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The United States offers two markedly different subsidy structures for private health insurance. When covered through employer-based plans, employees and their dependents benefit from the exclusion from taxable income of the premiums. Individuals without access to employer coverage may obtain subsidies for Marketplace coverage. This paper seeks to understand how the public subsidies embedded in the privately financed portion of the U.S. healthcare system impact the payments families are required to make under both ESI and Marketplace coverage, and the implications for finance equity. Using the Household Component of the Medical Expenditure Panel Survey (MEPS-HC) and Marketplace premium data, we assess horizontal and vertical equity by calculating public subsidies for and expected family spending under each coverage source and using Lorenz curves and Gini and concentration coefficients. Our study pooled the 2018 and 2019 MEPS-HC to achieve a sample size of 10,593 observations. Our simulations showed a marked horizontal inequity for lower-income families with access to employer coverage who cannot obtain Marketplace subsidies. Relative to both the financing of employer coverage and earlier Marketplace tax credits, the more generous Marketplace premium subsidies, first made available in 2021 under the American Rescue Plan Act, substantially increased the vertical equity of Marketplace financing. While Marketplace subsidies have clearly improved equity within the United States, we conclude with a comparison to other OECD countries highlighting the persistence of inequities in the U.S. stemming from its noteworthy reliance on employer-based private health insurance. • United States uses employer and individual private health insurance coverage. • No recent investigations of horizontal and vertical equity of U.S. private coverage. • Analysis of Gini coefficients and Lorenz curves suggests regressivity. • Public policies including insurance subsidies can reduce inequities. [ABSTRACT FROM AUTHOR]

English-language reporting on the continuing difficulties in accessing Evusheld reflects the marginalization of immunocompromised people in discussions about the public policy response to Covid-19. Moreover, the lack of available data on global Evusheld access, particularly in low-income countries, has emerged as a key form of nonknowledge that must be redressed within public health research. Through examining how knowledge about domestic and global barriers to Evusheld access circulates, and does not circulate, within The New York Times , this paper identifies a case study of the social production of ignorance related to a key issue in the Covid-19 pandemic. Drawing on science and technology studies, the history of science and media studies, I situate these trends in the context of longer explanatory histories of nonknowledge. First, through a critical discourse analysis of the New York Times' reporting on Evusheld access in the U.S., I trace the individualizing framework evident in many articles to longstanding trends in reporting on health and illness, and to the structural marginalization of immunocompromised people in U.S. Secondly, I argue that the near-total absence of reporting on Evusheld access in low-income countries is consistent with the longstanding structural neglect of health crises in the global south. • New York Times coverage of preventative treatment Evusheld rarely discusses access barriers. • Access barriers discussed are largely logistical rather than structural. • The perspectives of immunocompromised people are rarely included in Times articles on Evusheld. • Failure to include voices from impacted communities contributes to agnogenesis. • Centering the perspectives of constituencies most impacted by a health crisis will advance health equity. [ABSTRACT FROM AUTHOR]

