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  1. Article ; Online: Social Determinants and Health Equity in Functional Medicine.

    Bharmal, Nazleen

    Physical medicine and rehabilitation clinics of North America

    2022  Volume 33, Issue 3, Page(s) 665–678

    Abstract: The functional medicine matrix provides us with an opportunity to understand how social determinants of health (SDOH) and health related social needs may be root causes and contributors to current health and illness among patients. The matrix also allows ...

    Abstract The functional medicine matrix provides us with an opportunity to understand how social determinants of health (SDOH) and health related social needs may be root causes and contributors to current health and illness among patients. The matrix also allows us to map and recognize the intersectionality of SDOH on exposures and behaviors that influence antecedents, triggers, mediators, lifestyle factors, and clinical imbalances. Incorporating SDOH into clinical evaluations helps uncover and address the complex factors that lead to health disparities in order to provide more optimal patient-centered care.
    MeSH term(s) Health Equity ; Humans ; Patient-Centered Care ; Social Determinants of Health
    Language English
    Publishing date 2022-06-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1196791-2
    ISSN 1558-1381 ; 1047-9651
    ISSN (online) 1558-1381
    ISSN 1047-9651
    DOI 10.1016/j.pmr.2022.04.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Online: Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage

    Bharmal, Nazleen / Williams, Malcolm V / Martin, Laurie T / Lopez, Christian

    A Case Study on Tacoma-Pierce County, Washington

    2016  

    Keywords Insurance & actuarial studies ; History of the Americas ; Medicolegal issues ; Public health & preventive medicine ; Health Sciences ; History ; Business
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030611792
    ISBN 9780833096197 ; 0833096192
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  3. Book ; Online: Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage

    Heyer, Kate / Bharmal, Nazleen / Martin, Laurie T / Williams, Malcolm V / Armstrong, Courtney

    A Case Study on Boston and Massachusetts

    2016  

    Keywords Insurance & actuarial studies ; History of the Americas ; Medicolegal issues ; Public health & preventive medicine ; Health Sciences ; History ; Business
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030609866
    ISBN 9780833096203 ; 0833096206
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  4. Book ; Online: Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage

    Williams, Malcolm V / Martin, Laurie T / Bharmal, Nazleen / Lopez, Christian / Armstrong, Courtney

    A Case Study on Eagle, Garfield, and Pitkin Counties, Colorado

    2016  

    Keywords Insurance & actuarial studies ; History of the Americas ; Medicolegal issues ; Public health & preventive medicine ; Health Sciences ; History ; Business
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030610785
    ISBN 9780833096180 ; 0833096184
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  5. Book ; Online: Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage

    Elligers, Julia Joh / Bharmal, Nazleen / Martin, Laurie T / Williams, Malcolm V / Armstrong, Courtney

    A Case Study on West Virginia

    2016  

    Keywords Insurance & actuarial studies ; History of the Americas ; Medicolegal issues ; Public health & preventive medicine ; Health Sciences ; History ; Business
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030609879
    ISBN 9780833096210 ; 0833096214
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  6. Book ; Online: Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage

    Williams, Malcolm V / Martin, Laurie T / Armstrong, Courtney / Bharmal, Nazleen / Elligers, Julia Joh

    Seven Case Studies from Local and State Health Departments

    2016  

    Keywords Insurance & actuarial studies ; Medicolegal issues ; Public health & preventive medicine ; Business ; Health Sciences
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030612385
    ISBN 9780833096258 ; 0833096257
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  7. Book ; Online: Barriers to Enrollment in Health Coverage in Colorado

    Martin, Laurie T / Bharmal, Nazleen / Blanchard, Janice C / Harvey, Melody / Williams, Malcolm V

    2014  

    Keywords Insurance & actuarial studies ; History of the Americas ; Medicolegal issues ; Health Sciences ; Business ; History
    Language English
    Size 1 Online-Ressource
    Publisher RAND Corporation
    Document type Book ; Online
    Note English
    HBZ-ID HT030612357
    ISBN 9780833089472 ; 0833089471
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  8. Article ; Online: Primary care referral patterns for patients with asthma: analysis of real-world data.

    Ortega, Hector / Bharmal, Nazleen / Khatri, Sumita

    The Journal of asthma : official journal of the Association for the Care of Asthma

    2022  Volume 60, Issue 3, Page(s) 609–615

    Abstract: Objective: To identify features related to management of patients prior to referral from primary care physicians (PCPs) to pulmonologists and allergists.: Methods: This is an analysis of patient claims data from Symphony Health (2013-2018). To ... ...

