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Book part
Publication date: 30 August 2019

Karen E. Joseph-Kent

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in…

Abstract

Purpose

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

Method

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Findings

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

Implications/Limitations

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

Originality

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.

Details

Underserved and Socially Disadvantaged Groups and Linkages with Health and Health Care Differentials
Type: Book
ISBN: 978-1-83867-055-9

Keywords

Book part
Publication date: 25 February 2021

Nguyen Huu Minh and Phan Thi Mai Huong

Purpose: To explore emotional support, daily housework assistance, and economic support for older adults provided by the Vietnamese family within the context of the impacts of…

Abstract

Purpose: To explore emotional support, daily housework assistance, and economic support for older adults provided by the Vietnamese family within the context of the impacts of socio-economic, demographic, and other factors.

Methodology: (1) The researchers used data from censuses taken from 1989 to 2019; national surveys of Internal Migration, Labor and Employment and other topics; and recent large sample sociological surveys (2) adapted a modified Diamond Care Model (Ochiai, 2009) to analyze effects of the characteristics of older adults; and of the country’s laws, policies, and socio-economic changes, on the families’ caregiving activities supporting the older adults.

Findings: The family is still the most important institution providing care for older adults in Viet Nam. Most older people live with their children and see this as an age-old security solution despite differences related to lifestyles and interests. However, when the average number of working-age people per older person decreases, as older adults live longer, household sizes are smaller, and there is increased large migration, the demand for non-family caregiving for older adults will increase. Since social services to help meet this demand are limited, the traditional family support system for the elderly in Viet Nam will face many challenges as families try to assure the quality of care needed in the very near future.

Value: This chapter shows systematically a relationship between elderly care in the Vietnamese family and socio-economic, demographic, and associated factors based on comprehensive data sources. The results can help us think about how to create an appropriate future model for taking care of older adults in Viet Nam that combines the efforts of families and the support of comprehensive social policies by the community.

Details

Aging and the Family: Understanding Changes in Structural and Relationship Dynamics
Type: Book
ISBN: 978-1-80071-491-5

Keywords

Book part
Publication date: 25 February 2021

Els-Marie Anbäcken, Anna-Lena Almqvist, Carl Johansson, Kazushige Kinugasa, Miho Obata, Jinhee Hyun, Jinsook Lee and Young Joon Park

Purpose: The aim is to explore how family relations are affected by societal changes in relation to informal and formal caregiving and self-determination of older adults…

Abstract

Purpose: The aim is to explore how family relations are affected by societal changes in relation to informal and formal caregiving and self-determination of older adults.

Design/methodology/approach: Care managers (CMs)/social workers (SWs) (N = 124) participated in a comparative vignette study including Japan, South Korea, and Sweden. Systems theory was used.

Findings: Japanese CMs/SWs clearly describe their efforts to create networks in a relational way between formal and informal actors in the community. South Korean CMs/SWs balance between suggesting interventions to support daily life at home or a move to a nursing home, often acknowledging the family as the main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting the older adult and the interventions offered, and families primarily give social support. Regarding self-determination, the Japanese priority is for CMs/SWs to harmonize within the family and the community. South Korean CMs/SWs express ambivalent attitudes to older adults’ capability for self-determination in the intersection between formal and family care. Swedish CMs/SWs adhere to the older adult’s self-determination, while acknowledging the role of the family in persuading the older adult to accept interventions. The results suggest emerging defamilialization in South Korea, while tendencies to refamilialization are noticed in Japan and Sweden, albeit in different ways.

Research limitations/implications: In translation, nuances may be lost. A focus on changing families shows that country-specific details in care services have been reduced. For future research, perspectives of “care” need to be studied on different levels.

Originality/value: Using one vignette in three countries with different welfare regimes, discussing changing views on families’, communities’ and societal caregiving is unique. This captures changes in policy, influencing re- and defamilialization.

Details

Aging and the Family: Understanding Changes in Structural and Relationship Dynamics
Type: Book
ISBN: 978-1-80071-491-5

Keywords

Book part
Publication date: 18 September 2018

Nekehia T. Quashie

Barbados is at a very advanced stage of population aging. Health care services are designed to ensure universal access for all Barbadians but the contributing factors for older…

Abstract

Purpose

Barbados is at a very advanced stage of population aging. Health care services are designed to ensure universal access for all Barbadians but the contributing factors for older adults’ health care utilization are not well explored. This chapter examines gender differences in the correlates of seeking medical care among older adults in Barbados.

