Racism, Chronic Disease, and Mental Health: Time to Change Our Racialized System of Second-Class Care.

In this article, we describe how the "weathering hypothesis" and Adverse Childhood Experiences set the stage for higher rates of chronic disease, mental health disorders and maternal mortality seen in African American adults. We illustrate the toll that untreated and overtreated mental health disorders have on Black individuals, who have similar rates of mental health disorders as their white counterparts but have fewer outpatient mental health services and higher rates of hospitalizations. We discuss the history of Medicaid, which, while passed alongside Medicare during the Civil Rights era, was Congress's concession to Southern states unwilling to concede federal oversight and funds to the provision of equal healthcare for poor and Black people.

Recognizing and intervening in child sex trafficking.

Know the risk factors, choose from among 3 validated screening tools, and use a trauma-informed approach with those likely involved in trafficking.

Transportation characteristics associated with non-arrivals to paediatric clinic appointments: a retrospective analysis of 51 580 scheduled visits.

Background: Prior work has not studied the effects of transportation accessibility and patient factors on clinic non-arrival.

Objectives: Our objectives were: (1) to evaluate transportation characteristics and patient factors associated with clinic non-arrival, (2) to evaluate the comparability of bus and car drive time estimates, and (3) to evaluate the combined effects of transportation accessibility and income on scheduled appointment non-arrival.

Methods: We queried electronic administrative records at an urban general pediatrics clinic.

Curriculum and evaluation results of a third-year medical student longitudinal pathway on underserved care.

Background: There is a need to train compassionate and competent physicians to care for the growing underserved population in this country.

Description: The authors developed the third-year Longitudinal Ambulatory Care Experience (LACE) Underserved Care pathway at Baylor College of Medicine in 2003 to help interested students prepare to be clinicians who care for the underserved. The pathway curriculum included seminar/journal clubs on relevant underserved care topics, clinical time with an underserved care preceptor, visits to community organizations, an assignment to help an uninsured patient obtain health care funding, and a group project.