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Ezell JM. Rethinking and Reinforcing Cultural Humility Against the Culture Wars: A Framework For Addressing Receptivity to Diversity Initiatives. MEDICAL EDUCATION ONLINE 2024; 29:2307710. [PMID: 38300902 PMCID: PMC10836480 DOI: 10.1080/10872981.2024.2307710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Jerel M. Ezell
- Community Health Science, School of Public Health, University of California Berkeley, Berkeley, CA, USA
- Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA
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Bernard K, McGowan VJ, Bambra C. "Power, control, strain": Lay perceptions of health inequalities across England's 'North South divide'. Soc Sci Med 2024; 355:117089. [PMID: 39024711 DOI: 10.1016/j.socscimed.2024.117089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/14/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
People in the North of England live shorter, less healthy lives than those in the South. Despite the significance of this 'North South health divide', regional health inequalities in England are under-researched qualitatively. Existing literature on geographical inequalities in health is largely confined to the neighbourhood level, is quantitative, and consists of very little lay knowledge. The current study is the first to examine lay perspectives of health inequalities on a regional level: exploring how people living in two urban areas of the North and South of England experience and perceive the North South health divide - including its causes and solutions. Using three focus group discussions with a total of 34 participants, and conducting participatory analysis, we identified three key themes: 'inequalities of power', 'lack of control over lived environment' and 'communities under strain'. Findings align with existing research on lay perspectives of health inequalities at the neighbourhood level - identifying a network of material-structural and psychosocial factors. Participants across both regions discussed political and economic structures as central to understanding regional health inequalities, supporting calls to adopt a political economy approach in understanding health and place. Deindustrialisation, unemployment, loss of community facilities, and disengagement from politics were more present in Northern narratives than Southern. Findings add important 'social meaning' to emerging research on the North South health divide, reinforcing the urgency of public health professionals' recommendations for fair redistribution of power, wealth and resources to reduce regional health inequalities. In the context of government policy which diverges from public health evidence, this study sparks questions of how health inequalities research can intersect with wider social and political movements organising for systemic change.
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Affiliation(s)
- Kate Bernard
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
| | - Victoria J McGowan
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
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Moon D, Pabayo R, Hwang J. An evolution of socioeconomic inequalities in self-rated health in Korea: Evidence from Korea National Health and Nutrition Examination Survey (KNHANES) 1998-2018. SSM Popul Health 2024; 26:101689. [PMID: 38952742 PMCID: PMC11215416 DOI: 10.1016/j.ssmph.2024.101689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 07/03/2024] Open
Abstract
Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: -0.154; 2016/2018: -0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.
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Affiliation(s)
- Daseul Moon
- Centre for Labour Health, People's Health Institute, Seoul, South Korea
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jongnam Hwang
- Division of Social Welfare & Health Administration, Wonkwang University, Iksan, South Korea
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Ezell JM. The Health Disparities Research Industrial Complex. Soc Sci Med 2024; 351:116251. [PMID: 37865583 DOI: 10.1016/j.socscimed.2023.116251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/14/2023] [Indexed: 10/23/2023]
Abstract
Research focused on health disparities-whether relating to one's race/ethnicity, gender expression, sexual orientation, citizenship status, income level, etc.-constitutes a large, generative, and highly profitable portion of scholarship in academic, clinical, and government settings. Health disparities research is expressed as a means of bringing greater attention to, and ultimately addressing via evidence-based implementation science, acts of devaluation and oppression that have continually contributed to these inequities. Philosophies underlying health disparities research's expansive and growing presence mirror the formal logic and ethos of the Military Industrial Complex and the Prison Industrial Complex. The "Health Disparities Research Industrial Complex," operationalized in this article, represents a novel mutation and extension of these complexes, primarily being enacted through these three mechanisms: 1) The construction and maintenance of beliefs, behaviors, and policies in healthcare, and society more broadly, that create and sustain disadvantages in minority health; 2) the creation and funding of research positions that inordinately provide non-minoritized people and those without relevant lived experiences the ability to study health disparities as "health equity tourists"; and 3) the production of health disparities research that, due to factors one and two, is incapable of fully addressing the disparities. In this piece, these and other core elements of the Health Disparities Research Industrial Complex, and the research bubble that it has produced, are discussed. Additionally, strategies for reducing the footprint and impact of the Health Disparities Research Industrial Complex and better facilitating opportunities for meaningful implementation in the field are presented.
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Affiliation(s)
- Jerel M Ezell
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Berkeley Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
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Grice-Jackson T, Rogers I, Ford E, Dickinson R, Frere-Smith K, Goddard K, Silver L, Topham C, Nahar P, Musinguzi G, Bastiaens H, Van Marwijk H. A community health worker led approach to cardiovascular disease prevention in the UK-SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project. FRONTIERS IN HEALTH SERVICES 2024; 4:1152410. [PMID: 38784704 PMCID: PMC11113076 DOI: 10.3389/frhs.2024.1152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/20/2024] [Indexed: 05/25/2024]
Abstract
Background This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.