Methodology/approach

Logistic regression models were applied to data drawn from the 2000 Survey of Health, Well-Being and Aging of Older Adults in Latin America and the Caribbean (SABE), Bridgetown sample (n = 1,068).

Findings

Health needs, based on chronic conditions, were positively associated with seeking medical care for men and women. Different forms and directions of intergenerational support were associated with men and women seeking care. Among men, receiving financial support was positively associated with seeking care. Among women, providing financial support was associated with lower odds of seeking care while receiving instrumental support was associated with higher odds of seeking care.

Research limitations/implications

Medical care is only one form of health care use and there is no specification of the nature of care or consultation. The sample is cross-sectional and limited to older adults in urban areas. The relative importance of enabling factors and health needs, especially, may differ across time and space within Barbados.

Originality/value

The study contributes to the literature on health care utilization among older adults within developing countries and highlights the pertinence of family relations influencing gender differences in health care utilization.

Details

Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care
Type: Book
ISBN: 978-1-78756-175-5

Keywords

Book part
Publication date: 11 July 2019

Thomas DeLeire

This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, and health and health care utilization of childless adults using…

Abstract

This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, and health and health care utilization of childless adults using longitudinal data from the 2004 Panel of the Survey of Income and Program Participation. From July to September 2005, TennCare, the Tennessee Medicaid program, disenrolled approximately 170,000 adults following a change in eligibility rules. Following this eligibility change, the fraction of adults in Tennessee covered by Medicaid fell by over 5 percentage points while uninsured rates increased by almost 5 percentage points relative to adults in other Southern states. There is no evidence of an increase in employment rates in Tennessee following the disenrollment. Self-reported health and access to medical care worsened as hospitalization rates, doctor visits, and dentist visits all declined while the use of free or public clinics increased. The Tennessee experience suggests that undoing the expansion of Medicaid eligibility to adults that occurred under the Affordable Care Act likely would reduce health insurance coverage, reduce health care access, and worsen health but would not lead to increases in employment.

Details

Health and Labor Markets
Type: Book
ISBN: 978-1-78973-861-2

Keywords

Book part
Publication date: 8 August 2016

Bridget Gorman, Becky Wade and Alexa Solazzo

To determine gendered patterns of preventive medical care (physical and dental/optical) use among pan-ethnic U.S. Asian and Latino adults.

Abstract

Purpose

To determine gendered patterns of preventive medical care (physical and dental/optical) use among pan-ethnic U.S. Asian and Latino adults.

Methodology/approach

Using National Latino and Asian American Study (2004) data, we apply Andersen’s (1995) Behavioral Model of Health Services Use to assess how preventive care use among Asian and Latino men and women varies as a function of predisposing, enabling, and need-based characteristics. We explore whether adjustment for these factors mediates gender disparities in both physical and dental/optical check-ups, and test whether certain factors operate differently among men versus women.

Findings

A higher proportion of women reported a routine care visit last year, especially among Latinos. Adjusting for predisposing, enabling, and need-based factors explained the gender difference in reporting a dental/optician check-up, but not a physical check-up, among both Asian and Latino adults.

Research limitations/implications

Our findings illustrate how gender patterns in routine care use differ by race/ethnicity, and highlight the fundamental importance of enabling characteristics (especially health insurance and having a regular doctor) for shaping routine care use between men and women, both Asian and Latino. Limitations of this chapter are that the data are cross-sectional and were collected before the implementation of the Affordable Care Act, and measures are self-reported.

Originality/value

This chapter focuses on Asian and Latinos because they represent the fastest growing minority populations in the United States, yet few studies have evaluated gender differences in preventative health care use among these groups.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

Keywords

Book part
Publication date: 7 October 2011

John Cantiello, Myron D. Fottler, Dawn Oetjen and Ning Jackie Zhang

This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status…

Abstract

This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status, perceived value, and perceived need are all examined in order to determine what the literature reveals regarding each variable and how each variable impacts a young adult's decision to purchase health insurance. Results indicate that socioeconomic status, demographics, perceived value, and perceived need were the most significant determinates of health insurance status of young adults. A conceptual framework is also examined and used to illustrate theoretical implications. Managerial implications for marketing health plans to young adults are also addressed. Finally, policy implications concerning the new Patient Protection and Affordable Care Act are addressed.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

Book part
Publication date: 27 December 2013

Lynda L. Anderson, Sheryl A. Larson and Shauna McDonald

This study examined access to and quality of supports for families of adolescents with disabilities.

