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A longitudinal analysis of violence and healthcare service utilization in Mexico.
Vargas, Laura X; Richmond, Therese S; Allen, Heidi L; Meisel, Zachary F.
Afiliação
  • Vargas LX; Penn Injury Science Center and School of Nursing, University of Pennsylvania, PA, Philadelphia, USA. lxv2000@nursing.upenn.edu.
  • Richmond TS; University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
  • Allen HL; Columbia University, School of Social Work, New York, NY, USA.
  • Meisel ZF; University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
Int J Equity Health ; 20(1): 75, 2021 03 10.
Article em En | MEDLINE | ID: mdl-33691724
OBJECTIVES: We analyze the degree to which community violence in Mexico, largely due to organized crime violence, affects health care service utilization. METHODS: This study exploits temporal and geographic variation in monthly county-level homicide rates, matching outpatient service utilization from individual longitudinal measures. Sensitivity analyses test for an age specific concentration of violence, respiratory conditions that are likely unrelated to violence, insurance status and health center availability per capita. We test for distributional responses to violence by urban and rural localities. RESULTS: The likelihood of service utilization increases by 5.2% with each additional homicide per 100,000. When we include self-reported health conditions in the model, our main coefficient remains significant at 4.5%. We find no added effect to our results from interaction terms for age specific concentration of violence, respiratory conditions, insurance status, or health center availability. A substantial increase of 11.7% in the likelihood of service utilization occurs in localities with > = 100,000 inhabitants, suggesting that service utilization is sensitive to the location of violence. CONCLUSIONS: Results highlight the relationship between and increase in violence at the local level and an increase in health care service utilization. This study is among the first to examine this relationship empirically in Mexico. Future research is needed to shed more light on this relationship and its mechanisms.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Violência / Aceitação pelo Paciente de Cuidados de Saúde / Atenção à Saúde / Homicídio Tipo de estudo: Observational_studies Aspecto: Determinantes_sociais_saude / Implementation_research Limite: Female / Humans País/Região como assunto: Mexico Idioma: En Revista: Int J Equity Health Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Violência / Aceitação pelo Paciente de Cuidados de Saúde / Atenção à Saúde / Homicídio Tipo de estudo: Observational_studies Aspecto: Determinantes_sociais_saude / Implementation_research Limite: Female / Humans País/Região como assunto: Mexico Idioma: En Revista: Int J Equity Health Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido