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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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Chang AB, Dharmage SC, Marchant JM, McCallum GB, Morris PS, Schultz A, Toombs M, Wurzel DF, Yerkovich ST, Grimwood K. Improving the Diagnosis and Treatment of Paediatric Bronchiectasis Through Research and Translation. Arch Bronconeumol 2024; 60:364-373. [PMID: 38548577 DOI: 10.1016/j.arbres.2024.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/02/2024] [Accepted: 03/04/2024] [Indexed: 06/05/2024]
Abstract
Bronchiectasis, particularly in children, is an increasingly recognised yet neglected chronic lung disorder affecting individuals in both low-to-middle and high-income countries. It has a high disease burden and there is substantial inequity within and between settings. Furthermore, compared with other chronic lung diseases, considerably fewer resources are available for children with bronchiectasis. The need to prevent bronchiectasis and to reduce its burden also synchronously aligns with its high prevalence and economic costs to health services and society. Like many chronic lung diseases, bronchiectasis often originates early in childhood, highlighting the importance of reducing the disease burden in children. Concerted efforts are therefore needed to improve disease detection, clinical management and equity of care. Modifiable factors in the causal pathways of bronchiectasis, such as preventing severe and recurrent lower respiratory infections should be addressed, whilst also acknowledging the role played by social determinants of health. Here, we highlight the importance of early recognition/detection and optimal management of bronchiectasis in children, and outline our research, which is attempting to address important clinical knowledge gaps discussed in a recent workshop. The research is grouped under three themes focussing upon primary prevention, improving diagnosis and disease characterisation, and providing better management. Our hope is that others in multiple settings will undertake additional studies in this neglected field to further improve the lives of people with bronchiectasis. We also provide a resource list with links to help inform consumers and healthcare professionals about bronchiectasis and its recognition and management.
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Affiliation(s)
- Anne B Chang
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Julie M Marchant
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Gabrielle B McCallum
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Peter S Morris
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Department of Paediatrics, Royal Darwin Hospital, Darwin, NT, Australia
| | - Andre Schultz
- Wal-yan Respiratory Research Centre, Telethon Kids Institute and Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, WA, Australia; Department of Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia
| | - Maree Toombs
- NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Danielle F Wurzel
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie T Yerkovich
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia; NHMRC Centre for Research Excellence in Paediatric Bronchiectasis (AusBREATHE), Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Keith Grimwood
- Departments of Infectious Disease and Paediatrics, Gold Coast Health, Gold Coast, QLD, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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Blackburn CC, Nuzhath T. An exploration of barriers to access to healthcare in Hancock County, Tennessee: A qualitative study. Health Expect 2024; 27:e14074. [PMID: 38769887 PMCID: PMC11106589 DOI: 10.1111/hex.14074] [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: 09/18/2023] [Revised: 03/29/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE Explore barriers to healthcare access in Hancock County, Tennessee using a conceptual framework for access to healthcare. METHODS We collected data from 30 participants in Hancock County during 1 week in April 2023 using a combination of network and purposive sampling. We analyzed the data using thematic analysis and the conceptual framework of healthcare access. RESULTS All dimensions of the conceptual framework of healthcare access presented barriers to healthcare access for participants of the study. A lack of acceptability of local healthcare among participants manifested in a perceived lack of availability of healthcare. This resulted in participants travelling or considering it necessary to travel long distances for care, even in a life-threatening emergency, despite the local availability of a hospital with an emergency department. CONCLUSIONS A lack of acceptability can create healthcare access barriers similar to a lack of availability of healthcare facilities. PATIENT OR PUBLIC CONTRIBUTION The research team met several times with the leader of a local community organization to discuss this research in Hancock County. These conversations helped to inform the study design and provided necessary background to conduct in-depth interviews. Members of the community organization helped identify individuals to interview and provide access to Remote Area Medical clinic patients. The research team discussed the final themes with the primary community collaborator.
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Affiliation(s)
- Christine Crudo Blackburn
- Department of Health Policy and Management, School of Public HealthTexas A&M UniversityCollege StationTexasUSA
| | - Tasmiah Nuzhath
- Department of Global Health and Population, T.H. Chan School of Public HealthHarvard UniversityCambridgeMassachusettsUSA
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García-Padilla FM, Sánchez-Alcón M, Sosa-Cordobés E, Ortega-Galán ÁM, Garrido-Fernández A. Attitude towards health promotion in university students. Construction and validation of a scale. GACETA SANITARIA 2024; 38:102395. [PMID: 38781777 DOI: 10.1016/j.gaceta.2024.102395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To construct and validate a questionnaire about the attitude of university students toward health promotion. METHOD A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales. RESULTS A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate. CONCLUSIONS The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.
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Hanneke R, Brunskill A. Searching for the social determinants of health: observations from evidence synthesis publications. Syst Rev 2024; 13:134. [PMID: 38755700 PMCID: PMC11097542 DOI: 10.1186/s13643-024-02551-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/26/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The social determinants of health (SDOH) are the focus of an exponentially increasing number of publications, including evidence syntheses. However, there is not an established standard for searching for SDOH literature. This study seeks to identify published evidence syntheses pertaining to the SDOH, analyzing the search strategies used and the studies included within these reviews. The primary objectives are to compare search strategies and create a test set of SDOH publications. METHODS We searched PubMed, Embase, and Scopus for evidence syntheses that mentioned the SDOH in their research questions and included an SDOH search strategy. Relevant data extracted from each review included databases searched; search terms used for the SDOH; conceptual frameworks referenced; and the citations of primary studies included in the reviews, which were compiled to form a test set of cited papers. The relative recall of the respective search strategies was tested by documenting the total number of MEDLINE results each retrieved and the number of test set papers retrieved. RESULTS Sixty-four evidence syntheses were identified and included in the analysis, and 2750 cited papers were extracted. Findings indicate few commonalities across search strategies in search terms used, the total number of results retrieved, and the number of test set cited papers retrieved. One hundred and ninety-three unique MeSH terms and 1385 unique keywords and phrases were noted among the various search strategies. The number of total results retrieved by the SDOH search strategies ranged from 21,793 to over 16 million. The percentage of cited papers retrieved by the search strategies ranged from 2.46 to 97.9%. Less than 3% of the cited papers were indexed with the Social Determinants of Health MeSH. CONCLUSIONS There has been little consistency across evidence syntheses in approaches to searching for SDOH literature. Differences in these strategies could have a significant impact on what literature is retrieved, included in reviews, and, consequently, incorporated into evidence-based practice. By documenting these differences and creating a set of papers relevant to SDOH, this research provides a snapshot of the current challenges in searching for SDOH content and lays the groundwork for the creation of a standardized search approach for SDOH literature.
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Affiliation(s)
- Rosie Hanneke
- Library of the Health Sciences, University of Illinois Chicago, 1750 W Polk St. MC 763, Chicago, IL, 60612, USA.
| | - Amelia Brunskill
- Library of the Health Sciences, University of Illinois Chicago, 1750 W Polk St. MC 763, Chicago, IL, 60612, USA
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Bartoll-Roca X, López MJ, Pérez K, Artazcoz L, Borrell C. Short-term health effects of an urban regeneration programme in deprived neighbourhoods of Barcelona. PLoS One 2024; 19:e0300470. [PMID: 38630702 PMCID: PMC11023398 DOI: 10.1371/journal.pone.0300470] [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: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 04/19/2024] Open
Abstract
Urban regeneration programmes are interventions meant to enhance the wellbeing of residents in deprived areas, although empirical evidence reports mixed results. We evaluated the health impact of a participatory and neighbourhood-wide urban regeneration programme, Pla de Barris 2016-2020, in Barcelona. A pre-post with a comparison group study design. Using data from a cross-sectional survey performed in 2016 and 2021. The health outcomes analysed were mental health, alcohol and psychotropic drug use, perceived health status, physical activity and obesity. Depending on the investment, two intervention groups were defined: moderate- and high-intensity intervention groups. The analysis combined difference-in-difference estimation with an inverse weighting derived from a propensity score to reduce potential biases. The impact of the intervention in percentages and its confidence interval were estimated with a linear probability model with clustered adjusted errors. The intervention had a positive impact on health outcomes in women in the high-intensity intervention group: a reduction of 15.5% in the relative frequency of those experiencing poor mental health, and of 21.7% in the relative frequency of those with poor self-perceived health; and an increase of 13.7% in the relative frequency of those doing physical activity. No positive impact was observed for men, but an increase of 10.3% in the relative frequency of those using psychotropic drugs in the high-intensity intervention group. This study shows positive short-term effects of the urban regeneration programme Pla de Barris 2016-2020 on health outcomes in women in the high-intensity intervention group. These results can guide future interventions in other areas.
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Affiliation(s)
- Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Lucía Artazcoz
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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Laker B, Weisz N, Vassolo R. Countercyclical approach to enhancing health and well-being in healthcare systems: strategies for economic resilience and sustainable care. BMJ LEADER 2024:leader-2023-000873. [PMID: 38408842 DOI: 10.1136/leader-2023-000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/20/2024] [Indexed: 02/28/2024]
Affiliation(s)
| | - Natalia Weisz
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
| | - Roberto Vassolo
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
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Schaller A, Stassen G, Baulig L, Lange M. Physical activity interventions in workplace health promotion: objectives, related outcomes, and consideration of the setting-a scoping review of reviews. Front Public Health 2024; 12:1353119. [PMID: 38406496 PMCID: PMC10884305 DOI: 10.3389/fpubh.2024.1353119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Background The workplace is a recognized setting for promoting health among adults, and physical activity (PA) interventions are an integral part of workplace health promotion (WHP). Objectives The present review of reviews aims to provide an overview of the main objectives and related outcomes addressed in WHP-related PA interventions, as well as the setting-specific aspects considered in the research field. Methods A scoping review of reviews was conducted. Reviews were included if they were peer-reviewed, written in English, and focused on PA interventions conducted in the context of WHP. A literature search was conducted in PubMed, SPORTDiscus, and Web of Science. Reviews were included if they had been published after the year 2000. Information on the following dimensions was extracted: author, region, number of primary studies included, target group(s), PA interventions included, main objective(s), related outcomes, and setting-specific aspects. Results A total of 17 reviews were included. Six reviews aimed at solely identifying the effectiveness of promoting daily PA and reducing sedentary behavior. Eleven reviews showed a combined approach considering physical activity behavior and/or health and job-related outcomes. Outcomes in the primary studies were heterogeneous. None of the reviews had an explicit definition of WHP and setting-specific information was very general and sparse. The reported setting-specific information was referred to the general importance of the workplace setting, the specific importance as an access route to target groups, and implementation aspects. Regarding the additional characteristics of the reviews, the selection of primary studies was restricted to a specific region in 2 of the 17 reviews in advance. Three reviews restricted the target group (sedentary workers, women, desk-based workers), while eleven reviews included working adults in general and, three reviews gave no information about the target group. Eleven intervention approaches of the reviews were behaviorally oriented, two focused solely on environmental interventions, and four reviews can be attributed to a combined approach considering behavioral and environmental interventions. Conclusion For sustainable future developments, the present results indicate a strong need for conceptual consolidation of WHP in the research field of PA interventions. Therefore, both WHP and health-related PA interventions need to take a comprehensive approach comprising behavioral and environmental interventions.
