Abstract:
BACKGROUND:People experiencing homelessness are often marginalized and are known to face barriers to accessing acceptable and respectful healthcare services. This study examines the experience of accessing hospital-based services of persons experiencing homelessness or vulnerable housing in southeastern Ontario and considers the potential of Equity-Oriented Health Care (EOHC) as an approach to improving care. METHODS:Focus groups and in-depth interviews with people with lived experience of homelessness (n=31), as well as in-depth interviews of health and social service provider key informants (n=10) were combined with qualitative data from a survey of health and social service providers (n=136). Interview transcripts and written survey responses were analyzed using directed content analysis to examine experiences of people with lived experience of homelessness within the healthcare system. RESULTS:Healthcare services were experienced as stigmatizing and shaming particularly for patients with concurrent substance use. These negative experiences could lead to avoidance or abandonment of care. Despite supposed universality, participants felt that the healthcare system was not accountable to them or to other equity-seeking populations. Participants identified a system that was inflexible, designed for a perceived middle-class population, and that failed to take into account the needs and realities of equity-seeking groups. Finally, participants did identify positive healthcare interactions, highlighting the importance of care delivered with dignity, trust, and compassion. CONCLUSIONS:The experiences of healthcare services among the homeless and vulnerably housed do not meet the standards of universally accessible patient-centered care. EOHC could provide a framework for changes to the healthcare system, creating a system that is more trauma-informed, equity-enhancing, and accessible to people experiencing homelessness, thus limiting identified barriers and negative experiences of care.
journal_name
Int J Equity Healthjournal_title
International journal for equity in healthauthors
Purkey E,MacKenzie Mdoi
10.1186/s12939-019-1004-4subject
Has Abstractpub_date
2019-07-01 00:00:00pages
101issue
1issn
1475-9276pii
10.1186/s12939-019-1004-4journal_volume
18pub_type
杂志文章abstract:OBJECTIVE:This narrative review aimed to identify and categorize the barriers and facilitators to the provision of brief intervention and behavioral change programs that target several risk behaviors among the Indigenous populations of Australia, Canada, and New Zealand. METHODS:A systematic database search was conduc...
journal_title:International journal for equity in health
pub_type: 杂志文章,评审
doi:10.1186/s12939-019-1059-2
更新日期:2019-11-05 00:00:00
abstract:BACKGROUND:The actual distribution of stroke and myocardial infarction (MI) associated with social economic status (SES) among the Chinese population is unclear. We aim to understand the development of disparity in stroke and myocardial infarction (MI) across different income groups in Chinese population. METHODS:Data...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0986-2
更新日期:2019-06-11 00:00:00
abstract:BACKGROUND:With the depth development of health care system reform in China, emergency medical services (EMS) is confronted with challenges as well as opportunities. This study aimed to analyze the equity of China's EMS needs, utilization, and resources distribution, and put forward proposal to improve the equity. MET...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0507-5
更新日期:2017-01-11 00:00:00
abstract:BACKGROUND:Despite the recognition of power as being central to health research collaborations between high income countries and low and middle income countries, there has been insufficient detailed analysis of power within these partnerships. The politics of research in the global south is often considered outside of ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0488-4
更新日期:2016-12-12 00:00:00
abstract:BACKGROUND:In 2002 Afghanistan's Ministry of Public Health (MoPH) and its development partners initiated a new paradigm for the health sector by electing to Contract-Out (CO) the Basic Package of Health Services (BPHS) to non-state providers (NSPs). This model is generally regarded as successful, but literature is scar...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0847-4
更新日期:2018-10-05 00:00:00
abstract:BACKGROUND:With the adoption of the Sustainable Development Goals (SDGs), there is a renewed commitment of tackling the varied challenges of undernutrition, particularly stunting (SDG 2.2). Health equity is also a priority in the SDG agenda and there is an urgent need for disaggregated analyses to identify disadvantage...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-1046-7
更新日期:2019-10-15 00:00:00
abstract:BACKGROUND:Resources for coronary revascularisations have increased substantially since the early 1990s in Finland. At the same time, ischaemic heart disease (IHD) mortality has decreased markedly. This study aims to examine how these changes have influenced trends in absolute and relative differences between socioecon...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-017-0536-8
更新日期:2017-02-20 00:00:00
abstract:BACKGROUND:The concept of social capital has been extensively used to explain the relationship between socioeconomic status (SES) and adolescent health and well-being. Much less is known about the specific mechanism through which social capital impacts the relationship. This paper investigates whether an individual's p...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0490-x
更新日期:2016-12-12 00:00:00
abstract:BACKGROUND:The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the l...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-9-13
更新日期:2010-05-25 00:00:00
abstract:BACKGROUND:An integrated and comprehensive hospital/community based health programme is presented, aimed at reducing maternal and child mortality and morbidity. It is run as part of a general programme of health care at a rural hospital situated in northern Tanzania. The purpose was through using research and statistic...
