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Factors Influencing unmet Medical Need among U.S. Adults: Disparities in Access to Health Services
Title
Factors Influencing unmet Medical Need among U.S. Adults: Disparities in Access to Health Services.
Creator
Khanijahani, Ahmad, Wan, Thomas, Malvey, Donna, Liu, Albert Xinliang, Anderson, Kim, University of Central Florida
Abstract / Description
Inequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive...
Show moreInequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive needed medical care or receiving medical care after a delay, due to the associated costs, constructed unmet medical need. This study used a four-year (2014-2017) National Health Interview Survey (NHIS) data (sample size: 296,301 adults) and implemented a conceptual framework to study disparities in access to health services and estimate the relative importance of predisposing, enabling, and need factors as the predictors of unmet medical need. Findings from machine learning and logistics regression models highlight the importance of health insurance coverage as a key contributing factor of health disparities. About 60% of variation in unmet medical need was predictable, with over 90% accuracy, solely with health insurance coverage status. Self-rated health status, family structure, and family income to poverty ratio were other statistically significant predictors. Even after controlling for a wide variety of sociodemographic and health status variables such as age, gender, perceived health status, education, income, etc., health insurance remains significantly associated with unmet medical need (OR: 5.03, 95%CI: 4.67-5.42). To ensure precise national estimates, proper survey data analysis methods were incorporated to account for the complex sampling method used by NHIS. Furthermore, the enabling factors (health insurance and income) exert much more weight on unmet medical need than predisposing factors and need factors. The findings raise the concerns about the existence and magnitude of disparities in health care access and provide a comprehensive framework to a target population for understanding the sources of health inequities with data-driven evidence. Results can be utilized to address potential areas for designing public policy and program interventions by identifying the relative vulnerability of different population groups for lacking access to affordable health services. Future studies using longitudinal panel data are necessary to establish a causal relationship between the predictors and unmet medical need.
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Date Issued
2019
Identifier
CFE0007477, ucf:52686
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007477
Work and Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, and Nurse Executives
Title
Work and Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, and Nurse Executives.
Creator
Raffenaud, Amanda, Unruh, Lynn, Liu, Albert Xinliang, Fottler, Myron, Andrews, Diane, University of Central Florida
Abstract / Description
The nursing workforce increasingly faces issues that affect clinical and managerial practice. One such issue is work-family conflict (WFC) and family-work conflict (FWC). Nurses face role strain as they confront the pressures from often competing work-and-family roles. This study assessed WFC/FWC among varying nurse roles: staff nurses, managerial nurses, and nurse executives. A random sample of 5,000 nurses, generated from registered nurses practicing in the state of Florida, was surveyed...
Show moreThe nursing workforce increasingly faces issues that affect clinical and managerial practice. One such issue is work-family conflict (WFC) and family-work conflict (FWC). Nurses face role strain as they confront the pressures from often competing work-and-family roles. This study assessed WFC/FWC among varying nurse roles: staff nurses, managerial nurses, and nurse executives. A random sample of 5,000 nurses, generated from registered nurses practicing in the state of Florida, was surveyed for this research study. Nurses were surveyed on demographics, perceptions regarding the work environment, and perceptions of WFC/FWC. Descriptively, nurses experienced more work-family conflict than family-work conflict. Regression analyses and ANOVAs indicated that staff nurses experienced less work-family conflict than nursing managers (second most) and nursing executives (highest). None of the nurse roles experienced significant levels of FWC. White nurses, compared to non-white nurses, experienced less WFC and FWC. WFC increased with shift length but FWC was not significantly affected by it. Paid leave for childbirth was associated with lower FWC. This study holds significant implication for the nursing workforce. Nurse managers and executives showed significantly higher WFC than staff nurses. This may discourage a nurse from taking on leadership roles or lead to leaving them. In an era where nurse managers and leaders are needed, efforts must be taken to decrease WFC/FWC factors. Nonwhite nurses reported higher levels of both WFC and FWC. This may contribute to tension at the workplace and a difficult family life. Leaders must continue to create platforms for nurses of all races and ethnicities to voice their work and family needs, and to be supported when doing so. Nurses working shifts over 8 hours had higher WFC levels. Although 12-hour shifts have been popular among staff and management, their use should be reevaluated. Finally, paid leave for childbirth is a program worth supporting, as it was a factor in lower FWC.
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Date Issued
2018
Identifier
CFE0007081, ucf:51997
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007081
The Effect of Registered Nurse Supply on Population Health Outcomes: A Distributed Lag Model Approach
Title
The Effect of Registered Nurse Supply on Population Health Outcomes: A Distributed Lag Model Approach.