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Affiliation(s)
- Andrea Schaller
- Department of Human Sciences, Institute of Sport Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Gerrit Stassen
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Lukas Baulig
- University of Police and Public Administration of North Rhine-Westphalia, Cologne, Germany
| | - Martin Lange
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany
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Macintyre AK, Shipton D, Sarica S, Scobie G, Craig N, McCartney G. Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high-income countries: a systematic review of reviews. Syst Rev 2024; 13:58. [PMID: 38331910 PMCID: PMC10851517 DOI: 10.1186/s13643-023-02429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND A fairer economy is increasingly recognised as crucial for tackling widening social, economic and health inequalities within society. However, which actions have been evaluated for their impact on inclusive economy outcomes is yet unknown. OBJECTIVE Identify the effects of political, economic and social exposures, interventions and policies on inclusive economy (IE) outcomes in high-income countries, by systematically reviewing the review-level evidence. METHODS We conducted a review of reviews; searching databases (May 2020) EconLit, Web of Science, Sociological Abstracts, ASSIA, International Bibliography of the Social Sciences, Public Health Database, Embase and MEDLINE; and registries PROSPERO, Campbell Collaboration and EPPI Centre (February 2021) and grey literature (August/September 2020). We aimed to identify reviews which examined social, political and/or economic exposures, interventions and policies in relation to two IE outcome domains: (i) equitable distribution of the benefits of the economy and (ii) equitable access to the resources needed to participate in the economy. Reviews had to include primary studies which compared IE outcomes within or between groups. Quality was assessed using a modified version of AMSTAR-2 and data synthesised informed by SWiM principles. RESULTS We identified 19 reviews for inclusion, most of which were low quality, as was the underlying primary evidence. Most reviews (n = 14) had outcomes relating to the benefits of the economy (rather than access to resources) and examined a limited set of interventions, primarily active labour market programmes and social security. There was limited high-quality review evidence to draw upon to identify effects on IE outcomes. Most reviews focused on disadvantaged groups and did not consider equity impacts. CONCLUSIONS Review-level evidence is sparse and focuses on 'corrective' approaches. Future reviews should examine a diverse set of 'upstream' actions intended to be inclusive 'by design' and consider a wider range of outcomes, with particular attention to socioeconomic inequalities.
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Affiliation(s)
- Anna K Macintyre
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK.
| | - Deborah Shipton
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Shifa Sarica
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Graeme Scobie
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Neil Craig
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Gerry McCartney
- School of Social & Political Sciences, University of Glasgow, Glasgow, UK
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Wu S, Ta L, Vieira J, Schwartz K, Perez J, Zeien J, Li D, Hartmark-Hill J. Adverse Childhood Experiences and Depression among Homeless Young Adults: A Social Determinants of Health Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:81. [PMID: 38248544 PMCID: PMC10815729 DOI: 10.3390/ijerph21010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Homelessness is a pervasive issue in the United States that presents significant challenges to public health. Homeless young adults (HYAs) are at particular risk for increased incidence and severity of depression. Using primary survey data (n = 205) collected in the Phoenix Metropolitan Area, Arizona, from June to August 2022, this study aims to examine the relationship between adverse childhood experiences (ACEs) and depression among HYAs. We adopted the ACEs 10-item scale to measure childhood traumatic experiences, whereas depression was measured by using a PHQ-4 depression scale and diagnosed depression. Regression models were conducted to test the relationships between ACEs and depression outcomes while controlling for the covariates at the individual, interpersonal, and socioeconomic/living environment levels. The average PHQ-4 score was 5.01 (SD = 3.59), and 59.69% of HYAs reported being diagnosed previously with depression. The mean ACEs score was 5.22 out of 10. Other things being equal, for every one unit increase in ACEs scores, the odds of being diagnosed with depression increased by 11.5%, yet it was not statistically significant, while the PHQ-4 score increased by 0.445 (p < 0.001). Overall, HYAs were disproportionately affected by depression. This study elucidates the complex relationship between ACEs and depression among HYAs.
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Affiliation(s)
- Shiyou Wu
- School of Social Work, Arizona State University, Phoenix, AZ 85004, USA
| | - Lac Ta
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Jaime Vieira
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Kendall Schwartz
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Joshua Perez
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Justin Zeien
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA;
| | - Danyi Li
- Keck School of Medicine Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA;
| | - Jennifer Hartmark-Hill
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
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Murphy M, Grundy EMD. Housing tenure and disability in the UK: trends and projections 2004-2030. Front Public Health 2024; 11:1248909. [PMID: 38239788 PMCID: PMC10795505 DOI: 10.3389/fpubh.2023.1248909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/08/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Housing is a major influence on health. Housing tenure is associated with housing conditions, affordability, and security and is an important dimension of housing. In the UK there have been profound changes in both housing conditions and the distribution of households by tenure over the past century, that is during the lifetimes of the current population. Methods We firstly reviewed and summarise changes in housing conditions, housing policy and tenure distribution as they provide a context to possible explanations for health variations by housing tenure, including health related selection into different tenure types. We then use 2015-2021 data from a large nationally representative UK survey to analyse associations between housing tenure and self-reported disability among those aged 40-69 controlling for other socio-demographic factors also associated with health. We additionally examine changes in the association between housing tenure and self-reported disability in the population aged 25 and over in the first two decades of the 21st century and project trends forward to 2030. Results Results show that associations between housing tenure and disability by tenure were stronger than for any other indicator of socio-economic position considered with owner-occupiers having the best, and social renters the worst, health. Differences were particularly marked in reported mental health conditions and in economic activity, with 28% of social renters being economically inactive due to health problems, compared with 4% of owner-occupiers. Rates of disability have increased over time, and become increasingly polarised by tenure. By 2020 the age standardised disability rate among tenants of social housing was over twice as high as that for owner occupiers, with projections indicating further increases in both levels, and differentials in, disability by 2030. Discussion These results have substantial implications for housing providers, local authorities and for public health.
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Affiliation(s)
- Michael Murphy
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Emily M. D. Grundy
- Institute for Economic and Social Research, University of Essex, Essex, United Kingdom
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Boiko DI, Shyrai PO, Mats OV, Karpik ZI, Rahman MH, Khan AA, Alanazi AM, Skrypnikov AM. Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: A preliminary result from online-survey. Sleep Med 2024; 113:342-348. [PMID: 38104463 DOI: 10.1016/j.sleep.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/19/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
The ongoing Russian-Ukrainian conflict has caused a significant displacement of individuals, with an estimated five million Ukrainians seeking temporary refuge in other countries. We conducted a survey among Ukrainians in various countries worldwide using a convenience sample and analyzed 144 responses. The participants were divided into two groups: group 1, consisting of 92 Ukrainian refugees who were forced to leave their country due to the conflict, and group 2, comprising 52 individuals who did not change their place of residence. Data were collected through a structured online questionnaire consisting of socio-demographic questions, Depression, Anxiety, and Stress Scale-21, Insomnia Severity Index, and Symptom Checklist-90 during May-November 2022. We found that there were statistically significantly higher levels of obsessive-compulsive symptoms, depression, hostility, and overall distress in group 1. Group 1 had a higher risk of depression, anxiety, and stress, but not insomnia. In our study, refugee status, dissatisfaction with the state of health, job loss, suffering due to hostilities, and the received support from volunteers, friends, or relatives were the most important factors for the mental disorders. A bi-directional relationship was discovered between anxiety and insomnia, with both symptoms being associated with COVID-19 and subsequent psychiatric disorders. This study highlights the mental health and sleep problems faced by Ukrainian refugees as a result of the conflict linked to numerous social factors. Ukrainian refugees need social support programs and special attention to their mental health to facilitate their post-migration adaptation and integration into the host society.
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Affiliation(s)
- Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine.
| | - Polina O Shyrai
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Oksana V Mats
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Zoriana I Karpik
- Medical Faculty, Poltava State Medical University, Poltava, Ukraine
| | - Md Habibur Rahman
- Department of Global Medical Science, Yonsei University, Wonju 26426, Gangwon-do, South Korea
| | - Azmat Ali Khan
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Amer M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Andrii M Skrypnikov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
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Wearn A, Shepherd L. Determinants of routine cervical screening participation in underserved women: a qualitative systematic review. Psychol Health 2024; 39:145-170. [PMID: 35296200 DOI: 10.1080/08870446.2022.2050230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as 'underserved.' A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups. METHODS Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead's social model of health was used as a broad a priori coding framework. RESULTS Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation. CONCLUSIONS These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.
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Affiliation(s)
- Angela Wearn
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lee Shepherd
- Department of Psychology, Northumbria University, Northumberland Building, Newcastle Upon Tyne, UK
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14
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Burgess-Flowers J, de Saxe Zerden L, Yokovich K. The social determinants of health, social work, and dental patients: a case study. SOCIAL WORK IN HEALTH CARE 2024; 63:117-130. [PMID: 38111138 DOI: 10.1080/00981389.2023.2292546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/16/2023] [Indexed: 12/20/2023]
Abstract
Oral health has been largely overlooked in conceptualizing health, and the workforce responsible for addressing the Social Determinants of Health (SDOH) within oral health settings has received little attention. While the role for social work in oral health has remained limited, there has been recent growth articulating its role in dental education. This paper presents a case study of how social work has been implemented into one school of dentistry in the U.S. to address SDOH and offers a roadmap for integration of social work into dental education, including opportunities for interprofessional health care experiences related to SDOH.
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Affiliation(s)
- Jamie Burgess-Flowers
- Workman School of Dental Medicine, High Point University, High Point, North Carolina, USA
| | - Lisa de Saxe Zerden
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelsey Yokovich
- Foundation for Health Leadership and Innovation, Cary, North Carolina, USA
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15
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Driscoll DL, O'Donnell H, Patel M, Cattell-Gordon DC. Assessing and Addressing the Determinants of Appalachian Population Health: A Scoping Review. JOURNAL OF APPALACHIAN HEALTH 2023; 5:85-102. [PMID: 38784141 PMCID: PMC11110904 DOI: 10.13023/jah.0503.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Introduction Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities. Methods This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the following inclusion criteria were reviewed: original article, published in the last five years, involving an Appalachian population, and includes a rigorous assessment of an association between a population health determinant and one or more leading causes of Appalachian morbidity and mortality. Results The search returned 221 research articles, including 30 interventional studies. The top three health outcomes included cancer (43.59%), diseases of despair (23.08%), and diabetes (12.82). Access to care (27.3%), rurality (18.9%), and education (14.8%) were the most common population health determinants identified. Interventional studies were categorized by program types: education, technology, partnerships, and multilevel interventions. Due to the heterogeneity of study types, the studies were combined using a narrative synthesis. Implications The results of this work can inform the development and evaluation of additional programs to promote Appalachian population health. Our study team will use these results to inform community-based discussions that develop strategic plans to mitigate health disparities in Central and Southcentral Appalachian Virginia.