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Affiliation(s)
- Thomas Grice-Jackson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Robert Dickinson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Kat Frere-Smith
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Katie Goddard
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Linda Silver
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Catherine Topham
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Papreen Nahar
- Department of Global Health Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Central Region, Uganda
| | - Hilde Bastiaens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Harm Van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
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Cash-Gibson L, Benach J. Understanding Health Inequalities Research Capacities: Insights and Recommendations From Comparing Two High Income Settings. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:163-170. [PMID: 38311911 DOI: 10.1177/27551938241230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Generating evidence on health inequalities (HI) is necessary to raise awareness of these issues, describe and monitor their evolution, analyze their causes, and inform interventions aiming to improve health equity. Yet not all cities and countries have the capacity to produce this type of research. Recent research provides new contextual and causal insights into this research production process, and in-depth understanding on why and how this type of research is produced in certain settings. This article aims to analyze two recent case studies that have uniquely explored this process in two high producers of HI research and high-income country settings to identify learning and distil recommendations, which may be insightful for other settings. Expanding and investing in this line of research is critical, particularly in places with lower HI research output and related capacity, in order to identify key contextual conditions and mechanisms that may enable or hinder this process. This new knowledge could guide the development of new HI research capacity strengthening strategies to foster this research in different settings, worldwide. More understanding is also needed on the relationship between HI research, policy, and action in order to tackle HI.
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Affiliation(s)
- Lucinda Cash-Gibson
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University-Universitat Pompeu Fabra Public Policy Center (UPF-BSM), Barcelona, Spain
- UPF- Barcelona School of Management (UPF-BSM), University Pompeu Fabra, Barcelona, Spain
| | - Joan Benach
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University-Universitat Pompeu Fabra Public Policy Center (UPF-BSM), Barcelona, Spain
- UPF- Barcelona School of Management (UPF-BSM), University Pompeu Fabra, Barcelona, Spain
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Ecological Humanities Research Group (GHECO), Universidad Autónoma de Madrid, Madrid, Spain
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Loades ME, Coetzee B, Osborn T, Human S, Venturo-Conerly K. Lessons learned from conducting mental health intervention research in schools in the global south: Our experiences in South Africa and Kenya. Clin Child Psychol Psychiatry 2024; 29:187-197. [PMID: 37442764 PMCID: PMC10748453 DOI: 10.1177/13591045231189409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
Most of the world's population of young people live in lower-and middle-income countries (LMICs; (Weine, Horvath Marques, Singh, & Pringle, 2020)), and these young people experience heightened rates of known risk factors for developing mental disorders such as poverty and exposure to trauma (Atwoli, Stein, Koenen, & McLaughlin, 2015). Access to professional psychological treatments is limited in LMICs due to structural barriers (e.g., a dearth of trained professionals) and cultural factors like stigma and beliefs about mental health and illness. Therefore, schools, which are widely attended, may be a good location for providing mental health interventions, and it is important that we develop and evaluate feasible, acceptable, effective, and scalable interventions for use in this context. Yet under 10% of clinical trials of psychotherapies (Venturo-Conerly, Eisenman, Wasil, Singla, & Weisz, 2022) have been conducted in LMICs. And there are particular challenges to conducting research in schools, as has been highlighted in the UK context by Moore et al. (2022). Building on that commentary, our aim herein is to share our learnings from conducting psychotherapy research in schools in Kenya and South Africa.
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Affiliation(s)
| | - Bronwynè Coetzee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | | | - Suzanne Human
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Celeste RK, Goulart MA, Bastos JL, Borrell LN. Research on racial/ethnic inequities in oral health over the past 80 years: The role of racism. J Clin Periodontol 2023; 50:1582-1589. [PMID: 37670498 DOI: 10.1111/jcpe.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/06/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023]
Abstract
AIM This study aims to (1) describe trends in explanations provided for racial/ethnic inequities in dental caries and periodontitis, and (2) explore the patterns of relatedness among explanations for these inequities. MATERIALS AND METHODS Highly cited publications based on studies indexed in the Scopus database were retrieved and assessed for eligibility. Explanations for racial/ethnic inequities were classified into eight different, but interrelated domains. We assessed trends and examined the relations among explanations using multiple correspondence analysis. RESULTS A total of 200 articles among the most cited publications were selected. The proportion of studies invoking racism as an explanation for racial inequities in oral health increased from 0% to 14.3%, from 1937 to 2020. The proportions of individual socio-economic factors increased from 52.0% to 82.9%, and dental care from 28.0% to 62.9%. The remaining explanations were stable: psychological/behavioural processes (62.5%), biological factors (49.5%), contextual/area-level effects (24.0%) and immigrant paradox (4.0%). Multiple correspondence analysis revealed a smaller axial distance between racism and the following categories: studies from Brazil, recent publications and Blacks/Hispanics/mixed-race groups. Publications about immigrants were axially closer to the high-income countries category. CONCLUSIONS Our findings call on dental researchers to consider racism as a cause for existing racial/ethnic inequities in oral health.
