Are neighbourhood inequalities in adult health explained by socio-economic and psychosocial determinants in adolescence and the subsequent life course in northern Sweden? A decomposition analysis

How do labour market conditions explain the development of mental health over the life-course? a conceptual integration of the ecological model with life-course epidemiology in an integrative review of results from the Northern Swedish Cohort

BACKGROUND

The aim of this study was to contribute to the theoretical development within the field of labour market effects on mental health during life by integrating Bronfenbrenner's ecological model with mainly earlier theoretical work on life-course theory.

METHODS

An integrative review was performed of all 52 publications about labour market conditions in relation to mental health from the longitudinal Northern Swedish Cohort study. Inductive and deductive qualitative content analysis were performed in relation to Bronfenbrenner's ecological framework combined with life-course theories.

RESULTS

The following nine themes were identified: 1. Macroeconomic recession impairs mental health among young people. 2. The mental health effects on individuals of youth unemployment seem rather insensitive to recession. 3. Small but consistent negative effect of neighbourhood unemployment and other work-related disadvantaged on individuals' mental health over life. 4. Youth unemployment becomes embodied as scars of mental ill-health over life. 5. Weak labour market attachment impairs mental health over life. 6. Bidirectional relations between health and weak labour market attachment over life. 7. Macrolevel structures are of importance for how labour market position cause poor health. 8. Unequal gender relations at work impacts negatively on mental health. 9. The agency to improve health over life in dyadic relations. Unemployment in society permeates from the macrolevel into the exolevel, defined by Bronfenbrenner as for example the labour market of parents or partners or the neighbourhood into the settings closest to the individual (the micro- and mesolevel) and affects the relations between the work, family, and leisure spheres of the individual. Neighbourhood unemployment leads to poor health among those who live there, independent of their employment status. Individuals' exposure to unemployment and temporary employment leads to poorer mental health over the life-course. Temporal dimensions were identified and combined with Bronfenbrenner levels into a contextual life-course model CONCLUSION: Combining the ecosocial theory with life-course theories provides a framework for understanding the embodiment of work-related mental health over life. The labour market conditions surrounding the individual are of crucial importance for the embodiment of mental health over life, at the same time as individual agency can be health promoting. Mental health can be improved by societal efforts in regulations of the labour market.

Identification and analysis of spatial access disparities related to primary healthcare in Batna City, Algeria

The issue of reducing spatial disparities is one of the most pressing concerns for policymakers and planners, which consider a crucial focus in planning and public service, especially accessibility to healthcare. Accessibility and proximity are the principal keys to providing good public service. Therefore, a healthcare system that meets the requirements of availability and affordability will be useless if spatial accessibility is not provided equally to all demands (population). Many technics and methods exist to quantify accessibility, including the two-step floating catchment area (2SFCA) method, its widely used to measure healthcare accessibility based on the travel distance threshold. This research paper aims to use the 2SFCA method to measure the spatial healthcare accessibility in Batna City because the 2SFCA method offers to measure accessibility on both spatial and functional levels. The spatial level will consider the threshold distances between the health demand (population) and the health provider location (healthcare facilities); moreover, functional accessibility is measured based on facility to population ratio that will give a better overview of Batna's healthcare provider. As a result, the optimal threshold distance that offers balanced results between the spatial accessibility score and other WHO ratios will be a distance between 1000- and 1500-meters travel distance. In addition, the central census districts have a higher access score than the rest of the city's districts; most census districts that do not have accessibility (12% of the population) to healthcare facilities are concentrated in the southwest of Batna city.

Links between life-course SES and frailty trajectory moderated by community environment resources: Person-environment Fit perspective

INTRODUCTION

Drawing from the life course and person-environment fit perspectives, this study examined whether life-course SES disadvantages during childhood, adulthood and old- age influence frailty development in late- life and how community environment resources moderated the association between life-course SES disadvantages and frailty trajectories over a seven-year follow-up period.

METHODS

Data from 11,675 participants aged ≥ 50 years at baseline who participated in the four waves (2011-2018) of the China Health and Retirement Longitudinal Survey (CHARLS) were used. Life-course SES disadvantages were self-reported, and community environment resources (basic infrastructure and voluntary organizations) were ascertained from informed officials in the community. Frailty development was measured at each wave by the Frailty Index (FI) based on 39 potential deficits. Multilevel growth modeling was used to examine the interactive effect of life-course SES disadvantages and community environment resources on frailty development.

RESULTS

Life-course SES disadvantage exerted cumulatively negative effects on frailty trajectory, and individuals with SES disadvantages in two or three life stages reported higher initial levels of and faster increases in frailty scores. Community environmental resources (basic infrastructure and voluntary organizations) had a protective effect on frailty development and buffered the negative effects of SES vulnerability experiences accumulated over the life course. Community basic infrastructure resources played an important role in slowing the progression of frailty for individuals with cumulative SES disadvantage and downward mobility.

DISCUSSION

Our findings provided new evidence of person-environmental docility among older adults, documenting the role of community resources in buffering SES disparities in health during later-life.

"I just wanted money for food": a qualitative study of the experiences of Australians during the COVID-19 pandemic

Aim

The social and economic impacts that have occurred during the COVID-19 pandemic can disproportionally affect those already experiencing poverty or at risk of poverty. Therefore, this study sought to explore the relationship between well-being and social determinants of health among Australian adults during the pandemic.

Subject and Methods

Semi-structured interviews were undertaken with 20 participants, aged 21-65 years, from various socioeconomic areas.

Results

Three main themes emerged from the analysis of the data: food security; housing outcomes; and psychological and emotional impact. Participants in low socioeconomic areas struggled with food security, having to access food banks, which was precipitated by employment loss during the pandemic. Some female participants experienced worsening inequalities and lack of financial and housing stability, affecting their overall well-being.

Conclusion

This study identified that there was a clear social divide between adults living in low socioeconomic areas compared with those living in high socioeconomic areas, with participants in low socioeconomic areas faring worse in terms of exacerbated social determinants of health and consequent impacts on well-being.

Socioeconomic Inequalities in Mortality among Foreign-Born and Spanish-Born in Small Areas in Cities of the Mediterranean Coast in Spain, 2009-2015

Many studies have analysed socioeconomic inequalities and its association with mortality in urban areas. However, few of them have differentiated between native and immigrant populations. This study is an ecological study of mortality by overall mortality and analyses the inequalities in mortality in these populations according to the level of deprivation in small areas of large cities in the Valencian Community, from 2009 to 2015. The census tract was classified into five deprivation levels using an index based on socioeconomic indicators from the 2011 census. Rates and relative risks of death were calculated by sex, age, level of deprivation and country of birth. Poisson regression models have been used. In general, there was a higher risk of death in natives at the levels of greatest deprivation, which did not happen in immigrants. During the 2009-2015 period, there were socioeconomic inequalities in mortality, particularly in natives, who presented a higher risk of death than immigrants. Future interventions and social policies should be implemented in order to reduce inequalities in mortality amongst socioeconomic levels and to maintain the advantage that the immigrant population enjoys.