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Gaietto K, Han YY, Rosser FJ, Acosta-Pérez E, Forno E, Canino G, Celedón JC. Socioeconomic status, diet, and recurrent severe asthma exacerbations in Puerto Rican youth. J Allergy Clin Immunol Glob 2024; 3:100220. [PMID: 38375461 PMCID: PMC10875262 DOI: 10.1016/j.jacig.2024.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 02/21/2024]
Abstract
Background Why Puerto Rican youths have higher rates of severe asthma exacerbations (SAEs) than their non-Hispanic White peers is unclear. Objective We aimed to identify risk factors associated with recurrent SAEs in Puerto Rican youths with asthma. Methods We performed cross-sectional and longitudinal analyses of recurrent SAEs in 209 Puerto Rican youths with asthma who participated in 2 cross-sectional studies approximately 5.2 years apart: the Puerto Rico Genetics of Asthma and Lifestyle study (visit 1, participants aged 6-14 years) and the Epigenetic Variation and Childhood Asthma in Puerto Ricans study (visit 2, participants aged 9-20 years). Recurrent SAEs were defined as at least 2 SAEs in the previous year. Results Of the youths in our study, there were 80 (38.3%) and 47 (22.4%) with recurrent SAEs at visit 1 and visit 2, respectively, and 31 participants (14.8%) had persistent recurrent SAEs (ie, recurrent SAEs at both visits). In multivariable analyses, low household income was significantly associated with 2.4 to 12.3 times increased odds of recurrent SAEs in all analyses, with stronger longitudinal associations. Low parental education level, nonprivate or employer-based health insurance, overweight or obesity, residential proximity to a major road, and low or moderate level of outdoor activity were each significantly associated with recurrent SAEs in at least 1 analysis. Further, persistence of low parental numeracy level, low household income, and an unhealthy diet were each associated with persistent recurrent SAEs. Conclusion In this study of Puerto Rican youths with asthma, persistence of low parental numeracy level, a low household income, and an unhealthy diet were associated with persistent recurrent SAEs. Our findings support policies promoting equity and healthy lifestyles for Puerto Rican children and their families.
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Affiliation(s)
- Kristina Gaietto
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Franziska J. Rosser
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
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Kluitenberg Harris C, Wu HS, Lehto R, Wyatt G, Given B. Relationships Among Determinants of Health, Cancer Screening Participation, and Sexual Minority Identity: A Systematic Review. LGBT Health 2024. [PMID: 38557207 DOI: 10.1089/lgbt.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: To address cancer screening disparities and reduce cancer risk among sexual minority (SM) groups, this review identifies individual, interpersonal, and community/societal determinants of cancer screening (non)participation among differing SM identities. Methods: Seven scientific databases were searched. Inclusion criteria were as follows: (1) used quantitative methods; (2) English language; (3) cancer screening focus; and (4) at least one SM group identified. Articles were excluded if: (1) analysis was not disaggregated by SM identity (n = 29) and (2) quantitative analysis excluded determinants of cancer screening (n = 19). The Sexual and Gender Minority Health Disparities Research Framework guided literature synthesis. Results: Twelve studies addressed cervical (n = 4), breast (n = 3), breast/cervical (n = 3), or multiple cancers (n = 2). Other cancers were excluded due to inclusion/exclusion criteria. The total sample was 20,622 (mean 1525), including lesbian (n = 13,409), bisexual (n = 4442), gay (n = 1386), mostly heterosexual (n = 1302), and queer (n = 83) identities. Studies analyzing individual-level determinants (n = 8) found that socioeconomic status affected cervical, but not breast, cancer screening among lesbian and bisexual participants (n = 2). At the interpersonal level (n = 7), provider-patient relationship was a determinant of cervical cancer screening among lesbian participants (n = 4); a relationship not studied for other groups. Studies analyzing community/societal determinants (n = 5) found that rurality potentially affected cervical cancer screening among lesbian, but not bisexual people (n = 3). Conclusions: This review identified socioeconomic status, provider-patient relationship, and rurality as determinants affecting cancer screening among SM people. While literature addresses diverse SM groups, inclusion/exclusion criteria identified studies addressing cisgender women. Addressing disparities in the identified determinants of cervical cancer screening may improve participation among SM women. Further research is needed to understand determinants of cancer screening unique to other SM groups.
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Affiliation(s)
| | - Horng-Shiuann Wu
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Barbara Given
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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Singh S, Zhong S, Rogers K, Hachinski V, Frisbee S. Corrigendum: Prioritizing determinants of cognitive function in healthy middle-aged and older adults: insights from a machine learning regression approach in the Canadian longitudinal study on aging. Front Public Health 2024; 12:1372914. [PMID: 38410659 PMCID: PMC10896419 DOI: 10.3389/fpubh.2024.1372914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2023.1290064.].
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Affiliation(s)
- Sarah Singh
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Shiran Zhong
- Department of Geography, University of Western Ontario, London, ON, Canada
| | - Kem Rogers
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Vladimir Hachinski
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Department of Clinical Neurological Sciences, and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stephanie Frisbee
- Department of Pathology and Laboratory Medicine, and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
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Babaita AO, Jahan Y, Nakamura R, Moriyama M. Identifying key factors for successful formulation and implementation of healthcare policies on non-communicable diseases: a multinational analysis. Front Public Health 2024; 12:1292176. [PMID: 38389939 PMCID: PMC10881649 DOI: 10.3389/fpubh.2024.1292176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Objectives Non-communicable diseases (NCDs) are a major public health concern that accounts for 74% of global deaths each year. The increasing burden of NCDs exhausts public health resources and threatens the achievement of the 2030 agenda for sustainable development. The purpose of this study is to thematically analyze the contributory factors in the health policy process and reforms to strengthen the prevention of NCDs across borders, as well as the milestones achieved through the process of policy-making, change, and implementation. Method This study informs and draws on the findings of contributory factors in the health policy process for preventing NCDs across borders: United States, England, Sweden, Bangladesh, Singapore, South Korea, and Thailand. Ten experts from the seven countries were recruited purposively for a semi-structured interview (e-Interview) on the NCD policy-making process in their countries, either through health ministries or the authors' network. This descriptive qualitative study design is guided by the "Three I's" framework of public policy (institutions, ideas, and interests). In addition to the information obtained from the interviewee, data were also sourced from relevant documents and homepages suggested by the interviewee, as well as health homepages of the countries. Result The following themes were generated: (1) environmental policies and social determinants, (2) multistakeholder involvement, (3) interministerial collaboration, (4) independent evidence and review institution, (5) integrated health data, and (6) primary care system. There was a shift from individual-targeted policies to environmental policies and social determinants. Notably, national campaigns were developed through non-governmental organizations (NGOs) for the primary prevention of NCDs. Conclusion The shift from behavioral modification and treatment to social determinants is important. NCDs are broad and require a multisector and multilevel approach. Establishing an organization or hierarchical body to overlook NCDs could result in increased awareness, focus, and surveillance and enhance the policy process.
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Affiliation(s)
| | - Yasmin Jahan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Kunitachi, Japan
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Singh S, Zhong S, Rogers K, Hachinski V, Frisbee S. Prioritizing determinants of cognitive function in healthy middle-aged and older adults: insights from a machine learning regression approach in the Canadian longitudinal study on aging. Front Public Health 2023; 11:1290064. [PMID: 38186704 PMCID: PMC10768541 DOI: 10.3389/fpubh.2023.1290064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The preservation of healthy cognitive function is a crucial step toward reducing the growing burden of cognitive decline and impairment. Our study aims to identify the characteristics of an individual that play the greatest roles in determining healthy cognitive function in mid to late life. Methods Data on the characteristics of an individual that influence their health, also known as determinants of health, were extracted from the baseline cohort of the Canadian Longitudinal Study of Aging (2015). Cognitive function was a normalized latent construct score summarizing eight cognitive tests administered as a neuropsychological battery by CLSA staff. A higher cognitive function score indicated better functioning. A penalized regression model was used to select and order determinants based on their strength of association with cognitive function. Forty determinants (40) were entered into the model including demographic and socioeconomic factors, lifestyle and health behaviors, clinical measures, chronic diseases, mental health status, social support and the living environment. Results The study sample consisted mainly of White, married, men and women aged 45-64 years residing in urban Canada. Mean overall cognitive function score for the study sample was 99.5, with scores ranging from 36.6 to 169.2 (lowest to highest cognitive function). Thirty-five (35) determinants were retained in the final model as significantly associated with healthy cognitive functioning. The determinants demonstrating the strongest associations with healthy cognitive function, were race, immigrant status, nutritional risk, community belongingness, and satisfaction with life. The determinants demonstrating the weakest associations with healthy cognitive function, were physical activity, greenness and neighborhood deprivation. Conclusion Greater prioritization and integration of demographic and socioeconomic factors and lifestyle and health behaviors, such greater access to healthy foods and enhancing aid programs for low-income and immigrant families, into future health interventions and policies can produce the greatest gains in preserving healthy cognitive function in mid to late life.
