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Karatekin C, Gresham B, Barnes AJ, Corcoran F, Kritzik R, Mason SM. Re-politicizing the WHO's social determinants of health framework. Health Promot Int 2024; 39:daae122. [PMID: 39322424 DOI: 10.1093/heapro/daae122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024] Open
Abstract
Although the World Health Organization's (WHO's) framework on social and structural determinants of health and health inequities (SSDHHI) has done much to raise awareness of these determinants, it does not go far enough in considerations of politics and power. The framework has become more de-politicized since its publication, with the definition of social determinants shifting toward downstream and individualized factors. In the meantime, new research fields on legal, commercial and political determinants of health and health inequities have emerged; however, these have not become integrated adequately into broader SSDHHI frameworks. To address these challenges, we argue for a re-politicization and an expansion of the WHO's framework by including the agents who have power over shaping structural determinants and the ways they use power to shape these determinants. We also provide a more detailed conceptualization of structural determinants to facilitate research. We propose a guideline for evaluating studies according to the extent to which they point upstream versus downstream and incorporate agents and considerations of power. We then use this framework to encourage more research on associations among agents, mechanisms of power, and structural determinants; how changes in structural determinants affect power dynamics among agents; and a wider focus on structural determinants beyond laws and policies, such as broad economic and sociopolitical systems. We also urge researchers to consider societal and institutional forces shaping their research with respect to SSDHHI. Research based on this framework can be used to provide evidence for advocacy for structural changes and to build more just systems that respect the fundamental human right to a healthy life.
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Affiliation(s)
- Canan Karatekin
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN 55416, USA
| | - Bria Gresham
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN 55416, USA
| | - Andrew J Barnes
- Department of Pediatrics, Medical School, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Frederique Corcoran
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN 55416, USA
| | - Rachel Kritzik
- Institute of Child Development, University of Minnesota, 51 E. River Road, Minneapolis, MN 55416, USA
| | - Susan Marshall Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd St., Room 300 West Bank Office Building, Minneapolis, MN 55454, USA
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Kinitz DJ, Ross LE, MacEachen E, Gesink D. 'How can you worry about employment and survival at the same time?': employment and mental health among precariously employed cisgender and transgender sexual minority adult men in Toronto, Canada. CULTURE, HEALTH & SEXUALITY 2024:1-16. [PMID: 39342499 DOI: 10.1080/13691058.2024.2408349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/20/2024] [Indexed: 10/01/2024]
Abstract
This study addresses a gap in the labour market and occupational health literatures among sexual and gender minority workers by exploring the relationship between precarious employment and mental health through a political economy framework. Narratives from 20 cisgender and transgender sexual minority men were analysed to uncover the production of employment and mental health inequities. Results are presented temporally, including employment readiness, looking for work, and on the job, illuminating the social and structural processes that underly participants' stories of precarious employment and mental health. A cyclical pattern was identified whereby participants' mental ill-health resulted in separation from the labour market and increased employment precarity that subsequently further impacted their mental health. Interventions and programmes must consider multipronged approaches that address all aspects of this syndemic, including social stigma and discrimination towards sexual and gender minority people and improved access to stable employment, mental healthcare, and adequate social welfare systems.
