User:Cathycoeur/sandbox

Public hospital
The "United States" portion focuses more on non-profit than public hospitals and not to compare and contrast them but just to state those claims; yet the topic should be mostly if not only about public hospitals since the introduction distinguished non-profit and public hospitals as two different entities. This distracted me and made me wonder what are the similarities and discrepancies in how the non-profits and public hospitals are run that could explain why they are both facing funding and operational deficiency and if the the claims about the non-profits in rural areas being "disproportionately represented in high numbers of patients with uncompensated care" valid for applies to the public hospitals as well. The non-profits, if not only maybe for comparison's sake, should be the subject of a different article and perhaps another existing article about non-profit hospitals could have been used for reference for a reader who might want to know more about non-profit hospitals to just click the link to that separate article. It is mostly neutral and based on the sources' claims. The non-profit hospitals are overrepresented yet they are not public hospitals according to the introduction of the article. The citations work and the author gets all their references from the same HealthAffairs website. Some of the claims seem to be supported by these articles. However, the wording like "disproportionally" does not show the real data shown by the source. The reference for some facts appear reliable but some references are a dead end. The author only uses a source that does a comparison of the public hospital in the US to other types of hospitals and has no source that clearly explains what the setting of a public hospital is and what kinds of services they offer, how they are administered and the role they play in the healthcare system in the USA.
 * Is everything in the article relevant to the article topic? Is there anything that distracted you?
 * Is the article neutral? Are there any claims, or frames, that appear heavily biased toward a particular position?
 * Are there viewpoints that are overrepresented, or underrepresented?
 * Check a few citations. Do the links work? Does the source support the claims in the article?
 * Check a few citations. Do the links work? Does the source support the claims in the article?
 * Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?
 * Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?
 * Is any information out of date? Is anything missing that could be added?

The author uses past tense in their wording for comparing the provision of "profitable medical services" in public, non-profit and for-profit hospitals. This shows that this information is outdated as the author does not give data showing the new record.

I would like to see more data and less claims in this article. It does stay on the topic for the most part, but just needs more improvement in giving detail for the information rather than just leaving the reader hanging. There is only a conversation regarding the neutrality of the article and whether or not its claim is that public hospitals are better than other hospitals. only two editors have commented on the talk page. This article is rated Stub-Class High Importance from WikiProject Hospitals The topic speaks of political and economic aspects, the point of view of the administration/authorities, and from mere observation of hospitals whereas we talked a lot about healthcare delivery from the point of view of the population, the cultural side more than the
 * Check out the Talk page of the article. What kinds of conversations, if any, are going on behind the scenes about how to represent this topic?
 * How is the article rated? Is it a part of any WikiProjects?
 * How does the way Wikipedia discusses this topic differ from the way we've talked about it in class?

Potential sources:
Fonkych, Kateryna, and Glenn Melnick. “Disproportionate Share Hospital Subsidies for Treating the Uninsured.” Medical Care, vol. 48, no. 9, 2010, pp. 809–814. JSTOR, JSTOR, www.jstor.org/stable/25750560. http://www.jstor.org/stable/pdf/25750560.pdf?refreqid=excelsior:23ef3bc6b8cb3eabdcf360a5d37500dc

Somerville M, Seeff L, Hale D, O'Brien D. Hospitals, Collaboration, and Community Health Improvement. Journal Of Law, Medicine & Ethics[serial online]. March 2, 2015;43:56-59. Available from: Index to Legal Periodicals and Books (H.W. Wilson), Ipswich, MA. Accessed October 5, 2017.http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=11&sid=fb5c80d8-6f79-45b4-92a8-e10851f9e9c1%40sessionmgr4008

Wiley, Lindsay F.1, and Gene W.2 Matthews. 2017. "Health Care System Transformation and Integration: A Call to Action for Public Health." Journal Of Law, Medicine & Ethics 45, 94-97. Index to Legal Periodicals and Books (H.W. Wilson), EBSCOhost (accessed October 17, 2017). http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=6&sid=4be13294-025b-4551-8313-3052f8f49da5%40sessionmgr4006

Homeless women in the United States
Most points, if not every point in the article is relevant to the article. However, the author(s) digress(es) away from stating facts throughout the reading. Talking about “women and poverty” within the domestic violence section is very distractive and very off topic as low wage and work in the workforce appear to be different than domestic violence which happens usually at home or in personal relationships rather than professional. Even though these two might impact. The article puts a lot of effort criminalizing men in this issue rather than explaining the factors associated with being a homeless woman from an objective point of view.
 * Is everything in the article relevant to the article topic? Is there anything that distracted you?

