into universal barriers for refugees, but they deal with very different healthcare systems and often investigate different refugee populations. The studies which have been conducted in the United States address a wide array of refugee populations spread throughout very different regions of the United States (Mirza 2014; Wagner and Thiruchandurai 2013). Diversity in research within the United States is vital because of the large number of refugees that the United States accepts each year and because of the widely varying circumstances for refugees in different regions of the country. The ability for refugees to access health care varies widely from rural to urban areas and from state to state depending on policies (Mirza 2014). Larger hospitals in urban areas are more likely to be equipped with more extensive translational services than practices in rural areas tend to employ, and the state legislation concerning refugees varies drastically from state to state which can drastically affect health outcomes. These diverse studies help to assess the impact of the legislation implemented on both the federal and state levels. Numerous federal health programs, such as the Affordable Care Act and Medicaid, have the potential to drastically affect the health experiences for refugees, but as mentioned above, a significant amount of health care policy for refugees is determined on the state level. This study is important, because the majority of the studies which have been conducted in the United States tend to focus on large cities and this is an opportunity to examine the experience of refugees in a more rural area. It is also a unique opportunity to evaluate the impact and unused potential of Utah's progressive refugee legislation.

The number of undocumented migrants in high-income countries has increased in recent decades, imposing considerable political, fiscal, and social pressures on governments. This has fostered discussions on whether and to what extent undocumented migrants should get access to public programs and public benefits. Looking at the 2012 Spanish health reform, this is the first paper to document the impacts of a restriction on access to the health-care system for undocumented migrants on health-care utilization, health-care system perceptions, and self-reported health in a high-income country. We show that such restrictions may significantly reduce planned care for undocumented migrants and result in sharp fall in positive opinions about the health-care services still left available to them. We also exploit the heterogeneity in implementing the policy across regions and report stronger effects in regions that enforced the national ban more fully. Furthermore, in the first 3 years since the implementation of the reform, we find suggestive evidence of a worsening in self-assessed health. This study is relevant for policymakers in the developed world, especially in countries that have recently implemented initiatives aimed at reducing the health-care coverage for targeted groups, such as the United Kingdom and the United States.

Gender disparity in various socioeconomic and cultural spheres, a common phenomenon in India, has a cumulative effect upon the health status of women. Poor rural women are disadvantaged by both types of disparity—rural–urban disparity and male–female disparity. This article tries to explore the disparity in access to health care services between rural and urban women and the implications of this disparity upon their children's health status.

Since 1994 the issue of how access is impacted by managed care in rural Utah has been the focus of State advisory groups, the Utah Health Policy Commission, and the legislature. The Health Systems Improvement Act (1995) formalized the concern with a request that the Utah Department of Health study this impact (Sinclair et. Al., #2, pg. 1). In focus meetings around the state, the perception that managed care can negatively impact access in rural communities is generally accepted without significant controversy. Such comments often assume that rural residents will be forced to travel further or will receive fewer services that insurers have excluded from their managed care plans.

Using data from the 2019 National Survey of Children's Health, we evaluated family structure differences in youth health care access and experiences. We found youth living with their married biological/adoptive parents generally had greater health care access than youth living in structurally diverse families. Differences, however, varied based on which aspect of health care access was examined and the specific types of structurally diverse families youth were living in. Youth living in single-father and other relative-headed families showed the most consistent differences in health care access from youth living with their married biological/adoptive parents. In terms of health care experiences, youth living in several structurally diverse families were more likely to have had time alone with health care providers. Furthermore, there were differences in family-centered care, but the effect size and magnitude of the differences were small.

Purpose
The purpose of this paper is to investigate the association between social capital (SC) and health care access problem among the older people in Bangladesh.


Design/methodology/approach
This study applied a random sampling method to select 310 older adults (all aged 60 years) in Bangladesh. Exploratory factor analysis was employed to extract SC dimensions. Logistic regression was applied to measure the association of SC dimensions and access.


Findings
The logistic regression result shows that with a one-unit increase in social network, norms of reciprocity, and civic participation, health care access problem will be decreased by OR= 0.732 (95% CI =0.529–1.014); OR=0.641 (95% CI = 0.447–0.919); and OR=0.748 (95% CI = 0.556–1.006) units. Respondents who have economic hardship were 3.211 (OR=3.211, CI = 0.84–5.59) times more likely to say that they had health care access problem compared with who had no economic hardship.


Research limitations/implications
The study showed that the lower level of SC and presence of economic hardship increased the probability to health care access problem among the older people. Improving SC may be helpful in reducing health care access problem. However, economic hardship reductions are also important to reduce the health care access problem. Improving SC and reducing economic hardship thus should be implemented at the same time.


Practical implications
The study showed that low SC and economic hardship increased the probability to health care access problem. Improving SC may be helpful in reducing health inequity. However, economic hardship reductions also important to health care access. Therefore, improving SC and reducing economic hardship should be implemented at the same time.


Originality/value
This study has a great policy importance in regard to reducing health care access problem among the older adult in Bangladesh as SC has a potential to bring about a concomitant improvement in the condition of the health care access.

The Republic of the Marshall Islands is a sovereign nation previously under the administrative control of the United States. Since 1986, the Compacts of Free Association (COFA) between the Republic of the Marshall Islands and the United States allows Marshall Islands citizens to freely enter, lawfully reside, and work in the United States, and provides the United States exclusive military control of the region.

Cover -- Half Title -- Title -- Copyright -- Contents -- Abbreviations -- Introduction: A Contentious Term of Medical Decision Making -- 1. Medical Necessity? A Definitional, Philosophical, and Historical Question -- 2. In the Archive: Coding for Necessity and the Necessity of Coding -- 3. "No Legitimate Use": Marijuana and the Bounds of the Medical -- 4. Contesting the Medical Necessity for Mental Health -- 5. Reproductive Politics: The Cases of C-Section and Abortion -- Conclusion: Embracing the Politics of Medical Necessity -- Acknowledgments -- Notes -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- R -- S -- T -- U -- V -- W.