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Affiliation(s)
- Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariel Aquino Goulart
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Community Oral Health, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK
| | - João L Bastos
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Luisa N Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, New York, USA
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Bridger EK, Tufte-Hewett A, Comerford DA. Perceived health inequalities: are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced? BMC Public Health 2023; 23:2326. [PMID: 38001407 PMCID: PMC10668500 DOI: 10.1186/s12889-023-17120-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND One underexamined factor in the study of lay views of socioeconomic health inequalities is occupation-related health. Examining health by occupational social class has a long history in the UK but has been comparatively overlooked in US public health literatures, where the relationship between health and work has attended more to hazard exposure. METHODS Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in "higher managerial/professional" and "routine" occupations. We examine perceptions of inequality and desires for equality across occupation groups as a function of country and key socio-demographic variables. RESULTS 67.8% of UK and 53.7% of US participants identified that professionals live longer than routine workers. Multivariate models indicated that US participants were markedly less likely to be aware of occupation-related inequalities after controlling for age, gender, and education. Awareness was negatively related to age (in the US) and recent voting behaviours (both samples). Desiring equal life expectancy was less likely in the US sample, and less likely across both samples among older participants and those with lower levels of education. CONCLUSION Employing a novel approach to measuring perceived and ideal life expectancy inequality, this is the first study to examine perceptions of lifespan inequality by occupational groups. It reports widespread understanding of the occupation-related gradient in lifespan and a desire that these inequalities be eliminated in the UK, but considerably less awareness and desire for equality in the US. Greater tolerance for social status inequalities in the US than other similar countries appear to also extend to differences in life expectancy.
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Affiliation(s)
- Emma K Bridger
- School of Psychology and Vision Sciences, University of Leicester, Leicester, England
| | | | - David A Comerford
- Behavioural Science Centre, University of Stirling, Stirling, Scotland.
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Ivey Henry P, Spence Beaulieu MR, Bradford A, Graves JL. Embedded racism: Inequitable niche construction as a neglected evolutionary process affecting health. Evol Med Public Health 2023; 11:112-125. [PMID: 37197590 PMCID: PMC10184440 DOI: 10.1093/emph/eoad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/11/2023] [Indexed: 05/19/2023] Open
Abstract
Racial health disparities are a pervasive feature of modern experience and structural racism is increasingly recognized as a public health crisis. Yet evolutionary medicine has not adequately addressed the racialization of health and disease, particularly the systematic embedding of social biases in biological processes leading to disparate health outcomes delineated by socially defined race. In contrast to the sheer dominance of medical publications which still assume genetic 'race' and omit mention of its social construction, we present an alternative biological framework of racialized health. We explore the unifying evolutionary-ecological principle of niche construction as it offers critical insights on internal and external biological and behavioral feedback processes environments at every level of the organization. We Integrate insights of niche construction theory in the context of human evolutionary and social history and phenotype-genotype modification, exposing the extent to which racism is an evolutionary mismatch underlying inequitable disparities in disease. We then apply ecological models of niche exclusion and exploitation to institutional and interpersonal racial constructions of population and individual health and demonstrate how discriminatory processes of health and harm apply to evolutionarily relevant disease classes and life-history processes in which socially defined race is poorly understood and evaluated. Ultimately, we call for evolutionary and biomedical scholars to recognize the salience of racism as a pathogenic process biasing health outcomes studied across disciplines and to redress the neglect of focus on research and application related to this crucial issue.
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Affiliation(s)
- Paula Ivey Henry
- Department of Social and Behavioral Sciences, T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Angelle Bradford
- Department of Physiology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joseph L Graves
- Department of Biology, North Carolina A&T State University, Greensboro, NC, USA
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Cash-Gibson L, Martinez-Herrera E, Benach J. Why and how has the United Kingdom become a high producer of health inequalities research over the past 50 years? A realist explanatory case study. Health Res Policy Syst 2023; 21:23. [PMID: 36959666 PMCID: PMC10037802 DOI: 10.1186/s12961-023-00968-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Evidence on health inequalities has been growing over the past few decades, yet the capacity to produce research on health inequalities varies between countries worldwide and needs to be strengthened. More in-depth understanding of the sociohistorical, political and institutional processes that enable this type of research and related research capacity to be generated in different contexts is needed. A recent bibliometric analysis of the health inequalities research field found inequalities in the global production of this type of research. It also found the United Kingdom to be the second-highest global contributor to this research field after the United States. This study aims to understand why and how the United Kingdom, as an example of a "high producer" of health inequalities research, has been able to generate so much health inequalities research over the past five decades, and which main mechanisms might have been involved in generating this specific research capacity over time. METHODS We conducted a realist explanatory case study, which included 12 semi-structured interviews, to test six theoretical mechanisms that we proposed might have been involved in this process. Data from the interviews and grey and scientific literature were triangulated to inform our findings. RESULTS We found evidence to suggest that at least four of our proposed mechanisms have been activated by certain conditions and have contributed to the health inequalities research production process in the United Kingdom over the past 50 years. Limited evidence suggests that two new mechanisms might have potentially also been at play. CONCLUSIONS Valuable learning can be established from this case study, which explores the United Kingdom's experience in developing a strong national health inequalities research tradition, and the potential mechanisms involved in this process. More research is needed to explore additional facilitating and inhibiting mechanisms and other factors involved in this process in this context, as well as in other settings where less health inequalities research has been produced. This type of in-depth knowledge could be used to guide the development of new health inequalities research capacity-strengthening strategies and support the development of novel approaches and solutions aiming to tackle health inequalities.