This article makes a claim about "naturally abusive men" being the reason for power dynamics between them and women and domestic violence. This is a big claim as we do not know the nature of the domestic violence, nor do we know where/from who the abuse came from, nor does the article show facts about abusive men and the link for reference does not work either. The author/s is/are seemingly biased toward women.
 * Is the article neutral? Are there any claims, or frames, that appear heavily biased toward a particular position?

From the start, the article does not just give facts, but it also takes sides to take action on a problem. In this case, the mental health of homeless women is what the last sentence of the introduction advocating for as an issue to be addressed. This makes the article polarized.

The article also encourages reader "give credit" to a social movement that supposedly supported the domestic violence victims. That does not seem neutral. Rephrasing the sentence to make it more neutral and showing the reference would be better.

From the beginning of the article, there is a sense of contradictory overrepresentation and underrepresentation of homeless families at the same time. On one hand, there is a claim that homeless families represent 50% of homeless population, on the other hand, there is a claim that men are in the 15th percentile of the homeless population and that there are very few homeless families. Not only do these two claims contradict each other, but they also do not seem to be back by any reliable source. The reference linked to the entire introduction is not so easily accessible. Additionally, I notice a wrong syntax in the sentence "If a young single-mother is responsible for raising her child or children without familial support and material resources typically heads a homeless family"
 * Are there viewpoints that are overrepresented, or underrepresented?

When the Article generalizes homelessness as a result of domestic violence but does not specify whether it is across genders or just for women and yet makes the assumption that "abusive men" are the cause, that is an overrepresentation and assumption.

The third link (www.acog.org/resources) does not work and I am not sure if the page actually exists. This is supposed to support the point that domestic violence is the reason why a range of 20-50% women and children end up on the streets. This range seems very wide to me. additionally, it is distracting, knowing that this topic is mainly about women and just the fact that she used statistics including both women and children throws off the accuracy of the percentage for women in particular.
 * Check a few citations. Do the links work? Does the source support the claims in the article?

The first link of the article works but requires to sign up for an account to access it. Therefore I could not really judge whether it is reliable or not. I am not sure which facts of the introduction it supports, though their is a lot of statistics in this section of the article. All of the links i have clicked do not work! I cannot say these sources are anywhere close to being reliable nor neutral, nor biased as they do not seem to even exist.
 * Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?

The article needs to explain what counts as being a homeless woman, as a reference for the data.
 * Is any information out of date? Is anything missing that could be added?

This article could talk about homeless women by state/county if possible. Maybe this could help understand the social, political and economic factors/trend that might be correlated to this phenomenon if it is one and help the reader touch on some real data.

Analysis across ethnicities and perhaps even different immigration/citizenship statuses

Which portion of the population of women are homeless? Intersectionality?

Services available or not to homeless women. Do women take advantage of public benefits available? are they aware? on what scale?

What is it like to be a homeless woman? How do you survive on a day to day basis?

It gave 2005 data on homelessness of women and children due to violence, that is 12 years ago, I am curious about current up to date data if there are any. But also I do not have access to the author/s' source.

This article makes so many claims but has barely any statistical or factual data.

this article needs to find more reliable and accessible sources. Most of them do not work

The article does not emphasize on why the women's movement was born and how did it relate to homeless women?

Again this article really needs source links that actually work. This all seems like attractive claims.

There was ongoing talk about the neutrality of this article in addition to the weasel words (vague, unverified claims), and the fact that it is just claiming that men are the reason for women's trauma. Some asked for a total makeover of the article and others wanted it completely removed ASAP deleted from wikipedia. These discussions were last held in 2012.
 * Check out the Talk page of the article. What kinds of conversations, if any, are going on behind the scenes about how to represent this topic?

