To JHCPU readers,
The Note from the Editor appears below. Following the link will bring you to the full table of contents.
With best wishes for the new academic year,
Ginny Brennan
Note from the Editor
Public Health and Politics
Positioned at the nexus of social science and health, the
Journal's work is necessarily political. One of the many concerns
in the U.S. as we approach the Fall of 2022 is the U.S. Supreme Court's
June decision in Dobbs v. Jackson Women's Health Organization to
overturn Roe v. Wade and with it the Constitutional
guarantee of the right to abortion, abrogating women's moral autonomy
over their reproductive health. In this issue, Frohwirth and colleagues
consider another contested site in the reproductive health care
landscape—contraception affected by abortion policy—as
they assess the impact on women in Iowa of a 2017 reduction in Medicaid
coverage of contraceptive care. Due to the new law, patients enrolled
in the state family planning program could no longer access subsidized
care at publicly funded clinics affiliated
with abortion provision, and over 15,000 patients had to find to find a
new family planning provider. The researchers learned in their
qualitative study that high fees for visits and contraceptive methods,
restrictive or inadequate insurance coverage, and
access barriers such as long appointment wait times were the most
common barriers to preferred contraceptive care, and these barriers
compounded one another. Furthermore, barriers grew once the more
restrictive Iowa Medicaid policy was in place. The authors
conclude that policy changes supportive of contraceptive care would
decrease vulnerability and increase reproductive autonomy.
Several papers in this issue bear on the construction of datasets or use
datasets in new and sophisticated ways. We publish them aware of the
fact that database construction is central to many highly political
debates. Qato and colleagues introduce an intermediate-level
variable—the nursing home—into an analysis of the distribution of
COVID19 vaccination among nursing home residents. Looking at over 12,000
nursing homes in terms of the racial heterogeneity of the residents,
the authors find that residents of the quantile
of homes that were more predominantly non-Hispanic White were
significantly more likely to be vaccinated (mean vaccinated 85.65%) than
residents of the quantile that was least predominantly non-Hispanic
White (mean vaccinated 72.74%). The authors of this short
article conclude, "A higher proportion of White residents per facility
was associated with higher resident COVID-19 vaccination rates
reflecting continued disparities in quality of care during the
pandemic."
While it is not construed formally as a variable, the construct of
neighborhood in the paper by DiFiore and colleagues reveals significant
patterns in the distribution of food insecurity. They assess food
insecurity in relationship to perceived neighborhood
safety, social cohesion, informal social control, and crime, adjusted
for demographics, socioeconomic status, and neighborhood
characteristics. The participants in the study were 300 mothers and
female caregivers of Medicaid-enrolled two- to four-year old
children in Philadelphia. Greater food security was associated with
higher perceived neighborhood safety and social cohesion, and lower
police-recorded violent crime rates. The evidence of this research
suggests that the structural condition of living in a
supportive neighborhood social environment may protect against food
insecurity.
Kong and colleagues conducted COVID19/food security research, using
longitudinal data to assess the interrelationships among food
insecurity, mental health, and the COVID19 pandemic. They found that
food insecurity was associated with stress, depression, and
anxiety. They also found that these conditions improved over time
during the pandemic among food-secure participants but worsened among
food-insecure participants. The pandemic appears to worsen the already
vicious cycle connecting food insecurity and mental
health.
Two papers based on the Youth Risk Behavior Survey (YRBS) argue for
enriched variables for coding race and ethnicity. Jones and Satter
analyze mental health outcomes based on race and ethnicity and, in doing
so, they observe that over 80% of respondents to
the YRBS who self-identified as American Indian/Alaska Native also
self-identified as Hispanic. American Indians/Alaska Natives are often
multi-racial and of Hispanic/Latino ethnicity, and therefore outcomes
differ widely depending on whether one examines
American Indian/Alaska Native alone or in combination with other
racial/ethnic variables. Also using the YRBSS, Braun and colleagues
assessed tobacco and alcohol use and adolescent sexual practices among
Black, bi/multi-racial, and White adolescents. They
find that results differed across all three groups, leading them to
conclude that nuanced racial categories are called for.
It is our hope that these and the many other papers in this quarter's
issue—through their attention to social, scientific, and political
decisions affecting health and health care—will serve to advance health
justice, either through or in spite of the political
process.
Virginia M. Brennan, PhD, MA
Editor, JHCPU
Associate Professor, Meharry Medical College
My source:
Spiritof1848 Listserv WWW.SPIRITOF1848.ORG #Spiritof1848
orcid.org/0000-0002-0192-8965