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Affiliation(s)
- Lucinda Cash-Gibson
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Mercè Rodoreda 24 Building, Campus Ciutadella UPF, Ramon Trias Fargas, 25-27, 08003, Barcelona, Catalonia, Spain.
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (UPF-BSM), Barcelona, Catalonia, Spain.
- UPF Barcelona School of Management (UPF-BSM), Barcelona, Spain.
| | - Eliana Martinez-Herrera
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Mercè Rodoreda 24 Building, Campus Ciutadella UPF, Ramon Trias Fargas, 25-27, 08003, Barcelona, Catalonia, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (UPF-BSM), Barcelona, Catalonia, Spain
- Research Group of Epidemiology, National School of Public Health "Héctor Abad Gómez", University of Antioquia, Calle 62 No. 52-59 Bloque 33 Segundo Piso, Medellín, Colombia
| | - Joan Benach
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Mercè Rodoreda 24 Building, Campus Ciutadella UPF, Ramon Trias Fargas, 25-27, 08003, Barcelona, Catalonia, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (UPF-BSM), Barcelona, Catalonia, Spain
- Ecological Humanities Research Group (GHECO), Universidad Autónoma, Madrid, Spain
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Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative. Int J Equity Health 2023; 21:193. [PMID: 36694195 PMCID: PMC9872273 DOI: 10.1186/s12939-022-01798-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 01/25/2023] Open
Abstract
Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in 'Pathfinder' countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants.
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Macdonald ME, Muirhead V, Doughty J, Freeman R. Critically engaging vulnerability: Rethinking oral health with vulnerabilized populations. Community Dent Oral Epidemiol 2022; 50:469-475. [PMID: 34751455 DOI: 10.1111/cdoe.12703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/08/2021] [Accepted: 10/08/2021] [Indexed: 01/27/2023]
Abstract
This paper is the third in a series of narrative reviews challenging core concepts in oral health research and practice. Our series started with a framework for Inclusion Oral Health. Our second review explored one component of this framework, looking at how intersectionality adds important complexity to oral public health. This current manuscript drills into a second component of Inclusion Oral Health, exploring how labels can lead to 'othering' thereby misrepresenting populations and (re)producing harms. Specifically, we address a common oral public health label: vulnerable populations. This term is commonly used descriptively: an adjective (vulnerable) is used to modify a noun (population). What this descriptor conceals is the 'how,' 'why,' and 'therefore' that leads to and from vulnerability: How and why is a population made vulnerable; to what are they vulnerable; what makes them 'at risk,' and to what are they 'at risk'? In concealing these questions, we argue our conventional approach unwittingly does harm. Vulnerability is a term that implies a population has inherent characteristics that make them vulnerable; further, it casts populations as discrete, homogenous entities, thereby misrepresenting the complexities that people live. In so doing, this label can eclipse the strengths, agency and power of individuals and populations to care for themselves and each other. Regarding oral public health, the convention of vulnerability averts our research gaze away from social processes that produce vulnerability to instead focus on the downstream product, the vulnerable population. This paper theorizes vulnerability for oral public health, critically engaging its production and reproduction. Drawing from critical public health literature and disability studies, we advance a critique of vulnerability to make explicit hidden assumptions and their harmful outcomes. We propose solutions for research and practice, including co-engagement and co-production with peoples who have been vulnerabilized. In so doing, this paper moves forward the potential for oral public health to advance research and practice that engages complexity in our work with vulnerabilized populations.
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Affiliation(s)
- Mary Ellen Macdonald
- Faculty of Dentistry, and Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada
| | - Vanessa Muirhead
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Janine Doughty
- Pathway Homelessness and Inclusion Oral Health Fellow, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
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Louvel S, Soulier A. Biological embedding vs. embodiment of social experiences: How these two concepts form distinct thought styles around the social production of health inequalities. Soc Sci Med 2022; 314:115470. [PMID: 36327636 DOI: 10.1016/j.socscimed.2022.115470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/10/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This article compares research on biological embedding and the embodiment of social experiences, two concepts proposed in the 1990s to introduce a new perspective on the social production of health inequalities. We draw on Ludwig Fleck's concept of 'thought style' (1935/2008) to question the possible emergence of a common research program around the processes by which the social becomes biological. METHODS We compiled a corpus of 322 articles referring to either biological embedding or to the embodiment of social experiences, identified in the Web of Science core collection and published from 1990 to 2021. We analyzed the articles' use of these concepts using scientometric indicators and qualitative content analysis. RESULTS Initial differences between the research agendas associated with biological embedding and embodiment are strengthened as both concepts circulate around scientific communities studying the social production of health inequalities. Thought styles formed around embedding and embodiment differ significantly in terms of shared references, sets of methods and research questions, and policy recommendations. Research on biological embedding forms a thought style shared by researchers in the biomedical and public health sciences. Conversely, the concept of embodiment of social experiences connects perspectives from biomedical, public health, human and social sciences, and gathers three thought styles, one identical to that of biological embedding and two formed in social epidemiology and in medical anthropology. CONCLUSIONS Acknowledging the differences between the concepts and divergences in their evolution provides an opportunity for identification of topics where thought styles are either complementary or in tension.