It was nominated for deletion in April 2012. It is part of WikiProject Women's History, WikiProject Sociology, WikiProject United States and in all 3 it was rated-start class (low important).
 * How is the article rated? Is it a part of any WikiProjects?

We have not emphasized on this topic in class; however, this article really uses a narrative of causality/effect relationship between men and homeless women.
 * How does the way Wikipedia discusses this topic differ from the way we've talked about it in class?

Potential Sources:
Watson J. Gender-based violence and young homeless women: femininity, embodiment and vicarious physical capital. Sociological Review [serial online]. May 2016;64(2):256. Available from: Complementary Index, Ipswich, MA. Accessed October 5, 2017.

Welch-Lazoritz M, Whitbeck L, Armenta B. Characteristics of Mothers Caring for Children During Episodes of Homelessness. [serial online]. November 2015;51(8):913. Available from: Complementary Index, Ipswich, MA. Accessed October 5, 2017.

Public hospital
==== 1) Fonkych, Kateryna, and Glenn Melnick. “Disproportionate Share Hospital Subsidies for Treating the Uninsured.” Medical Care, vol. 48, no. 9, 2010, pp. 809–814. JSTOR, JSTOR, www.jstor.org/stable/25750560. ==== This article compares the shares in governmental subsidies in DSH hospitals and non DSH hospitals as well as non-profit and for profit private hospitals in the USA. It shows that the DSH Hospitals actually receive less compensation than private non-DSH hospitals, yet have a greater share in uninsured patients.

I will use this Article to show the low share of government funding of public hospitals for uncompensated services as compared to private hospitals.

==== 2) Ko M, Needleman J, Derose K P, Laugesen M J, Ponce J. "Residential Segregation and the Survival of U.S. Urban Public Hospitals" Medical Care Research and Review. Vol 71, Issue 3, pp. 243 - 260. First published date: December-19-2013. ==== This article highlights the correlation between residential and racial segregation to the closure of urban public hospitals. This is a due to socioeconomic and political disparities among urban public hospitals due to demography of served communities. Disproportionate increase in the share of safety net care services, and reduction in the governmental, political support the urban public hospitals receive. The authors hypothesize that the non-hispanic white voters' support of public hospitals might. The lack of government financial, and resource based support engenders the financial and service quality instability for urban public hospitals and this might lead to closure or conversion of the urban public hospital to private hospitals.

I will use this article to actually show the findings for urban public hospitals and focus the "United States" portion of the article more on public hospitals and less on the not-for-profit hospitals as they are not the headline of the wiki article. I will also use it to explain how demographics could explain the lower performance of public hospitals and their service delivery to minorities as most of the patients I encounter during my practice experience are minorities and mostly Black Americans.

==== 3) Wiley, Lindsay F.1, and Gene W.2 Matthews. 2017. "Health Care System Transformation and Integration: A Call to Action for Public Health." Journal Of Law, Medicine & Ethics 45, 94-97. Index to Legal Periodicals and Books (H.W. Wilson), EBSCOhost. ==== This article talks about the collaboration of public health and not-for-profit hospitals to improve community health outcomes. One of the main arguments are in conducting Community Health Needs Assessment and the focus on funding activities specific to social determinants of health in low-income and minority communities.

I would like to use the role of the IRS and laws and regulations in the reinforcement of the work for community development.

==== 4) The role of US public hospitals in urban health. Academic Medicine [serial online]. n.d.;79(12):1162-1168. Available from: Science Citation Index, Ipswich, MA. ==== This source defines public hospitals as federally and locally owned and funded by government. They serve the role of safety-net hospitals in the metropolitan areas for low income and uninsured patients. The source employs data from large public hospital associations such as the National Association of Public Hospitals (NAPH) to show the large share of primary outpatient and uninsured patient in public hospitals. Though published in 2004, this source, like some of my other sources, shows the strains to the public hospitals capacity due to increasing number of uncompensated care patients and government budget cuts.