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Affiliation(s)
| | | | | | - David C Cattell-Gordon
- Center for Telehealth at the University of Virginia (retired); ThreadEx Consulting LLC (current)
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16
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Zheng X, Xue B, Xiao S, Li X, Chen Y, Shi L, Liang X, Tian F, Zhang C. Development and validation of a multimorbidity risk prediction nomogram among Chinese middle-aged and older adults: a retrospective cohort study. BMJ Open 2023; 13:e077573. [PMID: 37940154 PMCID: PMC10632863 DOI: 10.1136/bmjopen-2023-077573] [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] [Received: 07/13/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES The aim of this study is to establish a self-simple-to-use nomogram to predict the risk of multimorbidity among middle-aged and older adults. DESIGN A retrospective cohort study. PARTICIPANTS We used data from the Chinese Longitudinal Healthy Longevity Survey, including 7735 samples. MAIN OUTCOME MEASURES Samples' demographic characteristics, modifiable lifestyles and depression were collected. Cox proportional hazard models and nomogram model were used to estimate the risk factors of multimorbidity. RESULTS A total of 3576 (46.2%) participants have multimorbidity. The result showed that age, female (HR 0.80, 95% CI 0.72 to 0.89), chronic disease (HR 2.59, 95% CI 2.38 to 2.82), sleep time (HR 0.78, 95% CI 0.72 to 0.85), regular physical activity (HR 0.88, 95% CI 0.81 to 0.95), drinking (HR 1.27 95% CI 1.16 to 1.39), smoking (HR 1.40, 95% CI 1.26 to 1.53), body mass index (HR 1.04, 95% CI 1.03 to 1.05) and depression (HR 1.02, 95% CI 1.01 to 1.03) were associated with multimorbidity. The C-index of nomogram models for derivation and validation sets were 0.70 (95% CI 0.69 to 0.71, p=0.006) and 0.71 (95% CI 0.70 to 0.73, p=0.008), respectively. CONCLUSIONS We have crafted a user-friendly nomogram model for predicting multimorbidity risk among middle-aged and older adults. This model integrates readily available and routinely assessed risk factors, enabling the early identification of high-risk individuals and offering tailored preventive and intervention strategies.
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Affiliation(s)
- Xiao Zheng
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Yimin Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Lei Shi
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Xiaoyan Liang
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Feng Tian
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
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17
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Buse K, Bestman A, Srivastava S, Marten R, Yangchen S, Nambiar D. What Are Healthy Societies? A Thematic Analysis of Relevant Conceptual Frameworks. Int J Health Policy Manag 2023; 12:7450. [PMID: 38618792 PMCID: PMC10699824 DOI: 10.34172/ijhpm.2023.7450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/16/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to healthy societies and to develop a model to help conceptualize future research and policy initiatives. METHODS Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential healthy societies approach. RESULTS The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four "components": people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments-built and natural-and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the 'Anthropocene.' These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic. CONCLUSION The literature offers little critical reflection on why greater progress has not been made, or on the need to organise and resist the prevailing systems which perpetuate ill-health.
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Affiliation(s)
- Kent Buse
- The George Institute for Global Health, Imperial College London, London, UK
| | - Amy Bestman
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Robert Marten
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Sonam Yangchen
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Devaki Nambiar
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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18
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Scheefhals ZTM, de Vries EF, Molenaar JM, Numans ME, Struijs JN. Observational Data for Integrated Maternity Care: Experiences with a Data-Infrastructure for Parents and Children in the Netherlands. Int J Integr Care 2023; 23:20. [PMID: 38145057 PMCID: PMC10742107 DOI: 10.5334/ijic.7012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/30/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Observational data are increasingly seen as a valuable source for integrated care research. Especially since the growing availability of routinely collected data and quasi-experimental methods. The aim of this paper is to describe the potentials and challenges when using observational data for integrated maternity care research, based on our experience from developing and working with the Data-InfrAstructure for ParEnts and childRen (DIAPER). Methods and Results We provide a description of DIAPER, which is a linked data-infrastructure on the individual level based on maternity care claims data, quality and utilization of maternity care and data from municipal registries, covering the life course from preconception to adulthood. We then discuss potentials and practical applications of DIAPER such as to evaluate alternative payment models for integrated maternity care, to set the policy agenda regarding postpartum care, to provide insights into value of care and into provider variation, and to evaluate (policy) interventions designed to promote and support integrated maternity care. This is relevant for several stakeholders: policy makers, payers, providers and clients/patients. Based on experiences with DIAPER, we identify remaining challenges: missing data sources (especially self-reported outcomes), suboptimal quality of data, privacy concerns and potential biases introduced during data linkage, and describe how these challenges were tackled within the applications of DIAPER. Conclusions With DIAPER we demonstrated that using observational data can be of added value for integrated care research, but also that challenges remain. It is essential to keep exploring and developing the possibilities of observational data and continue the discussions in the scientific community. Learning from each other's successes and failures will be critical.
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Affiliation(s)
- Zoë T. M. Scheefhals
- Department of National Health and Healthcare, National Institute for Public Health and the Environment (RIVM), The Netherlands
- Department of Public Health and Primary Care, LUMC Health Campus The Hague, The Netherlands
| | - Eline F. de Vries
- Department of Health Economics and Healthcare, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - Joyce M. Molenaar
- Department of National Health and Healthcare, National Institute for Public Health and the Environment (RIVM), The Netherlands
- Department of Public Health and Primary Care, LUMC Health Campus The Hague, The Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, LUMC Health Campus The Hague, The Netherlands
| | - Jeroen N. Struijs
- Department of National Health and Healthcare, National Institute for Public Health and the Environment (RIVM), The Netherlands
- Department of Public Health and Primary Care, LUMC Health Campus The Hague, The Netherlands
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Saijonkari M, Paronen E, Lakka T, Tolmunen T, Linnosmaa I, Lammintakanen J, Isotalo J, Rekola H, Mäki-Opas T. Promotive and preventive interventions for mental health and well-being in adult populations: a systematic umbrella review. Front Public Health 2023; 11:1201552. [PMID: 37719731 PMCID: PMC10501832 DOI: 10.3389/fpubh.2023.1201552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Mental health disorders are increasing worldwide, leading to significant personal, economic, and social consequences. Mental health promotion and prevention have been the subject of many systematic reviews. Thus, decision makers likely face the problem of going through literature to find and utilize the best available evidence. Therefore, this systematic umbrella review aims to evaluate the effectiveness of interventions for promoting mental health and mental well-being, as well as for the primary prevention of mental health disorders. Methods Literature searches were performed in APA PsycInfo, Medline, and Proquest Social Science databases from January 2000 to December 2021. The search results were screened for eligibility using pre-defined criteria. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool. The key findings of the included reviews were narratively synthesized and reported with an emphasis on reviews achieving higher methodological quality. Results Out of the 240 articles found, 16 systematic reviews and four systematic umbrella reviews were included. The methodological quality of included reviews was low or critically low. Discussion This review suggests that interventions using cognitive-behavioral therapy and those developing resilience, mindfulness, or healthy lifestyles can be effective in the promotion of mental health and well-being in adult populations. Motivational interviewing may reduce alcohol consumption in young adults. Indicated or selective prevention is likely to be cost-effective compared to universal prevention. Parenting interventions and workplace interventions may be cost-effective in terms of promoting mental health. Due to the low methodological quality of the included reviews and substantial heterogeneity among the reported results, the findings from the reviews we summarized should be interpreted with caution. There is a need for further rigorous, high-quality systematic reviews.
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Affiliation(s)
- Maija Saijonkari
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Elsa Paronen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | | | - Ismo Linnosmaa
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- Department of Public Health and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Johanna Lammintakanen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Jenni Isotalo
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Hanna Rekola
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tomi Mäki-Opas
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services Research Center, North Savo Wellbeing Services County, Kuopio, Finland
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20
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Coswosck KHC, Marques-Rocha JL, Moreira JA, Guandalini VR, Lopes-Júnior LC. Quality of life of transgender people under the lens of social determinants of health: a scoping review protocol. BMJ Open 2023; 13:e067575. [PMID: 37524549 PMCID: PMC10391788 DOI: 10.1136/bmjopen-2022-067575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION There is an urgent need for knowledge about the transgender population to inform the development of clinical protocols and training of health professionals on the unique issues affecting this population. Discussing transgender quality of life (QoL) through the lens of social determinants of health (SDOHs) would enable gender-specific health interventions. Here, we aimed to review the evidence on the QoL of transgender people from an SDOH perspective. METHODS AND ANALYSIS A scoping review (ScR) protocol following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews statement and guided by the Joanna Briggs Institute was used. MEDLINE/PubMed, Cochrane Library, Embase, PsycINFO, Web of Science, Scopus and registry sites such as ClinicalTrials.gov and WHO ICTRP will be searched. Additional sources to be searched include ProQuest Dissertations/Theses Global, British Library, Google Scholar and Preprints for Health Sciences-medRXiv. Two independent researchers will carry out the selection, data charting and data synthesis. No date restriction will be applied in this ScR. The search will be restricted to articles published in English, Spanish and Portuguese. The results will be presented in tables, narrative summaries and graphs and will be graded on the type of data presented and the results. The search strategy will be updated in April 2023. The expected completion date of this ScR is July 2023. ETHICS AND DISSEMINATION This ScR protocol does not require ethical approval. Dissemination plans include peer-reviewed publications, conference presentations to be shared with experts in the field, and advisory groups to inform discussions on future research. It is hoped that our findings will be of interest to practitioners, researchers, stakeholders, public and private managers, and the general population concerned with this emerging public health issue. TRIAL REGISTRATION NUMBER osf.io/9ukz6.