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Affiliation(s)
- David J Kinitz
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Keeton VF, Leon-Martinez D, Robles DC, Martinez E, Lessard L, Garza MA, Kuppermann M, Chambers Butcher BD. Latina Women's Perinatal Experiences and Perspectives Around Discrimination, Anti-immigrant Policies, and Community Violence. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00262-4. [PMID: 39251084 DOI: 10.1016/j.jogn.2024.07.007] [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: 03/04/2024] [Revised: 07/26/2024] [Accepted: 08/13/2024] [Indexed: 09/11/2024] Open
Abstract
OBJECTIVE To describe experiences of Latina women who were currently pregnant or recently gave birth around discrimination, anti-immigrant policies, and community violence during the early COVID-19 pandemic. DESIGN Qualitative secondary analysis. SETTING Online or phone interviews. PARTICIPANTS Latina women who were currently pregnant or recently gave birth (N = 26). METHODS We used reflexive thematic analysis to examine transcribed data from semistructured interviews conducted during the early COVID-19 pandemic with a subgroup of participants enrolled in a larger study related to prenatal care. Participants were English- or Spanish-speaking, Medicaid-eligible, Latina-identifying women who resided in Fresno County, California. We analyzed responses to questions about personal discrimination, the Black Lives Matter movement, and immigration policies using the theoretical frameworks of critical race theory and the political economy of health. RESULTS We identified four major themes: Avoidance of Community Engagement, Chronic Fear and Vigilance, The Role of Media, and Everyday Discrimination and Injustice. CONCLUSION Participant experiences reflect the pervasiveness of fear and socioeconomic inequity and call attention to the racialized structures that affect health and health care access for Latina women. These exposures during the perinatal period may have intergenerational effects. These findings underscore the need for responsive and race-conscious perinatal nursing care for Latina women, assessment of the effect of the current sociopolitical environment on well-being, and policies that support equitable access to health and social care.
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Karuveettil V, Janakiram C, John D, Mathur M, Varma B, Green H. Political economy analysis of health: a scoping review protocol. JBI Evid Synth 2024; 22:1906-1913. [PMID: 38745473 DOI: 10.11124/jbies-23-00204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The objective of this scoping review is to identify and map the literature on concepts, definitions, frameworks, outcomes, and applications of political economic analysis of health. INTRODUCTION The political economy of health approach seeks to understand how political and economic domains interact and shape individual and population health outcomes. A political economic analysis can provide insights into health problems and inequalities; however, there needs to be more clarity on how the political economy framework is defined and the methods adopted for conducting political economy analysis concerning health. INCLUSION CRITERIA Studies focusing on the political economy analysis addressing specific health problems will be included. The study population is not limited to any sociodemographic characteristics, and there will be no restrictions on language or the source of evidence (primary studies or secondary data studies). Both qualitative and quantitative methodologies will included, but narrative and systematic reviews will be excluded, as will conference abstracts and editorials. Studies involving sector- or country-level analysis will be included. METHODS The review will follow the JBI methodology for scoping reviews. Databases to be searched include MEDLINE, Scopus, Web of Science, Cochrane CENTRAL, CINAHL, Embase, ProQuest, DynaMed, and gray literature via Google Scholar and OAIster. Two reviewers will perform study screening and data extraction using a customized data extraction form. The concepts, definitions, frameworks, outcomes, and applications of the political economy of health will be summarized and discussed. The health problems addressed using political economy analysis will be enumerated. Stakeholder engagement will guide all steps of the study. Results will be presented in tabular and graphical formats accompanied by a narrative summary. REVIEW REGISTRATION Open Science Framework https://osf.io/4qaxr/.
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Affiliation(s)
- Vineetha Karuveettil
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Amrita Centre for Evidence Based Oral Health: A JBI Centre of Excellence, Ernakulam, Kerala, India
| | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Amrita Centre for Evidence Based Oral Health: A JBI Centre of Excellence, Ernakulam, Kerala, India
| | - Denny John
- Evidence Synthesis and Implementation for Indigenous Health: A JBI Affiliated Group, MANT (Manbhum Ananda Ashram Nityananda Trust), Kolkata, India
- Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Manu Mathur
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Balagopal Varma
- Department of Paediatric and Preventive Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Heidi Green
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW, Australia
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Weiler AM, Caxaj CS. Housing, health equity, and global capitalist power: Migrant farmworkers in Canada. Soc Sci Med 2024; 354:117067. [PMID: 38972093 DOI: 10.1016/j.socscimed.2024.117067] [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: 08/01/2023] [Revised: 05/27/2024] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
Health scholars are becoming increasingly attuned to the intimate ties between a person's housing and their access to mental and physical health. However, existing models for understanding the link between housing and health equity do not adequately theorize why inequities arise and persist, who benefits from these social arrangements, and how they operate transnationally. How do domestic and global dynamics of political economy shape housing and health equity for migrant farmworkers? How can conceptual models of housing and health equity better account for political economy? To answer these conceptual questions, our study examines the empirical case of migrant agricultural workers in Canada. Migrant worker housing provides a pertinent case for better conceptualizing capitalist power dynamics in housing and health equity on a global scale. Specifically, we draw on in-depth interviews conducted between 2021 and 2022 with 151 migrant workers Ontario and British Columbia. Participants' housing and health concerns aligned with existing literature, including issues such as overcrowding and barriers to health care due to a remote rural location. Our analysis identified three empirical themes: Precarity, Paternalism, and a lack of Political Participation. Drawing from these insights, we recommend a refined model of housing and health equity that keeps an analytical lens trained on global racial capitalism.
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Affiliation(s)
- Anelyse M Weiler
- University of Victoria, Department of Sociology, PO Box 3050 STN CSC, Victoria, BC, V8W 3P5, Canada.
| | - C Susana Caxaj
- Room 3306, FIMS & Nursing Building, Western University, London, Ontario, N6A 5B9, Canada
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Plamondon KM, Shahram SZ. Defining equity, its determinants, and the foundations of equity science. Soc Sci Med 2024; 351:116940. [PMID: 38761454 DOI: 10.1016/j.socscimed.2024.116940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/23/2024] [Accepted: 05/01/2024] [Indexed: 05/20/2024]
Abstract
Advancing equity as a priority is increasingly declared in response to decades of evidence showing the association between poorer health outcomes and the unfair distribution of resources, power, and wealth across all levels of society. Quandries present, however, through incongruence, vagueness and disparate interpretations of the meaning of equity dilute and fragment efforts across research, policy and practice. Progress on reducing health inequities is, in this context, unsurprisingly irresolute. In this article, we make a case for equity science that reimagines the ways in which we (as researchers, as systems leaders, as teachers and mentors, and as citizens in society) engage in this work. We offer a definition of equity, its determinants, and the paradigmatic foundations of equity science, including the assumptions, values, and processes., and methods of this science. We argue for an equity science that can more meaningfully promote coherent alignment between intention, knowledge and action within and beyond the health sciences to spark a more equitable future.
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Affiliation(s)
- Katrina M Plamondon
- Equity Science Lab, Faculty of Health & Social Development, School of Nursing, University of British Columbia, ART360, 1147 Research Road, Kelowna, BC, Canada.
| | - Sana Z Shahram
- Equity Science Lab, Faculty of Health & Social Development, School of Nursing, University of British Columbia, ART360, 1147 Research Road, Kelowna, BC, Canada.
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Bemme D, Béhague D. Theorising the social in mental health research and action: a call for more inclusivity and accountability. Soc Psychiatry Psychiatr Epidemiol 2024; 59:403-408. [PMID: 38407626 DOI: 10.1007/s00127-024-02632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Affiliation(s)
| | - Dominique Béhague
- King's College London, London, UK
- Vanderbilt University, Nashville, USA
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Abstract
The critical political economy of health offers different explanations for the social causes of health and the social factors determining the distribution of these causes. However, the relational, post-anthropocentric and monist ontology of the new materialisms overcomes this complexity, while retaining a critical focus. In this perspective, the social, economic and political relations of capitalism act upon bodies and other matter in everyday events, rather than as 'social structures'. Using a conceptual toolkit of 'affect', 'assemblage', 'capacity' and 'micropolitics', the paper asks the question: 'what does capitalism do?' The re-analysis of the social and economic relations of capitalism in terms of a production-assemblage and a market-assemblage reveals not only the workings of capitalist accumulation, but also how previously-unremarked more-than-human affects in these assemblages simultaneously produce uncertainty, waste and inequalities. This micropolitical economy of health is illustrated with examples from recent research, including a critical assessment of health inequalities during the Covid-19 pandemic.