My PE org serves in public safety-net hospitals that provide a large scale of medical assistance to patients in the Alameda county. I would like to use this article as one of my references to edit the leading paragraph of the United States section of my article. I will try to focus this paragraph to show the role of the public hospitals and safety-net hospitals (which I will link to the original wikipedia "Safety Net Hospital" article). I will also use it along with the other sources to focus the topic more on public hospitals' work/challenges.

==== 5) Buntin, M. B., & Ayanian, J. Z. (2017). Social Risk Factors and Equity in Medicare Payment. New England Journal Of Medicine, 376(6), 507. doi:10.1056/NEJMp1700081 ==== This article

==== 6) Sara R, Mark A. H. Chapter 8 The Safety-Net Role of Public Hospitals and Academic Medical Centers: Past, Present, and Future. Critical Issues in Health and Medicine [e-book]. New Brunswick: Rutgers University Press; 2012:183. Available from: Project MUSE, Ipswich, MA. ==== History of safety-net role of public hospitals and Academic Medical Centers and the increase in Disproportionate Share of uninsured and underinsured patients.

==== 7) Makaroun L, Bowman C, Chen A, et al. Specialty Care Access in the Safety Net--the Role of Public Hospitals and Health Systems. Journal Of Health Care For The Poor & Underserved [serial online]. February 2017;28(1):566-581. Available from: CINAHL Plus with Full Text ====

Homeless women in the United States
==== 1) Winetrobe H, Wenzel S, Rhoades H, Henwood B, Rice E, Harris T. Unstable Housing and Homelessness: Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing. Women's Health Issues [serial online]. May 1, 2017;27:286-293. Available from: ScienceDirect, Ipswich, MA. ==== This article shows the differences in age, but more importantly the family, friend and acquaintance support homeless women get as compared to the homeless men's attachment or detachment from family and health support. It also confirms the fact that homeless women are more likely to be care takers and less educated than homeless men. This article shows me that homeless women are not homeless for being lonely and having to thrive on their own. These cases occur a lot in my PE org, for both men and women, that are homeless but have family that they might not be able to stay with on a long-term basis for many reasons.

This will article help show that some homeless women have close family and acquaintances who are housed and are in touch with them.

==== 2)Lisa A, Ronald A, Lillian G. The Health Circumstances of Homeless Women in the United States. International Journal Of Mental Health [serial online]. 2005;(2):62. Available from: JSTOR Journals, Ipswich, MA. ==== This article not only gives me a very clear definition of what being homeless is, but also uses a sample study from the part of the United States the authors say has one of the highest concentration of homeless people in the USA (Los Angeles) to reflect a seemingly more accurate data on the health and health care situation of homeless women in the larger population. The study was done using the UCLA Homeless Women's Health Study (HWHS). This study identified statistical data on the marital statuses, the races, ages, education levels, how long and what conditions of homelessness they are into and what caused them to end up homeless and an assessment of their access to health and health history. This source really sums up many questions addressed in the wiki article and I think using it along with the other sources I can check the similarities and differences of this very broad sources the problems my other sources, which are more focused specific topics regarding homeless women, address.

==== 3) Welch-Lazoritz M, Whitbeck L, Armenta B. Characteristics of Mothers Caring for Children During Episodes of Homelessness. [serial online]. November 2015;51(8):913. Available from: Complementary Index, Ipswich, MA. Accessed October 5, 2017. ==== This essay describes from surveys held in different states, the correlation between homeless women, homeless mothers and the likelihood of social and mental issues. In my wiki article I would like to use this source to make a compare and contrast evaluation of being a homeless woman with and without being a care giver. This will be done in terms of physical and mental health.

I want to use this article and the 2nd source to update the mental health section of the wiki article. My PE org works with some homeless women who are also care givers and are struggling with mental and behavioral health and sometimes substances abuse.

