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Disparities in chiropractic utilization by race,ethnicity and socioeconomic status:A scoping review of the literature

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Journal of Integrative Medicine 2023年第2期21卷 159-167页

作者： Jordan A.Gliedt Antoinette L.Spector Michael J.Schneider Joni Williams Staci Young Department of Neurosurgery Medical College of WisconsinMilwaukeeWI 53226USA Department of Rehabilitation Sciences and Technology University of Wisconsin-MilwaukeeMilwaukeeWI 53201USA Department of Physical Therapy University of PittsburghPittsburghPA 15219USA Clinical and Translational Science Institute University of PittsburghPittsburghPA 15213USA Department of Medicine Division of Internal MedicineMedical College of WisconsinMilwaukeeWI 53226USA Department of Family and Community Medicine Medical College of WisconsinMilwaukeeWI 53226USA

Background Chiropractic is the largest complementary and alternative medicine profession in the United States,with increasing global growth.A preliminary literature review suggests a lack of widespread diversity of chiropractic patient profiles.Objective There have been no prior studies to comprehensively integrate the literature on chiropractic utilization rates by race,ethnicity,and socioeconomic status.The purpose of this scoping review is to identify and describe the current state of knowledge of chiropractic utilization by race,ethnicity,education level,employment status,and income and poverty level.Search strategy Systematic searches were conducted in PubMed,Ovid MEDLINE,Cumulative Index of Nursing and Allied health Literature(CINAHL),Cochrane Database of Systematic Reviews,and Index to Chiropractic Literature from inception to May 2021.Inclusion criteria Articles that reported race or ethnicity,education level,employment status,income or poverty level variables and chiropractic utilization rates for adults(≥18 years of age)were eligible for this review.Data extraction and analysis Data extracted from articles were citation information,patient characteristics,race and ethnicity,education level,employment status,income and poverty level,and chiropractic utilization rate.A descriptive numerical summary of included studies is provided.This study provides a qualitative thematic narrative of chiropractic utilization with attention to race and ethnicity,education level,income and poverty level,and employment status.Results A total of 69 articles were eligible for review.Most articles were published since 2003 and reported data from study populations in the United States.Of the race,ethnicity and socioeconomic categories that were most commonly reported,chiropractic utilization was the highest for individuals identifying as European American/White/non-Hispanic White/Caucasian(median 20.00%;interquartile range 2.70%-64.60%),those with employment as a main income source(median utilization 78.50%;interquartile range

关键词： Chiropractic Utilization health inequities health disparities Low-back pain Neck pain

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Inequity in the global distribution of monkeypox vaccines

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World Journal of Clinical Cases 2023年第19期11卷 4498-4503页

作者： Marcos Roberto Tovani-Palone Neel Doshi Paolo Pedersini Department of Research Analytics Saveetha Dental College and HospitalsSaveetha Institute of Medical and Technical SciencesChennai 600077India Department of Medicine Pravara Institute of Medical SciencesAhmednagar 413736India IRCCS Fondazione Don Carlo Gnocchi Milan 20148Italy

Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.Although its case fatality risk has not been high,a significant percentage of patients require hospitalization.In this context,local initiatives were taken to extend the limited supply of vaccines against the disease;however,such measures have not been sufficient to contain the spread of cases and ensure an equitable distribution of health resources.As a result,endemic regions of low-income countries continue to have insufficient access to mpox vaccination.Despite this and considering the global scope of the disease,there is still little discussion in the literature about the difficulties in achieving adequate vaccination coverage rates for the target population of interest.In this article,we briefly discussed general aspects of the disease,including its surveillance,the current global context of challenges for mpox vaccination,and issues on global allocation of health resources as well as proposed related recommendations.

关键词： Monkeypox Smallpox vaccine health inequities Vaccination coverage Vaccination hesitancy healthcare financing

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