Creator
Sampson, Carla Jackie, Unruh, Lynn, Malvey, Donna, Liu, Albert Xinliang, Neff, Donna, University of Central Florida
Abstract / Description
Registered nurses (RNs) are essential to providing care in the healthcare system. To date, research on the relationship between healthcare provider supply and population health has focused on physician supply. This study explored the effect of RN supply on population health outcomes in the U.S. This is a retrospective, cross-sectional study of U.S. counties and county equivalents using national data. Seven population health outcomes (total and disease specific mortalities and low infant birth...
Show moreRegistered nurses (RNs) are essential to providing care in the healthcare system. To date, research on the relationship between healthcare provider supply and population health has focused on physician supply. This study explored the effect of RN supply on population health outcomes in the U.S. This is a retrospective, cross-sectional study of U.S. counties and county equivalents using national data. Seven population health outcomes (total and disease specific mortalities and low infant birth weight rate) were the response variables. The predictor variable, RN supply, and some control variables were anticipated to have an asynchronous effect on the seven outcome variables in the hypothesized relationship. Therefore, these variables were examined using three different models: contemporaneous; a three-year lagged; and a distributed lag (both contemporaneous and lagged variables). Quadratic terms for RN and physician supply variables were included. Because the Area Health Resource File (AHRF) outcome variables were skewed toward zero and left censored, Tobit regression analyses were used. Data were obtained from 19 states using historical RN Supply data for 1,472 counties, representing 47% of the total target population of 3,108 U.S. counties and county equivalents. Regions with rural populations(-)the Midwest and Southeast(-)were overrepresented. Higher RN supply is positively related to higher mortality rates from ischemic heart disease, other cardiovascular disease, and chronic lower respiratory disease in the distributed lag models. Higher RN supply is not significantly related to rates of low infant birth weight, infant mortality, or mortality from cerebrovascular disease in any model. Higher RN supply is positively related to total deaths in the contemporaneous and lagged model. The results suggest a counter-intuitive, but non-linear relationship between RN supply and health outcomes. More research is needed to understand these relationships and policies must be devised to reduce the current and growing future RN shortage.
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Date Issued
2018
Identifier
CFE0007091, ucf:51933
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007091
Constructing and Validating an Integrative Economic Model of Health Care Systems and Health Care Markets: A Comparative Analysis of OECD Countries
Title
Constructing and Validating an Integrative Economic Model of Health Care Systems and Health Care Markets: A Comparative Analysis of OECD Countries.
Creator
Helligso, Jesse, Wan, Thomas, Liu, Albert Xinliang, King, Christian, Hamann, Kerstin, University of Central Florida
Abstract / Description
This dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and...
Show moreThis dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and academic literature. The results show that, free market systems have decreased access to care, good quality of care, and are economically inefficient resulting in 2.7 years of life expectancy lost and wasted expenditures (expenditures that do not increase life expectancy) of $3474 per capita ($1.12 trillion per year in the U.S.). Socialized systems are the most economically efficient systems but have decreased access to care compared to universal systems, increased access to care compared to free market systems and have the lowest quality of care of all three systems resulting in 3 months of life expectancy lost per capita and a saving of $335 per capita. Universal systems perform better than either of the other 2 systems based on quality and access to care. The models show that health insurance is a Giffen Good; a good that defies the law of demand. This study is the first fully demonstrated case of a Giffen good. This investigation shows how the theoretically informed integrative model behaves as predicted and influences health outcomes contingent upon the system type. To test and substantiate this integrative model, regression analysis, Time-Series-Cross-Section analysis, and structural equation modeling were performed using longitudinal data provided and standardized by the Organization for Economic Cooperation and Development (OECD). The results demonstrate that universal health care systems are superior to the other two systems.
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Date Issued
2018
Identifier
CFE0007335, ucf:52114
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007335
Predictors of hospital quality and efficiency
Title
Predictors of hospital quality and efficiency.
Creator
Fotovvat, Hoda, Wan, Thomas, Liu, Albert Xinliang, Ramirez, Bernardo, Yu, Chia-Yuan, University of Central Florida
Abstract / Description
American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician...