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Affiliation(s)
- Séverine Louvel
- PACTE - Sciences Po Grenoble, 1030 Avenue Centrale, Domaine Universitaire, 38040 Grenoble Cedex 09, France.
| | - Alexandra Soulier
- IHPST - Institut D'histoire et de Philosophie des Sciences et des Techniques (UMR 8590), Maison de La Philosophie - Marin Mersenne, 13, Rue Du Four, 75006 Paris, France.
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15
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Social Differences in Health Behaviours among Jordanian Adolescents. Eur J Investig Health Psychol Educ 2022; 12:1191-1204. [PMID: 36005232 PMCID: PMC9407352 DOI: 10.3390/ejihpe12080083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Social differences are evident in both developed and developing countries. During adolescence, there are limited differences in morbidity and mortality, but differences do appear in terms of health behaviours. This study aims to examine the relationship(s) between social differences and students’ health behaviours. A cross-sectional study was conducted in 2020 with a sample of high school students (N = 2741, aged 13–18 years) in Jordan. Besides descriptive statistics, bivariate logistic regression analysis was used to detect the odds risk for each social difference indicator. Females were engaged in more healthy dietary and hygienic behaviours and less engaged in smoking. Males were more physically active. Adolescents with a higher parental education level were more engaged in healthy behaviours; however, they drank carbonated soft drinks and ate fast food more often. Higher SES (socioeconomic status) self-evaluation was positively associated with eating breakfast and fruit and vegetables, being physically active, drinking carbonated soft drinks, eating fast food, and smoking. Our findings suggest that socioeconomic differences are important to understanding Jordanian adolescents’ health behaviours. While females tend to engage in more healthy behaviours, the role of parental education and perceived family affluence is not always beneficial in terms of adolescents’ dietary habits, hygienic behaviour, or smoking.
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16
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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Portacolone E, Torres JM, Johnson JK, Benton D, Rapp T, Tran T, Martinez P, Graham C. The Living Alone with Cognitive Impairment Project's Policy Advisory Group on Long-Term Services and Supports: Setting a Research Equity Agenda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6021. [PMID: 35627558 PMCID: PMC9141001 DOI: 10.3390/ijerph19106021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 12/17/2022]
Abstract
(1) Background: A United States national policy advisory group (PAG) was convened to identify barriers and facilitators to expand formal long-term services and support (LTSS) for people living alone with cognitive impairment (PLACI), with a focus on equitable access among diverse older adults. The PAG's insights will inform the research activities of the Living Alone with Cognitive Impairment Project, which is aimed at ensuring the equitable treatment of PLACI. (2) Methods: The PAG identified barriers and facilitators of providing effective and culturally relevant LTSS to PLACI via one-on-one meetings with researchers, followed by professionally facilitated discussions among themselves. (3) Results: The PAG identified three factors that were relevant to providing effective and culturally relevant LTSS to PLACI: (i) better characterization of PLACI, (ii) leveraging the diagnosis of cognitive impairment, and (iii) expanding and enhancing services. For each factor, the PAG identified barriers and facilitators, as well as directions for future research. (4) Conclusions: The barriers and facilitators the PAG identified inform an equity research agenda that will help inform policy change.
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Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
- Philip Lee Institute for Health Policy Studies, University of California, San Francisco, CA 94158, USA
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, USA;
| | - Julene K. Johnson
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA;
| | - Thomas Rapp
- LIRAES, Université Paris Cité, 75006 Paris, France;
- Sciences Po Paris, LIEPP, 75006 Paris, France
| | - Thi Tran
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Paula Martinez
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Carrie Graham
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
- Center for Health Care Strategies, Hamilton, NJ 08619, USA
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18
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Benach J, Cash-Gibson L, Rojas-Gualdrón DF, Padilla-Pozo Á, Fernández-Gracia J, Eguíluz VM. Inequalities in COVID-19 inequalities research: Who had the capacity to respond? PLoS One 2022; 17:e0266132. [PMID: 35551268 PMCID: PMC9098009 DOI: 10.1371/journal.pone.0266132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/07/2022] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 pandemic has been testing countries’ capacities and scientific preparedness to actively respond and collaborate on a common global threat. It has also heightened awareness of the urgent need to empirically describe and analyze health inequalities to be able to act effectively. In turn, this raises several important questions that need answering: What is known about the rapidly emerging COVID-19 inequalities research field? Which countries and world regions have been able to rapidly produce research on this topic? What research patterns and trends have emerged, and how to these compared to the (pre-COVID-19) global health inequalities research field? Which countries have been scientifically collaborating on this important topic? Where are the scientific knowledge gaps, and indirectly where might research capacities need to be strengthened? In order to answer these queries, we analyzed the global scientific production (2020–2021) on COVID-19 associated inequalities by conducting bibliometric and network analyses using the Scopus database. Specifically, we analyzed the volume of scientific production per country (via author affiliations), its distribution by country income groups and world regions, as well as the inter-country collaborations within this production. Our results indicate that the COVID-19 inequalities research field has been highly collaborative; however, a number of significant inequitable research practices exist. When compared to the (pre-COVID-19) global health inequalities research field, similar inequalities were identified, however, several new dynamics and partnerships have also emerged that warrant further in-depth exploration. To ensure preparedness for future crises, and effective strategies to tackle growing social inequalities in health, investment in global health inequalities research capacities must be a priority for all.