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Affiliation(s)
- Sarah Singh
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Shiran Zhong
- Department of Geography, University of Western Ontario, London, ON, Canada
| | - Kem Rogers
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Vladimir Hachinski
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Department of Clinical Neurological Sciences, and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stephanie Frisbee
- Department of Pathology and Laboratory Medicine, and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
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Morgan MJ, Stratford E, Harpur S, Rowbotham S. Local government's roles in community health and wellbeing in Australia: Insights from Tasmania. Health Promot J Austr 2023. [PMID: 38050655 DOI: 10.1002/hpja.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
ISSUE ADDRESSED Local governments are well-placed to respond to communities' health and wellbeing needs. However, in the Australian state of Tasmania, the sector's roles in that respect are unclear. METHODS We interviewed 10 municipal personnel in Tasmania to understand their views on local governments' community health and wellbeing functions. RESULTS Participants had an integrative understanding of community health and wellbeing and recognised that collective effort from all tiers of government, community members, and other place-based stakeholders would improve outcomes. They identified several roles local governments have to support and drive such improvements, including in relation to diverse place-specific determinants of health and wellbeing. Capacity and capability to fulfil what is needed varied, with rural and remote councils generally less able than urban counterparts to respond consistently or comprehensively to community members' complex needs. However, in the presence of clear expectations and parameters, and appropriate support from other tiers of government, participants were eager for their councils to do more to improve their communities' health and wellbeing, including via a mandate in legislation. CONCLUSION Local governments have the potential to do more to improve health and wellbeing outcomes in Tasmania, and the greatest gains could be made by addressing spatial inequalities faced by the sector. That insight is extensible to other comparable jurisdictions. SO WHAT?: We argue the need both for a shared societal goal of equitable wellbeing supported by all tiers of government and for actions proportionate to the needs of council areas.
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Affiliation(s)
- Michelle J Morgan
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
- Department of Health, Public Health Services, Tasmanian Government, Hobart, Tasmania, Australia
| | - Elaine Stratford
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Siobhan Harpur
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Samantha Rowbotham
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
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Grove LR, Berkowitz SA, Cuddeback G, Pink GH, Stearns SC, Stürmer T, Domino ME. Permanent Supportive Housing Receipt and Health Care Use Among Adults With Disabilities. Med Care Res Rev 2023; 80:596-607. [PMID: 37366069 PMCID: PMC10637096 DOI: 10.1177/10775587231183192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/10/2023] [Indexed: 06/28/2023]
Abstract
This study assessed whether permanent supportive housing (PSH) participation is associated with health service use among a population of adults with disabilities, including people transitioning into PSH from community and institutional settings. Our primary data sources were 2014 to 2018 secondary data from a PSH program in North Carolina linked to Medicaid claims. We used propensity score weighting to estimate the average treatment effect on the treated of PSH participation. All models were stratified by whether individuals were in institutional or community settings prior to PSH. In weighted analyses, among individuals who were institutionalized prior to PSH, PSH participation was associated with greater hospitalizations and emergency department (ED) visits and fewer primary care visits during the follow-up period, compared with similar individuals who largely remained institutionalized. Individuals who entered PSH from community settings did not have significantly different health service use from similar comparison group members during the 12-month follow-up period.
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Affiliation(s)
| | | | | | | | | | - Til Stürmer
- The University of North Carolina at Chapel Hill, USA
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Badu E, Hallett J, Vujcich D, Crawford G, Bellringer ME. Setting the scene: a scoping review of gambling research in Ghana. Health Promot Int 2023; 38:daad171. [PMID: 38091619 DOI: 10.1093/heapro/daad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Ghana, like many other African countries, has seen a rapid expansion in gambling industry activity in the last decade with sports betting becoming a popular pastime among young Ghanaian males. The proliferation of land based, and online gambling operations presents a significant public health threat to the citizenry. Yet little is known about gambling participation and harms, the size of the gambling market and the role of the gambling industry in influencing and perpetuating gambling behaviour in Ghana. The aim of this study was to contribute to understanding the extent of gambling research in Ghana by mapping out what the current literature indicates. Six databases were searched for peer-reviewed journal articles that focused on gambling in Ghana. The findings from this review demonstrate gambling research in Ghana is in a nascent state with a predominant focus on individual factors and limited consideration of public health. The implications for future research are highlighted, including the requirement for a nationally representative study to understand the prevalence of gambling participation and harm, and the role of the gambling industry. Public health action grounded in sound evidence is urgently required to address the individual and community level problems associated with this harmful commodity.
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Affiliation(s)
- Emmanuel Badu
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
- School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
| | - Jonathan Hallett
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
- School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
| | - Daniel Vujcich
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
- School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
- School of Population Health, Curtin University, Building 400, Kent Street, Bentley, Western Australia 6102, Australia
| | - Maria E Bellringer
- Gambling and Addictions Research Centre, School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
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Lagazzi E, Proaño-Zamudio JA, Argandykov D, Rafaqat W, Abiad M, Romijn AS, van Ee EPX, Velmahos GC, Kaafarani HMA, Hwabejire JO. Burden of Social and Behavioral Determinants of Health on Infectious Complications in Emergency General Surgery. Surg Infect (Larchmt) 2023; 24:869-878. [PMID: 38011709 DOI: 10.1089/sur.2023.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: Infectious complications lead to worse post-operative outcomes and are used to compare hospital performance in pay-for-performance programs. However, the impact of social and behavioral determinants of health on infectious complication rates after emergency general surgery (EGS) remains unclear. Patients and Methods: All patients undergoing EGS in the 2019 Nationwide Readmissions Database were included. The primary outcome of the study was the rate of infectious complications within 30 days, defined as a composite outcome including all infectious complications occurring during the index hospitalization or 30-day re-admission. Secondary outcomes included specific infectious complication rates. Multivariable regression analyses were used to study the impact of patient characteristics, social determinants of health (insurance status, median household income in the patient's residential zip code), and behavioral determinants of health (substance use disorders, neuropsychiatric comorbidities) on post-operative infection rates. Results: Of 367,917 patients included in this study, 20.53% had infectious complications. Medicare (adjusted odds ratio [aOR], 1.3; 95% confidence interval [CI], 1.26-1.34; p < 0.001), Medicaid (aOR, 1.24; 95% CI,1.19-1.29; p < 0.001), lowest zip code income quartile (aOR, 1.17; 95% CI, 1.13-1.22; p < 0.001), opioid use disorder (aOR,1.18; 95% CI,1.10-1.29; p < 0.001), and neurodevelopmental disorders (aOR, 2.16; 95% CI, 1.90-2.45; p < 0.001) were identified as independent predictors of 30-day infectious complications. A similar association between determinants of health and infectious complications was also seen for pneumonia, urinary tract infection (UTI), methicillin-resistant Staphylococcus aureus (MRSA) sepsis, and catheter-association urinary tract infection (CAUTI). Conclusions: Social and behavioral determinants of health are associated with a higher risk of developing post-operative infectious complications in EGS. Accounting for these factors in pay-for-performance programs and public reporting could promote fairer comparisons of hospital performance.
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Affiliation(s)
- Emanuele Lagazzi
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Humanitas Research Hospital, Rozzano, Italy
| | - Jefferson A Proaño-Zamudio
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Dias Argandykov
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wardah Rafaqat
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - May Abiad
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Anne-Sophie Romijn
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, Division of Trauma and Emergency Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Elaine P X van Ee
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Leiden University Medical Center, Leiden, The Netherlands
| | - George C Velmahos
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Haytham M A Kaafarani
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - John O Hwabejire
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Alqahtani A, Alhusseini N. Assessing Social Determinants of Health Among Patients With Depression at Primary Healthcare Centers in Riyadh City. Cureus 2023; 15:e48854. [PMID: 38106797 PMCID: PMC10723624 DOI: 10.7759/cureus.48854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND AND PURPOSE Depression is a common and serious medical illness that is greatly influenced by socioeconomic, demographic, and biological factors. The recognition of social determinants of depression can help reduce the risk factors and promote mental health. The purpose of this study was to assess the social determinants of health (SDOH) of patients with depression and to classify its categories at primary healthcare centers (PHCs) in Riyadh, Saudi Arabia. METHODOLOGY A cross-sectional study using a self-administered questionnaire was conducted among 322 participants who were selected through a convenience sampling technique from June 2021 to August 2022. The study included Saudi and non-Saudi patients at the Ministry of Health PHCs in Riyadh, Saudi Arabia, aged 12 years and older. Independent samples of t-test and one-way ANOVA test were used to assess differences in means of numerical variables. Correlations were made by the Pearson correlation coefficient. A p-value of <0.05 was set as the level of statistical significance. Logistic regression was used to determine the main variables associated with moderate to severe depression. RESULTS The findings showed 51% had minimal to mild depression, 27% had moderate depression, and 22% had moderately severe to severe depression. A greater proportion of females had moderate to severe depression (61%) (p=0.007). Also, moderate to severe depression was higher in those with lower monthly income(54%)(p=0.03). Saudi nationals were found to have a higher percentage of moderate to severe depression(51%)(p=0.007). Marital status was found to be associated with depression as single respondents were more likely to have moderate to severe depression (p=0.052) with 54%. CONCLUSION SDOH including gender, income, marital status, and nationality are associated with depression. Having a comprehensive system focusing not only on mental health services but also on the social determinants of mental health is very important. Future research is needed to understand the association between depression and SDOH in Saudi Arabia. The study results can help policymakers determine the areas that require improvements.
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Affiliation(s)
- Abdulrahman Alqahtani
- Family and Community Medicine, Alfaisal University College of Medicine, Riyadh, SAU
- Public Health, Ministry of Health, Riyadh, SAU
| | - Noara Alhusseini
- Epidemiology and Public Health, Alfaisal University College of Medicine, Riyadh, SAU
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Cardona-Arias JA, Narváez Moreno NN, Higuita-Gutiérrez LF. HIV in Three Groups of Young People from Medellín: General Population, Organizations for People with Socioeconomic Vulnerability, and Men Who Have Sex with Other Men. HIV AIDS (Auckl) 2023; 15:641-648. [PMID: 37933247 PMCID: PMC10625778 DOI: 10.2147/hiv.s434036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023] Open
Abstract
Introduction In Colombia, there are no studies that analyze the effect of socioeconomic vulnerability and belonging to the group of men who have sex with other men (MSM) on the prevalence of HIV in young people. Objective To compare the prevalence of HIV in three groups of young people from Medellín-Colombia: general population, socioeconomic vulnerability and MSM. Methods This cross-sectional analytical study included 2449 young people from the general population, 1736 from institutions that serve young people in situations of socioeconomic vulnerability, and 2269 MSM. The prevalence of infection in each group was determined, statistical differences were identified using Pearson's Chi-square and Trend's Chi-square, and crude and adjusted odds ratios were estimated using logistic regression with 95% confidence intervals. Analyses were performed in SPSS 29.0. Results HIV prevalence was 0.8% in the general population group, 1.3% in young people with socioeconomic vulnerability, and 5.6% in MSM. The groups with the highest HIV were as follows: (i) in MSM it was 4.1 compared to the general population, (ii) between 25-28 years of age it was 2.9 times compared to those under 20 years, (iii) in men it was 10 times that registered in women, (iv) in young people with primary, secondary, technical and university studies it was 7.1; 6.7; 11.0 and 14.5 times that found in those who did not register studies, (v) in affiliates of the subsidized health regime it was 2.2 times and in those without affiliation 2.4 times compared to the infection in affiliates of the contributory health regime. Conclusion HIV prevalence was high, and explained by socioeconomic vulnerability, having sex between men, gender, age, education, and health affiliation, demonstrating the intersectionality of determinants of the health system, socioeconomic status, and determinants individuals in the occurrence of HIV in young people in Medellín.
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Affiliation(s)
| | | | - Luis Felipe Higuita-Gutiérrez
- Escuela de Microbiología, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Antioquia, Colombia
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12
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Ananthapavan V, Peden AE, Angell B, Macniven R. Barriers to preschool aged children's participation in swimming lessons in New South Wales, Australia. Health Promot J Austr 2023. [PMID: 37807369 DOI: 10.1002/hpja.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/20/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
ISSUE ADDRESSED To understand barriers to uptake of subsidised swimming lessons by children aged 3-6 years old ('preschool aged children'), including from priority populations, in New South Wales (NSW). METHODS A thematic analysis of 4191 qualitative responses from parents/carers of preschool aged children describing barriers that resulted in their child's non-participation in subsidised swimming lessons in the past 12 months was conducted. Data, including parent/carer sociodemographic variables, were collected through registrations for the NSW Government's First Lap voucher program. RESULTS Seven overarching barriers to participation were identified: (1) child's disability or health needs; (2) swimming lesson affordability; (3) family or personal circumstances; (4) lack of or poor availability of swimming lessons; (5) parent/carer availability, including to fulfil participation requirements; (6) COVID-19 and (7) deprioritisation of formal swimming lessons due to parent/carer perceptions relating to its importance. These may limit the uptake of swimming lessons in preschool aged children, particularly those who are Aboriginal and Torres Strait Islander, from culturally and linguistically diverse backgrounds, living with a disability, from low socioeconomic families and living in regional and remote areas. CONCLUSION Structural barriers must be addressed to increase uptake of swimming lessons in preschool aged children, particularly in priority populations, to reduce drowning risk. SO WHAT?: Evidence-based policy initiatives, with robust evaluation, should seek to address the availability and flexibility of swimming lessons, including for priority populations; complexities associated with supervision requirements; poor awareness of parents/carers of the importance of swimming for preschool aged children and the lack of continuity of swimming for children in out of home care.
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Affiliation(s)
- Vidthyany Ananthapavan
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
| | - Amy E Peden
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Blake Angell
- The George Institute for Global Health, Newtown, Australia
| | - Rona Macniven
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
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Ezeama NN, Okunna N, Ezeama CO. Multi-Level Correlates of the Nutritional Status of Nigerian Women of Reproductive Age. Community Health Equity Res Policy 2023; 44:109-121. [PMID: 37724033 DOI: 10.1177/2752535x221126071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Poor nutrition compromises the capacity of women to perform their vital roles as mothers and productive workers in their families, communities and society. Using a conceptual framework developed by the United Nations Children's Fund, this study determines individual-, household- and community-level factors associated with the nutritional status of Nigerian women of reproductive age. A secondary analysis of pooled data from the Nigeria Demographic and Health Survey (NDHS) for 2003, 2008, 2013 and 2018 was conducted involving 82,734 non-pregnant women aged 15-49 years. Multinomial logistic regression was used to determine predictors of nutritional status. Study results show that a significant proportion of the women had poor nutritional status; the prevalence of underweight, overweight and obesity were 12.1%, 16.8% and 7.2% respectively. Statistically significant factors associated with poor nutritional status were found at all three levels, highlighting the need for effective multidimensional, multisectoral policy interventions to address the double burden of malnutrition among women in Nigeria.
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Affiliation(s)
- Nkiru N Ezeama
- Department of Community Medicine and Primary Health Care, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Nene Okunna
- Department of Health, West Chester University, West Chester, PA, USA
| | - Chukwuemeka O Ezeama
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
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Torres-Muñoz J, Alberto Cedeño D, Murillo J, Torres-Figueroa S, Torres-Figueroa J. Sociodemographic determinants and mortality of premature newborns in a medium and low-income population in Colombia, 2017-2019. Biomedica 2023; 43:385-.95. [PMID: 37871568 PMCID: PMC10624478 DOI: 10.7705/biomedica.6863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/15/2023] [Indexed: 10/25/2023]
Abstract
Introduction The birth of premature babies is a public health problem with a high impact on infant morbidity and mortality. About 40% of mortality in children under five years occurs in the first month of life. Objective To identify the association between maternal sociodemographic factors, premature birth, and mortality in newborns under 37 weeks in Santiago de Cali, 2017-2019. Materials and methods We conducted a descriptive, cross-sectional study. We evaluated the records of Cali's Municipal Public Health Office. We calculated the crude and adjusted odd ratios and confidence intervals (95%) using the logistic regression model, data processing in Stata 16, and georeferencing the cases in the QGIS software. Results From 2017 to 2019, premature babies in Cali corresponded to 11% of births. Poor prenatal care increased 3.13 times the risk of being born before 32 weeks (adjusted OR = 3.13; 95% CI = 2.75 - 3.56) and 1.27 times among mothers from outside the city (adjusted OR = 1.27; 95% CI = 1.15-1.41). Mortality was 4.29 per 1,000 live births. The mortality risk in newborns weighing less than 1,000 g increased 3.42 times (OR = 3.42; 95% CI = 2.85-4.12), delivery by cesarean section in 1.46 (OR = 1.46; CI 95% = 1.14-1.87) and an Apgar score - five minutes after birth- lower than seven in 1.55 times (OR = 1.55; CI 95% = 1.23-1.96). Conclusions We found that less than three prenatal controls, mothers living outside Cali, afro-ethnicity, and cesarean birth were associated with prematurity of less than 32 weeks. We obtained higher mortality in newborns weighing less than 1,000 g.
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Affiliation(s)
- Javier Torres-Muñoz
- INSIDE Research Group, Departmento de Pediatría, Universidad del Valle, Cali, Colombia,.
| | | | - Jennifer Murillo
- INSIDE Research Group, Departmento de Pediatría, Universidad del Valle, Cali, Colombia,.
| | - Sofía Torres-Figueroa
- INSIDE Research Group, Departmento de Pediatría, Universidad del Valle, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.
| | - Julián Torres-Figueroa
- INSIDE Research Group, Departmento de Pediatría, Universidad del Valle, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.
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Fiscella K, Yousefi Nooraie R. Health first, for all: Envisioning a novel complementary pathway for translational research. J Clin Transl Sci 2023; 7:e186. [PMID: 37706002 PMCID: PMC10495821 DOI: 10.1017/cts.2023.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Kevin Fiscella
- Department of Family Medicine, University of Rochester, Rochester, NY, USA
| | - Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
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16
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Amlani AM. Effect of Determinants of Health on the Hearing Care Framework: An Economic Perspective. Semin Hear 2023; 44:232-260. [PMID: 37484988 PMCID: PMC10361793 DOI: 10.1055/s-0043-1769611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Hearing care is expanding accessibility to consumers through new service delivery channels and methods of technology distribution (see Brice et al, this issue). This diversification has the potential to overcome longstanding consumer disparities (e.g., health, socioeconomic, psychological, environmental) in receiving care and provider constraints (e.g., accessibility, geography, direct access) to delivering care that adversely impacts quality of life (e.g., social isolation, depression, anxiety, self-esteem). In this article, the reader is provided with an overview of health outcomes factors (i.e., determinants of health)-in the context of an economic framework (i.e., supply, demand)-and their effect on consumer behavior and provider preferences toward hearing healthcare services. This overview also affords readers with strategic business insights to assess and integrate future hearing care services and technology to consumers in their local markets.
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Abstract
The World Health Organization defines social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." This current journal issue has the theme of structural determinants of health. In 2016 (Creative Nursing Vol. 22), we published 49 articles in four issues addressing Determinants of Health: Social Determinants, Structural Determinants, Caregiver Determinants, and Global Determinants. This editorial presents the highlights of those four journal issues, then connects each of the articles in this current issue to the theme; these articles reveal the systems and structures that support our caring from many angles, levels, and perspectives. Readers are challenged to recognize the potential, embedded in every system and structure, for disparities in the provision of our care.
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Haro‐Ramos AY, Brown TT, Deardorff J, Aguilera A, Pollack Porter KM, Rodriguez HP. Frontline work and racial disparities in social and economic pandemic stressors during the first COVID-19 surge. Health Serv Res 2023; 58 Suppl 2:186-197. [PMID: 36718961 PMCID: PMC10339174 DOI: 10.1111/1475-6773.14136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To assess the magnitude of racial-ethnic disparities in pandemic-related social stressors and examine frontline work's moderating relationship on these stressors. DATA SOURCES Employed Californians' responses to the Institute for Governmental Studies (IGS) poll from April 16-20, 2020, were analyzed. The Pandemic Stressor Scale (PSS) assessed the extent to which respondents experienced or anticipated problems resulting from the inability to pay for basic necessities, job instability, lacking paid sick leave, unavailability of childcare, and reduced wages or work hours due to COVID-19. STUDY DESIGN Mixed-effects generalized linear models estimated (1) racial-ethnic disparities in pandemic stressors among workers during the first COVID-19 surge, adjusting for covariates, and (2) tested the interaction between race-ethnicity and frontline worker status, which includes a subset of essential workers who must perform their job on-site, to assess differential associations of frontline work by race-ethnicity. DATA COLLECTION The IGS poll data from employed workers (n = 4795) were linked to the 2018 Centers for Disease Control and Prevention Social Vulnerability Index at the zip code level (N = 1068). PRINCIPAL FINDINGS The average PSS score was 37.34 (SD = 30.49). Whites had the lowest PSS score (29.88, SD = 26.52), and Latinxs had the highest (50.74, SD = 32.61). In adjusted analyses, Black frontline workers reported more pandemic-related stressors than White frontline workers (PSS = 47.73 vs. 36.96, p < 0.001). Latinxs reported more pandemic stressors irrespective of frontline worker status. However, the 5.09-point difference between Latinx frontline and non-frontline workers was not statistically different from the 4.6-point disparity between White frontline and non-frontline workers. CONCLUSION Latinx workers and Black frontline workers disproportionately reported pandemic-related stressors. To reduce stress on frontline workers during crises, worker protections like paid sick leave, universal access to childcare, and improved job security are needed, particularly for those disproportionately affected by structural inequities, such as racially minoritized populations.
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Affiliation(s)
- Alein Y. Haro‐Ramos
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Timothy T. Brown
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Julianna Deardorff
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
- Community Health SciencesUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
| | - Adrian Aguilera
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
- School of Social Welfare BerkeleyUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | - Keshia M. Pollack Porter
- Department of Health Policy and ManagementJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Hector P. Rodriguez
- Health Policy and ManagementUniversity of California Berkeley School of Public HealthBerkeleyCaliforniaUSA
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Eisenkraft Klein D, Shawanda A. Bridging the commercial determinants of Indigenous health and the legacies of colonization: A critical analysis. Glob Health Promot 2023:17579759231187614. [PMID: 37522186 DOI: 10.1177/17579759231187614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
To date, there has been scarce effort to consider the intertwining of colonization and the commercial determinants of Indigenous health. This is a vital omission, and one that this paper proposes to address. We propose how four losses of tradition borne out of colonialism are intertwined with four respective commercial determinants of Indigenous health: 1) loss of traditional diets and the ultra-processed food industry; 2) loss of traditional ceremony and the tobacco industry; 3) loss of traditional knowledge and the infant formula industry; and 4) loss of traditional support networks and the alcohol industry. Building on Indigenous efforts to decolonize spaces and assert control over their own lives, we argue that analyzing the mechanisms through which industry activities intersect with colonial legacies will improve broader understandings of Indigenous health disparities.
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Affiliation(s)
| | - Amy Shawanda
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Canada
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Comeau D, Johnson C, Bouhamdani N. Review of current 2SLGBTQIA+ inequities in the Canadian health care system. Front Public Health 2023; 11:1183284. [PMID: 37533535 PMCID: PMC10392841 DOI: 10.3389/fpubh.2023.1183284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Gender identity and sexual orientation are determinants of health that can contribute to health inequities. In the 2SLGBTQIA+ community, belonging to a sexual and/or gender minority group leads to a higher risk of negative health outcomes such as depression, anxiety, and cancer, as well as maladaptive behaviors leading to poorer health outcomes such as substance abuse and risky sexual behavior. Empirical evidence suggests that inequities in terms of accessibility to health care, quality of care, inclusivity, and satisfaction of care, are pervasive and entrenched in the health care system. A better understanding of the current Canadian health care context for individuals of the 2SLGBTQIA+ community is imperative to inform public policy and develop sensitive public health interventions to make meaningful headway in reducing inequity. Our search strategy was Canadian-centric and aimed at highlighting the current state of 2SLGBTQIA+ health inequities in Canada. Discrimination, patient care and access to care, education and training of health care professionals, and crucial changes at the systemic and infrastructure levels have been identified as main themes in the literature. Furthermore, we describe health care-related disparities in the 2SLGBTQIA+ community, and present available resources and guidelines that can guide healthcare providers in narrowing the gap in inequities. Herein, the lack of training for both clinical and non-clinical staff has been identified as the most critical issue influencing health care systems. Researchers, educators, and practitioners should invest in health care professional training and future research should evaluate the effectiveness of interventions on staff attitudinal changes toward the 2SLGBTQIA+ community and the impact on patient outcomes.
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Affiliation(s)
- Dominique Comeau
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Center, Research Sector, Moncton, NB, Canada
| | - Claire Johnson
- School of Public Policy Studies, Université de Moncton, Moncton, NB, Canada
| | - Nadia Bouhamdani
- Vitalité Health Network, Dr. Georges-L.-Dumont University Hospital Center, Research Sector, Moncton, NB, Canada
- Medicine and Health Sciences Faculty, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Moncton, Moncton, NB, Canada
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Martí-Lluch R, Bolíbar B, Llobera J, Maderuelo-Fernández JA, Magallón-Botaya R, Sánchez-Pérez Á, Fernández-Domínguez MJ, Motrico E, Vicens-Pons E, Notario-Pacheco B, Alves-Cabratosa L, Ramos R. Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis. Front Public Health 2023; 11:1067249. [PMID: 37427254 PMCID: PMC10325828 DOI: 10.3389/fpubh.2023.1067249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. Methods This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. Discussion The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
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Affiliation(s)
- Ruth Martí-Lluch
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Bonaventura Bolíbar
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Joan Llobera
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Balearic Islands Health Service (Ib-Salut), Primary Care Research Unit of Mallorca, Palma, Spain
- Hospital Universitari Son Espases, GrAPP-caIB—Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - José A Maderuelo-Fernández
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Salamanca, Spain
- Instituto de investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Gerencia Regional de salud de Castilla y León (SACyL), Gerencia de Atención Primaria de Salamanca, Salamanca, Spain
| | - Rosa Magallón-Botaya
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Primary Health Care Research Group of Aragón (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Álvaro Sánchez-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Unidad de Investigación Atención Primaria de Bizkaia. Subdirección para la Coordinación de la Atención Primaria, Dirección General Osakiadetza, Vitoria, Spain
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios Instituto Investigación Biocruces, Baracaldo, Bizkaia, Spain
| | - Ma José Fernández-Domínguez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Ourense Health Area, SERGAS, Ourense, Spain
- Centro de Saúde de Leiro, SERGAS, Leiro, Spain
- I-Saúde Group, Hospital Álvaro Cunqueiro Bloque Técnico, South Galicia Health Research Institute, Vigo, Spain
| | - Emma Motrico
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Departamento de Psicología, Universidad Loyola Andalucía, Sevilla, Spain
| | - Enric Vicens-Pons
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Parc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu, St Boi de Llobregat, Catalunya, Spain
| | - Blanca Notario-Pacheco
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Rafel Ramos
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l’Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Girona, Spain
- Parc Hospitalari Martí Julià, Institut d'Investigació Biomèdica de Girona (IDIBGI), Salt, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, Universitat de Girona, Girona, Spain
- Atenció Primària, Institut Català de la Salut, Girona, Catalonia, Spain
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Foulds HJA. It's Not All About that Base Weight: Chipping the Glass Ceiling of Women's Cardiovascular Health. J Am Heart Assoc 2023:e030454. [PMID: 37301751 DOI: 10.1161/jaha.123.030454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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23
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Young-Silva Y, Berenguera A, Jacques-Aviñó C, Gil-Girbau M, Arroyo-Uriarte P, Chela-Alvarez X, Ripoll J, Martí-Lluch R, Ramos R, Elizondo-Alzola U, Garcia-Martinez S, Méndez-López F, Tamayo-Morales O, Martínez-Andrés M, Motrico E, Gómez-Gómez I, Fernández-Alvarez R, Juvinyà-Canal D. Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis. Front Public Health 2023; 11:1069957. [PMID: 37361167 PMCID: PMC10289184 DOI: 10.3389/fpubh.2023.1069957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity. Objectives This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status. Method and analysis This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program. Discussion We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135.
