PAST-DUE (Prevention and Social Determinants: Disparities and Utilization in Latino Elders)

项目概要/摘要 60岁及以上的美国人未充分利用推荐的预防性医疗保健。老年 拉美裔美国人对预防服务的利用不足程度甚至超过非西班牙裔美国人 白人，但造成这种差距最严重的因素知之甚少。一些 卫生服务文献中的证据表明，健康的社会决定因素（个人- 以及社区一级的经济、社会和环境因素）影响预防性药物的使用。 保健然而，不确定哪些具体服务可能是老年人最没有充分利用的。 拉丁美洲人，以及哪些社会决定因素与这一群体的利用率最密切相关。 缺乏关于社会决定因素和预防性服务利用的知识， 拉丁美洲老年人的死亡率至少部分是由于缺乏关于流动健康的全面数据 与个人和社区一级健康的社会决定因素有关的护理利用情况。 该项目将评估老年拉美人和老年人在预防服务使用方面的差异。 非西班牙裔白人，并确定这些差异背后的因素。为此，我们将 利用来自大型全国性社区卫生中心网络的独特数据资源 共享的电子健康记录数据与社区一级的社会决定因素有关， 健康数据。这个大型的纵向数据集包含了前所未有的数据链接， 我们评估差距，评估哪些社会决定因素影响利用率和差距， 确定其中哪些可能会随着时间的推移最显着;在这样做的时候，我们将解决一个 重要的知识差距。了解最重要的因素（个人或社区） 影响预防服务的使用是至关重要的，以人口为基础的干预措施的优先次序， 改进预防性筛查。 了解健康的社会决定因素对预防服务的相对影响 在老年拉丁美洲人中使用将使行动/干预在三个方面：1。它将使更多的知情 改善美国老年人公共卫生和健康的政策决定。2.它将促进 医疗保健提供者和社区机构之间的战略伙伴关系， 干预美国老年人生活中的社会因素。3.它将帮助临床提供者 了解他们的病人的障碍，以照顾利用，并进一步点的护理工作，以解决 这些障碍影响了老年患者对推荐医疗保健的利用 服务

Project Summary/Abstract Americans aged 60 and over underutilize recommended preventive healthcare. Older Latino-Americans underutilize preventive services to an even greater degree than non-Hispanic whites, but the factors that drive this disparity most heavily are poorly understood. Some evidence in the health services literature suggests that social determinants of health (individual- and community-level economic, social, and environmental factors) affect utilization of preventive health care. It is uncertain, however, which specific services may be most underused by older Latinos, and which social determinants are most strongly associated with this group's utilization. The dearth of knowledge about social determinants and preventive service utilization in older Latinos is due, at least in part, to the lack of comprehensive data on ambulatory health care utilization linked to data on individual- and community-level social determinants of health. This project will assess disparities in preventive service use between older Latinos and older non-Hispanic Whites, and identify the factors underlying those disparities. To do so, we will leverage a unique data resource from a large, national network of community health centers with shared electronic health record data that is linked to community-level social determinants of health data. This large, longitudinal dataset contains unprecedented data linkages which will let us assess disparities, evaluate which social determinants affect utilization and disparities, and determine which of these may do so most significantly over time; in so doing, we will address an important knowledge gap. Understanding the factors (individual or community) that most heavily impact preventive service use is crucial to the prioritization of population-based interventions to improve preventive screening. Understanding the relative impact of social determinants of health on preventive service use in older Latinos will enable action/intervention in three ways: 1. It will enable more informed policy decisions to improve public health and wellness in older Americans. 2. It will facilitate strategic partnerships between healthcare providers and community agencies poised to intervene in social factors in the lives of older Americans. 3. It will help clinical providers understand their patients' barriers to care utilization, and further point-of-care efforts to address these barriers that influence their older patients' utilization of recommended health care services.