Abstract

Purpose

This study examined access to and quality of supports for families of adolescents with disabilities.

Methodology

An online survey was completed by family members of transition-aged young adults who had participated in parent training sessions on topics related to transitions to adulthood. Survey responses came from all 50 states, the District of Columbia, and 4 U.S. territories.

Findings

More than one-third of families reported unmet information needs related to areas such as employment, housing, preparing for adult relationships, and preparing others to support the family members with disabilities. Families of younger transition-aged youth, youth with Autism Spectrum Disorder or other disabilities, and families with lower household incomes reported more unmet needs. The overall quality of services families reported receiving was 2.19 on a 4-point scale of 1 to 4. Parents reported needing more information and quality of supports related to the transition of youth from school to adulthood.

Practical implications

Given the scope of unmet needs, ongoing collaboration between schools, agencies, organizations, and other entities that serve families is critical. While schools play a key role in supporting the transition process, other organizations also have a role.

Social implications

The results from this survey demonstrate that the need for support is not limited to youth with disabilities, but that family members also have information and support needs related to their roles as caregivers in the transition process.

Originality

This survey provides information about unmet needs and current services from a national sample that includes often underserved populations and includes sufficient numbers of respondents to allow comparisons between families, based on the type of disability their family member had.

Details

Disability and Intersecting Statuses
Type: Book
ISBN: 978-1-78350-157-1

Keywords

Book part
Publication date: 30 December 2004

Eva Kahana, Amy Dan, Boaz Kahana, Kyle Kercher, Gul Seçkin and Kurt Stange

This paper examines the health care experiences of older adults over a five-year period, including continuity in care, changes in health insurance coverage, and satisfaction with…

Abstract

This paper examines the health care experiences of older adults over a five-year period, including continuity in care, changes in health insurance coverage, and satisfaction with care.

Face-to-face interviews were conducted annually with 415 older adults (mean age = 84, range = 72–105), 100 of whom were originally health maintenance organization (HMO) subscribers and 315 of whom were receiving fee-for-service care. Several predictors of health care experiences were examined, including personal characteristics, health status and health care variables. Coverage type (HMO or fee-for-service) was the most consistent predictor. HMO subscribers were more likely than fee-for-service recipients to experience changes in insurance (both negative and positive changes) and discontinuity in physician care, although satisfaction with care did not vary among HMO and non-HMO members. Two-thirds of HMO subscribers and nearly one-third of fee-for-service recipients reported changes in insurance coverage over the five-year study period. In terms of perspectives on HMO care, the most frequently mentioned advantage of HMO care among those in HMOs was diminished costs, while fee-for-service subscribers did not believe there were any advantages to being in an HMO. Those not in HMOs viewed loss of physician choice and poor quality care as major disadvantages of HMOs. Results of this study demonstrate that older adults commonly experience changes in their health care coverage and physician care. They adapt to these changes through positive appraisals of the type of case they receive.

Details

Chronic Care, Health Care Systems and Services Integration
Type: Book
ISBN: 978-1-84950-300-6

Book part
Publication date: 21 September 2015

Michael Polgar

Sociology promotes and describes public health, helping to explain macro-social dynamics of mental health care through studies of organizations, networks, and systems of care.

Abstract

Purpose

Sociology promotes and describes public health, helping to explain macro-social dynamics of mental health care through studies of organizations, networks, and systems of care.

Methodology/approach

This chapter summarizes sociological research on mental health care organizations and systems, illustrating a macro-social perspective by examining the problem of transitions in care for young adults. Summary findings from a regional mental health services research project describe a system of care that includes 100 organizations. This system helps young adults with mental health needs.

Findings

The scope and management of care involves a focus on modes of treatment supported by research evidence and delivered effectively by people with cultural competencies. Care and continuity of care are delivered through coordinated systems of inter-organizational networks, linking organizations and providers. Active inter-organizational linkages are needed to support mental health for young adults during challenging and sometimes difficult transitions.

Originality/value

This research summarizes original and regional data on mental health care organizations within a regional system of care. Practical implications include support for the importance of coordination, transition planning, and cultural competence within and among organizations. Sociological and original research on organizations and systems should continue to elaborate the needs and values of mental health services for regional planning and public health.

Details

Education, Social Factors, and Health Beliefs in Health and Health Care Services
Type: Book
ISBN: 978-1-78560-367-9

Keywords

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