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Affiliation(s)
- Yudy Young-Silva
- Unitat de Suport a la recerca Girona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Girona, Spain
- Facultat d’Infermeria, Universitat de Girona, Girona, Spain
| | - Anna Berenguera
- Facultat d’Infermeria, Universitat de Girona, Girona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Goli Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
| | - Montserrat Gil-Girbau
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de LLobregat, Spain
- Parc Sanitari Sant Joan de Déu, San Boi de Llobregat, Spain
| | - Paula Arroyo-Uriarte
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de LLobregat, Spain
| | - Xenia Chela-Alvarez
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion-Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Joana Ripoll
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion-Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Ruth Martí-Lluch
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l'Atenció Primària Jordi Gol I Gurina (IDIAPJGol), Girona, Catalonia, Spain
- Girona Biomedical Research Institute, Girona, Catalonia, Spain
| | - Rafel Ramos
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Vascular Health Research Group of Girona, Institut Universitari per a la Recerca a l'Atenció Primària Jordi Gol I Gurina (IDIAPJGol), Girona, Catalonia, Spain
- Girona Biomedical Research Institute, Girona, Catalonia, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- Primary Care Services, Catalan Institute of Health, Girona, Catalonia, Spain
| | - Usue Elizondo-Alzola
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios, Instituto Investigación de Biocruces, Barakaldo, Spain
| | - Sandra Garcia-Martinez
- Grupo de Investigación en Ciencias de la Diseminación e Implementación en Servicios Sanitarios, Instituto Investigación de Biocruces, Barakaldo, Spain
| | - Fátima Méndez-López
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Olaya Tamayo-Morales
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL) Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Mária Martínez-Andrés
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Faculty of Nursing, Universidad de Castilla La Mancha, Albacete, Spain
- Social and Health Research Center, Universidad de Castilla La Mancha, Cuenca, Spain
| | - Emma Motrico
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | - Irene Gómez-Gómez
- Network on Chronicity, Primary Care, and Health Prevention and Promotion(RICAPPS), Spain
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
| | - Roberto Fernández-Alvarez
- Ourense Health Area, SERGAS, Ourence, Spain
- Centro de Saúde de Allariz, SERGAS, Allariz, Spain
- I-Saúde Grup, South Galicia Health Research Institute, Vigo, Spain
| | - Dolors Juvinyà-Canal
- Facultat d’Infermeria, Universitat de Girona, Girona, Spain
- Grup de recerca Salut i Atenció sanitària Universitat de Girona, Girona, Spain
- Càtedra de Promoció de la Salut Universitat de Girona, Girona, Spain
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Kamdar N, Khan S, Brostow DP, Spencer L, Roy S, Sisson A, Hundt NE. Association between modifiable social determinants and mental health among post-9/11 Veterans: A systematic review. J Mil Veteran Fam Health 2023; 9:8-26. [PMID: 37886122 PMCID: PMC10601397 DOI: 10.3138/jmvfh-2022-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Introduction As U.S. Veterans reintegrate from active duty to civilian life, many are at risk for negative modifiable social determinants of health. The prevalence of mental health conditions among Veterans is also high. Awareness of the associations between these two factors is growing. This systematic review provides a comprehensive analysis of the current state of knowledge of the associations between modifiable social determinants and mental health among U.S. Veterans. Methods The authors systematically searched four databases and identified 28 articles representing 25 unique studies that met inclusion criteria. Findings from the studies were extracted and synthesized on the basis of modifiable social determinants. Study quality and risk of bias were assessed using the Methodological Quality Questionnaire. Results The studies identified in the systematic review examined three modifiable social determinants of health: 1) housing stability, 2) employment and finances, and 3) social support. Although the lack of validity for measures of housing stability, employment, and finances compromised study quality, the overall evidence suggests that Veterans with access to supportive social determinants had better mental health status. Evidence was particularly robust for the association between strong social support and lower symptoms of posttraumatic stress disorder. Discussion Current evidence suggests the need to consider modifiable social determinants of health when designing mental health interventions. However, more research encompassing a wider range of modifiable social determinants such as food security, education, and transportation and using comprehensive methods and validated instruments is needed. Future research also needs to intentionally include Veterans from diverse racial-ethnic groups.
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Affiliation(s)
- Nipa Kamdar
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United States
| | - Sundas Khan
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United States
| | - Diana P. Brostow
- Veterans Health Administration Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, United States
| | - Lia Spencer
- Brandeis University, Waltham, Massachusetts, United States
| | - Sharmily Roy
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - Amy Sisson
- The Texas Medical Center Library, Houston, Texas, United States
| | - Natalie E. Hundt
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, United States
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Koshy L, Burns K, Godinho Nascimento MH, Ike NAU, Herati H, Filice E, Rotolo B, Betini GS, Ward PR, Dubé È, Meyer SB. Newcomer perceptions of COVID-19 countermeasures in Canada. Health Promot Int 2023; 38:daad051. [PMID: 37326406 DOI: 10.1093/heapro/daad051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Newcomers to Canada have been disproportionally affected by COVID-19, with higher rates of infection and severity of illness. Determinants of higher rates may relate to social and structural inequities that impact newcomers' capacity to follow countermeasures. Our aim was to describe and document factors shaping newcomers' acceptance of COVID-19 countermeasures. Semi-structured qualitative interviews were conducted with individuals living in Canada for <5 years. Participants were asked to discuss their pandemic experiences, and perceptions and acceptance of measures. Five themes were identified: (i) belief in the necessity and efficacy of countermeasures; (ii) negative impact of measures on health/wellbeing; (iii) existing barriers to newcomer settlement exacerbated by pandemic measures; (iv) countermeasure adherence related to immigration status and (v) past experiences shaping countermeasure acceptance. Government should continue to provide messaging regarding the importance of measures for individual and population heath and continue to demonstrate a commitment to the interests of citizens. Importantly, newcomer trust in government should not be taken for granted, as this trust is critical for the acceptance of government interventions now and moving forward. It will be important to ensure that newcomers are given support to overcome challenges to settlement that were intensified during the pandemic.
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26
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Leta K, Lauwerier E, Willems S, Vermeersch S, Demeester B, Verloigne M. Smoking prevention within social work organizations: a qualitative study about youngsters' and youth workers' perceptions. Health Promot Int 2023; 38:7171694. [PMID: 37202340 DOI: 10.1093/heapro/daad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Tobacco smoking uptake is still a major public health concern, especially among youngsters living in vulnerable situations. Finding optimal ways to engage youngsters in smoking prevention is important. Compared to traditional settings such as schools, social work settings providing sports-based and recreational activities (SR-settings) tend to reach and engage youngsters more. This study aimed to gain insight into the reasons for smoking uptake among youngsters living in vulnerable situations and the conditions through which SR-settings are potentially beneficial for smoking prevention initiatives. Data were collected in two SR-settings in Flanders, Belgium, by means of five focus group discussions and six individual interviews with youngsters (n = 38, mean age = 12.9 ± 2.61 years, 69.7% boys) and eight individual interviews with youth workers (n = 8, mean age = 27.5 ± 7.95 years, 87.5% men). A thematic analysis (TA) approach was applied to analyse the data. Besides individual factors, such as attitudes towards smoking, the desire to be part of a group and conformity to group norms seem to be important drivers of smoking uptake among youngsters in vulnerable situations. The presence of powerful role models in SR-settings with whom youngsters identify may counteract group norms by encouraging healthy behaviour. SR-settings seem suitable for questioning perceptions of vulnerable youngsters, unlike other settings where they may struggle to be heard. The conditional characteristics of SR-settings, such as authentic group processes, having meaningful roles, and being heard, make these contexts promising venues for smoking prevention efforts among vulnerable youngsters. Youth workers who have established trusting relationships with youngsters seem well-suited to communicate smoking prevention messages. A participatory approach, in which youngsters are involved in developing smoking prevention programs, is desirable.
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Affiliation(s)
- Kenji Leta
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Sarah Vermeersch
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Babette Demeester
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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Mulligan K. Digital inclusion, online participation and health promotion: promising practices from community-led participatory journalism. Glob Health Promot 2023; 30:35-39. [PMID: 36287081 PMCID: PMC10273864 DOI: 10.1177/17579759221126150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/28/2022] [Indexed: 09/28/2023]
Abstract
A growing body of evidence demonstrates that digital inclusion mediates access to other social determinants of health - directly, through access to and literacy in technologies or services, and indirectly, by supporting people's capacity to participate fully and equitably in civic and cultural life online. Novel approaches to community-led participatory journalism, in which people from equity-deserving communities are supported to tell their own stories, suggest promising practices for online civic engagement as an emerging approach to promoting health though digital inclusion.
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28
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Badu E, Mpofu C, Came H. African Hut model of health: a framework for improving African migrant health in Aotearoa/New Zealand. Health Promot Int 2023; 38:7125513. [PMID: 37067167 DOI: 10.1093/heapro/daad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
There is renewed international effort to improve the health and well-being of migrants. For African migrants, theoretical frameworks designed to account for and guide interventions to address the underlying mechanisms that interact to influence health and well-being remain largely underdeveloped. The aim of this study was to address this gap by providing a unique socio-ecological framework with specific entry points for targeted health promotion action aimed at improving the health and well-being of African migrants living in Aotearoa New Zealand. The African Hut model of health was developed through an inductive iterative approach informed by a review of the evidence and semi-structured interviews with key informants. The interviews were conducted in person using one-on-one format and employed to refine initial themes from the literature. A hybrid thematic analysis, involving both inductive and deductive approaches was used to analyse the interview data. The health and well-being of African migrant communities are the outcome of complex interplay of individual, economic, social and structural factors. To protect and promote the health of African communities in Aotearoa requires tailored interventions that centre culture and deliver holistically.
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Affiliation(s)
- Emmanuel Badu
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Charles Mpofu
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Heather Came
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
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Abstract
Around the world, children are being exposed to intensive marketing for gambling products. This normalizes perceptions that gambling is essentially a harmless form of entertainment, despite mounting evidence of the harms it causes. Young people and their parents are supportive of strategies to protect children from being exposed to gambling marketing. Yet existing regulatory efforts are inconsistent and inadequate, and have not protected children from exposure to the many forms of marketing now being developed and exploited by the gambling industry. We outline existing knowledge about strategies used by the gambling industry to market its products, with a specific focus on the potential impact of gambling marketing on young people. We provide a definition of gambling marketing and outline the different forms of promotion that are currently used to market gambling, current regulatory responses, and the impact of marketing on children and young people. We then argue that a comprehensive public health approach to gambling is urgently required, which must include effective action to limit the influence of marketing for gambling products, while recognizing that it is never possible to insulate children entirely from their reach.
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Affiliation(s)
| | - May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Hannah Pitt
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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30
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Callway R, Le Gouais A, Bird EL, Chang M, Kidger J. Integrating Health into Local Plans: A Comparative Review of Health Requirements for Urban Development in Seven Local Planning Authorities in England. Int J Environ Res Public Health 2023; 20:4079. [PMID: 36901090 PMCID: PMC10002235 DOI: 10.3390/ijerph20054079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
A local plan is a statutory policy document that supports urban development decisions across a local government area in England. Local plans are reported to need more specific requirements for development proposals regarding wider health determinants to address potential health outcomes and health inequalities. This study reviews the integration of Health in Local Plans of seven local planning authorities through documentary analysis methods. A review framework was formulated based on health and planning literature regarding local plans, health policy and determinants of health and dialogue with a local government partner. The findings identify opportunities to strengthen the consideration of Health in Local Plans, including ensuring that policies are informed by local health priorities and signpost national guidance, strengthening health-related requirements for developers (e.g., indoor air quality, fuel poverty and security of tenure) and improving implementation of requirements for developers (e.g., through adoption of health management plans and community ownership). The study identifies further research needs regarding how policies are interpreted by developers in practice, and on national guidance for Health Impact Assessment. It highlights the benefit of undertaking a comparative review, contrasting local plan policy language and identifying opportunities to share, adapt and strengthen planning requirements regarding health outcomes.
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Affiliation(s)
- Rosalie Callway
- Population Health Sciences, Bristol Medical School, University of Bristol, 1–5 Whiteladies Road, Bristol BS8 1NU, UK
| | - Anna Le Gouais
- Population Health Sciences, Bristol Medical School, University of Bristol, 1–5 Whiteladies Road, Bristol BS8 1NU, UK
| | - Emma L. Bird
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK
| | - Michael Chang
- Department of Civil Engineering, University of Bristol, Bristol BS8 1TL, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, 1–5 Whiteladies Road, Bristol BS8 1NU, UK
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31
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Hutchinson-Colas JA, Balica A, Chervenak FA, Friedman D, Locke LS, Bachmann G, Cheng RFJ. New Jersey maternal mortality dashboard: an interactive social-determinants-of-health tool. J Perinat Med 2023; 51:188-196. [PMID: 35224952 DOI: 10.1515/jpm-2021-0673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/04/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The United States maternal mortality (MM) rate is the highest amid developed/industrialized nations, and New Jersey's rate is among the highest. Healthcare professionals, public health officials, and policy makers are working to understand drivers of MM. An interactive data visualization tool for MM and health-related information (New Jersey Maternal Mortality Dashboard [NJMMD]) was recently developed. METHODS NJMMD is an open-source application that uses data from publicly available state/federal government sources to provide a cross-sectional, high-level depiction of potential relationships between MM and demographic, social, and public health factors. RESULTS MM rates or ratios (maternal deaths/1,000 women aged 15-49 years or 100,000 live births, respectively) are available by year (2005-2017), age (5-year [15-49] periods), and race/ethnicity (non-Hispanic White, Black, or Asian; Hispanic; or other), and by contextual social determinants of health (percent insured; percent covered by Medicaid; difference in nulliparous, term, singleton, vertex Cesarian birth rate from New Jersey goal; number of obstetrician/gynecologists or midwives per capita; and poverty rate). Bar graphs also can be produced with these variables. CONCLUSIONS NJMMD is the first publicly available, interactive, state-focused MM tool that takes into account the intersection of social and demographic determinants of health, which play important roles in health outcomes. Trends and patterns in variables associated with MM and health can be identified for New Jersey and each of its 11 counties, and inform areas of focus for further analysis. Outputs may enable researchers, policy makers, and others to develop appropriate interventions and be better positioned to set benchmarks, allocate resources, and evaluate outcomes.
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Affiliation(s)
- Juana A Hutchinson-Colas
- The Women's Health Institute and the Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Adrian Balica
- The Women's Health Institute and the Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Frank A Chervenak
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | | | - Linda Sloan Locke
- New Jersey Affiliate American College of Nurse-Midwives, Maywood, NJ, USA
| | - Gloria Bachmann
- The Women's Health Institute and the Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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32
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Hogg-Graham R, Mamaril CB, Benitez JA, Gatton K, Mays GP. Impact of state Medicaid expansion on cross-sector health and social service networks: Evidence from a longitudinal cohort study. Health Serv Res 2023; 58:634-641. [PMID: 36815298 PMCID: PMC10154156 DOI: 10.1111/1475-6773.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To examine the impact of state Medicaid expansion on the delivery of population health activities in cross-sector health and social services networks. Community networks are multisector, interorganizational networks that provide services ranging from the direct provision of individual social services to the implementation of population-level initiatives addressing community outcomes. DATA SOURCES We used data measuring the composition of cross-sector population health networks 2006-2018 National Longitudinal Survey of Public Health Systems (NALSYS) linked with the Area Health Resource File. STUDY DESIGN A difference-in-differences approach was used to examine the impact of expansion on organization engagement in population health activities and network structure. DATA COLLECTION/EXTRACTION METHODS Stratified random sampling of local public health jurisdictions in the United States. We restricted our data to jurisdictions serving populations of 100,000 or more and states that had NALSYS observations across all time periods, resulting in a final sample size of 667. PRINCIPAL FINDINGS Results from our adjusted difference-in-differences estimates indicated that Medicaid expansion was associated with a 2.3 percentage point increase in the density of population health networks (p < 0.10). Communities in states that expanded Medicaid experienced significant increases in the participation of local public health, local government, hospital, nonprofit, insurer, and K-12 schools. Of the organizations with significant increases in expansion communities, nonprofits (7.7 percentage points, p < 0.01), local public health agencies (6.5 percentage points, p < 0.01), hospitals (5.8 percentage points, p < 0.01), and local government agencies (6.0 percentage points, p < 0.05) had the largest gains. CONCLUSIONS Our study found increases in cross-sector participation in population health networks in states that expanded Medicaid compared with nonexpansion states, suggesting that additional coverage gains are associated with positive changes in population health network structure.
