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

项目摘要/摘要 60岁及以上的美国人未充分利用建议的预防性医疗保健。更老的 拉美裔美国人对预防性服务的利用不足，甚至比非西班牙裔美国人更严重 白人，但造成这种差距最大的因素却鲜为人知。一些人 卫生服务文献中的证据表明，健康的社会决定因素(个人-- 以及社区层面的经济、社会和环境因素)影响预防措施的使用 医疗保健。然而，还不确定哪些特定的服务可能被较老的人利用得最少 拉丁美洲人，以及哪些社会决定因素与这一群体的使用最密切相关。 缺乏关于社会决定因素和预防性服务利用的知识 年长的拉丁裔人至少在一定程度上是由于缺乏关于门诊健康的全面数据 保健利用与个人和社区一级健康的社会决定因素的数据相联系。 该项目将评估年长的拉美裔人和年长的拉丁裔人在预防性服务使用方面的差异 非西班牙裔白人，并找出导致这些差异的因素。要做到这一点，我们将 利用来自全国大型社区卫生中心网络的独特数据资源 使用共享的电子健康记录数据，该数据与社区层面的社会决定因素相关联 健康数据。这一大型纵向数据集包含前所未有的数据链接，这将使 美国评估差距，评估哪些社会决定因素影响利用率和差距，以及 确定随着时间的推移，其中哪些可能会产生最大的影响；在这样做的过程中，我们将解决 重要的知识鸿沟。了解最重要的因素(个人或社区) 影响预防服务的使用对于确定以人口为基础的干预措施的优先次序至关重要 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 在年长的拉丁裔人中使用将通过三种方式实现行动/干预：1.它将使更多的信息 政策决定，以改善美国老年人的公共健康和福祉。2.它将促进 医疗保健提供者和社区机构之间的战略合作伙伴关系 干预老年美国人生活中的社会因素。3.它将帮助临床提供者 了解他们的患者在护理利用方面的障碍，并进一步努力解决护理点问题 这些障碍影响他们的老年患者对推荐的医疗保健的利用 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.