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Affiliation(s)
| | - Jose Luiz Marques-Rocha
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Juliana Almeida Moreira
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Valdete Regina Guandalini
- Graduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
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21
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Baughan N, Pell JP, Mackay DF, Clark D, King A, Fleming M. Educational outcomes in childhood cancer survivors: A Scotland-wide record-linkage study of 766,217 schoolchildren. PLoS One 2023; 18:e0286840. [PMID: 37494295 PMCID: PMC10370705 DOI: 10.1371/journal.pone.0286840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/24/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND A cancer diagnosis during childhood greatly disrupts the lives of those affected, causing physical and psychological challenges. We aim to investigate educational outcomes among schoolchildren with a previous cancer diagnosis compared to their peers. METHODS Individual records from four national education databases and three national health databases were linked to construct a cohort of all singleton schoolchildren born in Scotland attending Scottish local-authority schools between 2009-2013. Pupils previously diagnosed with any cancer, haematological cancers, and central nervous system (CNS) cancers, were compared to their unaffected peers with respect to five educational outcomes: special educational need (SEN), absenteeism, school exclusion, academic attainment, and unemployment. Analyses were adjusted for sociodemographic and maternity factors and chronic conditions. RESULTS Of 766,217 pupils, 1,313 (0.17%) had a previous cancer diagnosis. Children with any cancer had increased odds of SEN (OR 3.26, 95% CI 2.86-3.71), absenteeism (IRR 1.82, 95% CI 1.70-1.94), and low attainment (OR 2.15, 95% CI 1.52-3.03) compared to their peers. Similar findings were observed for haematological (SEN OR 2.62, 95% CI 2.12-3.24; absenteeism IRR 2.04, 95% CI 1.85-2.25; low attainment OR 2.17, 95% CI 1.31-3.61) and CNS (SEN OR 6.44, 95% CI 4.91-8.46; absenteeism IRR 1.75, 95% CI 1.51-2.04; low attainment OR 3.33, 95% CI 1.52-7.30) cancers. Lower exclusions were observed among children with any cancer (IRR 0.51, 95% CI 0.31-0.83) and CNS cancer (IRR 0.20, 95% CI 0.06-0.61). No associations were observed with unemployment. CONCLUSIONS This study highlights the wider impacts of childhood cancer on educational outcomes. These children need to be supported, as poor educational outcomes can further impact later health.
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Affiliation(s)
- Nicholas Baughan
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Daniel F Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - David Clark
- Public Health Scotland, Edinburgh, United Kingdom
| | - Albert King
- ScotXed, Scottish Government, Edinburgh, United Kingdom
| | - Michael Fleming
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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22
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Nguyen DT, Donnelly M, Van Hoang M, O'Neill C. The case for individualised public health interventions: Smoking prevalence and inequalities in Northern Ireland 1985-2015. Health Policy 2023; 135:104879. [PMID: 37441920 DOI: 10.1016/j.healthpol.2023.104879] [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: 02/17/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND While smoking prevalence in high income countries has declined over time, socioeconomic inequalities in smoking have widened. This study is one of the few studies to examine the longitudinal pattern of income-related smoking inequalities and only the second using concentration indices in its analysis. METHOD Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups. FINDINGS Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period. CONCLUSION Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.
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Affiliation(s)
- Duyen Thuy Nguyen
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom; Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam.
| | - Michael Donnelly
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| | - Minh Van Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam
| | - Ciaran O'Neill
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
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López-Contreras N, Puig-Barrachina V, Vives A, Olave-Müller P, Gotsens M. Social inequalities in self-perceived health in Chile, does the urban environment matter?: a cross-sectional study. Arch Public Health 2023; 81:128. [PMID: 37420299 DOI: 10.1186/s13690-023-01136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/18/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND The health of a population is determined by urban factors such as the physical, social and safety environment, which can be modified by urban regeneration policies. The aim of this study was to analyze the associations of elements of the social, physical and safety environment of the neighborhood in the urban context with self-perceived health (SPH), according to axes of inequality, such as gender and educational level in Chile in 2016. METHODS Cross-sectional study using a nationally representative population-based survey of Chile. We used data from the 2016 National Survey of Quality of Life and Health. Poor SPH in the urban population older than 25 years was analyzed in relation to social, physical and safety environment variables. Poisson multilevel regression models were estimated to obtain prevalence ratios (PR) and their respective 95% confidence intervals (95%CI). All analyses were stratified by sex and educational level. RESULTS SPH was worse in women than in men, especially in those with a lower education level. Poor SPH was associated with lack of support networks (PR = 1.4; 95%CI = 1.1-1.7), non-participation in social organizations (PR = 1.3; 95%CI = 1.1-1.6) and perceived problems with the quality of public space (PR = 1.3; 95%CI = 1.2-1.5) in women with a medium-high educational level and with a feeling of not belonging to the neighborhood (PR = 1.5; 95%CI = 1.2-1.8) and the perception of pollution problems (PR = 1.2; 95%CI = 1.0-1.4) in women with a low educational level. A feeling of unsafety was associated with both educational levels (PR = 1.3; 95%CI = 1.0-1.5). Poor SPH was associated with the feeling of not belonging (PR = 1.7; 95%CI = 1.2-2.5), and unsafety (PR = 2.1; 95%CI = 1.8-2.4) in men with a medium-high educational level, while there were fewer associations in men with a lower education level. CONCLUSIONS Urban interventions are recommended to improve the health of the resident population and should take into account axes of inequality.
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Affiliation(s)
- Natalia López-Contreras
- Universitat Pompeu Fabra, Barcelona, Spain.
- Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Universidad de La Frontera, Temuco, Chile.
| | - Vanessa Puig-Barrachina
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Alejandra Vives
- Departamento de Salud Pública, Escuela de Medicina, & Centro de Desarrollo Urbano Sustentable, CEDEUS, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Mercè Gotsens
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
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McCullogh E, Macpherson A, Hagel B, Giles A, Fuselli P, Pike I, Torres J, Richmond SA. Road safety, health equity, and the built environment: perspectives of transport and injury prevention professionals in five Canadian municipalities. BMC Public Health 2023; 23:1211. [PMID: 37349745 PMCID: PMC10286376 DOI: 10.1186/s12889-023-16115-7] [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: 11/23/2022] [Accepted: 06/13/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Concerns regarding health equity (HE) and the built environment (BE) are well established in the Canadian urban context. Transport and injury prevention professionals across sectors, such as transportation and public health, are involved in designing and implementing BE interventions that enhance the safety of vulnerable road users (VRUs). Results from a larger study examining barriers and facilitators to BE change are used to illustrate how transport and injury prevention professionals perceive HE concerns in their work in five Canadian municipalities. Broadening our understanding of how HE influences the professional BE change context is crucial when advocating for modifications that enhance the safety of equity-deserving VRUs and groups who experience marginalization. METHODS Interview and focus group data were gathered from transport and injury prevention professionals working in policy/decision-making, transport, police services, public health, non-profit organizations, schools/school boards, community associations, and private sectors across five Canadian urban municipalities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. Data were analyzed using thematic analysis (TA) to illustrate how equity considerations were perceived and applied in participants' BE change work. RESULTS The results of this study illustrate transport and injury prevention professionals' awareness of the varying needs of VRUs, as well as the inadequacies of current BEs in the Canadian urban context and consultation processes utilized to guide change. Participants emphasized the importance of equitable community consultation strategies, as well as specific BE changes that would support the health and safety of VRUs. Overall, the results highlight how HE concerns inform transport and injury prevention professionals' BE change work in the Canadian urban context. CONCLUSION For professionals working in urban Canadian transport and injury prevention sectors HE concerns influenced their perspectives of the BE and BE change. These results illustrate a growing need for HE to guide BE change work and consultation processes. Further, these results contribute to ongoing efforts in the Canadian urban context to ensure that HE is at the forefront of BE policy change and decision-making, while promoting existing strategies to ensure that the BE, and related decision-making processes, are accessible and informed by a HE lens.
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Affiliation(s)
| | | | | | | | | | - Ian Pike
- University of British Columbia, Vancouver, Canada
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25
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Cheddadi R, Khandekar NN, Yeramilli V, Martin C. The impact of maternal stress on the development of necrotizing enterocolitis: A comprehensive review. Semin Pediatr Surg 2023:151324. [PMID: 37316382 DOI: 10.1016/j.sempedsurg.2023.151324] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Necrotizing Enterocolitis (NEC) is a devastating intestinal inflammatory disease with significant morbidity and mortality. Numerous predictors have been implicated in the development of NEC, with a relatively less emphasis on maternal factors. Pregnancy drives women into a new stage of life that increases their susceptibility to biological and psychological stress. Additionally, maternal stress during pregnancy has been linked to various complications that can negatively impact both the mother and the developing fetus. These detrimental effects are facilitated by various systemic modifications. Similarly, there is evidence from animal studies that suggest a relationship between maternal stress and the occurrence of NEC due to the alterations observed in neonates. In this review, we will (1) discuss the physiological and psychological burden of maternal stress and how it can be linked to NEC, (2) summarize various predictors and risk factors of NEC, and (3) discuss the most widely utilized animal models for assessing the effects of prenatal stress on offspring.
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Affiliation(s)
- Riadh Cheddadi
- Department of Surgery, Division of Pediatric Surgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave. S., Lowder Building Suite 300, Birmingham, AL 35233, United States
| | | | - Venkata Yeramilli
- Department of Surgery, Division of Pediatric Surgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave. S., Lowder Building Suite 300, Birmingham, AL 35233, United States
| | - Colin Martin
- Department of Surgery, Division of Pediatric Surgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave. S., Lowder Building Suite 300, Birmingham, AL 35233, United States.
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Intergenerational educational trajectories and inequalities in longevity: A population-based study of adults born before 1965 in 14 European countries. SSM Popul Health 2023; 22:101367. [PMID: 36873264 PMCID: PMC9974424 DOI: 10.1016/j.ssmph.2023.101367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/03/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
Background While educational gradients in longevity have been observed consistently in adult Europeans, these inequalities have been understudied within the context of family- and country-level influences. We utilized population-based multi-generational multi-country data to assess the role (1) of parental and individual education in shaping intergenerational inequalities in longevity, and (2) of country-level social net expenditure in mitigating these inequalities. Methods We analyzed data from 52,271 adults born before 1965 who participated in the Survey of Health, Ageing and Retirement in Europe, comprising 14 countries. Mortality from all causes (outcome) was ascertained between 2013 and 2020. Educational trajectories (exposure) were High-High (reference), Low-High, High-Low, and Low-Low, corresponding to the sequence of parental-individual educational attainment. We quantified inequalities as years of life lost (YLL) between the ages of 50 and 90 estimated via differences in the area under standardized survival curves. We assessed the association between country-level social net expenditure and YLL via meta-regression. Results Inequalities in longevity due to educational trajectories were associated with low individual education regardless of parental education. Compared to High-High, having High-Low and Low-Low led to 2.2 (95% confidence intervals: 1.0 to 3.5) and 2.9 (2.2 to 3.6) YLL, while YLL for Low-High were 0.4 (-0.2 to 0.9). A 1% increase in social net expenditure led to an increase of 0.01 (-0.3 to 0.3) YLL for Low-High, 0.007 (-0.1 to 0.2) YLL for High-Low, and a decrease of 0.02 (-0.1 to 0.2) YLL for Low-Low. Conclusion In European countries, individual education could be the main driver of inequalities in longevity for adults older than 50 years of age and born before 1965. Further, higher social expenditure is not associated with smaller educational inequalities in longevity.
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Kolossváry E, Farkas K, Karahan O, Golledge J, Schernthaner GH, Karplus T, Bernardo JJ, Marschang S, Abola MT, Heinzmann M, Edmonds M, Catalano M. The importance of socio-economic determinants of health in the care of patients with peripheral artery disease: A narrative review from VAS. Vasc Med 2023; 28:241-253. [PMID: 37154387 PMCID: PMC10265288 DOI: 10.1177/1358863x231169316] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Socio-economic determinants of health (SDoH) include various nonmedical factors in the socio-economic sphere with a potentially significant impact on health outcomes. Their effects manifest through several mediators/moderators (behavioral characteristics, physical environment, psychosocial circumstances, access to care, and biological factors). Various critical covariates (age, gender/sex, race/ethnicity, culture/acculturation, and disability status) also interact. Analyzing the effects of these factors is challenging due to their enormous complexity. Although the significance of SDoH for cardiovascular diseases is well documented, research regarding their impact on peripheral artery disease (PAD) occurrence and care is less well documented. This narrative review explores to what extent SDoH are multifaceted in PAD and how they are associated with its occurrence and care. Additionally, methodological issues that may hamper this effort are addressed. Finally, the most important question, whether this association may contribute to reasonable interventions aimed at SDoH, is analyzed. This endeavor requires attention to the social context, a whole systems approach, multilevel-thinking, and a broader alliance that reaches out to more stakeholders outside the medical sphere. More research is needed to justify the power in this concept to improve PAD-related outcomes like lower extremity amputations. At the present time, some evidence, reasonable consideration, and intuitive reasoning support the implementation of various interventions in SDoH in this field.
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Affiliation(s)
- Endre Kolossváry
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Angiology, St Imre University Teaching Hospital, Budapest, Hungary
| | - Katalin Farkas
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Angiology, St Imre University Teaching Hospital, Budapest, Hungary
| | - Oguz Karahan
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Cardiovascular Surgery, Medical School of Alaaddin Keykubat University, Alanya/Antalya, Diyarbakir, Turkey
| | - Jonathan Golledge
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- James Cook University & Townsville University Hospital, Townsville, QLD, Australia
| | - Gerit-Holger Schernthaner
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Thomas Karplus
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Vascular Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Jonathan James Bernardo
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Vascular Medicine, St Luke’s Medical Center, Quezon, NCR, Philippines
| | - Sascha Marschang
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department Managing Committee, VAS-European Independent Foundation in Angiology/Vascular Medicine, Bruxelles, Belgium
| | - Maria Teresa Abola
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- University of the Philippines College of Medicine–Philippine, Philippine Heart Center, Quezon, Philippines
| | - Monica Heinzmann
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Angiology Unit, Allende Sanatorium, Nueva, Cordóba, Argentina
| | - Michael Edmonds
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- King’s College Hospital, Diabetic Foot Clinic, London, UK
| | - Mariella Catalano
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences L Sacco Hospital, Inter-University Research Center on Vascular Disease, University of Milan, Milan, Italy
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McHugh N, Baker R, Bambra C. Policy actors' perceptions of public participation to tackle health inequalities in Scotland: a paradox? Int J Equity Health 2023; 22:57. [PMID: 36997962 PMCID: PMC10062251 DOI: 10.1186/s12939-023-01869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Health inequalities are persistent and widening with transformative policy change needed. Radically shifting policy to tackle upstream causes of inequalities is likely to require public participation to provide a mandate, evidence and to address questions of co-design, implementation and acceptability. The aim of this paper is to explore perceptions among policy actors on why and how the public should be involved in policymaking for health inequalities. METHODS In 2019-2020, we conducted exploratory, in-depth, semi-structured interviews with 21 Scottish policy actors from a range of public sector bodies and agencies and third sector organisations that work in, or across, health and non-health sectors. Data were analysed thematically and used to examine implications for the development of participatory policymaking. RESULTS Policy actors viewed public participation in policymaking as intrinsically valuable for democratic reasons, but the main, and more challenging, concern was with how it could affect positive policy change. Participation was seen as instrumental in two overlapping ways: as evidence to improve policies to tackle health inequalities and to achieve public acceptance for implementing more transformative policies. However, our analysis suggests a paradox: whilst policy actors place importance on the instrumental value of public participation, they simultaneously believe the public hold views about health inequalities that would prevent transformative change. Finally, despite broad agreement on the need to improve public participation in policy development, policy actors were uncertain about how to make the necessary changes due to conceptual, methodological and practical challenges. CONCLUSIONS Policy actors believe in the importance of public participation in policy to address health inequalities for intrinsic and instrumental reasons. Yet, there is an evident tension between seeing public participation as a route to upstream policies and a belief that public views might be misinformed, individualistic, short-term or self-interested and doubts about how to make public participation meaningful. We lack good insight into what the public think about policy solutions to health inequalities. We propose that research needs to shift from describing the problem to focusing more on potential solutions and outline a potential way forward to undertake effective public participation to tackle health inequalities.
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Affiliation(s)
- Neil McHugh
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, Scotland, UK.
| | - Rachel Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle, England, UK
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Nguyen V, Ferdinand KC. Primordial prevention: Reducing consumption of sugar-sweetened beverages in racial/ethnic populations. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 27:100278. [PMID: 38511089 PMCID: PMC10946006 DOI: 10.1016/j.ahjo.2023.100278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/19/2023] [Accepted: 02/19/2023] [Indexed: 03/22/2024]
Abstract
Beyond pharmacotherapy in adulthood, primordial prevention in United States (U.S.) children and adolescents is needed to avoid the upcoming tsunami of cardiometabolic and cardiovascular disease (CVD). Healthcare disparities were unmasked by the disparate morbidity and mortality of COVID-19 in racial/ethnic populations, especially in persons with obesity, diabetes, and CVD. One potential successful strategic improvement of childhood cardiovascular health is to reduce sugar consumption in early life as CVD is the number one cause of death in patients with Type 2 diabetes (T2D). Furthermore, cardiologists treat more patients with T2D than endocrinologists. This commentary challenges cardiovascular specialists and other clinicians to address the increasing burden of cardiometabolic and CVD in adults, especially in racial/ethnic populations, by supporting primordial prevention in childhood.
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Affiliation(s)
- Vi Nguyen
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States of America
| | - Keith C. Ferdinand
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States of America
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Couper I, Jaques K, Reid A, Harris P. Placemaking and infrastructure through the lens of levelling up for health equity: A scoping review. Health Place 2023; 80:102975. [PMID: 36774810 DOI: 10.1016/j.healthplace.2023.102975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 02/12/2023]
Abstract
The planning and delivery of infrastructure influences how places create health equity. The scholarship on place and health has recently been developed into 'levelling up' principles for equity focussed policy and planning. We conducted a scoping review of the literature on infrastructure through urban regeneration and placemaking interventions. We interrogated the 15 final selected articles for their use of one or more of the five 'levelling' up principles. No article encompassed all five principles. It was most common to find two or three principles in action. Reviewing the articles against the principles allows a deeper explanation of how infrastructure planning practice can positively impact on health equity. We conclude that applying all the principles in standard infrastructure planning practice has great potential for creating places that are positive for health equity.
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Affiliation(s)
- Ines Couper
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Karla Jaques
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Andrew Reid
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Patrick Harris
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia.
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Tsakos G, Watt RG, Guarnizo-Herreño CC. Reflections on oral health inequalities: Theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol 2023; 51:17-27. [PMID: 36744970 DOI: 10.1111/cdoe.12830] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 02/07/2023]
Abstract
Health inequalities, including those in oral health, are a critical problem of social injustice worldwide, while the COVID-19 pandemic has magnified previously existing inequalities and created new ones. This commentary offers a summary of the main frameworks used in the literature of oral health inequalities, reviews the evidence and discusses the potential role of different pathways/mechanisms to explain inequalities. Research in this area needs now to move from documenting oral health inequalities, towards explaining them, understanding the complex mechanisms underlying their production and reproduction and looking at interventions to tackle them. In particular, the importance of interdisciplinary theory-driven research, intersectionality frameworks and the use of the best available analytical methodologies including qualitative research is discussed. Further research on understanding the role of structural determinants on creating and shaping inequalities in oral health is needed, such as a focus on political economy analysis. The co-design of interventions to reduce oral health inequalities is an area of priority and can highlight the critical role of context and inform decision-making. The evaluation of such interventions needs to consider their public health impact and employ the wider range of methodological tools available rather than focus entirely on the traditional approach, based primarily on randomized controlled trials. Civil society engagement and various advocacy strategies are also necessary to make progress in the field.
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Affiliation(s)
- Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Muacevic A, Adler JR. The Role of Social Determinants of Health in Promoting Health Equality: A Narrative Review. Cureus 2023; 15:e33425. [PMID: 36751221 PMCID: PMC9899154 DOI: 10.7759/cureus.33425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
Significant health disparities exist locally and even throughout the nation. Dipping health inequalities necessitates a focus on the inadequate spread of power, money, and resources, as well as the situations of daily living, which may be addressed through social determinants of health. This study aimed to review the role of health-related social factors in overcoming health disparities. We conducted a search of English-language literature, including studies published on health and health equalities or inequalities. Most reports show that social determinants of health have a higher effect on health. The elimination process of these health inequities occurs through well-designed economic and social policies. Every aspect of social determinants influences the health aspects of people; hence, some areas to focus on include employment, education, socioeconomic status, social support networks, health policies, and healthcare access. Launching interventions to reduce health disparities can help improve the community's health and health equality.
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Cardo Miota A, Valls Pérez B, Gil García E, Hernán García M. [Proposals for the community orientation of primary health care: to identify key agents for training]. GACETA SANITARIA 2022; 37:102269. [PMID: 36399988 DOI: 10.1016/j.gaceta.2022.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify the strengths available for the community orientation of primary health care (PHC) in the context of the evaluation of the piloting of a training program in Community Health for Resident Internal Specialists in Andalusia (Spain). METHOD We will conduct a qualitative, phenomenologically-oriented, explanatory research in which the opinion of the participants is analyzed. Sixty-seven professionals from six PHC Districts of Andalusia which were part of the training program called Project to Support the Revitalization of Primary Care Assets for Community Health (PARAC) were interviewed. RESULTS There is consensus in giving training a key weight in the community orientation of PHC. For this reason, those agents linked to training are identified as assets: general practice (GP) trainers, young professionals in training who bring updated perspectives and approaches to accredited PHC training centers, whose professionals must respond to the needs of their GP trainees, the multi-professional teaching units responsible for the GP trainees training and a medium and long-term health system thinking along with structures that coordinate and support the community work at the PHC centers. CONCLUSIONS The community orientation of PHC is an objective that requires the participation of all levels of the health system. Knowing its assets and working with them can contribute to provide proposals to advance towards a community-oriented PHC system.
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Johnson WR, Rega SA, Feurer ID, Karp SJ. Associations between social determinants of health and abdominal solid organ transplant wait-lists in the United States. Clin Transplant 2022; 36:e14784. [PMID: 35894259 DOI: 10.1111/ctr.14784] [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: 09/21/2021] [Revised: 07/07/2022] [Accepted: 07/17/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Societal factors that influence wait-listing for transplantation are complex and poorly understood. Social determinants of health (SDOH) affect rates of and outcomes after transplantation. METHODS This cross-sectional study investigated the impact of SDOH on additions to state-level, 2017-2018 kidney and liver wait-lists. Principal components analysis, starting with 127 variables among 3142 counties, was used to derive novel, comprehensive state-level composites, designated (1) health/economics and (2) community capital/urbanicity. Stepwise multivariate linear regression with backwards elimination (n = 51; 50 states and DC) tested the effects of these composites, Medicaid expansion, and center density on adult disease burden-adjusted wait-list additions. RESULTS SDOH related to increased community capital/urbanicity were independently associated with wait-listing (starting models: B = .40, P = .010 Kidney; B = .36, P = .038 Liver) (final models: B = .31, P = .027 Kidney, B = .34, P = .015 Liver). In contrast and surprisingly, no other covariates were associated with wait-listing (P ≥ .122). CONCLUSIONS These results suggest that deficits in community resources are important contributors to disparities in wait-list access. Our composite SDOH metrics may help identify at-risk communities, which can be the focus of local and national policy initiatives to improve access to organ transplantation.
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Affiliation(s)
- Wali R Johnson
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott A Rega
- Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Irene D Feurer
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Seth J Karp
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Kondo MC, McIntire RK, Bilal U, Schinasi LH. Reduction in socioeconomic inequalities in self-reported mental health conditions with increasing greenspace exposure. Health Place 2022; 78:102908. [PMID: 36193582 PMCID: PMC11151689 DOI: 10.1016/j.healthplace.2022.102908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, 100 North 20th Street, Suite 205, Philadelphia, PA, 19103, USA.
| | - Russell K McIntire
- Jefferson College of Population Health, Thomas Jefferson University, 901 Walnut St., 10th Floor, Philadelphia, PA, USA.
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Leah H Schinasi
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
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McHugh N. Eliciting public values on health inequalities: missing evidence for policy windows? EVIDENCE & POLICY : A JOURNAL OF RESEARCH, DEBATE AND PRACTICE 2022; 18:733-745. [PMID: 36865399 PMCID: PMC7614257 DOI: 10.1332/174426421x16286783870175] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND There is a widening health divide in the UK despite health inequalities being a long-standing subject of policy and research. New types of evidence are needed. KEY POINTS FOR DISCUSSION Knowledge of public values for non-health policies and their associated (non-)health outcomes is currently missing from decision-making processes. Eliciting public values using stated preference techniques can provide insights on what the general public would be willing to give-up for different distributions of (non-)health outcomes and the policies that can achieve them. To understand the role this evidence could have in decision-making processes, Kingdon's multiple streams analysis (MSA) is used as a policy lens to explore how evidence of public values could affect policy processes for ways to tackle health inequalities. CONCLUSIONS AND IMPLICATIONS This paper outlines how evidence of public values could be elicited through the use of stated preference techniques and suggests this could facilitate the creation of policy windows for tackling health inequalities. Additionally, Kingdon's MSA helps make explicit six cross-cutting issues when generating this new form of evidence. This suggests the need to explore reasons for public values and how decision-makers would use such evidence. With an awareness of these issues, evidence on public values has the potential to support upstream policies to tackle health inequalities.
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Affiliation(s)
- Neil McHugh
- Glasgow Caledonian University, United Kingdom
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Yun YH, Yoon H, Park E. Association of health asset value with subjective well-being, depression, health management strategy and habits in South Korea. Sci Rep 2022; 12:18093. [PMID: 36302839 PMCID: PMC9610329 DOI: 10.1038/s41598-022-23099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/25/2022] [Indexed: 12/30/2022] Open
Abstract
This study aims to measure the monetary value of health asset based on the self-reported health status and rate of health asset value (HAV), and to evaluate its application to the subjective well-being and health competency of a representative sample of South Korea. From March to April 2021, 1000 participants were randomly sampled nationwide in South Korea and administered questionnaires including self-reported rate of health asset value and health status, the Subjective Well-Being Index (SWBI), Patient Health Questionnaire-9 (PHQ-9), Smart Management Strategy for Health Assessment Tool (SAT), and 11 health habits. In multiple stepwise logistic regression model adjusted for basic demographic variables (age, sex, region, monthly income level, and comorbidity), current HAV was independently associated positively with SWBI (adjusted odds ratio [aOR], 4.32; confidence interval [CI] 2.27-8.23) and negatively with PHQ-9 (aOR 0.68; 95% CI 0.51-0.90). Core (aOR 1.66; CI 1.25-2.19), Preparation (aOR 1.79; CI 1.24-2.59), and Implementation Strategy scores of SAT (aOR 1.79; CI 1.26-2.55) were independently associated positively with current HAV. All 11 health habits were independently associated positively with current HAV (aOR range from 1.80 to 3.19). The HAV approach offers a new monetary value of health that can be used in making individual or political decisions of improving health or reducing health inequity.
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Affiliation(s)
- Young Ho Yun
- grid.31501.360000 0004 0470 5905Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Family Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799 Korea
| | - Hyejeong Yoon
- grid.31501.360000 0004 0470 5905Seoul National University College of Liberal Studies, Seoul, Korea
| | - Eunwoo Park
- grid.31501.360000 0004 0470 5905Seoul National University School of Law, Seoul, Korea
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Koffman J, Bajwah S, Davies JM, Hussain JA. Researching minoritised communities in palliative care: An agenda for change. Palliat Med 2022; 37:530-542. [PMID: 36271636 DOI: 10.1177/02692163221132091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and moral issues. Without the critical reflection of methods of study and reporting of findings, researchers may inadvertently compromise their contribution to reducing injustices and perpetuating racism. AIM To examine key evidence of the place of minoritised communities in palliative care research to devise recommendations that improve the precision and rigour of research and reporting of findings. METHODS Narrative review of articles identified from PubMed, CINAHL and Google Scholar for 10 years augmented with supplementary searches. RESULTS We identified and appraised 109 relevant articles. Four main themes were identified (i) Lack of precision when working with a difference; (ii) 'black box epidemiology' and its presence in palliative care research; (iii) the inclusion of minoritised communities in palliative care research; and (iv) the potential to cause harm. All stymie opportunities to 'level up' health experiences and outcomes across the palliative care spectrum. CONCLUSIONS Based on the findings of this review palliative care research must reflect on and justify the classification of minoritised communities, explore and understand intersectionality, optimise data quality, decolonise research teams and methods, and focus on reducing inequities to level up end-of-life care experiences and outcomes. Palliative care research must be forthright in explicitly indentifying instances of structural and systemic racism in palliative care research and engaging in non-judgemental debate on changes required.
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Affiliation(s)
- Jonathan Koffman
- University of Hull, Hull York Medical School, Wolfson Palliative Care Research Centre, Hull, UK
| | - Sabrina Bajwah
- King's College London, Cicely Saunders Institute, London, UK
| | - Joanna M Davies
- King's College London, Cicely Saunders Institute, London, UK
| | - Jamilla Akhter Hussain
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
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Albani V, Welsh CE, Brown H, Matthews FE, Bambra C. Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England. Soc Sci Med 2022; 311:115319. [PMID: 36088725 PMCID: PMC9441468 DOI: 10.1016/j.socscimed.2022.115319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/31/2022] [Accepted: 08/25/2022] [Indexed: 12/02/2022]
Abstract
One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.
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Affiliation(s)
- Viviana Albani
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Claire E Welsh
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Heather Brown
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK.
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Jenkins R, Vamos EP, Mason KE, Daras K, Taylor-Robinson D, Bambra C, Millett C, Laverty AA. Local area public sector spending and nutritional anaemia hospital admissions in England: a longitudinal ecological study. BMJ Open 2022; 12:e059739. [PMID: 36175095 PMCID: PMC9528630 DOI: 10.1136/bmjopen-2021-059739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Reductions in local government spending may have impacts on diets and health which increase the risk of hospital admissions for nutritional anaemias. Mechanisms include potential impacts of changes to local authority (LA) services (eg, housing services) on personal resources and food access, availability and provision. We therefore investigated the association between changes in LA spending and nutritional anaemia-related hospital admissions. Specifically, we address whether greater cuts to LA spending were linked to increased hospital admissions for nutritional anaemias. DESIGN Longitudinal analysis of LA panel data using Poisson fixed effects regression models. SETTING 312 LAs in England (2005-2018). MAIN EXPOSURE Total LA service expenditure per capita per year. MAIN OUTCOME Principal and total nutritional anaemia hospital admissions, for all ages and stratified by age (0-14, 15-64, 65+ years). RESULTS LA service expenditure increased by 9% between 2005 and 2009 then decreased by 20% between 2010 and 2018. Total nutritional anaemia hospital admissions increased between 2005 and 2018 from 173 to 633 admissions per 100 000 population. A £100 higher LA service spending was associated with a 1.9% decrease in total nutritional anaemia hospital admissions (adjusted incidence rate ratio (aIRR): 0.98, 95% CI: 0.96 to 0.99). When stratified by age, this was seen only in adults. A £100 higher LA service spending was associated with a 2.6% decrease in total nutritional anaemia hospital admissions in the most deprived LAs (aIRR: 0.97, 95% CI: 0.95 to 1.0). CONCLUSION Increased LA spending was associated with reduced hospital admissions for nutritional anaemia. Austerity-related reductions had the opposite effect, increasing admissions, with greater impacts in more deprived areas. This adds further evidence to the potential negative impacts of austerity policies on health and health inequalities. Among other impacts, re-investing in LA services may prevent hospital admissions associated with nutritional anaemias.
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Affiliation(s)
- Rosemary Jenkins
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building; St Dunstan's Road, London W6 8RP, UK
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building; St Dunstan's Road, London W6 8RP, UK
| | - Kate E Mason
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool; Waterhouse Building Block F, 2nd Floor, Liverpool L69 3BX, UK
| | - Konstantinos Daras
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool; Waterhouse Building Block F, 2nd Floor, Liverpool L69 3BX, UK
| | - David Taylor-Robinson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool; Waterhouse Building Block F, 2nd Floor, Liverpool L69 3BX, UK
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, NE1 4LE, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building; St Dunstan's Road, London W6 8RP, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building; St Dunstan's Road, London W6 8RP, UK
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Davey F, McGowan V, Birch J, Kuhn I, Lahiri A, Gkiouleka A, Arora A, Sowden S, Bambra C, Ford J. Levelling up health: A practical, evidence-based framework for reducing health inequalities. PUBLIC HEALTH IN PRACTICE 2022; 4:100322. [PMID: 36164497 PMCID: PMC9494865 DOI: 10.1016/j.puhip.2022.100322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022] Open
Abstract
There are substantial inequalities in health across society which have been exacerbated by the COVID-19 pandemic. The UK government have committed to a programme of levelling-up to address geographical inequalities. Here we undertake rapid review of the evidence base on interventions to reduce such health inequalities and developed a practical, evidence-based framework to 'level up' health across the country. This paper overviews a rapid review undertaken to develop a framework of guiding principles to guide policy. To that end and based on an initial theory, we searched one electrotonic database (MEDLINE) from 2007 to July 2021 to identify published umbrella reviews and undertook an internet search to identify relevant systematic reviews, primary studies, and grey literature. Titles and abstracts were screened according to the eligibility criteria. Key themes were extracted from the included studies and synthesised into an overarching framework of guiding principles in consultation with an expert panel. Included studies were cross checked with the initial theoretical domains and further searching undertaken to fill any gaps. We identified 16 published umbrella reviews (covering 667 individual studies), 19 grey literature publications, and 15 key systematic reviews or primary studies. Based on these studies, we develop a framework applicable at national, regional and local level which consisted of five principles - 1) healthy-by-default and easy to use initiatives; 2) long-term, multi-sector action; 3) locally designed focus; 4) targeting disadvantaged communities; and 5) matching of resources to need. Decision-makers working on policies to level up health should be guided by these five principles.
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Affiliation(s)
- Fiona Davey
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Vic McGowan
- NIHR School for Public Health Research, United Kingdom
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, United Kingdom
- NIHR Applied Research Collaboration North East and North Cumbria, United Kingdom
| | - Jack Birch
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Isla Kuhn
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Anwesha Lahiri
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Anna Gkiouleka
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Ananya Arora
- Cambridge Public Health, University of Cambridge, United Kingdom
| | - Sarah Sowden
- NIHR School for Public Health Research, United Kingdom
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, United Kingdom
- NIHR Applied Research Collaboration North East and North Cumbria, United Kingdom
| | - Clare Bambra
- NIHR School for Public Health Research, United Kingdom
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, United Kingdom
- NIHR Applied Research Collaboration North East and North Cumbria, United Kingdom
| | - John Ford
- Cambridge Public Health, University of Cambridge, United Kingdom
- NIHR School for Public Health Research, United Kingdom
- NIHR Applied Research Collaboration East of England, United Kingdom
- Corresponding author. Cambridge Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, United Kingdom.
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Dyar OJ, Haglund BJA, Melder C, Skillington T, Kristenson M, Sarkadi A. Rainbows over the world's public health: determinants of health models in the past, present, and future. Scand J Public Health 2022; 50:1047-1058. [PMID: 36076363 PMCID: PMC9578089 DOI: 10.1177/14034948221113147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The need to visualise the complexity of the determinants of population health and their interactions inspired the development of the rainbow model. In this commentary we chronicle how variations of this model have emerged, including the initial models of Haglund and Svanström (1982), Dahlgren and Whitehead (1991), and the Östgöta model (2014), and we illustrate how these models have been influential in both public health and beyond. All these models have strong Nordic connections and are thus an important Nordic contribution to public health. Further, these models have underpinned and facilitated other examples of Nordic leadership in public health, including practical efforts to address health inequalities and design new health policy approaches. Apart from documenting the emergence of rainbow models and their wide range of contemporary uses, we examine a range of criticisms levelled at these models – including limitations in methodological development and in scope. We propose the time is ripe for an updated generic determinants of health model, one that elucidates and preserves the core value in older models, while recognising the developments that have occurred over the past decades in our understanding of the determinants of health. We conclude with an example of a generic model that fulfills the general purposes of a determinants of health model while maintaining the necessary scope for further adjustments to be made in the future, as well as adjustments to location or context-specific purposes, in education, research, health promotion and beyond.
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Affiliation(s)
- Oliver J Dyar
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Bo J A Haglund
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Melder
- Existential Public Health and Psychology of Religion, University College Stockholm, Bromma, Sweden
| | - Tracey Skillington
- Department of Sociology and Criminology, University College Cork, Cork, Ireland
| | | | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Chaput JP, Gariépy G, Pendharkar SR, Ayas NT, Samuels C, Vallières A, Davidson JR, Morin CM, Simonelli G, Bourguinat C, Gruber R, Petit D, Narang I, Viau V, Carrier J. National strategy on the integration of sleep and circadian rhythms into public health research and policies: Report from the Canadian Sleep and Circadian Network. Sleep Health 2022; 8:551-563. [PMID: 35963823 DOI: 10.1016/j.sleh.2022.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/16/2022] [Accepted: 06/09/2022] [Indexed: 10/15/2022]
Abstract
Scientists in sleep and circadian rhythms, public health experts, healthcare providers, partners, and stakeholders convened in 2020 for a 2-day meeting organized by the Canadian Sleep and Circadian Network to develop a national strategy for the integration of sleep and circadian rhythms into public health and policies in Canada. The objective of this paper is to present the national strategy that emerged from this meeting of 60 participants from across Canada. The meeting focused on 4 key target priorities: (1) atypical working schedules, (2) sleep and circadian rhythms of children and adolescents, (3) insomnia, and (4) impact of sleep apnea on health. Following constructive discussions over 2 days, it was decided that the following 4 strategic objectives should be prioritized to accelerate the integration of sleep and circadian rhythms into public health policies in Canada: (1) Increase public health sleep and circadian rhythm research, (2) Increase public health education and knowledge mobilization on sleep, (3) Inform and support public health sleep interventions and policies, and (4) Promote sleep health training. The participants recommended that research and public health efforts should address the needs along the continuum of sleep health. The committee noted that strategies and interventions could differ across contexts, settings, sectors, and jurisdictions. The national strategy also identified high-priority research questions in public health and recommended mechanisms to build research capacity, providing a path forward for the integration of sleep and circadian rhythms into public health research and policies.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Gariépy
- École de santé publique, Département de médecine sociale et préventive, Université de Montréal, Montreal, Québec, Canada; Institut universitaire de santé mentale de Montréal, Montreal, Québec, Canada
| | - Sachin R Pendharkar
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Najib T Ayas
- Department of Medicine, Respiratory and Critical Care Division, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Annie Vallières
- École de Psychologie, Université Laval, Quebec City, Québec, Canada
| | - Judith R Davidson
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Charles M Morin
- École de Psychologie, Université Laval, Quebec City, Québec, Canada
| | - Guido Simonelli
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'Ile-de-Montréal, Montréal, Québec, Canada
| | | | - Reut Gruber
- Attention, Behavior and Sleep Laboratory, Douglas Hospital Research Centre, Montreal, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'Ile-de-Montréal, Montréal, Québec, Canada; Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada
| | - Indra Narang
- Translational Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | - Julie Carrier
- Département de psychologie, Université de Montréal, Montreal, Québec, Canada; Centre d'étude avancée en médecine du sommeil, Hôpital du Sacré-Cœur de Montréal, Montreal, Québec, Canada.
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Wilf-Miron R, Avni S, Valinsky L, Myers V, Ziv A, Peretz G, Luxenburg O, Saban M, Feder-Bubis P. Developing a National Set of Health Equity Indicators Using a Consensus Building Process. Int J Health Policy Manag 2022; 11:1522-1532. [PMID: 34273926 PMCID: PMC9808363 DOI: 10.34172/ijhpm.2021.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/30/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Considerable health inequities documented in Israel between communities, populations and regions, undermine the rights of all citizens to optimal health. The first step towards health equity is agreement on a set of national indicators, reflecting equity in healthcare provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We describe the process of reaching a consensus on a defined set of national equity indicators. METHODS The study was conducted between January 2019 and June 2020, in a multistage design: (A) Identifying appropriate and available inequity measures via interviews with stakeholders. (B) Agreement on the screening criteria (public health importance; gap characteristics; potential for change; public interest) and relative weighting. (C) Constructing the consultation framework as an online, 3-round Delphi technique, with a range of experts recruited from the health, welfare and education sectors. RESULTS Participants were of diverse age, gender, geographic location, religion and ethnicity, and came from academia, healthcare provision, government ministries and patient representative groups. Thirty measures of inequity, presented to participants, represented the following domains: Health promotion (11 indicators), acute and chronic morbidity (11), life expectancy and mortality (2), health infrastructures and affordability of care (4), education and employment (2). Of the 77 individuals contacted, 75 (97%) expressed willingness to participate, and 55 (73%) completed all three scoring rounds. The leading ten indicators were: Diabetes care, childhood obesity, adult obesity, distribution of healthcare personnel, fatal childhood injuries, cigarette smoking, infant mortality, ability to afford care, access to psychotherapy and distribution of hospital beds. Agreement among raters, measured as intra-class correlation coefficient (ICC), was 0.75. CONCLUSION A diverse range of consultants reached a consensus on the most important national equity indicators, including both clinical and system indicators. Results should be used to guide governmental decision-making and inter-sectoral strategies, furthering the pursuit of a more equitable healthcare system.
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Affiliation(s)
- Rachel Wilf-Miron
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomit Avni
- Strategic and Economic Planning Administration, Ministry of Health, Jerusalem, Israel
| | - Liora Valinsky
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Vicki Myers
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Arnona Ziv
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Gidi Peretz
- Strategic and Economic Planning Administration, Ministry of Health, Jerusalem, Israel
| | - Osnat Luxenburg
- Medical Technology, Health Information and Research Directorate, Ministry of Health, Jerusalem, Israel
| | - Mor Saban
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Paula Feder-Bubis
- Department of Health Policy and Management, Faculty of Health Sciences & Guildford Glazer Faculty of Business and management, Ben Gurion University of the Negev, Beersheba, Israel
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Johnson KF, Ieva K, Byrd J. Introduction to the Special Issue on School Counselors Addressing Education, Health, Wellness, and Trauma Disparities. PROFESSIONAL SCHOOL COUNSELING 2022; 26:2156759X221105451. [PMID: 36118910 PMCID: PMC9465282 DOI: 10.1177/2156759x221105451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This special issue is on school counselors addressing education, health,
wellness, and trauma disparities. The focus is on current and former school
counselors’ collective experiences to contextualize the impact of the
pandemic(s) on the lives and work of school counselors and the disruption to the
lives of the students and families served. The collection of nine articles
provides a window into the experiences of school counselors during the COVID-19
pandemic.
