RESUMEN
BACKGROUND: Care of the underserved remains one of the most compelling challenges to American healthcare. Federally Qualified Health Centers (FQHCs) address uninsurance and underinsurance by providing primary and preventive care to vulnerable populations with fees charged based on ability to pay. Our goal is to study the effectiveness of FQHCs system in engaging patients and the barriers to utilization, which have not been well defined. METHODS: Retrospective analysis was performed on data from "Living for Health" (L4H) program participants from 2008 to 2012. Univariate and multivariate logistic regression analysis were performed to determine factors associated with FQHC utilization. RESULTS: Among 9453 subjects screened, 1889 were referred to a FQHC, but only 201(11%) actually sought treatment. Public insurance, non-Hispanic ethnicity, and hypertension were associated with higher rates of FQHC utilization. Inability to afford costs, cultural factors and inflexible appointment times were the most common reasons for FQHC underutilization. CONCLUSION: The current status of FQHC utilization is sub-optimal. Community outreach programs like L4H can improve the access and utilization of FQHCs.
Asunto(s)
Centros Comunitarios de Salud , Relaciones Comunidad-Institución , Accesibilidad a los Servicios de Salud , Poblaciones Vulnerables , Adolescente , Adulto , Anciano , Citas y Horarios , Estudios Transversales , Femenino , Florida , Humanos , Modelos Logísticos , Masculino , Pacientes no Asegurados , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US). The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH). METHODS: This cross-sectional study used self-reported data from Living for Health Program (N = 1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US. RESULTS: Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ≤2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30-3.54; OR = 2.86, 95% CI 1.12-7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03-2.43; OR = 3.37, 95% CI 1.67-2.43, resp.). The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17-2.35). CONCLUSION: Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases.