Research Diary #3

Article #1: Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases.

This article relates directly to my research topic because it examines the relationship between wealth, income, and selected racial and ethnic differences in healthcare. This article uses the cross-sectional research method on a sample where the researchers, "analyzed to examine the association between socioeconomic status and racial and ethnic differences in functional status among those with hypertension, diabetes, a heart condition, and arthritis". This relates directly to my research question because within my questions it asks whether or not different races are more susceptible to chronic diseases. The results of this research indicated that African Americans have a higher rate of hypertension, diabetes, and arthritis in comparison to Whites. One thing I found interesting from this article is that Hispanics have higher rates of hypertension and diabetes, but lower rates of heart conditions.

R S Kington and J P Smith.  Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. American Journal of Public Health May 1997: Vol. 87, No. 5, pp. 805-810.

Article #2: The ANNALS of the American Academy of Political and Social Science

This article relates directly to my research question because it discusses how people with low socioeconomic status view health care and its accessibility. In the article it states that out of the households that were studied 20.2% had at least  one adult that experienced a health shock. A health shock is something that causes significant reductions in labour supply among households in low income households in particular are unable to fully smooth income losses from moderate and severe health shocks. With this being said the article also states, "These households were more likely to gain additional adult household members and employed household members, were more likely to move residence and to move distances greater than one mile, and were less likely to visit the food distribution center after the shock." I find this to be really interesting and surprising because it highlights the how health care and social changes can impact people in many ways that are not always though of. 

Leonard, Tammy, Hughes Amy, and Pruitt Sandi. "Sign In: Registered Users." Understanding How Low–Socioeconomic Status Households Cope with Health Shocks. Sage Publications, 20 Dec. 2016.

ARTICLE #3: Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race

This article relates directly to my research question because it examines how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). The researchers took samples of Whites, Blacks, and Native Americans and found that Whites with higher income and education levels increased perceptions about privilege and less about discrimination, however Blacks at the same level experienced more discrimination. At the end of the article it provides ideas for policies and preventions to reduce the negative perceptions toward people because of their race. I found this article to be interesting because it just adds more evidence for me to use in paper because I already had a solid thesis with evidence however this is just going to make my paper stronger.

Stepanikova, I., & Oates, G. (2017, January). Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race. American Journal of Preventive Medicine, 52(1), S86-S94.

ARTICLE 4: Are racial disparities in health conditional on socioeconomic status?

This article relates indirectly to my article because it discusses the link between health and socioeconomic status. This information will be good for my paper however it does not discuss the link to health care. The article explains the linkage and then proceeds to state the evidence between the two. "Overall, the findings provide evidence for the continuing significance of both race and SES in determining health status over time", I find this to be interesting because it seems as if overtime the health of people with low socioeconomic status will start to go down hill not only because of accessibility, but the discrimination that people face. No one whats to feel like they are not worthy or just a waste of space but with discrimination in the health care industry could potentially make a person not want to go to the doctors, the place where they should feel safe and taken care of.

Farmer, M., & Ferraro, K. (2005, January). Are racial disparities in health conditional on socioeconomic status? Science Direct.

ARTICLE #5: AFRICAN AMERICANS AND THEIR DISTRUST OF THE HEALTH CARE SYSTEM: HEALTH CARE FOR DIVERSE POPULATIONS

This article relates directly to my article because it provides historical events that have led up to this point of distrust in the health care system. The article uses examples like the Tuskegee Syphilis study to explain what people of color went through and how that event was one of the beginning events to where we are today. I plan on using this article to provide historical examples and statistics and incorporating them into my paper by possibly comparing and contrasting them to the statistics of today. One thing that I found interesting about this article is how it provides information from so fa back that is still very relevant to today.

Kennedy, Bernice Roberts, PHD, APRN, BC; Mathis, Christopher Clomus, PHD; Woods, Angela K, MSN. Journal of Cultural Diversity; Lisle14.2 (Summer 2007): 56-60.