Show moreAmerican hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this investigation explored the relationship of acute-care hospitals' performance to the contextual, organizational and patient characteristics, using a cross-sectional study design. This study developed and evaluated the quality and efficiency of hospitals with respects to the structural complexity, process adequacy, efficiency, and quality of care. The structure-process-outcome theory in quality of care developed by Donabedian (1980), is adopted for this investigation. Statistical methods such as confirmatory factor analysis (CFA) and covariance structure model are employed. The population surveyed by the American Hospital Association (AHA) are acute care hospitals throughout the United States, including more than 3000 acute care hospitals of all types of ownership. The data provided by HIMSS Analytics and AHA are available for 2015 and the data provided CMS quality indicators are available for 2016. The key finding of this research is that process adequacy mediates the relationship between hospital structure and performance variables. The efficiency variable played an important role in shaping quality. The location and hospital teaching status have a moderate impact in determining hospital performance by affecting the structure and process of hospitals.
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Date Issued
2019
Identifier
CFE0007888, ucf:52796
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0007888
The influence of perceived organizational support, perceived coworker support (&) debriefing on work-related compassion satisfaction, burnout, and secondary traumatic stress in Florida public safety personnel
Title
The influence of perceived organizational support, perceived coworker support (&) debriefing on work-related compassion satisfaction, burnout, and secondary traumatic stress in Florida public safety personnel.
Creator
Miller, Anastasia, Unruh, Lynn, Zhang, Ning, Wharton, Tracy, Liu, Albert Xinliang, University of Central Florida
Abstract / Description
The purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida...
Show moreThe purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida public safety by administering surveys gauging perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities that the personnel participate in. The Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue Version 5 was also sent out to establish the self-reported levels of compassion satisfaction, burnout, and secondary traumatic stress. The study found that there were differences in the levels of compassion satisfaction, burnout, and secondary traumatic stress between the public safety fields. It also found that there was a positive relationship between the presence of perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities on at least one of the constructs of compassion satisfaction, burnout, or secondary traumatic stress within the different public safety fields. This study furthers the literature by being the first study to compare the four different public safety fields in the state of Florida and with regards to those constructs.
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Date Issued
2016
Identifier
CFE0006357, ucf:51533
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006357
Unicondylar Knee Arthroplasty in the Inpatient vs Outpatient Setting: Impact on Process Time, Quality Outcomes, and Patient Satisfaction
Title
Unicondylar Knee Arthroplasty in the Inpatient vs Outpatient Setting: Impact on Process Time, Quality Outcomes, and Patient Satisfaction.
Creator
Zeini, Ibrahim, Ramirez, Bernardo, Noblin, Alice, Liu, Albert Xinliang, Sivo, Stephen, University of Central Florida
Abstract / Description
The implications of rising healthcare expenditures are of great concern nationally and internationally. Performing procedures in the outpatient setting can be one solution to this crisis. However, there is a lack of research on systematic approaches for transitioning procedures to the outpatient setting. Unicondylar knee arthroplasty (UKA) presents an opportunity, as it is already in the early stages of transitioning to the outpatient setting. The key step in facilitating an effective...
Show moreThe implications of rising healthcare expenditures are of great concern nationally and internationally. Performing procedures in the outpatient setting can be one solution to this crisis. However, there is a lack of research on systematic approaches for transitioning procedures to the outpatient setting. Unicondylar knee arthroplasty (UKA) presents an opportunity, as it is already in the early stages of transitioning to the outpatient setting. The key step in facilitating an effective transition to the outpatient setting is comparing outpatient UKAs with inpatient UKAs with a focus on process time, quality outcomes, and patient satisfaction. This study retrospectively compares 400 UKA patients in the outpatient setting with 675 UKA patients in the inpatient setting. The primary analytical tools for this study are Ordinary Least Squares Regression, Logistic Regression, and Ordinal Regression adjusting for comorbidity, social history, demographics, and surgery related characteristics. Outpatient UKAs outperformed inpatient UKAs across 11 of 18 variables analyzed. Process Time will be less for outpatient UKAs in all phases with the exception of Surgery Breakdown Time. The risk-adjusted quality outcomes of UKAs in the outpatient setting were better across Non-Surgery Related Complications, Follow-Up Pain, and Follow-Up Functional Range of Motion Limitation. Patient Satisfaction was higher for outpatient UKAs. There was a lack of consistent and appropriate information to conduct a substantial statistical analysis of the costs. These findings point towards outpatient UKAs being a viable option in the future. This research serves as a platform to launch a system-wide effort of transitioning procedures to the outpatient setting across different specialties.
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Date Issued
2015
Identifier
CFE0006427, ucf:51489
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006427
Local Health Department Adoption of Health Information Technology and Its Impact on Population Health
Title
Local Health Department Adoption of Health Information Technology and Its Impact on Population Health.