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Affiliation(s)
- Joan Benach
- Research Group on Health Inequalities, Environment and Employment Conditions (GREDS-EMCONET), Pompeu Fabra University, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (JHU-UPF PPC UPF-BSM), Barcelona, Spain
- Ecological Humanities Research Group (GHECO), Universidad Autónoma de Madrid, Spain
- * E-mail:
| | - Lucinda Cash-Gibson
- Research Group on Health Inequalities, Environment and Employment Conditions (GREDS-EMCONET), Pompeu Fabra University, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (JHU-UPF PPC UPF-BSM), Barcelona, Spain
- Pompeu Fabra University–UPF Barcelona School of Management (UPF-BSM), Barcelona, Spain
| | | | - Álvaro Padilla-Pozo
- Research Group on Health Inequalities, Environment and Employment Conditions (GREDS-EMCONET), Pompeu Fabra University, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center (JHU-UPF PPC UPF-BSM), Barcelona, Spain
| | - Juan Fernández-Gracia
- Institute for Cross-Disciplinary Physics and Complex Systems, Campus Universitat de les Illes Balears, Palma de Mallorca, Islas Baleares, Spain
| | - Víctor M. Eguíluz
- Institute for Cross-Disciplinary Physics and Complex Systems, Campus Universitat de les Illes Balears, Palma de Mallorca, Islas Baleares, Spain
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Gunn V, Kreshpaj B, Matilla-Santander N, Vignola EF, Wegman DH, Hogstedt C, Ahonen EQ, Bodin T, Orellana C, Baron S, Muntaner C, O’Campo P, Albin M, Håkansta C. Initiatives Addressing Precarious Employment and Its Effects on Workers' Health and Well-Being: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2232. [PMID: 35206419 PMCID: PMC8872425 DOI: 10.3390/ijerph19042232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/22/2022]
Abstract
The prevalence of precarious employment has increased in recent decades and aspects such as employment insecurity and income inadequacy have intensified during the COVID-19 pandemic. The purpose of this systematic review was to identify, appraise, and synthesise existing evidence pertaining to implemented initiatives addressing precarious employment that have evaluated and reported health and well-being outcomes. We used the PRISMA framework to guide this review and identified 11 relevant initiatives through searches in PubMed, Scopus, Web of Science, and three sources of grey literature. We found very few evaluated interventions addressing precarious employment and its impact on the health and well-being of workers globally. Ten out of 11 initiatives were not purposefully designed to address precarious employment in general, nor specific dimensions of it. Seven out of 11 initiatives evaluated outcomes related to the occupational health and safety of precariously employed workers and six out of 11 evaluated worker health and well-being outcomes. Most initiatives showed the potential to improve the health of workers, although the evaluation component was often described with less detail than the initiative itself. Given the heterogeneity of the 11 initiatives regarding study design, sample size, implementation, evaluation, economic and political contexts, and target population, we found insufficient evidence to compare outcomes across types of initiatives, generalize findings, or make specific recommendations for the adoption of initiatives.
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Affiliation(s)
- Virginia Gunn
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, St. George Campus, Toronto, ON M5T 1P8, Canada;
| | - Bertina Kreshpaj
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
| | - Nuria Matilla-Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
| | - Emilia F. Vignola
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10025, USA;
| | - David H. Wegman
- University of Massachusetts Lowell, Lowell, MA 01854, USA;
- La Isla Network, Washington, DC 20005, USA
| | - Christer Hogstedt
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
| | - Emily Q. Ahonen
- Division of Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
| | - Cecilia Orellana
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
| | - Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, New York, NY 11367, USA;
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, St. George Campus, Toronto, ON M5T 1P8, Canada;
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 1P8, Canada
- Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA 21205, USA
| | - Patricia O’Campo
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada;
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Maria Albin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
| | - Carin Håkansta
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 11365 Stockholm, Sweden; (B.K.); (N.M.-S.); (C.H.); (T.B.); (C.O.); (M.A.); (C.H.)