==== 4) Health Care for Homeless Women. Obstetrics & Gynecology [serial online]. October 2013;122(4):936-940. ====

==== 5) Burg M. HEALTH PROBLEMS OF SHELTERED HOMELESS WOMEN AND THEIR DEPENDENT CHILDREN. Health & Social Work [serial online]. May 1994;19(2):125. Available from: Complementary Index, Ipswich, MA. ====

==== 6) Kelly J, Cohen J, Grimes B, Philip S, Weiser S, Riley E. High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies. Journal Of Women's Health (15409996) [serial online]. August 2016;25(8):840. Available from: Complementary Index, Ipswich, MA. ====

==== 7) Zlotnick, C., Zerger, S., & Wolfe, P. B. (2013). Health Care for the Homeless: What We Have Learned in the Past 30 Years and What's Next. American Journal Of Public Health, 103(S2), S199-S205. doi:10. 2105/AJPH.2013.301586 ====

==== 8) Wenzel, S., Cederbaum, J., Song, A., Hsu, H., Craddock, J., Hantanachaikul, W., & ... Tucker, J. S. (2016). Pilot Test of an Adapted, Evidence-Based HIV Sexual Risk Reduction Intervention for Homeless Women. Prevention Science, 17(1), 112. doi:10.1007/s11121-015-0575-6 ====

==== 9) Teruya C, Longshore D, Gelberg L, et al. Health and health care disparities among homeless women. Women & Health [serial online]. December 2010;50(8):719-736. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 30, 2017. ====

Area:
Public hospitals are medical and health care institutions owned by governments and local city and county authorities. In the urban areas of the country, many of these institutions serve as Safety-net hospitals which allow the most disadvantaged communities to have access to health care regardless of income, with Medicare, Medicaid, or uninsured. Many Public Hospitals also develop programs for illness prevention for the reduction the cost of care for low-income patients and the hospital, involving Community Health Needs Assessment and identifying and addressing the social, economic, environmental, and individual behavioral determinants of health. Financial, geographic and political forces have placed many public hospitals, more than private and not-for-profit medical institutions, at a risk of conversion or closure. This is correlated with the fact that public hospitals, especially those located in segregated urban areas, receive the largest portion of disadvantaged patients.

I will only edit the United States Section of the article.

I would Like to add this statistics to this portion of the article: 23% of emergency care, 63% of burn care and 40% of trauma care are handled by Public hospitals in the urban cities of the United States.

Medicare is an insurance program that allows patients 65 or older, disabled young patients regardless of income to pay for their medical bills at a subsidized rate. Medicaid on the other hand is a medical assistance program that serves every age bracket of low-income patients. These are programs accepted by public hospitals. These two programs sound similar, but are different. In the article, I will link these two words to their original wikipedia articles for reference.

In the last sentence, check what the correlation between the earnings of a CEO of a not-for-profit hospital and public hospitals and there fate. are public hospitals are not all not-for-profit hospitals.

My added sentences/edits are in brackets. I have also linked some words and phrases to wikipedia articles dedicated to them e.g.: medicare, medicaid, not-for-profit hospital United States edited version: In the United States, two thirds of all urban hospitals are non-profit. The remaining third is split between for-profit and public, [public hospitals not necessarily being not-for-profit hospital corporations.] The urban public hospitals are often associated with medical schools. The largest public hospital system in America is the NYC Health + Hospitals.

[History]
[The safety-net role of public hospitals has evolved since 1700s when the first U.S. public hospital sheltered and provided medical healthcare to the poor. Until the late 20th century, public hospital represented the "poor house" that undertook social welfare roles. The "poor house" also provided secondarily medical care, specifically during epidemics. For this reason these "poor houses" were later known as "pest" houses. Following this phase was the "practitioner period" during which, the then welfare orientated urban public hospitals changed their focus to medical care and formalized nursing care. This new phase was highlighted by the private physicians providing care to patients outside their private practices into inpatient hospital settings. To put into practice the demands of the Flexner Report published in 1910, public hospitals later benefitted from the best medical care technology to hire full-time staff members, instruct medical and nursing students during the "academic period". The privatization of public hospitals was often contemplated during this period and stalled once an infectious disease outbreak such as influenza in 1918, tuberculosis in the early 1900s, and the polio epidemic in the 1950s hit the U.S. At this time, with the goal to improve people's health and welfare by allowing for effective health planning and the creation of neighborhood health centers, health policies like the Social Security Act were enacted. This was followed by Medicare and Medicaid Act in 1965 that gave poor Americans, mainly minorities, access to inpatient and outpatient medical care from public hospitals in after racial desegregation in the South. With their mandate to care for low income patients, the public hospital started engaging in leadership roles in the communities they care for since the 1980s.]