In Class Exercise 2/6-2/8

#1
1. M A Winkleby, D E Jatulis, E Frank, and S P Fortmann.  Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health June 1992: Vol. 82, No. 6, pp. 816-820.
2. Cross Sectional/Forward Selection Model
3. The author uses the cross sectional method to collect data on participants then examining independent variables like education, income, and occupation(SES) to examine the relationship of these factors to cardiovascular disease risk factors. I think that the authors chose this method instead of the others because they are using different groups of people who differ in many independent variables, but share one common characteristic.
4. The results of the study led them to realize "the relationship between these SES measures and risk factors was strongest and most consistent for education, showing higher risk associated with lower levels of education. Using a forward selection model that allowed for inclusion of all three SES measures after adjustment for age and time of survey, education was the only measure that was significantly associated with the risk factors".
5. One thing I found interesting is that "if economics or time dictate that a single parameter of SES be chosen and if the research hypothesis does not dictate otherwise, higher education may be the best SES predictor of good health."

#2
1. ST, Bird, and Bogart LM., Perceived Race-based and Socioeconomic Status(SES)-based Discrimination in Interactions With Health Care Providers.Europe PMC., 01 Jan. 1970.
2. Cross Sectional
3. The authors implemented the cross sectional method through studying African American Adults that completed self-report questionnaires regarding their experiences with and attitudes toward health care providers. I think that they chose this method versus the other ones because they wanted to get the opinions of everyday people instead of using statistical data.
4.  In conclusion the authors found that, "Almost two thirds (63%) of participants perceived discrimination in their interactions with health care providers based on their race or color, and 58.9% perceived discrimination based on their socioeconomic status or social class. Some experiences of perceived discrimination were correlated with measures of health care utilization. Education and stigma consciousness were positively correlated with perceptions of both race-based and SES-based discrimination. Stigma consciousness was not significantly correlated with education, suggesting that expectations that one will be stereotyped by doctors do not account for the relationship between education and reports of perceived discrimination in interactions with health care providers." by using the cross sectional research method.
5. One thing I found to be really interesting from this source is the evidence that they found. I think the most interesting piece I found was that the expectation of stereotyping from doctors has no relation to the relationship between education and reports of discrimination.

#3
1.Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in QualityAddressing Socioeconomic, Racial, and Ethnic Disparities in Health Care. JAMA. 2000;283(19):2579-2584.
2. Grounded Theory
3. The method that was used in this source is grounded theory.Grounded theory is ideally suited for qualitative research where the data is collected through interviews and observations and when you analyze data first and then form your theory. Which s exactly what this article did, "after reviewing literature on disparities in health care, we discuss the limitations in existing quality assessment for identifying and addressing these disparities."
4. Using the grounded theory method the authors collected the information that they needed and proceed to form a theory. "We propose 5 principles to address these disparities through modifications in quality performance measures: disparities represent a significant quality problem; current data collection efforts are inadequate to identify and address disparities; clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting; population-wide monitoring should incorporate adjustment for race/ethnicity and socioeconomic position; and strategies to adjust payment for race/ethnicity and socioeconomic position should be considered to reflect the known effects of both on morbidity."
5. Something that I found really interesting in this source is the fact that the authors came up with the five principles to address the disparities, and this is the first source that I have seen do that.

#4
1.Gay Becker and Edwina Newsom.  Socioeconomic Status and Dissatisfaction With Health Care Among Chronically Ill African Americans. American Journal of Public Health: May 2003, Vol. 93, No. 5, pp. 742-748.
2. Qualitative
3. This source uses the qualitative research method to address the differences in social class and how it is critical to an examination of racial disparities in health care. "Low socioeconomic status is an important determinant of access to health care.
4. Using the qualitative research method the researchers found,"Results from a qualitative, in-depth interview study of 60 African Americans who had one or more chronic illnesses found that low-income respondents expressed much greater dissatisfaction with health care than did middle-income respondents. Low socioeconomic status has potentially deadly consequences for several reasons: its associations with other determinants of health status, its relationship to health insurance or the absence there of, and the constraints on care at sites serving people who have low incomes." This is good evidence to use when writing my research paper because it correlates directly allowing to provide evidence.
5. One thing I found interesting in this article is the fact that people with low socioeconomic status expressed dissatisfaction with health care in comparison to people with middle-income. I found this interesting because that means that the people used in the study are most likely experiencing some  sort of discrimination because of their status, and they are noticing. I find this to be kind of disturbing because people are being treated unfairly because of their income and they might not even be in control of their status.

Research Diary #2

What is your topic? Or what are your key words thus far?

Policy

socioeconomic status

case control

accessibility

What is your research question? Have you decided to change it at all? And, if you have, how do I know that the way in which this question is formulated is appropriate to conduct a literature review with a systematic approach? 

