This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.

Breastfeeding has been shown by a number of studies to have numerous benefits on both the mother and the infant. Major health organizations such as the World Health Organization (WHO), now agree that breastfeeding should be encouraged and supported in all countries. But like many things, the wheels of the law are slow to catch up with scientific evident. Although breastfeeding is supported, working women do not have the option of breastfeeding without consequences. For example, in 2003, Kirstie Marshall, a then member of parliament in Australia was ejected from the lower house chamber on February 23, for breastfeeding her baby [3]. According to standing order 30 at the time, "Unless by order of the House, no Member of this House shall presume to bring any stranger into any part of the House appropriated to the Members of this House while the House, or a Committee of the whole House, is sitting" [3]. The rules did not specify the age of strangers, so the then 11-day-old baby, Charlotte Louise and her mother were shown the exit door of parliament. She had to choose between being present at times of major discussions or leaving the house to breastfeed her child, she chose to leave. More recent statistics show that developed nations like the US and Australia which also have high rates of women employment had low rates of breastfeeding. This might mean that workplace policies do not favor breastfeeding or expressing milk at work. Fortunately, laws have since been introduced in both the United States and Australia that support breastfeeding at the workplace. The next step would be to access how these laws affect breastfeeding statistics and how variation between these two countries like the paid parental leave in Australia (which is not present in all US states) would affect these numbers.

Objective: To explain the origins of the pediatric asthma cluster present in south and central phoenix, and propose potential solutions to combat this cluster. Methods: A comprehensive literature review of the different factors that contribute to asthma starting at a national level and working down to the Maricopa county level was conducted. Afterwards a literature review of past pediatric asthma intervention case studies was conducted. The results of both literature reviews were synthesized in regards to applicability in south and central phoenix. Results: A combined targeted intervention in health care delivery, patient/clinician education, and housing status/infrastructure could yield promising results in regards to combatting the pediatric asthma cluster in south and central phoenix.

This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it is suggested that state legislatures and the federal government adopt the rising trend of expanding scope of practice to the extent of the care providers' certification. This is a movement has garnered support throughout the country and 20 states already allow for nearly autonomous practice by advanced practice nurses (APNs). This paper looked at systematic review, peer-reviewed papers, state/federal legislation and labor statistics to demonstrate how this move could increase access to healthcare providers as well as decrease cost by nearly 25%. This paper also evaluated how to formalization of nursing education has had positive impacts on the French healthcare system. Additionally, it evaluated a more specific look at Arizona and used data provided by the Arizona Board of Nursing and The Arizona Medical Board to make a compelling argument as to why this is a viable option for solving the disparity between rural and urban healthcare. The conclusion of the paper was to push policy makers to make the statutory constraints of the profession closer to the certification the people receive in their education as opposed to relying on case law. Additionally, it would be helpful to use technological innovations, like project echo, to help these professionals practice in rural areas. This will ultimately lead to a healthcare system that better serves the needs of all populations, as well as decreasing the overall cost of care.

The term "Children with Special Health Care Needs," often abbreviated as CSHCN, is an umbrella term, encompassing a wide variety of children with a range of health conditions. As of 2011, CSHCN constituted 15-20% of all children age 0-17 in the United States (Bethell et al., 2013). Despite this, CSHCN "account for 80% of all pediatric medical expenses." (Hardy, Vivier, Rivara, & Melzer, 2012). This project specifically compares children with physical disability and behavioral disability in hopes of gaining a greater insight into both groups, assessing/comparing differences, and evaluating whether or not having a co-morbidity has a mediating or contending effect on care coordination.

Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status, historical trauma, and lack of access to healthcare facilities. Barriers to healthcare and challenges associated with achieving optimal health among Native Americans contribute to health disparities within these populations. If these barriers are to be overcome, they must be understood and addressed. Purpose: The purpose of this review was to identify barriers to healthcare access for Native American populations as well as strategies to address barriers. Method: A preliminary scan of several online databases was conducted. Key terms used in the search included American Indians, Native American, healthcare, healthcare access, health disparities, barriers, and intervention. Articles were selected based on relevance, and data from each chosen article were extracted and categorized. Results: The initial search resulted in 272 articles of potential interest. Based on the abstract review, 32 were deemed relevant, and full text reviews were completed. Based on the full text review, an additional 10 articles were excluded, resulting in a final review of 22 articles. The articles addressed barriers related to various health conditions: cancer treatment, drug or alcohol use, maternal and child health, historical trauma, diabetes and chronic illnesses, and oral health. Conclusion: Native Americans face several barriers to healthcare access that are associated with social, physical, and mental health disparities. Successful efforts to address these barriers include patient-centered, culturally-competent interventions. Others include interventions which focus on community involvement.

The Patient Protection and Affordable Care Act (ACA) was created in 2010 to ensure American Citizens to obtain healthcare in which one way is to apply for Medicaid as more persons became eligible under expansion of coverage. The policies concerning Medicaid expansion has not federally mandated that every state adopt Medicaid expansion by Supreme Court decision, therefore it has been questioned in its ability by the current presidential cabinet which has led the Republican House of Representatives to create reforms of the current health law. The reforms to Medicaid expansion included the use of block grants or per capita caps through the American Health Care Act (AHCA) in which either of the reform would give more power and funding rights to the states themselves. However, the Senate withdrew the bill before voting as majority did not agree with the provisions and wanted current health care law to remain as is. With this bill not having been passed, other options of reforms are going to be considered by the Republican House of Representatives and the President. In the meantime, it is evident that states that have not yet expanded Medicaid should apply for a waiver to adopt the Medicaid expansion policies. This is because under the ACA's Medicaid expansion there has been a decrease in uninsured persons nationally, including the state of Arizona.

In the United States, the Latino population is projected to reach approximately 28.6% of the total U.S. population by 2060. Despite their growing presence, Latinos encounter health disparities and worse health outcomes in comparison to their non-Hispanic White (NHW) counterparts. Latinos/ Hispanics have a higher prevalence of diabetes, hypertension, obesity, and late stage cancer diagnosis. Various social determinants of health (SDoH) such as socioeconomic status, education, insurance enrollment, language proficiency, immigration status among other variables intersect to influence Latino health status. However, even when all those factors were held equal, disparities remained. The aforementioned list did not include race/ethnicity, though race/ethnicity is a critical SDoH that influences one's access to care and the quality of care they receive. As such, examining the role of race may be the key to reducing persistent health disparities in access to care, quality of care, and health outcomes.