Forty Years of Family and Community Health
Happy 40th Anniversary Family and Community Health! For the past majority of this time, Family and Community Health has been a practical quarterly theme-based journal that presented creative, multidisciplinary perspectives and approaches for effective family and community health programs. Indexed as a nursing journal, many of the articles had direct relevance for clinical practice.
As we celebrate this important milestone, we reflect on the beginnings of the journal, the current direction of Family and Community Health, and highlight the featured articles in this volume. When the first issue of this journal was published in 1977, the following events occurred:
[check mark] The world's first all-in-one home computer was produced;
[check mark] Elvis Presley's last concert was held;
[check mark] President Jimmy Carter signed legislation which created the U.S. Department of Energy;
[check mark] Virginia Wade won Wimbledon;
[check mark] Space Mountain opened at Disneyland, beginning a 40 year run as one of the theme park's most popular attractions
Forty years ago, 15% of Americans did not have a usual source of care and there was a significant racial disparity in employer-based health insurance (77.4% among White Americans versus 58.6% among African Americans, and 58.4% among Hispanics). Health policy has changed significantly since the first issue of Family and Community Health; however, 27 million adults still do not have health insurance coverage. Access to care is considered one of the most significant indicators of health disparities in the United States and these differences have been consistent over the past 40 years despite advances that have improved the overall health status of children and adults. Resounding and compelling calls for action have been made from numerous stakeholder groups. Recommendations from the Centers for Disease Control and Prevention include: 1) increasing community awareness of health disparities as problems with solutions and 2) the implementation of dual strategies of universal and targeted intervention strategies based on lessons learned in decreasing certain health disparities. Rigorously conducted family and community health research studies can provide evidence that address these recommendations and ultimately improve the health of all Americans.
The editorial team at Family and Community Health is answering this clarion call by being a practical quarterly journal aiming to advance the science of health disparities and health equity focusing on families and communities. We recognize the lack of a singular definition of health disparities and health equity and the editorial team utilize the definitions of health disparities and health equity offered in Healthy People 2020. Health disparities are therefore "a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion."1 Health equity is defined as the "attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities."2
Family and Community Health publishes rigorous scholarly work from multiple disciplines using qualitative, quantitative, and mixed methods to highlight the full spectrum of family and community-focused research undertaken to reduce health disparities and to achieve health equity. Original theoretical, empirical and evidence-based articles, unsolicited state-of-the-science reviews, and solicited commentaries presenting innovative research about the relationship among families, communities, health disparities, and/or health equity are considered for publication (http://journals.lww.com/familyandcommunityhealth.pages/default.aspx).
We are pleased to commemorate the 40th anniversary of Family and Community Health with a diverse group of articles that address issues related to health disparities and health equity across a range of issues. Forrest et al analyzed data from the National Health and Nutrition Examination Survey (NHANES) to evaluate the prevalence of obesity and associated factors among Hispanic Americans. Previous studies have examined difference in obesity prevalence among racial groups, but few have examined the heterogeneity of these factors among a single high-risk group. The second article by a team of scholars led by Molokwu presents findings from a randomized clinical trial among 50-70 year olds to increase knowledge about colorectal cancer. According to the American Cancer Society, an estimated 95,520 new cases of colon cancer and 39,910 cases of rectal cancer will be diagnosed in 2017.3 The 6-month intervention follow-up findings achieved showed an increase in knowledge for participants in the active arm of the trial. In the Ramirez et al article, four training modules on environmental health designed to be delivered by community health workers (promotores de salud) are described; these modules are intended to be used for community empowerment and have implications for addressing environmental justice. The fourth article written by Dlugonski and colleagues presents an examination of the associations among the perceptions of community collective efficacy and physical activity, self-efficacy, social support, and health. Consistent with a larger body of literature, findings from this study demonstrated a positive association between physical activity and collective efficacy.
Parkinson's Disease is a common neurodegenerative disorder that affects 10 million people worldwide; the incidence of this condition is known to increase with age. Shuler et al examined factors that influence the access to clinical care for seniors who reside in rural communities. Models of care and approaches to increasing access to care for patients in medically underserved rural areas. Recent studies have shown that childhood obesity rates are higher in rural compared to urban areas.4 Dinkel et al examined the relationship between parental and child physical activity in rural areas in the United States (U.S.). Their findings illustrate that mothers' support for physical activity for and parental level of physical activity is moderately associated with child physical activity. The article by Raithatha and colleagues describes a pilot study regarding the management of non-communicable disease in rural health clinics in South Africa. This qualitative study examined barriers and facilitators of engaging community health workers to improve patient outcomes. The eighth article by Rao et al discusses the increase in age-adjusted suicide rate between 1999-2014 and offers a framework to elucidate the paradox of high rates of suicide among American Indian and Alaskan Native adolescents and the very low rates among elders compared to other racial and ethnic groups. The last article in this issue by Eun-Ok explores the association of immigration transition with the development of cardiovascular symptoms among White, African American, Asian, and Hispanic mid-life women 40-60 years of age.
For 40 years, Family and Community Health has featured interdisciplinary research studies intended to advance the health science literature focusing on families and communities. Our editorial team plans continue this tradition by disseminating high quality scientific studies that advance the science of health disparities and health equity in family and community. We hope you will continue to support and contribute to the research in this area. Here's to 40 more productive years!
-Bettina M. Beech, DrPH, MPH
Editor-in-Chief
Founding Dean, John D. Bower School of Population Health
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