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A 2-year community-randomized controlled trial of fluoride varnish to prevent early childhood caries in Aboriginal children.

https://arctichealth.org/en/permalink/ahliterature157658
Source
Community Dent Oral Epidemiol. 2008 Dec;36(6):503-16
Publication Type
Article
Date
Dec-2008
Author
Herenia P Lawrence
Darlene Binguis
Jan Douglas
Lynda McKeown
Bonita Switzer
Rafael Figueiredo
Audrey Laporte
Author Affiliation
Community Dentistry Discipline, Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. herenia.lawrence@utoronto.ca
Source
Community Dent Oral Epidemiol. 2008 Dec;36(6):503-16
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Caregivers - education
Cariostatic Agents - administration & dosage - therapeutic use
Child, Preschool
Cluster analysis
DMF Index
Dental Caries - epidemiology - prevention & control
Female
Fluorides, Topical - therapeutic use
Health Education, Dental
Health Status Disparities
Humans
Incidence
Indians, North American
Infant
Logistic Models
Male
Ontario - epidemiology
Prevalence
Sodium Fluoride - administration & dosage
Tooth, Deciduous
Abstract
To measure the effectiveness of fluoride varnish (FV) (Duraflor), 5% sodium fluoride, Pharmascience Inc., Montréal, QC, Canada) and caregiver counseling in preventing early childhood caries (ECC) in Aboriginal children in a 2-year community-randomized controlled trial.
Twenty First Nations communities in the Sioux Lookout Zone (SLZ), Northwest Ontario, Canada were randomized to two study groups. All caregivers received oral health counseling, while children in one group received FV twice per year and the controls received no varnish. A total of 1275, 6 months to 5-year-old children from the SLZ communities were enrolled. In addition, a convenience sample of 150 primarily non-Aboriginal children of the same age were recruited from the neighboring community of Thunder Bay and used as comparisons. Longitudinal examinations for the dmft/s indices were conducted by calibrated hygienists in 2003, 2004 and 2005.
Aboriginal children living in the SLZ or in Thunder Bay had significantly higher caries prevalence and severity than non-Aboriginal children in Thunder Bay. FV treatment conferred an 18% reduction in the 2-year mean 'net' dmfs increment for Aboriginal children and a 25% reduction for all children, using cluster analysis to adjust for the intra-cluster correlation among children in the same community. Adjusted odds ratio for caries incidence was 1.96 times higher in the controls than in the FV group (95% CI = 1.08-3.56; P = 0.027). For those caries-free at baseline, the number (of children) needed to treat (NNT) equaled 7.4.
Findings support the use of FV at least twice per year, in conjunction with caregiver counseling, to prevent ECC, reduce caries increment and oral health inequalities between young Aboriginal and non-Aboriginal children.
PubMed ID
18422711 View in PubMed
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11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).

https://arctichealth.org/en/permalink/ahliterature149701
Source
Lancet. 2009 Aug 22;374(9690):620-7
Publication Type
Article
Date
Aug-22-2009
Author
Jari Tiihonen
Jouko Lönnqvist
Kristian Wahlbeck
Timo Klaukka
Leo Niskanen
Antti Tanskanen
Jari Haukka
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio and Niuvanniemi Hospital, Department of Clinical Physiology, Kuopio University Hospital, Kuopio, Finland. jari.tiihonen@niuva.fi
Source
Lancet. 2009 Aug 22;374(9690):620-7
Date
Aug-22-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Antipsychotic Agents - adverse effects
Case-Control Studies
Cause of Death
Clozapine - adverse effects
Dibenzothiazepines - adverse effects
Drug Utilization - trends
Female
Finland - epidemiology
Follow-Up Studies
Health Status Disparities
Humans
Life expectancy
Male
Middle Aged
Patient Readmission - statistics & numerical data
Perphenazine - adverse effects
Proportional Hazards Models
Registries
Risk factors
Schizophrenia - drug therapy - mortality
Sex Distribution
Time Factors
Abstract
The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.
Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5.2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.
Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up, the gap in life expectancy between patients with schizophrenia and the general population did not widen between 1996 (25 years), and 2006 (22.5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1.41, 95% CI 1.09-1.82), and the lowest risk for clozapine (0.74, 0.60-0.91; p=0.0045 for the difference between clozapine vs perphenazine, and p
Notes
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897117
Comment In: Lancet. 2009 Nov 7;374(9701):1591; author reply 1592-319897118
Comment In: Lancet. 2009 Aug 22;374(9690):590-219595448
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897121
Comment In: Lancet. 2009 Nov 7;374(9701):1592; author reply 1592-319897120
PubMed ID
19595447 View in PubMed
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Aboriginal and Torres Strait Islander mental health: paradise lost?