Many Latinx and Indigenous Mexican populations in the United States Southwest live in unincorporated communities in the US-Mexico borderlands called colonias. These environmental justice communities often lack basic infrastructure, including healthcare services, prompting many to seek services across the border. However, due to geopolitical factors more vulnerable caregivers are limited to utilize healthcare services in the US. This paper reports the experiences and healthcare decision-making of caregivers living in colonias in the US-Mexico border region who care for children with respiratory health conditions. This study was carried out from September to December 2020. Focus groups and interviews were conducted with Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress. Qualitative interviews elicited caregivers' perspectives on the environmental factors affecting children's chronic health conditions and use of healthcare services. The analysis employed the concept of structure vulnerability to theorize geography as a structural determinant of health for caregivers faced with making healthcare decisions for their suffering from respiratory health conditions. A survey was administered to collect basic sociodemographic information. A total of 36 caregivers participated in the study. Structural factors including unincorporated community status and government inaction intersected with social determinants of health to prompt caregivers to cross the US-Mexico border to access healthcare services in Mexico for their children. Yet, more vulnerable caregivers (i.e., those without documentation status in the US) and their children, accessing healthcare services in the US was not an option limiting caregivers' ability to meet their children's healthcare needs. In such cases, geography acts as a structural determinant of health. This study shows the importance of geography in health. Rural unincorporated colonias located in the borderlands are precariously located and lack basic critical infrastructure including healthcare access. Within such places, historically and socially marginalized populations become invisible, are subject to the health effects of environmental hazards, and are limited depending on their positionality and thus vulnerability to healthcare services. • Municipal unincorporation contributes to health disparities among Latinx families in US-Mexico borderlands. • Latinx children in colonias are disproportionately exposed to environmental toxins. • Geography acts as a structural determinant of health for Latinx families in colonias. • A binational approach to health services should be prioritized for families in the borderlands. [ABSTRACT FROM AUTHOR]

Understanding barriers to abortion care is particularly important post -Dobbs. However, many abortion access studies recruit from abortion-providing facilities, which overlook individuals who do not present for clinic-based care. To our knowledge, no studies have reviewed research recruitment strategies in the literature or considered how they might affect our knowledge of abortion barriers. We aimed to identify populations included and sampling methods used in studies of abortion barriers in the United States. We used a scoping review protocol to search five databases for articles examining US-based individuals' experiences accessing abortion. We included English-language articles published between January 2011 and February 2022. For included studies, we identified the sampling strategy and population recruited. Our search produced 2763 articles, of which 71 met inclusion criteria. Half of the included papers recruited participants at abortion-providing facilities (n = 35), while the remainder recruited from online sources (n = 14), other health clinics (n = 10), professional organizations (n = 8), abortion funds (n = 2), community organizations (n = 2), key informants (n = 2), and an abortion storytelling project (n = 1). Most articles (n = 61) reported information from people discussing their own abortions; the rest asked nonabortion seekers (e.g., physicians, genetic counselors, attorneys) about barriers to care. Studies of abortion barriers enroll participants from a range of venues, but the majority recruit people who obtained abortions, and half recruit from abortion clinics. As abortion access becomes constrained and criminalized in the post- Roe context, our findings indicate how investigators might recruit study participants from a variety of settings to fully understand the abortion seeking experience. [ABSTRACT FROM AUTHOR]

• Close oversight by a Community Coordinator, relationships built with community partners, and the use of telehealth were creative solutions used by the Infant Toddler Court Teams during COVID-19 to support timely access to services. • This study builds on a companion paper that examined receipt and access to child health services at multiple Infant-Toddler Court Teams prior to and during the first year of the pandemic and details the challenges faced and the solutions identified by ITCT partners to support access to child services in the context of the COVID-19 pandemic within the US. • Understanding the challenges and solutions faced by the Infant-Toddler Court Team Community Coordinators during COVID-19 will be important for future pandemics or crises that impact care for child welfare involved children. This qualitative study examines Infant-Toddler Court Teams' (ITCT) responses to the impact of the COVID-19 pandemic on the accessibility and timeliness of services for children involved with an Infant Toddler Court Team (ITCT) within the United States. ITCTs utilize collaborative practice to improve, align, and integrate systems and build community capacity to improve outcomes for very young children and their families. This study reports findings from 350 transcripts of community partner interviews and an analysis of written case notes from ITCT Community Coordinators related to more than 700 instances of child service needs. We describe challenges faced and solutions and innovations developed by ITCTs to support and maintain child health services during the first year of the pandemic, as well as findings related to challenges associated with other types of services that reduced accessibility and timeliness. Understanding the challenges experienced and solutions developed can provide the child welfare field with insight and guidance on how to approach disruptions in care in the future and the persistent lack of service providers for court involved families. [ABSTRACT FROM AUTHOR]