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Perez-Lua FM, Chan-Golston AM, Burke NJ, Young MEDT. The Influence of Organizational Aspects of the U.S. Agricultural Industry and Socioeconomic and Political Conditions on Farmworkers' COVID-19 Workplace Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7138. [PMID: 38063568 PMCID: PMC10706775 DOI: 10.3390/ijerph20237138] [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: 10/12/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
Farmworkers in the U.S. experienced high rates of COVID-19 infection and mortality during the COVID-19 pandemic. Their workplace may have been a significant place of exposure to the novel coronavirus. Using political economy of health theory, this study sought to understand how organizational aspects of the agricultural industry and broader socioeconomic and political conditions shaped farmworkers' COVID-19 workplace safety during the pandemic. Between July 2020 and April 2021, we conducted and analyzed fourteen in-depth, semi-structured phone interviews with Latinx farmworkers in California. Findings show that regulatory oversight reinforced COVID-19 workplace safety. In the absence of regulatory oversight, the organization of the agricultural industry produced COVID-19 workplace risks for farmworkers; it normalized unsafe working conditions and the worker-rather than employer-responsibility for workplace safety. Under these conditions, farmworkers enacted personal COVID-19 preventative practices but were limited by financial hardships that were exacerbated by the precarious nature of agricultural employment and legal status exclusions from pandemic-related aid. Unsafe workplace conditions negatively impacted workplace camaraderie. Study findings have implications for farmworkers' individual and collective agency to achieve safe working conditions. Occupational safety interventions must address the organizational aspects that produce workplace health and safety inequities and disempower farmworkers in the workplace.
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Affiliation(s)
- Fabiola M. Perez-Lua
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, 5200 N Lake Road, Merced, CA 95343, USA; (A.M.C.-G.); (N.J.B.)
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Gao X, Berkowitz RL, Michaels EK, Mujahid MS. Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities. Am J Epidemiol 2023; 192:1731-1742. [PMID: 37246316 DOI: 10.1093/aje/kwad129] [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: 10/01/2022] [Revised: 04/12/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023] Open
Abstract
As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood-effects research questions and apply the appropriate measures and methods. This paper provides a road map for guiding health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, the road map consists of 4 broad stages for considering place and health: 1) why?: articulating the motivation for assessing place and health and grounding the motivation in theory; 2) what?: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3) how?: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4) now what?: discussing the implications of neighborhood research findings for future research, policy, and practice. This road map supports efforts to develop conceptually and analytically rigorous neighborhood research projects.
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Brothers TD, Bonn M, Lewer D, Comeau E, Kim I, Webster D, Hayward A, Harris M. Social and structural determinants of injection drug use-associated bacterial and fungal infections: A qualitative systematic review and thematic synthesis. Addiction 2023; 118:1853-1877. [PMID: 37170877 DOI: 10.1111/add.16257] [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: 10/03/2022] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND AIMS Injection drug use-associated bacterial and fungal infections are increasingly common, and social contexts shape individuals' injecting practices and treatment experiences. We sought to synthesize qualitative studies of social-structural factors influencing incidence and treatment of injecting-related infections. METHODS We searched PubMed, EMBASE, Scopus, CINAHL and PsycINFO from 1 January 2000 to 18 February 2021. Informed by Rhodes' 'risk environment' framework, we performed thematic synthesis in three stages: (1) line-by-line coding; (2) organizing codes into descriptive themes, reflecting interpretations of study authors; and (3) consolidating descriptive themes into conceptual categories to identify higher-order analytical themes. RESULTS We screened 4841 abstracts and included 26 qualitative studies on experiences of injecting-related bacterial and fungal infections. We identified six descriptive themes organized into two analytical themes. The first analytical theme, social production of risk, considered macro-environmental influences. Four descriptive themes highlighted pathways through which this occurs: (1) unregulated drug supply, leading to poor drug quality and solubility; (2) unsafe spaces, influenced by policing practices and insecure housing; (3) health-care policies and practices, leading to negative experiences that discourage access to care; and (4) restrictions on harm reduction programmes, including structural barriers to effective service provision. The second analytical theme, practices of care among people who use drugs, addressed protective strategies that people employ within infection risk environments. Associated descriptive themes were: (5) mutual care, including assisted-injecting and sharing sterile equipment; and (6) self-care, including vein health and self-treatment. Within constraining risk environments, some protective strategies for bacterial infections precipitated other health risks (e.g. HIV transmission). CONCLUSIONS Injecting-related bacterial and fungal infections are shaped by modifiable social-structural factors, including poor quality unregulated drugs, criminalization and policing enforcement, insufficient housing, limited harm reduction services and harmful health-care practices. People who inject drugs navigate these barriers while attempting to protect themselves and their community.
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Affiliation(s)
- Thomas D Brothers
- UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Matthew Bonn
- Canadian Association of People who Use Drugs (CAPUD), Dartmouth, Canada
| | - Dan Lewer
- UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Emilie Comeau
- Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Inhwa Kim
- Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Duncan Webster
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Canada
- Division of Infectious Diseases, Saint John Regional Hospital, Saint John, Canada
| | - Andrew Hayward
- UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Magdalena Harris
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Lekas HM, López-Cevallos D, Routen A. Exploring the intersections of structural inequities and health disparities: the challenge and opportunity of recognizing racism as a public health crisis. BMC Public Health 2023; 23:1423. [PMID: 37491202 PMCID: PMC10369700 DOI: 10.1186/s12889-023-16359-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023] Open
Abstract
Although increasingly being recognized as a driver of poor health and health inequities, there is limited research on the pervasive effects of racism on population health. In this editorial, we set the context and invite contributions for a BMC Public Health Collection of articles titled, "Racism as Public Health Crisis."
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Affiliation(s)
- Helen-Maria Lekas
- Nathan Kline Institute for Psychiatric Research and NYU School of Medicine, Orangeburg, NY, USA
| | - Daniel López-Cevallos
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 305 Arnold House 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Ash Routen
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Eisenberg-Guyot J, Finsaas MC, Prins SJ. Dead Labor: Mortality Inequities by Class, Gender, and Race/Ethnicity in the United States, 1986-2019. Am J Public Health 2023; 113:637-646. [PMID: 36926964 PMCID: PMC10186820 DOI: 10.2105/ajph.2023.307227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 03/17/2023]
Abstract
Objectives. To estimate social class inequities in US mortality using a relational measure based on power over productive property and workers' labor. Methods. We used nationally representative 1986-2018 National Health Interview Survey data with mortality follow-up through December 31, 2019 (n = 911 850). First, using business-ownership, occupational, and employment-status data, we classified respondents as incorporated business owners (IBOs), unincorporated business owners (UBOs), managers, workers, or not in the labor force (NLFs). Next, using inverse-probability-weighted survival curves, we estimated class mortality inequities overall, after subdividing workers by employment status and occupation, and by period, gender, race/ethnicity, and education. Results. UBOs, workers, and NLFs had, respectively, 6.3 (95% confidence interval [CI] = -8.1, -4.6), 6.6 (95% CI = -8.1, -5.0), and 19.4 (95% CI = -21.0, -17.7) per 100 lower 34-year survival rates than IBOs. Mortality risk was especially high for unemployed, blue-collar, and service workers. Inequities increased over time and were greater among male, racially minoritized, and less-educated respondents. Conclusions. We estimated considerable mortality inequities by class, gender, and race/ethnicity. We also estimated that class mortality inequities are increasing, threatening population health. Public Health Implications. Addressing class inequities likely requires structural, worker-empowering interventions. (Am J Public Health. 2023;113(6):637-646. https://doi.org/10.2105/AJPH.2023.307227).