https://arctichealth.org/en/permalink/ahliterature127344
Source
Med J Aust. 2012 Feb 6;196:89-90
Publication Type
Article
Date
Feb-6-2012
Author
Robert M Parker
Source
Med J Aust. 2012 Feb 6;196:89-90
Date
Feb-6-2012
Language
English
Publication Type
Article
Keywords
Female
Health Status Disparities
Humans
Intellectual Disability - ethnology
Male
Mental Disorders - ethnology
Mental Health - ethnology
Oceanic ancestry group - psychology
Psychotic Disorders - ethnology
Substance-Related Disorders - ethnology
Notes
Comment On: Med J Aust. 2012 Feb 6;196:133-522304609
Comment On: Med J Aust. 2012 Feb 6;196:118-2122304605
PubMed ID
22304588 View in PubMed
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Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature124122
Source
Int J Equity Health. 2012;11:27
Publication Type
Article
Date
2012
Author
Anna P Dawson
Margaret Cargo
Harold Stewart
Alwin Chong
Mark Daniel
Author Affiliation
University of South Australia, Sansom Institute for Health Research, Social Epidemiology and Evaluation Research Group, GPO Box 2471, IPC: CEA-01, Adelaide, South Australia, 5001, Australia.
Source
Int J Equity Health. 2012;11:27
Date
2012
Language
English
Publication Type
Article
Keywords
Cultural Competency
Delivery of Health Care - ethnology - methods
Female
Focus Groups
Health Manpower - statistics & numerical data
Health Policy
Health Status Disparities
Healthcare Disparities - ethnology - statistics & numerical data
Humans
Interviews as Topic
Male
Oceanic Ancestry Group - psychology - statistics & numerical data
Smoking Cessation - ethnology - methods - psychology - statistics & numerical data
Abstract
Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking.
We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes.
Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting.
Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.
Notes
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Cites: BMC Health Serv Res. 2012;12:10222533609
PubMed ID
22621767 View in PubMed
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Aboriginal peoples, health and healing approaches: the effects of age and place on health.

https://arctichealth.org/en/permalink/ahliterature139688
Source
Soc Sci Med. 2011 Feb;72(3):355-64
Publication Type
Article
Date
Feb-2011
Author
Kathi Wilson
Mark W Rosenberg
Sylvia Abonyi
Author Affiliation
University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road North, Mississauga, Ontario L5L 1C6, Canada. kathi.wilson@utoronto.ca
Source
Soc Sci Med. 2011 Feb;72(3):355-64
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Canada
Cohort Studies
Delivery of Health Care - utilization
Female
Health Status Disparities
Health Surveys
Humans
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Male
Medicine, Traditional - methods
Middle Aged
Social Identification
Young Adult
Abstract
For demographic reasons and as a result of a number of high profile health incidents in recent years, much of the health research and policy focus is on the younger cohorts of Aboriginal peoples in Canada. A critical examination of recent demographic trends reveals, however, that older cohorts of the Aboriginal population are increasing at a faster rate than younger cohorts, primarily due to improvements in life expectancy and declining fertility rates. Yet, there are surprisingly few health studies that have recognized the aging of the Aboriginal population. The overall goal of this paper is to examine differences in health status, use of conventional health care and traditional approaches to healing between older and younger cohorts of the Aboriginal population as well as to examine the importance of age as a determinant of health and health care use. Using data from the 2001 Statistics Canada Aboriginal Peoples Survey and contingency tables and logistic regression, the results demonstrate that older Aboriginal people face unique challenges - e.g. loss of traditional approaches to healing, geographic isolation, identity politics, constitutional and legal divisions within the Aboriginal community - with respect to their health and access to health services. These outcomes result from a colonial past and contemporary policies that affect all Aboriginal people.
PubMed ID
21036444 View in PubMed
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Aboriginal urbanization and rights in Canada: examining implications for health.