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Affiliation(s)
- Rachel Hogg-Graham
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Cezar B Mamaril
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Joseph A Benitez
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, Kentucky, USA.,Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Kelsey Gatton
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Glen P Mays
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, Colorado, USA
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Singh SS, Stranges S, Wilk P, Tang ASL, Frisbee SJ. Influence of the Social Environment on Ideal Cardiovascular Health. J Am Heart Assoc 2023; 12:e026790. [PMID: 36789849 PMCID: PMC10111502 DOI: 10.1161/jaha.122.026790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Background The environment plays a large role in the health of individuals; however, more research is needed to better understand aspects of the environment that most influence health. Specifically, our study examines how the social environment influences cardiovascular health (CVH). Methods and Results The social environment was characterized using measures of belonging and life and work stress in individuals, as well as nationally derived measures of marginalization, deprivation, economic status, and community well-being in neighborhoods. CVH was defined by the American Heart Association's Cardiovascular Health Index-a summed score of 7 clinical and behavioral components known to have the greatest impact on CVH. Data were obtained from the Canadian Community Health Survey 2015 to 2016 and multiple national data sources. Multilevel regression models were used to analyze the associations between CVH and the social environment. Overall, 27% of Canadians reported ideal CVH (6-7 score points), 68% reported intermediate CVH (3-5 score points), and 5% reported poor CVH (0-2 score points). The neighborhood environment contributed up to 7% of the differences in CVH between individuals. Findings indicated that residing in a neighborhood with greater community well-being (odds ratio [OR], 1.33 [95% CI, 1.26-1.41]) was associated with achieving higher odds of ideal CVH, while weaker community belonging (OR, 0.67 [95% CI, 0.62-0.72]) and residing in a neighborhood with greater marginalization (OR, 0.87 [95% CI, 0.82-0.91]) and deprivation (OR, 0.67 [95% CI, 0.64-0.69]) were associated with achieving lower odds of ideal CVH. Conclusions Aspects of individual-level social environment and residing in a neighborhood with a more favorable social environment were both independently and significantly associated with achieving ideal CVH.
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Affiliation(s)
- Sarah S Singh
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Department of Family Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Department of Precision Medicine Luxembourg Institute of Health Strassen Luxembourg
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Paediatrics, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada
| | - Anthony S L Tang
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Medicine, Division of Cardiology, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada
| | - Stephanie J Frisbee
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Lawson Health Research Institute London Ontario Canada
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Mavragani A, Holloway TP, Soward R, Patterson KAE, Ahuja KDK, Dalton L, Murray S, Hughes R, Byrne NM, Hills AP. "An Ounce of Prevention is Worth a Pound of Cure": Proposal for a Social Prescribing Strategy for Obesity Prevention and Improvement in Health and Well-being. JMIR Res Protoc 2023; 12:e41280. [PMID: 36800232 PMCID: PMC9985003 DOI: 10.2196/41280] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional "biomedical approach of care" to a "biopsychosocial model" required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level. OBJECTIVE The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation. METHODS This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated "navigator" will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives. RESULTS A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project. CONCLUSIONS Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/41280.
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Affiliation(s)
| | - Timothy P Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Kira A E Patterson
- College of Arts, Law and Education, University of Tasmania, Launceston, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Lisa Dalton
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Sandra Murray
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
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Lilly K, Kean B, Hallett J, Robinson S, Selvey LA. Factors of the policy process influencing Health in All Policies in local government: A scoping review. Front Public Health 2023; 11:1010335. [PMID: 36844855 PMCID: PMC9949293 DOI: 10.3389/fpubh.2023.1010335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Objectives This review aimed to identify factors in the policymaking environment that influence a Health in all Policies approach in local government, how these vary across different municipal contexts, and the extent that theories of the policy process are applied. Methods A scoping review was conducted to include sources published in English, between 2001 and 2021 in three databases, and assessed for inclusion by two blind reviewers. Results Sixty-four sources were included. Sixteen factors of the policy process were identified, expanding on previously reported literature to include understanding and framing of health, use of evidence, policy priority, and influence of political ideology. Eleven sources applied or referred to theories of the policy process and few reported findings based on different local government contexts. Conclusion There are a range of factors influencing a Health in All Policies approach in local government, although a limited understanding of how these differ across contexts. A theory-informed lens contributed to identifying a breadth of factors, although lack of explicit application of theories of the policy process in studies makes it difficult to ascertain meaningful synthesis of the interconnectedness of these factors.
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Affiliation(s)
- Kara Lilly
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Bridie Kean
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Jonathan Hallett
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Suzanne Robinson
- School of Population Health, Curtin University, Perth, WA, Australia
- Deakin Health Economics, Faculty of Health Sciences, Deakin University, Burwood, VIC, Australia
| | - Linda A. Selvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Martin-Sanchez F, Lázaro M, López-Otín C, Andreu AL, Cigudosa JC, Garcia-Barbero M. Personalized Precision Medicine for Health Care Professionals: Development of a Competency Framework. JMIR Med Educ 2023; 9:e43656. [PMID: 36749626 PMCID: PMC9943053 DOI: 10.2196/43656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/21/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Personalized precision medicine represents a paradigm shift and a new reality for the health care system in Spain, with training being fundamental for its full implementation and application in clinical practice. In this sense, health care professionals face educational challenges related to the acquisition of competencies to perform their professional practice optimally and efficiently in this new environment. The definition of competencies for health care professionals provides a clear guide on the level of knowledge, skills, and attitudes required to adequately carry out their professional practice. In this context, this acquisition of competencies by health care professionals can be defined as a dynamic and longitudinal process by which they use knowledge, skills, attitudes, and good judgment associated with their profession to develop it effectively in all situations corresponding to their field of practice. OBJECTIVE This report aims to define a proposal of essential knowledge domains and common competencies for all health care professionals, which are necessary to optimally develop their professional practice within the field of personalized precision medicine as a fundamental part of the medicine of the future. METHODS Based on a benchmark analysis and the input and expertise provided by a multidisciplinary group of experts through interviews and workshops, a new competency framework that would guarantee the optimal performance of health care professionals was defined. As a basis for the development of this report, the most relevant national and international competency frameworks and training programs were analyzed to identify aspects that are having an impact on the application of personalized precision medicine and will be considered when developing professional competencies in the future. RESULTS This report defines a framework made up of 58 competencies structured into 5 essential domains: determinants of health, biomedical informatics, practical applications, participatory health, and bioethics, along with a cross-cutting domain that impacts the overall performance of the competencies linked to each of the above domains. Likewise, 6 professional profiles to which this proposal of a competency framework is addressed were identified according to the area where they carry out their professional activity: health care, laboratory, digital health, community health, research, and management and planning. In addition, a classification is proposed by progressive levels of training that would be advisable to acquire for each competency according to the professional profile. CONCLUSIONS This competency framework characterizes the knowledge, skills, and attitudes required by health care professionals for the practice of personalized precision medicine. Additionally, a classification by progressive levels of training is proposed for the 6 professional profiles identified according to their professional roles.
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Affiliation(s)
- Fernando Martin-Sanchez
- Department of Biomedical Informatics and Digital Health, National Institute of Health Carlos III, Madrid, Spain
| | - Martín Lázaro
- Department of Medical Oncology, University Hospital Complex of Vigo, Vigo, Spain
| | | | - Antoni L Andreu
- European Infrastructure for Translational Medicine, Amsterdam, Netherlands
| | - Juan Cruz Cigudosa
- Department of University, Innovation and Digital Transformation, the Government of Navarra, Navarra, Spain
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Herrin J, Barthel A, Goutos D, Du C, Zhou S, Peltz A, Poyer J, Lin Z, Bernheim S. Measuring health disparities using a continuous social risk factor. Health Serv Res 2023; 58:30-39. [PMID: 36146904 PMCID: PMC9836958 DOI: 10.1111/1475-6773.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To propose and evaluate a novel approach for measuring hospital-level disparities according to the effect of a continuous, polysocial risk factor on those outcomes. STUDY SETTING Our cohort consisted of Medicare Fee-for-Service (FFS) patients 65 years and older admitted to acute care hospitals for one of six common conditions or procedures. Medicare administrative claims data for six hospital readmission measures including hospitalizations from July 2015 to June 2018 were used. STUDY DESIGN We adapted existing methodologies that were developed to report hospital-level disparities using dichotomous social risk factors (SRFs). The existing methods report disparities within and across hospitals; we developed and tested modified approaches for both methods using the Agency for Healthcare Research and Quality Socioeconomic Status Index. We applied the adapted methodologies to six 30-day hospital readmission measures included in the Centers for Medicare & Medicaid Services Hospital Readmissions Reduction Program measures. We compared the within- and across-hospital results for each to those obtained from using the original methods and dichotomizing the AHRQ SES Index into "low" and "high" scores. DATA COLLECTION We used Medicare FFS administrative claims data linked to U.S. Census data. PRINCIPAL FINDINGS For all six readmission measures we find that, when compared with the existing methods, the methods for continuous SRFs provide disparity results for more facilities though across a narrower range of values. Measures of disparity based on this approach are moderately to highly correlated with those based on a dichotomous version of the same risk factor, while reflecting a fuller spectrum of risk. This approach represents an opportunity for detection of provider-level results that more closely align with underlying social risk. CONCLUSION We have demonstrated the feasibility and utility of estimating hospital disparities of care using a continuous, polysocial risk factor. This approach expands the potential for reporting hospital-level disparities while better accounting for the multifactorial nature of social risk on hospital outcomes.