Creator
Yeung, Tina, Wan, Thomas, Cortelyou-Ward, Kendall, Liu, Albert Xinliang, Dziegielewski, Sophia, University of Central Florida
Abstract / Description
Since the enactment of the HITECH Act in 2009, the US has invested billions in building a robust health information technology (HIT) infrastructure that is secure, capable of the electronic transfer of data and allows for real-time access of patient medical data, among others. This empirical study explored the driving forces (coercive, mimetic, and normative) in the adoption of HIT (i.e. EHRs and HIEs) by local health departments (LHDs) and how it has impacted the population health of...
Show moreSince the enactment of the HITECH Act in 2009, the US has invested billions in building a robust health information technology (HIT) infrastructure that is secure, capable of the electronic transfer of data and allows for real-time access of patient medical data, among others. This empirical study explored the driving forces (coercive, mimetic, and normative) in the adoption of HIT (i.e. EHRs and HIEs) by local health departments (LHDs) and how it has impacted the population health of counties in the US. The researcher conducted a cross-sectional, quantitative study using secondary data sources. The study included data on 505 local health departments and 433 counties' population health data. Institutional theory guided this research and generalized estimating equations, logistic regression, and multiple linear regression were utilized to analyze health IT adoption by LHDs and its impact on county-level health outcomes. Results showed that normative forces, measured by the employment of IS specialists was most impactful in the adoption of both EHRs and HIEs. Mimetic forces, measured by the completion of a CHA and coercive forces measured by the implementation of the HITECH Act were not found to be statistically significant in the adoption of EHRs or HIEs. Finally, EHR adoption was statistically significant at improving population health at the county level. This research study has contributed in three areas: 1) to fill a knowledge gap on the impact of health IT adoption by LHDs on health outcomes; 2) to formulate a theoretically grounded framework to study population health and its variability; and 3) to identify target areas for public health interventions. In conclusion, a substantial amount of resources dedicated in creating a robust health IT infrastructure requires close analysis of the impact health IT has on the population health of our nation.
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Date Issued
2017
Identifier
CFE0006825, ucf:51801
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006825
The Diffusion and Performance of the Accountable Care Organization Model
Title
The Diffusion and Performance of the Accountable Care Organization Model.
Creator
Lin, Yi-ling, Wan, Thomas, Malvey, Donna, Liu, Albert Xinliang, Steen, Julie, University of Central Florida
Abstract / Description
Background: Unity in pursuit of the Triple Aim: better health, better care, and lower per capita cost, can be achieved through a well-designed health care delivery system. The accountable care organizations (ACOs) model is considered a key component of health care delivery system improvement because the model fosters better coordination of care through clinical integration and financial accountability. Within the six Centers for Medicaid (&) Medicare Services (CMS) ACO programs, the Medicare...
Show moreBackground: Unity in pursuit of the Triple Aim: better health, better care, and lower per capita cost, can be achieved through a well-designed health care delivery system. The accountable care organizations (ACOs) model is considered a key component of health care delivery system improvement because the model fosters better coordination of care through clinical integration and financial accountability. Within the six Centers for Medicaid (&) Medicare Services (CMS) ACO programs, the Medicare Shared Savings Program (MSSP) ACO has the largest size with a total of 432 ACOs formed; the service subjects of the MSSP ACO are the fee-for-service beneficiaries. Recently, academicians and researchers have been attracted to exploring ACOs' formation and performance. However, most of the early ACO research types are either descriptive or case study. Also, early researchers had limited access to ACO data sets, so they could utilize only regional and demographic factors to identify the predictors of ACO formation.Purpose: An integrative theoretical framework, Rogers' diffusion of innovation theory and Duncan's POET model, was used to examine ACO formation and performance. The first purpose of this study was to determine the relative influences of contextual variables and ACO characteristic variables on how early an ACO model was adopted. The second purpose was to examine how executives' perceptions of ACO performance and the ACO first-year performance are influenced by the contextual variables, ACO characteristic variables, and timing of the adoption of an ACO model. Methods: A cross-sectional design was formulated to gather data from a survey supplemented by secondary data with the analysis unit at the organization level. Study participants in the ACO survey included 2012, 2013, 2014, and 2015 ACO cohorts. Logistic regression was performed to examine the effects of POET and Rogers' five core characteristics in the early adoption of an ACO model (dichotomous). Additionally, multiple linear regression analysis was used to examine the effects of POET and the timing of adoption of an ACO model in the perceptions of ACO performance. ACO first-year