https://arctichealth.org/en/permalink/ahliterature115712
Source
Soc Sci Med. 2013 Aug;91:219-28
Publication Type
Article
Date
Aug-2013
Author
Laura C Senese
Kathi Wilson
Author Affiliation
Department of Geography & Program in Planning, University of Toronto, 100 St. George Street, Room 5047, Toronto, Ontario M5S 3G3, Canada. laura.senese@utoronto.ca
Source
Soc Sci Med. 2013 Aug;91:219-28
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health - ethnology
Canada
Cultural Characteristics
Female
Health Status Disparities
Human Rights
Humans
Indians, North American - psychology - statistics & numerical data
Male
Middle Aged
Prejudice - ethnology
Qualitative Research
Urban Health - ethnology
Urbanization
Young Adult
Abstract
Urbanization among Indigenous peoples is growing globally. This has implications for the assertion of Indigenous rights in urban areas, as rights are largely tied to land bases that generally lie outside of urban areas. Through their impacts on the broader social determinants of health, the links between Indigenous rights and urbanization may be related to health. Focusing on a Canadian example, this study explores relationships between Indigenous rights and urbanization, and the ways in which they are implicated in the health of urban Indigenous peoples living in Toronto, Canada. In-depth interviews focused on conceptions of and access to Aboriginal rights in the city, and perceived links with health, were conduced with 36 Aboriginal people who had moved to Toronto from a rural/reserve area. Participants conceived of Aboriginal rights largely as the rights to specific services/benefits and to respect for Aboriginal cultures/identities. There was a widespread perception among participants that these rights are not respected in Canada, and that this is heightened when living in an urban area. Disrespect for Aboriginal rights was perceived to negatively impact health by way of social determinants of health (e.g., psychosocial health impacts of discrimination experienced in Toronto). The paper discusses the results in the context of policy implications and future areas of research.
PubMed ID
23474122 View in PubMed
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Academic achievement and smoking: is self-efficacy an important factor in understanding social inequalities in Finnish adolescents?

https://arctichealth.org/en/permalink/ahliterature131629
Source
Scand J Public Health. 2011 Nov;39(7):714-22
Publication Type
Article
Date
Nov-2011
Author
Marjaana Pennanen
Ari Haukkala
Hein De Vries
Erkki Vartiainen
Author Affiliation
National Institute for Health and Welfare, Finland, Department of Public Health, University of Helsinki, Finland. marjaana.pennanen@thl.fi
Source
Scand J Public Health. 2011 Nov;39(7):714-22
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Achievement
Adolescent
Adolescent Behavior
Attitude
Cognition
Educational Status
Female
Finland
Health Status Disparities
Humans
Longitudinal Studies
Male
Questionnaires
Self Efficacy
Smoking - adverse effects - prevention & control - psychology
Socioeconomic Factors
Abstract
Poor academic achievement is strongly related to smoking but studies that examine the mechanism between academic achievement and smoking are lacking. The aim of this study, therefore, was to examine the smoking-related cognitions (i.e. attitude, social influence, self-efficacy and intention to smoke) in relation to academic achievement and determine whether these cognitions explain different patterns of smoking.
The study uses the data of a longitudinal study that was carried out in Finland, and the sample comprised 1,096 students in grades seven to nine.
During the seventh-grade students with poor academic achievement reported more positive attitudes to smoking and a greater social influence of their peers regarding smoking, weaker self-efficacy to refuse smoking and more intentions to smoke in the future compared to students with high academic achievement. Moreover, the follow-up analyses after a 24-month interval revealed that self-efficacy to refuse smoking of students with poor grades had become weaker compared to students with high grades. Furthermore, the influence of seventh-grade academic achievement predicting ninth-grade weekly smoking was partially mediated through the self-efficacy beliefs and the intention to smoke.
Differences in academic achievement may have an impact on adolescents' self-efficacy beliefs and the intention to smoke in the future. To reduce health inequalities a strong input on continuing research to improve smoking prevention methods, especially for students with low academic achievement, is needed.
PubMed ID
21893606 View in PubMed
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Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.