After debating between the two topics I was going to conduct my research on I originally chose to ask the question of "What are the long term effects of lead exposure in young children", however after doing some critical thinking I decided to change my topic on socioeconomic status and how it is linked to health.

 My new research question is: How do people with a low socioeconomic status view health care and its availability? Are people with low socioeconomic more susceptible to certain chronic diseases than others? How have some experiences made people with low socioeconomic status not want to take advantage of health services?

"A systematic review is a critical synthesis of research evidence, which involves analysis of all available and relevant evidence in a systematic, objective and robust manner. A formal, rigorous methodological process is followed (Figure 1). This includes clarification of the research question, identification of eligible literature using electronic bibliographic databases and other information sources, assessment of study quality, data extraction, summarising and interpretation of results. A common misconception is that systematic reviews can only be conducted on RCTs. Systematic review methodology can be adapted to address a wide range of questions and the study design of the included studies will be dictated by the research question. "

And what are the definitions on which it depends?


My question depends on key terms, all of which are linked to the literature and those terms are:

Cross Sectional Uses different groups of people who differ in the variable of interest but share other characteristics like socioeconomic status, educational background, and ethnicity to collect data 
Theory Proving/disproving a “common” idea (a theory)…. Generated in response to evidence that has been gathered

Policy Government, reform, laws

What is your hierarchy of evidence? And how do I know you going about finding the most appropriate evidence/method for your research question?

Policy

Theory

Cross sectional

ARTICLE 1: The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors

This article relates directly to my topic because it discusses how race and ethnicity can effect a persons healthcare. This article studied the role of race, ethnicity, and healthcare in emergency health departments. One thing I found interesting is that the article provides statistical evidence using their own group of people to study." Race/ethnicity-based disparities in routine ED use were due to the confounding effects of SES. Programs to reduce inappropriate ED use must be sensitive to an array of complex socioeconomic issues and may necessitate a substantial paradigm shift in how acute care is provided in low SES communities." I plan on using the articles findings to provide statistical evidence on how people are sometimes treated differently depending on their socioeconomic status.

Hong, Rick (2007). "The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors". The Journal of emergency medicine (0736-4679), 32 (2), p. 149.

ARTICLE 2: Effect of race and ethnicity and socioeconomic status on healthcare satisfaction

This article relates directly to my topic because there are multiple parts to my research question and this would relate to the part of the question where it asks how have some experiences made people with low socioeconomic status not want to take advantage of healthcare services. The article states that it found, "when measures of patient-provider communication are normalized, other demographic and socioeconomic characteristics (race, gender, education) are not shown to be predictors of patient satisfaction. The result of this study validates finding of other studies as well as the theory of social determinant of health." I found this to be interesting and plan on incorporating this article into my final research paper to help me back up my research question.'

Otake, Yoshiake. Effect of race and ethnicity and socioeconomic status on healthcare satisfaction, Icahn School of Medicine at Mount Sinai, Ann Arbor.2014.

ARTICLE 3: Key Factors Influencing Health Disparities Among African Americans

This article relates indirectly to my research question because it is directed to a specific group of people. With this being said I feel that I might make my research question directed towards a specific group of people because I am starting to feel as if it is too broad. " A significant body of literature suggests that racism or discrimination may be a contributing factor to misdiagnosis, late diagnosis, as well as, the scope and veracity of treatment once African Americans are diagnosed with chronic illness or disease ". I found this quote to be the most interesting because I know that African Americans are predisposed to some diseases and there is often discrimination toward colored races anywhere and everywhere. After reading this article I plan on redirecting my research question towards the African American community.

McFayden, Elgie. “Key Factors Influencing Health Disparities Among African Americans.” Race, Gender & Class, vol. 16, no. 3/4, 2009, pp. 120–132.

ARTICLE 4: Healthcare Disparities: The Salience of Social Class

This article relates directly to my topic because it discusses the unequal treatment of people with low socioeconomic status in the healthcare industry. "Empirical evidence demonstrates that minority and marginalized populations receive less and lower quality healthcare than more advantaged groups. Ethical analyses of these disparities explain their injustice. That disparities exist and constitute a moral wrong are uncontroversial views." I am very excited to use this source because it seems to hold the exact information that I am going to need when writing my research paper. This source is one that I feel holds the most information making it the main one out of the five.