- Working Life Science, Karlstad Business School, Karlstad University, 65188 Karlstad, Sweden
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20
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Kelly-Irving M, Ball WP, Bambra C, Delpierre C, Dundas R, Lynch J, McCartney G, Smith K. Falling down the rabbit hole? Methodological, conceptual and policy issues in current health inequalities research. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2036701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Michelle Kelly-Irving
- Centre for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
- Institut fédératif de recherche et d’études interdisciplinaire santé société, Université de Toulouse, Toulouse, France
| | | | - Clare Bambra
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, UK
| | - Cyrille Delpierre
- Centre for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Ruth Dundas
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Julia Lynch
- Department of Political Science and Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, U S.A
| | - Gerry McCartney
- College of Social Sciences, University of Glasgow, Glasgow, Scotland
| | - Katherine Smith
- School of Social Work & Social Policy, University of Strathclyde, Glasgow, UK
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21
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Yang K, Qi H. Research on Health Disparities Related to the COVID-19 Pandemic: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031220. [PMID: 35162243 PMCID: PMC8835299 DOI: 10.3390/ijerph19031220] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/25/2022]
Abstract
With the outbreak of the 2019 coronavirus (COVID-19) pandemic, the issue of increasing health disparities has received a great deal of attention from scholars and organizations. This study analyzes 2282 papers on COVID-19-related health disparities that have been retrieved from the WOS database, with 58,413 references. Using bibliometric analysis and knowledge mapping visualizations, the paper focuses on the academic structure and research trends by examining the research distribution of countries, journals and authors, keywords, highly cited articles, and reference co-citation. The results show that the United States has contributed the most, and the International Journal of Environmental Research and Public Health has published the largest number of papers on this topic. As for the core authors, Michael Marmot is the most productive. Issues such as racial health, mental health, and digital health disparities have been the trending topics of the COVID-19-related health disparities. The research directions include the features, factors, and interventions of health disparities under the influence of COVID-19. As such, this study provides literature support and suggestions to investigate COVID-19-related health disparities. The findings of the paper also remind public health regulators to consider factors of health disparities when developing long-term public health regulatory policies related to the pandemic.
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Affiliation(s)
- Keng Yang
- Institute of Economics, Tsinghua University, Beijing 100084, China;
- One Belt-One Road Strategy Institute, Tsinghua University, Beijing 100084, China
| | - Hanying Qi
- The New Type Key Think Tank of Zhejiang Province “Research Institute of Regulation and Public Policy”, Zhejiang University of Finance and Economics, Hangzhou 310018, China
- China Institute of Regulation Research, Zhejiang University of Finance and Economics, Hangzhou 310018, China
- Correspondence:
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22
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Ravi K, Bentounsi Z, Tariq A, Brazeal A, Daudu D, Back F, Elhadi M, Badwi N, Shah SSNH, Bandyopadhyay S, Khalil H, Kimura H, Sekyi-Djan MN, Abdelrahman A, Shaheen A, Mbonda Noula AG, Wong AT, Ndajiwo A, Souadka A, Maina AN, Nyalundja AD, Sabry A, Hind B, Nteranya DS, Ngugi DW, de Wet E, Tolis EA, Wafqui FZ, Essangri H, Moujtahid H, Moola H, Narain K, Ravi K, Wassim K, Odiero LA, Nyaboke LS, Metwalli M, Naisiae M, Pueschel MG, Turabi N, El Aroussi N, Makram OM, Shawky OA, Outani O, Carides P, Patil P, Halley-Stott RP, Kurbegovic S, Marchant S, Moujtahid S, El Hadrati S, Agarwal T, Kidavasi VA, Agarwal V, Steyn W, Matumo W, Fahmy YA, Omar Z, Amod Z, Eloff M, Hussein NA, Sharma D. Systematic analysis of authorship demographics in global surgery. BMJ Glob Health 2021; 6:bmjgh-2021-006672. [PMID: 34666988 PMCID: PMC8527109 DOI: 10.1136/bmjgh-2021-006672] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/09/2021] [Indexed: 02/06/2023] Open
Abstract
Background Global surgery has recently gained prominence as an academic discipline within global health. Authorship inequity has been a consistent feature of global health publications, with over-representation of authors from high-income countries (HICs), and disenfranchisement of researchers from low-income and middle-income countries (LMICs). In this study, we investigated authorship demographics within recently published global surgery literature. Methods We performed a systematic analysis of author characteristics, including gender, seniority and institutional affiliation, for global surgery studies published between 2016 and 2020 and indexed in the PubMed database. We compared the distribution of author gender and seniority across studies related to different topics; between authors affiliated with HICs and LMICs; and across studies with different authorship networks. Results 1240 articles were included for analysis. Most authors were male (60%), affiliated only with HICs (51%) and of high seniority (55% were fully qualified specialist or generalist clinicians, Principal Investigators, or in senior leadership or management roles). The proportion of male authors increased with increasing seniority for last and middle authors. Studies related to Obstetrics and Gynaecology had similar numbers of male and female authors, whereas there were more male authors in studies related to surgery (69% male) and Anaesthesia and Critical care (65% male). Compared with HIC authors, LMIC authors had a lower proportion of female authors at every seniority grade. This gender gap among LMIC middle authors was reduced in studies where all authors were affiliated only with LMICs. Conclusion Authorship disparities are evident within global surgery academia. Remedial actions to address the lack of authorship opportunities for LMIC authors and female authors are required.