https://arctichealth.org/en/permalink/ahliterature298634
Source
BMC Fam Pract. 2018 01 09; 19(1):12
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-09-2018
Author
Elisabeth Björk Brämberg
Jarl Torgerson
Anna Norman Kjellström
Peder Welin
Marie Rusner
Author Affiliation
Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska institutet, 171 77, Stockholm, Sweden. Elisabeth.bjork.bramberg@ki.se.
Source
BMC Fam Pract. 2018 01 09; 19(1):12
Date
01-09-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Comorbidity
Delivery of Health Care - organization & administration - standards
Female
General Practice - methods - organization & administration
Health Services Accessibility - standards
Health Status Disparities
Humans
Male
Mental Disorders - epidemiology - physiopathology
Middle Aged
Needs Assessment
Qualitative Research
Quality Improvement
Sweden
Abstract
Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness.
Flexible qualitative design. Data was collected by means of semi-structured individual interviews with patients with severe mental illness, relatives and clinicians representing primary and specialized health care. In all, 50 participants participated.
The main barrier to accessing somatic care is the gap between the organization of the health care system and the patients' individual health care needs. This is observed at both individual and organizational level. The health care system seems unable to support patients with severe mental illness and their psychiatric-somatic comorbidity. The main facilitators are the links between severe mental illness patients and medical departments. These links take the form of functions (i.e. systems which ensure that patients receive regular reminders), or persons (i.e. professional contacts who facilitate patients' access the health care).
Health care services for patients with severe mental illness need reorganization. Organizational structures and systems that facilitate cooperation between different departments must be put in place, along with training for health care professionals about somatic disease among psychiatric patients. The links between individual and organizational levels could be strengthened by introducing professional contacts, such as liaison physicians and case managers. This is also important to reduce stress and responsibility among relatives.
PubMed ID
29316894 View in PubMed
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Access to primary care from the perspective of Aboriginal patients at an urban emergency department.

https://arctichealth.org/en/permalink/ahliterature139323
Source
Qual Health Res. 2011 Mar;21(3):333-48
Publication Type
Article
Date
Mar-2011
Author
Annette J Browne
Victoria L Smye
Patricia Rodney
Sannie Y Tang
Bill Mussell
John O'Neil
Author Affiliation
School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. annette.browne@nursing.ubc.ca
Source
Qual Health Res. 2011 Mar;21(3):333-48
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Anthropology, Cultural
British Columbia
Canada
Emergency Service, Hospital - statistics & numerical data - utilization
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Status Disparities
Humans
Indians, North American - statistics & numerical data
Male
Middle Aged
Primary Health Care - statistics & numerical data
Time Factors
Triage
Urban Population - statistics & numerical data
Young Adult
Abstract
In this article, we discuss findings from an ethnographic study in which we explored experiences of access to primary care services from the perspective of Aboriginal people seeking care at an emergency department (ED) located in a large Canadian city. Data were collected over 20 months of immersion in the ED, and included participant observation and in-depth interviews with 44 patients triaged as stable and nonurgent, most of whom were living in poverty and residing in the inner city. Three themes in the findings are discussed: (a) anticipating providers' assumptions; (b) seeking help for chronic pain; and (c) use of the ED as a reflection of social suffering. Implications of these findings are discussed in relation to the role of the ED as well as the broader primary care sector in responding to the needs of patients affected by poverty, racialization, and other forms of disadvantage.
PubMed ID
21075979 View in PubMed
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Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
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PubMed ID
21915240 View in PubMed
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880 records – page 1 of 88.