Blacksher, E. (2008) ‘Healthcare Disparities: The Salience of Social Class’, Cambridge Quarterly of Healthcare Ethics, 17(2), pp. 143–153. 

ARTICLE 5: WAITING TIME AND SOCIOECONOMIC STATUS—AN INDIVIDUAL-LEVEL ANALYSIS

This article relates indirectly to my article because it is kind of like a sub-topic in regards to the topics that are listed in my question. My question states that I want to find how people with low socioeconomic status view health care, and are they more susceptible to chronic diseases. I think that if needed I could incorporate the statistics that are provided in this source to provide more information of how people with low socioeconomic status are treated. One thing I found interesting is that ,"For men, there is a statistically highly significant negative association between income and waiting time, driven by men in the highest income group, which constitutes 12% of all men. More educated women, that is, those having an education above compulsory schooling, experience lower waiting time than their fellow sisters with the lowest level of education".

Monstad, Karin (04/01/2014). "WAITING TIME AND SOCIOECONOMIC STATUS - AN INDIVIDUAL-LEVEL ANALYSIS". Health economics (1057-9230), 23 (4), p. 446.

Anything else interesting happen?

After conducting more research on my topic and finding sources I have decided to redirect my question towards the African American community.

explaining my research project

Audio for Research Diary 1

Research Diary #1

What was the process by which you narrowed down potential topics to two appropriate ones? And how were these decisions made on the basis of either class discussion, or our required, course textbook (Aveyard 2014), or both?

I wanted to choose something that I was interested in as well as wanted to look into more to gain more knowledge.

What research question did you choose, and how are I can be sure you're making a reasoned, academic judgment on the basis of chapters 1-3 (Aveyard 2014)?

After debating between the two topics I was going to conduct my research on I originally chose to ask the question of "What are the long term effects of lead exposure in young children", however after doing some critical thinking I decided to change my topic on socioeconomic status and how it is linked to health.

 My new research question is: How do people with a low socioeconomic status view health care and its availability? Are people with low socioeconomic more susceptible to certain chronic diseases than others? How have some experiences made people with low socioeconomic status not want to take advantage of health services?

What article (or articles) are you basing this question on, and what type of article is it (research, theory, policy, practice) (citation[s] in APA, please)? 

Brawley, O. W., & Goldberg, P. (2012). How we do harm: a doctor breaks ranks about being sick in America. New York: St. Martin's Press.

David R. Williams, PhD, MPH, Harold W. Neighbors, PhD, and James S. Jackson, PhD. Racial/Ethnic Discrimination and Health: Findings From Community Studies. American Journal of Public Health. 2003; 93:200–208.

Gay Becker, Rahima Jan Gates, and Edwina Newsom.  Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status. American Journal of Public Health: December 2004, Vol. 94, No. 12, pp. 2066-2073.

Paula A. Braveman, Catherine Cubbin, Susan Egerter, David R. Williams, and Elsie Pamuk.  Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us. American Journal of Public Health: April 2010, Vol. 100, No. S1, pp. S186-S196.

Williams, David R. (02/01/2010). "Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities". Annals of the New York Academy of Sciences (0077-8923), 1186 (1), p. 69.

How can I be sure that the key vocabulary of the question corresponds not only to literature in the field, but also to chapter 1-3 (Aveyard 2014)?

My research question implies that I will have to search for quality, credible research and use  those articles, journals,books, etc. that I find to write my paper, which is what the author suggests that we do.

Based on what your question is, what kind of literature are you going to need? Again, please explicitly reference the text (Aveyard 2014). What is your hierarchy of evidence?

cohort and case control studies

cross sectional studies

statistics

quantitative and qualitative research

How do you define your key terms, and how do these definitions link to key journals in the field?

• social determinants- what social factors could impact a persons decisions
• personal responsibility- taking responsibility for ones choices
• educational background-what level of edu a person may have
• socioeconomic status and susceptibility- are they more likely for a specific event to happen to them 
• socioeconomic status and experiences- do people with low socioeconomic statuses share similar experiences
• socioeconomic status, availability, and advantages

Did anything unexpected happen? From you initial search, does it appear as though your research question will work? Or does the vocabulary and/or type of research sought need to be changed?

I decided to change my original research question to the one that I have now because I felt that I was not truly interested in the topic because I already knew the effects however now, I have chosen a topic that I do think is interesting and would like to look more into.

Any final thoughts?

NONE