journal_title:International journal for equity in health
pub_type: 社论
doi:10.1186/1475-9276-8-27
更新日期:2009-07-30 00:00:00
abstract:INTRODUCTION:Many countries from the European region, which moved from a government financed and provided health system to social health insurance, would have had the risk of moving away from universal health coverage if they had followed a "traditional" approach. The Eastern European high-income countries studied in t...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0295-y
更新日期:2016-01-15 00:00:00
abstract:BACKGROUND:Dying at home is the most frequent preference of patients with advanced chronic conditions, their caregivers, and the general population. However, most deaths continue to occur in hospitals. The objective of this study was to analyse the socioeconomic inequalities in the place of death in urban areas of Medi...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01324-y
更新日期:2020-12-03 00:00:00
abstract:BACKGROUND:Residential segregation can foster health inequality mechanisms by increasing stress related to neighborhood violence and disorder. AIMS:We studied the association between neighborhood violence and disorder and inequalities in anxiety between two groups of perinatal Israeli women (Jewish, Palestinian-Arab) ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01339-5
更新日期:2020-12-09 00:00:00
abstract:BACKGROUND:Inequity in use of physician services has been detected even within health care systems with universal coverage of the population through public insurance schemes. In this study we analyse and compare inequity in use of physician visits (GP and specialists) in Norway based on data from the Surveys of Living ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-10-25
更新日期:2011-06-15 00:00:00
abstract:BACKGROUND:Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those r...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0978-2
更新日期:2019-06-03 00:00:00
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journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0955-9
更新日期:2019-04-16 00:00:00
abstract:BACKGROUND:The promotion of patient safety and drug safety through promotion of pharmacist's drug safety practice was among the most important aims of China's health delivery system reform, but regional inequity in pharmacist's drug safety practice was still serious in China. METHODS:The 2011 national patient safety a...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-38
更新日期:2012-08-06 00:00:00
abstract:BACKGROUND:Multimorbidity in primary care is a challenge not only for developing countries but also for low and medium income countries (LMIC). Health services in LMIC countries are being provided by both public and private health care providers. However, a critical knowledge gap exists on understanding the true extent...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01170-y
更新日期:2020-04-29 00:00:00
abstract:INTRODUCTION:Literature shows socioeconomic disparities are related to various aspects of diabetes care. However, few studies have explored the relationship between socioeconomics and healthcare outcomes, particularly with regard to preventable hospitalization. This cohort study employed hierarchical modelling to evalu...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0160-4
更新日期:2015-03-21 00:00:00
abstract:INTRODUCTION:Vietnam has succeeded in reducing maternal mortality in the last decades. Analysis of survey data however indicate that large inequities exist between different segments of the population. We have analyzed utilization of antenatal care and skilled birth attendance among Vietnamese women of reproductive age...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-24
更新日期:2012-05-15 00:00:00
abstract:BACKGROUND:China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the rela...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0719-y
更新日期:2018-02-05 00:00:00
abstract:INTRODUCTION:If an intervention is not well spatially targeted, appropriate levels of uptake, efficacy, long-term compliance and improved health outcomes are unlikely to be attained. Effective health interventions should seek to achieve not only absolute improvements in health but also to reduce inequity. There is ofte...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0256-x
更新日期:2015-10-29 00:00:00
abstract::In the debate on 'Third options' for health care delivery in low- and middle-income countries it is proposed that self-help should play a larger role. Self-help is expected to contribute towards improving population health outcomes and reducing government health care expenditure. We review scope and limitations of sel...
journal_title:International journal for equity in health
pub_type: 社论
doi:10.1186/1475-9276-3-1
更新日期:2004-04-15 00:00:00
abstract:BACKGROUND:Inequalities in health across social class, gender and regional context in Spain are well-known; however, there is a lack of research examining how these dimensions of inequality interact. This study explores self-rated health (SRH) inequalities across intersectional positions of gender, social class and reg...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01202-7
更新日期:2020-06-05 00:00:00
abstract:INTRODUCTION:Socio-economic inequalities in basic maternal health interventions exist in Egypt, yet little is known about health-seeking of poor households. This paper assesses levels of maternal health-seeking behaviours in women living in poor households in rural Upper Egypt, and compares these to national averages. ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-014-0111-5
更新日期:2014-11-25 00:00:00
abstract:BACKGROUND:Japan's stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians' experience...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-017-0534-x
更新日期:2017-02-22 00:00:00
abstract:BACKGROUND:Like other African countries, Tanzania has in recent years, been implementing various exemptions and targeting programmes to protect and ensure equitable access to health care by poorer segments of the population. A body of evidence indicates that exemption policies, while potentially effective in principle,...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-12-80
更新日期:2013-09-26 00:00:00
abstract:INTRODUCTION:Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01223-2
更新日期:2020-07-08 00:00:00
abstract:BACKGROUND:Breast cancer stands as the leading cause of cancer related mortality in women worldwide. Mammography screening has the potential to improve prognosis by reducing stage at diagnosis. Socioeconomic inequalities in mammography cancer screening have been widely reported. The influence of organised programs on s...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0811-3
更新日期:2018-07-03 00:00:00
abstract:BACKGROUND:The evaluation of geographical healthcare accessibility in residential areas provides crucial information to public policy. Traditional methods - such as Physician Population Ratios (PPR) or shortest travel time - offer only a one-dimensional view of accessibility. This paper developed an improved indicator:...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0411-z
更新日期:2016-08-02 00:00:00