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In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.

The case is written based on publicly available data from primary sources such as the company’s annual reports, company website and the company’s presentations, as well as from secondary sources comprising newspaper articles, research papers, research magazines, magazine articles, industry reports, research reports, etc. as indicated in the references. The company’s financials and peer data are sourced from the Thomson Reuters Eikon database.

The case examines the financial position of Macy’s, Inc., America’s largest and one of the oldest premier departmental stores, with a consolidated annual turnover of US$18,097m in the fiscal year 2020/2021 (FY, 2021). Over the previous few years, the company had been struggling with decreasing market share and profitability mainly due to increasing competition from online retailers and deep discounters, which was affecting the company’s share price. With the appointment of a new chief executive officer (CEO) in fiscal year (FY) 2017, Macy’s, Inc. undertook several changes to revive its financial health and improve its market share. However, it still registered heavy losses of US$3,944m in the FY 2020/2021, the company’s first time in the past decade. With many retailers filing for bankruptcy, was there more that Macy’s could do to improve the company’s position and regain lost investor confidence? Will its entry into emerging markets play a crucial role in its turnaround?

The case can be used in undergraduate and postgraduate courses such as accounting for managers, financial statement analysis, management accounting, introduction to accounting and advanced financial statement analysis. The case can also be effectively used to understand the primary fundamental analysis of the company that involves understanding the company’s positioning and strengths, weaknesses, opportunities and threats analysis. The case would also help business management and entrepreneurship students to get a preliminary idea about the change management process. Finally, the case can be used to familiarize students with using Microsoft Excel to build financial analysis worksheets.

Teaching notes are available for educators only.