[Financial repercussions of accumulated uncompensated care]
2) In the U.S., public hospitals receive significant funding from local, state, and/or federal governments. In addition, [many urban public hospitals in the U.S. playing the role of safety-net hospitals, which do not turn away the underinsured and uninsured such as the vulnerable ethnic minorities], may charge Medicaid, and private insurers for the care of patients. Public hospitals, especially in urban areas, have a high concentration of uncompensated care and graduate medical education as compared to all other American hospitals. [23% of emergency care, 63% of burn care and 40% of trauma care are handled by Public hospitals in the urban cities of the United States.]  Not only do public hospitals provide access to primary care, but also specialty [Many public hospitals also develop programs for illness prevention with the goal of reducing the cost of care for low-income patients and the hospital, involving Community Health Needs Assessment and identifying and addressing the social, economic, environmental, and individual behavioral determinants of health.]

3) For-profit hospitals were more likely to provide profitable medical services and less likely to provide medical services that were relatively unprofitable. Government or public hospitals were more likely to offer relatively unprofitable medical services. Not-for-profit hospitals often fell in the middle between public and for-profit hospitals in the types of medical services they provided. For-profit hospitals were quicker to respond to changes in profitability of medical services than the other two types of hospitals.

1) Public hospitals in America are closing at a much faster rate than hospitals overall. The number of public hospitals in major suburbs declined 27% (134 to 98) from 1996 to 2002. [Much research has proven the increase in uninsured and Medicaid enrollment entwined to unmet needs for subsidies to cover the disproportionate share of uncompensated care to be associated with the challenges faced by public hospitals to maintain their financial viability as they compete with the private sector for paying patients]. [Since the creation of the Affordable Care Act (ACA) in 2010, 15 million of the 48 million previously uninsured receive Medicaid. It is projected that this number will grow to about 33 million by 2018. ] [The provision of good quality ambulatory specialty care for these uninsured and Medicaid enrolled patients has particularly been a challenge for many urban public hospitals. This accounts for many factors ranging from a shortage of specialists who are more likely to practice in the more profitable sectors than in the safety-net, to the lack of clinical space. To overcome this challenge, some public hospitals have adopted the increase of specialty providers and clinics, deployment of nurse practitioners and physician assistants in specialty clinics, asynchronous electronic consultations, telehealth, the integration of Primary Care Providers (PCP) in the specialty clinics, and referral by PCP's to specialists.] [Non-profit rural hospitals were disproportionately represented with high numbers of patients with uncompensated care.(delete this sentence)] Public and non-profit rural hospitals form a large part of the health care safety net for the uninsured and poor underinsured in the U.S. [(make this paragraph the first one)]

[In 2009, at non-profit hospitals, the average CEO made $600,000 annually. The range was from $100,000 to $3 million.(Delete this sentence)]

Sector:
Homelessness can be defined in many ways. A general definition of this phenomenon is the (2). Chronic homelessness is defined by the U.S. Department of Housing and Urban Development as the state of 'an unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more or who has had at least four episodes of homelessness in the past three years." One of the sources defines "A woman ... as homeless if she spent any of the previous 30 nights (a) in a mission, homeless shelter, or transitional shelter; a hotel paid for by a voucher; a church or chapel; an all-night theater or other indoor public place; an abandoned building; a vehicle; the street or other outdoor public place; or (b) in a rehabilitation program for homeless people and also stayed in one of the settings mentioned" in their study on the physical mental and behavioral health causes and consequences of homelessness in women. These articles all draw on the social, domestic and behavioral factors related to homelessness in women in the United States. They show the effect of support and family on the homeless women. There is an emphasis on sexual abuse, substance use and poor mental health as observed more in homeless women.