    Abstract Objective: To identify features related to management of patients prior to referral from primary care physicians (PCPs) to pulmonologists and allergists.
    Methods: This is an analysis of patient claims data from Symphony Health (2013-2018). To characterize referrals, a longitudinal cohort included 12 months with no asthma claims prior to the index date, followed by 36 months of observation. We also assessed a cross-sectional cohort for 12 months at the end of the observational period to characterize disease control and treatment patterns. Referral was defined as the first appearance of a claim from an allergist or pulmonologist for a patient's initial visit for asthma. Descriptive statistics were used to analyze the data.
    Results: The majority of patients with asthma were managed by PCPs (60%), followed by pulmonologists (16%) and allergists (8%). Forty-three percent had uncontrolled asthma. Only 8% were referred to specialists within the first 24 months after initial diagnosis, of which 76% were seen by pulmonologists and 24% by allergists. Referrals resulted in treatment change in 55%-68% of the cases. Patients who received a referral were more likely to be on oral corticosteroids (OCS) and/or have more hospitalizations/ED visits.
    Conclusions: About one-third of the patients managed by PCPs received intermittent and/or chronic OCS prior to referral, which may be an indication of uncontrolled disease. The referral patterns in this analysis illustrate underutilization of specialists in the consultation and management of patients with uncontrolled asthma.
    MeSH term(s) Humans ; Asthma/diagnosis ; Asthma/drug therapy ; Cross-Sectional Studies ; Referral and Consultation ; Adrenal Cortex Hormones/therapeutic use ; Primary Health Care
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2022-06-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603816-5
    ISSN 1532-4303 ; 0277-0903
    ISSN (online) 1532-4303
    ISSN 0277-0903
    DOI 10.1080/02770903.2022.2082308
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Racial and ethnic differences in uncontrolled diabetes mellitus among adults taking antidiabetic medication.

    Berg, Kristen A / Bharmal, Nazleen / Tereshchenko, Larisa G / Le, Phuc / Payne, Julia Y / Misra-Hebert, Anita D / Rothberg, Michael B

    Primary care diabetes

    2024  

    Abstract: Aim: To examine whether racial and ethnic disparities in uncontrolled type 2 diabetes mellitus (T2DM) persist among those taking medication and after accounting for other demographic, socioeconomic, and health indicators.: Methods: Adults aged ≥20 ... ...

    Abstract Aim: To examine whether racial and ethnic disparities in uncontrolled type 2 diabetes mellitus (T2DM) persist among those taking medication and after accounting for other demographic, socioeconomic, and health indicators.
    Methods: Adults aged ≥20 years with T2DM using prescription diabetes medication were among participants assessed in a retrospective cohort study of the National Health and Nutrition Examination Survey 2007-2018. We estimated weighted sequential multivariable logistic regression models to predict odds of uncontrolled T2DM (HbA1c ≥ 8%) from racial and ethnic identity, adjusting for demographic, socioeconomic, and health indicators.
    Results: Of 3649 individuals with T2DM who reported taking medication, 27.4% had uncontrolled T2DM (mean HgA1c 9.6%). Those with uncontrolled diabetes had a mean BMI of 33.8, age of 57.3, and most were non-Hispanic white (54%), followed by 17% non-Hispanic Black, and 20% Hispanic identity. In multivariable analyses, odds of uncontrolled T2DM among those with Black or Hispanic identities lessened, but persisted, after accounting for other indicators (Black OR 1.38, 97.5% CI: 1.04, 1.83; Hispanic OR 1.79, 97.5% CI 1.25, 2.57).
    Conclusions: Racial and ethnic disparities in T2DM control persisted among individuals taking medication. Future research might focus on developmental and epigenetic pathways of disparate T2DM control across racially and ethnically minoritized populations.
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2273997-X
    ISSN 1878-0210 ; 1751-9918
    ISSN (online) 1878-0210
    ISSN 1751-9918
    DOI 10.1016/j.pcd.2024.02.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Healthcare and Social Needs Assessment and Response Quality Among Black Men.

    Bharmal, Nazleen / Sack, Elizabeth / Guo, Ning / Alejandro-Rodriguez, Marilyn / Holmes, Jonathan C / Modlin, Charles / Pfoh, Elizabeth R

    Journal of community health

    2023  Volume 49, Issue 2, Page(s) 187–192

    Abstract: To understand Black men's healthcare and social needs and determine if the resources that healthcare systems offer meet expectations. We surveyed men who had previously participated in at least one Minority Men's Health Fair in Cleveland, Ohio. In this ... ...

    Abstract To understand Black men's healthcare and social needs and determine if the resources that healthcare systems offer meet expectations. We surveyed men who had previously participated in at least one Minority Men's Health Fair in Cleveland, Ohio. In this descriptive study, we spoke with men up to three times (i.e., phases) between May and October 2020 by email and/or telephone. Phase 1 was a needs assessment survey. Phase 2 involved outreach to those who identified a need to provide a resource. Phase 3 determined whether the resource met individuals' needs. We described the demographic characteristics of the survey respondents, the percentage of men reporting a need and wanting a resource, and whether the resource resolved their need. Of the 768 men contacted, 275 completed the survey (36% response rate). The majority of respondents were 50-69 years old, identified as Black, and had at least a bachelor's degree. Eighty-five percent reported a need, of which wellness, financial, and healthcare access were among the top-reported needs. Among the men identifying a need, 35% were interested in a resource. Resources that were provided for employment, behavioral health, oral health, vision, or wellness needs were deemed insufficient. A few individuals reported that resources for food/personal hygiene, financial support, health care access, annual health screening, and medication met their needs. Among men with healthcare and social needs, only a fraction were interested in a resource, and fewer reported that the resource met their needs. These results warrant a greater understanding of what constitutes a resolution of healthcare and social needs from patients' perspectives.
    MeSH term(s) Aged ; Humans ; Male ; Middle Aged ; Black People ; Health Services Accessibility ; Men ; Men's Health ; Needs Assessment ; Black or African American
    Language English
    Publishing date 2023-08-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 426631-6
    ISSN 1573-3610 ; 0094-5145
    ISSN (online) 1573-3610
    ISSN 0094-5145
    DOI 10.1007/s10900-023-01272-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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