Search results

The purpose of this paper is to identify factors, within a framework for integration, associated with healthcare utilization (primary care use, dental care, and insurance coverage) for Colorado refugees, by gender.

The Refugee Integration Survey and Evaluation project was a four-year longitudinal study of refugees that resettled in Colorado beginning in 2011. Refugees from Burma and Bhutan were used in this secondary data analysis. Various integration domains were explored as predictors, across gender groups, of the healthcare utilization outcome variables (physical exam in the past 12 months, dental exam in the past 12 months, and current healthcare coverage) using bivariate and multivariate logistic regression analyses.

In 2015, 73.1 percent of the sample reported accessing primary health care in the past year, and only 13.2 percent used dental care services. Nearly three-quarters reported having health insurance at the time of survey. In the adjusted models, there was a strong positive association between the outcome variable “physical exam” and the predictor variables “employment and economic self-sufficiency” (OR=0.70, p<0.001), “social bonding” (OR=3.73, p<0.001), and “safety and stability” (OR=2.23, p<0.001). Additionally, education and training predicted dental visit (OR=2.06, p<0.01). None of the integration domains were statistically significant predictors of dental visits in the adjusted models.

This study offers insights about facilitators and barriers to healthcare utilization uptake after resettling in a major US city. These findings can be used by agencies and governmental organizations to best tailor healthcare services and promotion of those services for this vulnerable population.

The early care and education (ECE) workforce plays a pivotal role in shaping early childhood developmental trajectories and simultaneously experiences significant mental health disparities. The purpose of this study is to investigate how social determinants of health and external stressors are associated with the mental health of ECE staff, which represent a low-resourced segment of the workforce; how psychological capital (psycap) can mitigate these associations.

The authors administered an 89-item survey to 332 ECE staff employed in 42 Head Start centers in the USA. The authors ran three hierarchical linear regression models to analyze associations between social determinants of health, external sources of stress, psycap and potential moderation effects and mental health outcomes.

Individuals experiencing greater finance-related stress reported 0.15 higher scores on the depression scale and 0.20 higher scores on the anxiety scale than those experiencing less finance-related stress (p < 0.05). Individuals experiencing greater work-related stress reported 1.26 more days of poorer mental health in the past month than those experiencing less work-related stress (p < 0.01). After controlling for all sociodemographic variables and sources of stress, psycap was significantly and negatively associated with depressive symptomology (b-weight = −0.02, p < 0.01) and the number of poor mental health days reported in the past month (b-weight = −0.13, p < 0.05). Moderation models suggest that higher levels of psycap may mitigate the association between work-related stress and the number of poor mental health days reported in the past month (b-weight = −0.06, p = 0.02).

The implications of these findings suggest a need for policy change to mitigate social determinants of health and promote pay equity and multi-level interventio ns that target workplace-related stressors and psycap to combat poor mental health of the ECE workforce.