performance dataset consisted only of ACO cohorts from 2012 through 2014. Finally, confirmatory factor analysis and structural equation modeling were conducted to examine the measurement model of the ACO first-year performance and a full latent variable model, respectively. Major Findings: A survey of ACO executives/managers between October 2015 and February 2016 was conducted. The 447 MSSP ACOs in my mailing list yielded a response rate of 13.65 % (n=61). Of the 61 MSSP ACOs, 42 (52.5%) were late adopters whose contractual agreement with CMS started in 2014 or 2015, and 36 (59.0%) were with hospital-based composition. Among ACOs that participated in my survey, their current degree of IT adoption in functionalities (62.27 vs. 52.50 points), usage levels (65.19 vs. 49.49 points), and integration levels (62.24 vs. 53.37 points) were better than their initial years. The multiple logistic regression presented that MSSP ACOs were more likely to be early adopters of a CMS if their service areas had high unemployment rates (OR=2.23; 95% CI: 1.13 - 4.39). In the multiple linear regression analysis, the executives in the early ACOs perceived their organizations as more effective than the late adopters, with 12.65 points higher in an aggregate of eight ACO quality domains (p = .005). Three hundred and seventeen MSSP ACOs, with contractual agreements with CMS before 2015, had retained their year-one performance records (the actual ACO performance with eight quality domains). The variability in the actual ACO performance was explained by the predictor variables of the study with an R-square of 15%. The actual ACO performance was likely to be improved if ACOs had more Medicare assigned beneficiaries or had the hospital-based composition. On the other hand, if ACOs' service areas were located in areas of high poverty concentration, a high unemployment rate, or a lower competitive index, their ACO performance was relatively lower than their counterparts. Implications: The findings suggest that managers should consider strategies to increase economies of scale in size and to have hospital involvement in their ACOs in order to increase effective management. Inadequate capital for information technology improvements is the biggest barrier inhibiting healthcare providers' willingness to join an ACO. Regardless of rural or urban areas, financial support is still important for those potential ACO participants who are planning to invest in necessary infrastructure. ACOs that involved hospitals also showed better performance than those ACOs without hospital involvement. This information may help health policy makers to define core principles of the best ACO model in the future. Conclusions: This study makes a unique contribution using a theoretically integrative framework with Rogers' diffusion of innovation theory coupled with Duncan's POET model to examine ACO formation and ACO performance. In the early ACO adopters, three-fifths of the ACOs had hospital involvement; and the levels of their current IT degree in functionalities, usage levels, and integration levels are higher than the late ACO adopters. This study demonstrates that contextual variables, such as unemployment rates at ACO service areas, relatively influence how early an ACO model was adopted. Executives in the early ACOs had higher perceptions of overall organizational effectiveness as compared with the late adopters. The first-year performance of 2012, 2013, and 2014 ACO cohorts is positively influenced by the size of assigned Medicare beneficiaries and hospital-based ACO and is negatively influenced by the poverty rate, unemployment rate, and market competition scores (Herfindah-Hirschman Index).
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Date Issued
2016
Identifier
CFE0006347, ucf:51576
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006347
Is Conflict a Factor in a Population's Quality of Life? A Comparative Study of University Students in the Palestinian Territories and Jordan
Title
Is Conflict a Factor in a Population's Quality of Life? A Comparative Study of University Students in the Palestinian Territories and Jordan.
Creator
Asi, Yara, Unruh, Lynn, Ramirez, Bernardo, Liu, Albert/Xinliang, Sadri, Houman, University of Central Florida
Abstract / Description
As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken...
Show moreAs nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the Palestinian population itself that impact HRQoL, and not on the extent to which the presence of the conflict and its consequences disturb physical and mental health outcomes compared to areas without conflict. The purpose of this study is to evaluate the impact of long-term conflict by comparing HRQoL in the oPt and the neighboring country of Jordan, as well as to assess how demographic factors such as socioeconomic status and household size can moderate or aggravate this impact. The potential mediating factors of insecurity and perceived stress will also be assessed. This study found that the presence of conflict was not the most significant predictor of low HRQoL. The mitigating factor of a traditional foundation of mental resilience in Palestinian culture is addressed as a potential explanation for this result. The implications of this study are wide-ranging, particularly in their ability to contribute to healthcare policy recommendations in war-affected areas, and to bolster our understanding of the health status and needs of those living in these areas.
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Date Issued
2015
Identifier
CFE0005574, ucf:50233
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0005574