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Affiliation(s)
- Kaprea F. Johnson
- The Ohio State
University, Columbus, OH, USA
- Kaprea F. Johnson, PhD, is a professor in
the Department of Educational Studies at the Ohio State University in Columbus,
OH.
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Hou SHJ, Tran A, Cho S, Forbes C, Forster VJ, Stokoe M, Allapitan E, Wakefield CE, Wiener L, Heathcote LC, Michel G, Patterson P, Reynolds K, Schulte FSM. The Perceived Impact of COVID-19 on the Mental Health Status of Adolescent and Young Adult Survivors of Childhood Cancer and the Development of a Knowledge Translation Tool to Support Their Information Needs. Front Psychol 2022; 13:867151. [PMID: 35846688 PMCID: PMC9285488 DOI: 10.3389/fpsyg.2022.867151] [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: 01/31/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Adolescent and young adult (AYA; 13 to 39 years) survivors of childhood cancer may be especially vulnerable to physical health and mental health concerns during the pandemic. We investigated the impact of COVID-19 on the mental health status of AYA survivors (Aim 1) and shared tailored, evidence-based health-related information on COVID-19 (Aim 2). Methods Between May and June 2020, participants completed a cross-sectional online survey assessing their cancer history, current mental health status, and their COVID-19 information needs. Results Ninety-four participants (78 females, 13 males, 2 non-binary) with a mean age of 26.9 years (SD = 6.2) were included in the final sample. Participants reported residing from 10 countries and 94% identified as White. Nearly half of the participants (49%) described their mental health status as worse now than before the pandemic. Thirty-nine participants (41%) that indicated their current mental health status was tied to fears/worries about their past cancer and treatment experienced a higher level of anxiety and PTSS than those who did not report the same. Most participants (77%) had not received any information related to the potential risks of COVID-19 and expressed an interest in receiving this information. In response, an infographic detailing recommended strategies for coping with mental health problems in the pandemic, along with preliminary study findings, was developed. Discussion AYA survivors reporting their mental health status was linked to their past cancer experienced poorer mental health. There is a value to educating survivors on their potential health risks, but accounting for their perceived mental health vulnerabilities should be considered when disseminating knowledge. The use of an infographic is a unique contribution towards the development of innovative and personalized means of sharing health education to this vulnerable yet resilient group. This research on the mental health status of AYA survivors very early in the pandemic informs continued initiatives investigating the rapidly changing nature of how COVID-19 may impact AYA survivors today and in the future.
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Affiliation(s)
- Sharon H J Hou
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychology, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Andrew Tran
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sara Cho
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Caitlin Forbes
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Mehak Stokoe
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Elleine Allapitan
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Lori Wiener
- Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, United States
| | - Lauren C Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gisela Michel
- Department Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, Canteen Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kathleen Reynolds
- Long Term Survivor's Clinic, Alberta Children's Hospital, Calgary, AB, Canada.,Department of Medicine, Faculty of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Long Term Survivor's Clinic, Alberta Children's Hospital, Calgary, AB, Canada
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Moor I, Bieber J, Niederschuh L, Winter K. Die Bedeutung schulischer Gesundheitsförderung für die Erhöhung gesundheitlicher Chancengleichheit. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:749-757. [PMID: 35657386 PMCID: PMC9164180 DOI: 10.1007/s00103-022-03551-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
ZusammenfassungSozioökonomisch bedingte Ungleichheiten in der Gesundheit sind ein wichtiges Public-Health-Handlungsfeld und deren Reduzierung eines ihrer wichtigsten Ziele. Bislang ist es jedoch kaum gelungen, gesundheitliche Ungleichheiten zu verringern, was zugleich auch auf ein großes Forschungsdefizit hinweist. Auch im Kindes- und Jugendalter lassen sich bereits Ungleichheiten in der Gesundheit und dem Gesundheitsverhalten feststellen, wobei jene mit einem niedrigen sozioökonomischen Status verglichen mit sozial privilegierteren Gleichaltrigen oftmals mehr Risikofaktoren und gleichzeitig weniger Ressourcen aufweisen. Obwohl Gesundheitsförderung auf gesundheitliche Chancengleichheit abzielt, berücksichtigen Interventionen nur selten den sozioökonomischen Status und können entsprechend wenig Evidenz über sozioökonomisch differenzierte Interventionseffekte liefern. Wie kann es daher gelingen, allen Heranwachsenden die gleichen Chancen auf ein gesundes Aufwachsen zu ermöglichen?Um der Beantwortung dieser Frage näherzukommen, ist es zum einen das Ziel des Beitrags, einen Überblick über gesundheitliche Ungleichheiten im Kindes- und Jugendalter zu geben und die Rolle von Gesundheitsförderung sowie aktuelle Forschungsdefizite in diesem Zusammenhang aufzuzeigen. Zum anderen soll die Bedeutung der Schule und schulischer Gesundheitsförderungsmaßnahmen bei der Verringerung gesundheitlicher Ungleichheiten und der Erhöhung gesundheitlicher Chancengleichheit herausgestellt werden. Die Schule ist nicht nur ein Ort, an dem Heranwachsende unabhängig von ihrer sozialen Herkunft stets erreicht werden können, sondern hat das Potenzial, gesundheitliche Ungleichheiten sowohl zu verschärfen als auch zu reduzieren.
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Affiliation(s)
- Irene Moor
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle/Saale, Deutschland.
| | - Janis Bieber
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle/Saale, Deutschland
| | - Liska Niederschuh
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle/Saale, Deutschland
| | - Kristina Winter
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle/Saale, Deutschland
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48
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Jones GL, Mitchell CA, Hirst JE, Anumba DOC. Understanding the relationship between social determinants of health and maternal mortality: Scientific Impact Paper No. 67. BJOG 2022; 129:1211-1228. [PMID: 35139580 DOI: 10.1111/1471-0528.17044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Within this document we use the terms pregnant woman and women's health. However, it is important to acknowledge that it is not only people who identify as women for whom it is necessary to access care. Obstetric and gynaecology services and delivery of care must therefore be appropriate, inclusive and sensitive to the needs of those individuals whose gender identity does not align with the sex they were assigned at birth.
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Affiliation(s)
| | | | - Jane E Hirst
- Royal College of Obstetricians and Gynaecologists, London, UK
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49
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Grootjans SJM, Stijnen MMN, Kroese MEAL, Ruwaard D, Jansen MWJ. Collaborative governance at the start of an integrated community approach: a case study. BMC Public Health 2022; 22:1013. [PMID: 35590241 PMCID: PMC9118649 DOI: 10.1186/s12889-022-13354-y] [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: 06/22/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We studied collaborative governance at the start of an integrated community approach aiming to improve population health, quality of care, controlling health care costs and improving professional work satisfaction. Our objective was to investigate which characteristics of collaborative governance facilitate or hamper collaboration in the starting phase. This question is of growing importance for policymakers and health initiatives, since on a global scale there is a shift towards 'population health management' where collaboration between stakeholders is a necessity. In addition, it is crucial to investigate collaborative governance from the beginning, since it offers opportunities for sustainability of collaboration later on in the process. METHODS We performed a qualitative case study in four deprived neighbourhoods in the city of Maastricht, the Netherlands. An integrated community approach was implemented, involving various stakeholders from the public and private health sectors and provincial and local authorities. Data was collected from December 2016 to December 2018, with a triangulation of methods (50 observations, 24 interviews and 50 document reviews). The Integrative Framework for Collaborative Governance guided data collection and analysis. RESULTS We focused on the dynamics within the collaborative governance regime, consisting of principled engagement, shared motivation and capacity for joint action. We found that shared goalsetting, transparency, being physically present, informal meetings, trust and leadership are key aspects at the start of collaborative governance. An extensive accountability structure can both hamper (time-consuming which hinders innovation) and facilitate (keep everybody on board) collaboration. The characteristics we found are of significance for policy, practice and research. Policymakers and practitioners can use our lessons learned for implementing similar (population health) initiatives. This case study contributes to the already existing literature on collaborative governance adding to the knowledge gap on the governance of population health approaches. TRIAL REGISTRATION NTR6543 , registration date; 25 July 2017.
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Affiliation(s)
- Sanneke J M Grootjans
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.
| | - M M N Stijnen
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.,Living Lab Public Health Limburg, Public Health Service South Limburg (GGD Zuid Limburg), Het Overloon 2, 6411 TE, Heerlen, The Netherlands
| | - M E A L Kroese
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - D Ruwaard
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - M W J Jansen
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.,Living Lab Public Health Limburg, Public Health Service South Limburg (GGD Zuid Limburg), Het Overloon 2, 6411 TE, Heerlen, The Netherlands
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50
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Mah J, Rockwood K, Stevens S, Keefe J, Andrew MK. Do Interventions Reducing Social Vulnerability Improve Health in Community Dwelling Older Adults? A Systematic Review. Clin Interv Aging 2022; 17:447-465. [PMID: 35431543 PMCID: PMC9012306 DOI: 10.2147/cia.s349836] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Social vulnerability occurs when individuals have been relatively disadvantaged by the social determinants of health. Complex interventions that reduce social vulnerability have the potential to improve health in older adults but robust evidence is lacking. Objective To identify, appraise and synthesize evidence on the effectiveness of complex interventions targeting reduction in social vulnerability for improving health related outcomes (mortality, function, cognition, subjective health and healthcare use) in older adults living in the community. Methods A mixed methods systematic review was conducted. Five databases and targeted grey literature were searched for primary studies of all study types according to predetermined criteria. Data were extracted from each distinct intervention and quality was assessed using the Mixed Methods Appraisal Tool. Effectiveness data were synthesized using vote counting by direction of effect, combining p values and Albatross plots. Results Across 38 included studies, there were 34 distinct interventions categorized as strengthening social supports and communities, helping older adults and their caregivers navigate health and social services, enhancing neighbourhood and built environments, promoting education and providing economic stability. There was evidence to support positive influences on function, cognition, subjective health, and reduced hospital utilization. The evidence was mixed for non-hospital healthcare utilization and insufficient to determine effect on mortality. Conclusion Despite high heterogeneity and varying quality of studies, attention to reducing an older adult's social vulnerability assists in improving older adults' health.
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Affiliation(s)
- Jasmine Mah
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Susan Stevens
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Melissa K Andrew
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
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