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Affiliation(s)
- Jerzy Eisenberg-Guyot
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Megan C Finsaas
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Seth J Prins
- Jerzy Eisenberg-Guyot and Megan C. Finsaas are with the Department of Epidemiology and Seth J. Prins is with the Departments of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
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Raphael D, Bryant T. Socialism as the way forward: updating a discourse analysis of the social determinants of health. CRITICAL PUBLIC HEALTH 2023. [DOI: 10.1080/09581596.2023.2178387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Dennis Raphael
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Toba Bryant
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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Harvey M, Piñones-Rivera C, Holmes SM. Thinking with and Against the Social Determinants of Health: The Latin American Social Medicine (Collective Health) Critique from Jaime Breilh. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2022; 52:433-441. [PMID: 36052418 DOI: 10.1177/00207314221122657] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The concept of the social determinants of health has become increasingly accepted and mainstream in anglophone public health over the past three decades. Moreover, it has been widely adopted into diverse geographic, sociocultural, and linguistic contexts. By recognizing the role of social conditions in influencing health inequalities, the concept challenges narrow behavioral and reductive biological understandings of health. Despite this, scholars and activists have critiqued the concept of the social determinants of health for being incomplete and even misrepresenting the true nature of health inequities. Arguably, these critiques have been most thoroughly developed among those working in the Latin American social medicine and collective health traditions who formulated the "social determination of health" paradigm and the concept of interculturality decades prior to the advent of the social determinants of health. We draw on Jaime Breilh's main works, with a focus on the recently published book, Critical Epidemiology and the People's Health, to (1) provide a broad overview of the social determination of health paradigm and its approach to interculturality and (2) clarify how these ideas and the broader collective health movement challenge assumptions within the social determinants of health concept.
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Affiliation(s)
- Michael Harvey
- Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, RI, USA
| | | | - Seth M Holmes
- Division of Society and Environment, University of California Berkeley, Berkeley, CA, USA.,University of Amsterdam Institute for Advanced Study, Amsterdam, Netherlands
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Westbrook M, Harvey M. Framing health, behavior, and society: a critical content analysis of public health social and behavioral science textbooks. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2095255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Marisa Westbrook
- Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, Colorado, USA
| | - Michael Harvey
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Cai M, Moore S, Ball C, Flynn M, Mulkearn K. The role of union health and safety representatives during the COVID‐19 pandemic: A case study of the UK food processing, distribution, and retail sectors. INDUSTRIAL RELATIONS JOURNAL 2022; 53. [PMCID: PMC9350389 DOI: 10.1111/irj.12377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This article highlights the weakness of the UK's occupational health and safety infrastructure exposed by the COVID‐19 pandemic. Utilising a political economy perspective, it captures the critical role of workplace union safety representatives in mitigating risk and contesting the expropriation of health and recommodification of labour, specifically inadequate sick pay.
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Affiliation(s)
- Minjie Cai
- Centre for Research on Employment and WorkUniversity of GreenwichLondonUK
| | - Sian Moore
- Centre for Research on Employment and WorkUniversity of GreenwichLondonUK
| | - Chris Ball
- Centre for Research on Employment and WorkUniversity of GreenwichLondonUK
| | - Matt Flynn
- Centre for Research into the Older WorkforceUniversity of HullHullUK
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18
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Montiel I, Park J, Husted BW, Velez-Calle A. Tracing the connections between international business and communicable diseases. JOURNAL OF INTERNATIONAL BUSINESS STUDIES 2022; 53:1785-1804. [PMID: 35345569 PMCID: PMC8942389 DOI: 10.1057/s41267-022-00512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
We posit that international business and the emergence and spread of communicable diseases are intrinsically connected. To support our arguments, we first start with a historical timeline that traces the connections between international business and communicable diseases back to the sixth century. Second, following the epidemiology of communicable diseases, we identify two crucial transitions related to international business: the emergence of epidemics within a host country and the shift from epidemics to global pandemics. Third, we highlight international business contextual factors (host country regulatory quality, urbanization, trade barriers, global migration) and multinationals' activities (foreign direct investment, corporate political activity, global supply chain management, international travel) that could accelerate each transition. Finally, building on public health insights, we suggest research implications for business scholars on how to integrate human health challenges into their studies and practical implications for global managers on how to help prevent the emergence and spread of communicable diseases.