I will do more research on homeless women's health and I will create a "Health in homeless women in the United States" section and add a "mental health" "health care" "Infectious Disease" subsections. Mental Health of Homeless Women edited version New Header: [Health and HealthCare of Homeless Women]

Intro [Healthcare for homeless women]

With less access to health care, the homeless are at increasing risk of poor health outcomes. Homeless women especially, are less likely to benefit from routine medical assistance, health insurance, cancer screening, adequate prenatal care, appropriate ambulatory care, and specialty care for specific disorders. Additionally, the homeless population has a higher death rate than the general population in the United States. Research conducted from the mid-1980s to the late 1990s show that health conditions such as hypertension, arthritis, mental illness, victimization, tuberculosis, HIV and substance abuse are most common in the homeless population.

Subheader1: [Infectious Diseases in Homeless Women]

[Social determinants of health go hand in hand with the occurrence of Herpes Simplex Virus type 2 (HSV-2), and so does homelessness. In the United States, about 21 to 24% are infected with HSV-2 as compared to 88% among homeless women and an even higher prevalence among HIV positive homeless women. Despite this seroprevalence, homeless women are not considered to be a high-risk population in national guidelines. HSV-2 increases the risk of HIV infection. Most homeless women are unaware of their HSV-2 infection. This renders them more vulnerable to HIV exposure.]

[In addition to financial instability, the contraction of HIV/AIDS has been shown to be more associated with homelessness. Homeless women are more likely than poor, housed women to practice unprotected sexual activity with multiple partners and to expose themselves to HIV.

Subheader2: [Mental Health of Homeless Women]

Poor mental health of women is an important precursor to homelessness, as well as a consequence of homelessness for both women and their children. Mental illness is reported in 30% of homeless persons, and in 50% to 60% of homeless women. [Homeless women without children are more likely than homeless mothers to disclose their admission into a mental institution. ] Homeless women are especially impacted by certain mental health illnesses including antisocial personality behavior, depression, stress, and post-traumatic stress disorder.

- Added citation and edited sentence:
In the United States, two thirds of all urban hospitals are non-profit. The remaining third is split between for-profit and public, [public hospitals not necessarily being not-for-profit hospital corporations.]

- created subsection:

 * "History" that I entirely wrote with a 19-sentence paragraph
 * Added 3 citations in the history subsection

- created subsection:
Total of 5 citations
 * "Financial repercussions of accumulated uncompensated care" with some edits like sentence and citations added)
 * Added 2 citations in the subsection
 * modified the second sentence of the first paragraph with my own input from my sources
 * Wrote 3 sentences in the first paragraph
 * Deleted sentence about not-forprofit DSH in the 3rd paragraph
 * Deleted the last sentence of the subsection talking about CEO salary of not-for-profit hospitals. this seemed irrelevant to me
 * Added 5 sentences to the 3rd paragraph and two citations

1) The role of US public hospitals in urban health.
This source defines public hospitals as federally and locally owned and funded by government. They serve the role of safety-net hospitals in the metropolitan areas for low income and uninsured patients. The source employs data from large public hospital associations such as the National Association of Public Hospitals (NAPH) to show the large share of primary outpatient and uninsured patient in public hospitals. Though published in 2004, this source, like some of my other sources, shows the strains to the public hospitals capacity due to increasing number of uncompensated care patients and government budget cuts.

I used this article to write about the historical stages of public hospitals in the US.

2)  "Residential Segregation and the Survival of U.S. Urban Public Hospitals".
This article highlights the correlation between residential and racial segregation to the closure of urban public hospitals. This is a due to socioeconomic and political disparities among urban public hospitals due to demography of served communities. Disproportionate increase in the share of safety net care services, and reduction in the governmental, political support the urban public hospitals receive. The authors hypothesize that the non-hispanic white voters' support of public hospitals might. The lack of government financial, and resource based support engenders the financial and service quality instability for urban public hospitals and this might lead to closure or conversion of the urban public hospital to private hospitals.