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Affiliation(s)
- Krithi Ravi
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Zineb Bentounsi
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Aiman Tariq
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | | | - Davina Daudu
- The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia
| | - Francesca Back
- University of Oxford Medical Sciences Division, Oxford, UK
| | | | - Nermin Badwi
- Zagazig University Faculty of Human Medicine, Zagazig, Egypt.,InciSioN Egypt, Zagazig, Egypt
| | | | | | - Halimah Khalil
- Birmingham Medical School, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | | | | | | | - Ahmed Shaheen
- Alexandria University Faculty of Medicine, Alexandria, Egypt
| | | | - Ai-Ting Wong
- Red Cross War Memorial Children's Hospital, Rondebosch, South Africa
| | | | - Amine Souadka
- National Institute of Oncology, Mohammed V University of Rabat, Rabat, Morocco
| | | | | | | | - Bourja Hind
- Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Daniel Safari Nteranya
- Department of Surgery, Official University of Bukavu, Bukavu, Congo.,Association of Future African Neurosurgeons, Yaoundé, Cameroon
| | | | - Elsa de Wet
- University of the Free State, Bloemfontein, South Africa
| | | | - F Z Wafqui
- Faculty of Medicine and Pharmacy, Casablanca, Morocco
| | - Hajar Essangri
- National Institute of Oncology, Mohammed V University of Rabat, Rabat, Morocco
| | - Hajar Moujtahid
- Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | - Husna Moola
- University of Cape Town, Rondebosch, South Africa
| | - Kapil Narain
- University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | - Krupa Ravi
- University of Oxford Medical Sciences Division, Oxford, UK
| | - Kyrillos Wassim
- Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | | | | | | | - Maryanne Naisiae
- University of Nairobi College of Health Sciences, Nairobi, Kenya
| | | | - Nafisa Turabi
- Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, India
| | - Nouhaila El Aroussi
- Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | - Omar Mohamed Makram
- Department of Cardiology, Faculty of Medicine, October 6 University, 6th of October City, Egypt.,London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Omar A Shawky
- Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Oumaima Outani
- Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | - Peter Carides
- University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | | | | | - Sabina Kurbegovic
- Medical Faculty, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Sara Moujtahid
- Ibn Sina University Hospital Center, Rabat, Morocco.,Mohammed V University, Rabat, Morocco
| | - Soukaina El Hadrati
- Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | | | | | | | - Wilme Steyn
- Chris Hani Baragwanath Hospital, Bertsham, South Africa
| | | | | | - Zaayid Omar
- Rondebosch Medical Centre, Cape Town, South Africa
| | - Zachary Amod
- University of Cape Town, Rondebosch, South Africa
| | - Madelein Eloff
- University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South Africa
| | | | - Dhananjaya Sharma
- Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, India
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23
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Dijkstra I, Horstman K. 'Known to be unhealthy': Exploring how social epidemiological research constructs the category of low socioeconomic status. Soc Sci Med 2021; 285:114263. [PMID: 34411967 DOI: 10.1016/j.socscimed.2021.114263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/06/2021] [Accepted: 07/22/2021] [Indexed: 01/07/2023]
Abstract
We examine how the category of low socioeconomic status (LSES) was constructed in European social epidemiological research and policy advice from 1977 to 2019. We analysed 22 empirical social epidemiological research publications on LSES and health, as well as six scientific advisory reports that offered government officials an overview of scientific evidence on health inequalities. We show the construction and reification of LSES as a problematic group in dominant thought, which consists of the following components: 1) the proliferation of SES concepts, indicators and groups labelled LSES; 2) generalisation through which LSES is constructed as a single population; 3) problematisation through which LSES is constructed as an inherently unhealthy population; and 4) individualisation by which a LSES personality is presented as an explanation of health differences. We also show how this knowledge is extrapolated into the policy domain in the form of scientific advisory reports. These findings provide evidence of the construction of LSES as an inherently unhealthy population through hyperproliferation and references to the objectivity of scientific research. With respect to the LSES category, the dynamics of research and policy resemble those regarding categories of ethnicity and gender. We conclude that if the construction of LSES remains unquestioned, social epidemiology might continue to (re)produce what it examines: LSES populations 'known to be unhealthy'.
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Affiliation(s)
- Ilse Dijkstra
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Klasien Horstman
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, PO Box 616, 6200, MD, Maastricht, the Netherlands.
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24
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Cookson R, Doran T, Asaria M, Gupta I, Mujica FP. The inverse care law re-examined: a global perspective. Lancet 2021; 397:828-838. [PMID: 33640069 DOI: 10.1016/s0140-6736(21)00243-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
An inverse care law persists in almost all low-income and middle-income countries, whereby socially disadvantaged people receive less, and lower-quality, health care despite having greater need. By contrast, a disproportionate care law persists in high-income countries, whereby socially disadvantaged people receive more health care, but of worse quality and insufficient quantity to meet their additional needs. Both laws are caused not only by financial barriers and fragmented health insurance systems but also by social inequalities in care seeking and co-investment as well as the costs and benefits of health care. Investing in more integrated universal health coverage and stronger primary care, delivered in proportion to need, can improve population health and reduce health inequality. However, trade-offs sometimes exist between health policy objectives. Health-care technologies, policies, and resourcing should be subjected to distributional analysis of their equity impacts, to ensure the objective of reducing health inequalities is kept in sight.
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Affiliation(s)
- Richard Cookson
- Centre for Health Economics, University of York, York, England.
| | - Tim Doran
- Department of Health Sciences, University of York, York, England
| | - Miqdad Asaria
- Department of Health Policy, London School of Economics, London, England
| | - Indrani Gupta
- Health Policy Research Unit, Institute of Economic Growth, Delhi, India
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