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Affiliation(s)
- Ivan Montiel
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Junghoon Park
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Bryan W. Husted
- Tecnológico de Monterrey, EGADE Business School, Eugenio Garza Lagüera & Rufino Tamayo, Valle Oriente, 66269 San Pedro Garza García, Nuevo León Mexico
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19
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Gogoi N, Sumesh SS. The Political Economy of Public Health Inequalities and Inequities in India: Complexities, Challenges, and Strategies for Inclusive Public Health Care Policy. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2022; 52:225-235. [PMID: 35084231 DOI: 10.1177/00207314211066748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article examines the political economy of health inequalities and inequities in the public health care system in India and identifies potential areas for interventions to promote equal and equitable health care for marginalized people. Drawing on the Political Economy of Health Model of Research, this article reiterates the inadequacy of policy frameworks and programs in ensuring accessible, affordable, and quality public health care services to all. We argue that for policies to be successful, policymakers should consider the diverse social registries of class, caste, religion, gender, region, ethnicity, and age, as well as their intersections. We also argue that health care policies and programs need to be: (a) dynamic and flexible, (b) intersectional and backed up by sufficient grassroots research, and (c) equitable at every stage of policy formulation, implementation, and evaluation.
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Affiliation(s)
| | - S S Sumesh
- 28688Tezpur University, Sonitpur, Assam, India
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20
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Medvedyuk S, Govender P, Raphael D. The reemergence of Engels' concept of social murder in response to growing social and health inequalities. Soc Sci Med 2021; 289:114377. [PMID: 34662784 DOI: 10.1016/j.socscimed.2021.114377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/29/2021] [Accepted: 09/04/2021] [Indexed: 12/18/2022]
Abstract
In 1845, Friedrich Engels identified how the living and working conditions experienced by English workers sent them prematurely to the grave, arguing that those responsible for these conditions -- ruling authorities and the bourgeoisie -- were committing social murder. The concept remained, for the most part, dormant in academic journals through the 1900s. Since 2000, there has been a revival of the social murder concept with its growth especially evident in the UK over the last decade as a result of the Grenfell Tower Fire and the effects of austerity imposed by successive Conservative governments. The purpose of this paper is to document the reemergence of the concept of social murder in academic journal articles. To do so we conducted a scoping review of content applying the social murder concept since 1900 in relation to health and well-being. We identified two primary concepts of social murder: social murder as resulting from capitalist exploitation and social murder as resulting from bad public policy across the domains of working conditions, living conditions, poverty, housing, race, health inequalities, crime and violence, neoliberalism, gender, food, social assistance, deregulation and austerity. We consider reasons for the reemergence of Engels' social murder concept and the role it can play in resisting the forces responsible for the living and working conditions that kill.
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Affiliation(s)
- Stella Medvedyuk
- School of Health Policy and Management, York University, Toronto, Canada
| | - Piara Govender
- School of Health Policy and Management, York University, Toronto, Canada
| | - Dennis Raphael
- School of Health Policy and Management, York University, Toronto, Canada.
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21
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Scott-Marshall HK. A Political Economy Lens on Health Inequalities in the 21st Century. Am J Public Health 2021; 111:553-555. [PMID: 33689434 DOI: 10.2105/ajph.2021.306161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Heather K Scott-Marshall
- Heather K. Scott-Marshall is adjunct professor of Social and Behavioural Health Sciences within the Dalla Lana School of Public Health at the University of Toronto, Toronto, Ontario, Canada. She is also President of Mission Research, Toronto
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