I will use this article to actually show the findings for urban public hospitals and focus the "United States" portion of the article more on public hospitals and less on the not-for-profit hospitals as they are not the headline of the wiki article. I will also use it to explain how demographics could explain the lower performance of public hospitals and their service delivery to minorities.

==== 3)  "Deadly Inequality in the Health Care "Safety Net": Uninsured Ethnic Minorities' Struggle to Live with Life-Threatening Illnesses".  ==== This article explains the racial/ethnic/inequalities existing in the safety net affecting the uninsured minorities.

I used this article to emphasize that the majority of the uninsured are ethnic minorities and that the safety net offers both inpatient and outpatient care.

==== 4) HChapter 8: The Safety-Net Role of Public Hospitals and Academic Medical Centers: Past, Present, and Future". The Health Care Safety Net in a Post-Reform World. ==== This article also shows the historical role of public hospitals in the safety net and the challenges and adaption to the increase in Medicaid and uninsured patients.

I used this article to show the history of public hospitals as safety net actors and methods which the public hospitals have employed to continue providing effective primary and specialty care through the integration and partnership between the two levels of care.

==== 5) Specialty Care Access in the Safety Net-the Role of Public Hospitals and Health Systems. ==== This article shows the role played by public hospitals in overcoming the increase in uncompensated care since the passage of the ACA through the reorganization of primary and specialty clinics, new methods of communication between them and referral.

I used these points in my contributions to the article as well as the projected number of Medicaid enrollees by 2018.

Major Contributions

 * Changed the "Mental Health of homeless women" section to "Health and Health Care of homeless women"
 * Wrote a 4-sentence introduction to the section with 3 citations
 * Created "infectious diseases in homeless women" subsection
 * Added sentenced about HIV and citations to it
 * Added Sentences about HSV and citations to it


 * Changed the "Mental Health of homeless women" section to a subsection.
 * added sentence and citation to it

Minor Contributions
Total of 8 citations added
 * Added citation and edited typo to the Decline of the welfare state
 * Moved the "Women and poverty subsection into the "Decline of the welfare state" section

1) Health Care for Homeless Women.
This article is about the unmet health needs of the homeless women. I used this to also introduce the section on the lack of access to health care for homeless people and the most common health outcome of homelessness among women.

==== 2) Burg M. HEALTH PROBLEMS OF SHELTERED HOMELESS WOMEN AND THEIR DEPENDENT CHILDREN.  ====

==== 3) High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies. ==== This article surveyed homeless women and screened them for HSV-2 and compared these numbers to national numbers and also found a correlation between these, the conditions of living of these women (social and behavioral) putting them more at risk.

I use this for statistics and the lack of awareness among homeless women.

==== 4) Health Care for the Homeless: What We Have Learned in the Past 30 Years and What's Next.  ====

==== 5) Pilot Test of an Adapted, Evidence-Based HIV Sexual Risk Reduction Intervention for Homeless Women. Prevention Science ==== This source is describing a Sister to Sister preventive method against HIV to be very effective.

I used this source mainly for statistics and exposure to HIV

6)Health and health care disparities among homeless women.
This article states that White homeless women have more unmet health needs than other races/ethnic groups.

I introduced this source in my intro to the section to show the lack of access to health care being higher for homeless women than for housed women.

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7) Characteristics of Mothers Caring for Children During Episodes of Homelessness. ====== This essay describes from surveys held in different states, the correlation between homeless women, homeless mothers and the likelihood of social and mental issues. In my wiki article I would like to use this source to make a compare and contrast evaluation of being a homeless woman with and without being a care giver. This will be done in terms of physical and mental health.

I want to use this article and the 2nd source to update the mental health section of the wiki article. My PE org works with some homeless women who are also care givers and are struggling with mental and behavioral health and sometimes substances abuse.

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8) Social Welfare : A History Of The American Response To Need. Chapters 8 & 9. ====== This book gives a historical account of welfare from English colonies to the 20th century. I will be using this book to cite the "decline of the welfare state" section for welfare reform laws.