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Affiliation(s)
- Jeph Herrin
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Department of Internal MedicineYale University School of MedicineNew HavenConnecticutUSA
- Flying Buttress AssociatesCharlottesvilleVirginiaUSA
| | - Andrea Barthel
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
| | - Demetri Goutos
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Department of Health Law, Policy, and ManagementBoston University School of Public HealthBostonMassachusettsUSA
| | - Chengan Du
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Section of Cardiovascular MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Sheng Zhou
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Department of Emergency MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Alon Peltz
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Department of Population MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - James Poyer
- The Center for Clinical Standards and QualityThe Centers for Medicare and Medicaid ServicesBaltimoreMarylandUSA
| | - Zhenqiu Lin
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Department of Internal MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Susannah Bernheim
- The Yale Center for Outcomes Research and EvaluationYale New Haven Health Systems CorporationNew HavenConnecticutUSA
- Section of General Internal MedicineYale University School of MedicineNew HavenConnecticutUSA
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Booth EJ, Kitsantas P, Min H, Pollack AZ. Opioids and Disability Among Women of Reproductive Age. J Womens Health (Larchmt) 2022; 31:1751-1762. [PMID: 36126295 DOI: 10.1089/jwh.2022.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Despite nearly one in five U.S. women of reproductive age reporting a disability, limited research exists on opioid behaviors in this vulnerable population. This study examined associations between disability and past-year prescription opioid use and misuse, and described types of opioids, sources, and motives for opioid misuse among nonpregnant women of reproductive age. In addition, the effects of social, medical, and behavioral determinants of health on opioid use and misuse were assessed in this population of women with disabilities. Materials and Methods: Data were used from the 2015-2019 National Survey on Drug Use and Health (n = 93,679). Descriptive statistics and logistic regression models were used in the analyses. Results: Overall, 48.0% of women with a disability reported past-year prescription of any opioid use compared to 32.3% of women without disabilities, and 10.4% of women with disabilities reported opioid misuse relative to 4.2% of women without disabilities. Hydrocodone was the most used (29.3%) and misused (5.87%) opioid. Women with disabilities had higher adjusted odds of opioid use (adjusted odds ratio [AOR] 1.59; 95% confidence interval [CI], 1.50-1.67) and misuse (AOR 2.01; 95% CI, 1.82-2.21) than those without disabilities. Tobacco, alcohol use, and poor to fair health were all associated with higher odds of opioid misuse. For their last opioid misuse, 5.2% attained the opioids from a dealer or stranger, and 22.1% used opioids to get high. Conclusion: Women with disabilities are at an amplified risk for prescription opioid use and misuse. Improved medical provider education, training and capacity, and reinforcing related community-based support programs for this population are imperative.
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Affiliation(s)
- Edward J Booth
- Department of Health Administration and Policy and George Mason University, Fairfax, Virginia, USA
| | - Panagiota Kitsantas
- Department of Health Administration and Policy and George Mason University, Fairfax, Virginia, USA
| | - Hua Min
- Department of Health Administration and Policy and George Mason University, Fairfax, Virginia, USA
| | - Anna Z Pollack
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
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Poráčová J, Uher I, Vašková H, Kimáková T, Konečná M, Blaščáková MM, Sedlák V. Effectiveness of Adherence to a Mediterranean Diet in the Management of Overweight Women: The Prospective Interventional Cohort Study. Int J Environ Res Public Health 2022; 19:15927. [PMID: 36498001 PMCID: PMC9740687 DOI: 10.3390/ijerph192315927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Evidence indicates that unhealthy eating habits constitute multilevel obstacles threatening health and well-being. Studies suggest that consumer choices have turned irremovably towards Western diets. The Mediterranean diet (MD) is considered one of the most effective in preventing and treating overweight and obesity, yet its results and associations are ambiguous. This explanatory research aims to examine the effect of the MD on anthropometric and biochemical variables in 181 females from an Eastern European country. The sample was divided into three distinct clusters based on age (tricenarian, quadragenarian, and quinquagenarian). Anthropometric and biochemical examinations in the three-month MD program plan failed to provide convincing evidence of the benefits of the MD on selected integrands. However, total body fat (FATP) values between groups showed a significant difference (p ≤ 0.032) between groups A and C (p ≤ 0.029), which can be attributed to the age of the cohort (30-39 vs. 50-60 years). Values in groups A and B (p ≤ 0.001) and C and A (p ≤ 0.001) were significant between the cohorts but did not indicate any changes in visceral fat (VFATL) in the individual groups. The presented findings can have implications for further investigation and the development of more comprehensive instruments, incorporating critical add-on constituents that will be appropriate to monitor, evaluate, and predict body weight management in experimentation.
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Affiliation(s)
- Janka Poráčová
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia
| | - Ivan Uher
- Institute of Physical Education and Sport, Pavol Jozef Šafárika University, 040 01 Košice, Slovakia
| | - Hedviga Vašková
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia
| | - Tatiana Kimáková
- Department of Public Health and Hygiene, Pavol Jozef Šafárik University, 040 01 Košice, Slovakia
| | - Mária Konečná
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia
| | | | - Vincent Sedlák
- Faculty of Humanities and Natural Sciences, University of Prešov, 080 01 Prešov, Slovakia
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Gerken J, Zapata D, Kuivinen D, Zapata I. Comorbidities, sociodemographic factors, and determinants of health on COVID-19 fatalities in the United States. Front Public Health 2022; 10:993662. [PMID: 36408029 PMCID: PMC9669977 DOI: 10.3389/fpubh.2022.993662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Previous studies have evaluated comorbidities and sociodemographic factors individually or by type but not comprehensively. This study aims to analyze the influence of a wide variety of factors in a single study to better understand the big picture of their effects on case-fatalities. This cross-sectional study used county-level comorbidities, social determinants of health such as income and race, measures of preventive healthcare, age, education level, average household size, population density, and political voting patterns were all evaluated on a national and regional basis. Analysis was performed through Generalized Additive Models and adjusted by the COVID-19 Community Vulnerability Index (CCVI). Effect estimates of COVID-19 fatality rates for risk factors such as comorbidities, sociodemographic factors and determinant of health. Factors associated with reducing COVID-19 fatality rates were mostly sociodemographic factors such as age, education and income, and preventive health measures. Obesity, minimal leisurely activity, binge drinking, and higher rates of individuals taking high blood pressure medication were associated with increased case fatality rate in a county. Political leaning influenced case case-fatality rates. Regional trends showed contrasting effects where larger household size was protective in the Midwest, yet harmful in Northeast. Notably, higher rates of respiratory comorbidities such as asthma and chronic obstructive pulmonary disease (COPD) diagnosis were associated with reduced case-fatality rates in the Northeast. Increased rates of chronic kidney disease (CKD) within counties were often the strongest predictor of increased case-fatality rates for several regions. Our findings highlight the importance of considering the full context when evaluating contributing factors to case-fatality rates. The spectrum of factors identified in this study must be analyzed in the context of one another and not in isolation.
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Kirshchina IA, Shestakova TV, Soloninina AV, Krasheninnikov AE, Habriev RU. [NORMATIVE AND LEGAL ASPECTS OF THE FORMATION OF THE BASIC PREREQUISITES OF PUBLIC HEALTH (PUBLICATIONS REVIEW)]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:746-752. [PMID: 36282641 DOI: 10.32687/0869-866x-2022-30-5-746-752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/06/2022] [Indexed: 06/16/2023]
Abstract
Preservation of public health is the main goal of social progress and development of the society. The search for potential opportunities to improve individual and public health indicators is a positive predictor of increasing the socio-economic efficiency of the society and increasing the healthy life expectancy of citizens. The scientific review provides arguments in favor of the need for professional collaboration of specialists from various industries in order to universally realize the most important right of citizens to protect their own and public health. Regulatory legal documents defining national and international policy in the field of health protection and forming the general vector of development of health care activities were used as the sources of information for the formation of the basis of the study. As a result of a logical generalization of global and national priorities and trends in the development of the healthcare sector, the main prerequisites (determinants) of health saving of citizens, adopted by the world community and reflected in domestic documents, are formulated. The main prerequisites (determinants) of health are defined as: promotion of activities that advantage health protection; creation of a single preventive space; specification of the concept of "responsible attitude to health"; coverage of the entire life cycle of a person and all spheres of his activity in the formation of a responsible attitude to health and motivation for its preservation; development of information technologies in the field of health protection; expansion of intersectoral and interdisciplinary cooperation in order to maintain and strengthen health; improvement of public health literacy; transformation of health services from the standpoint of health protection; development of human resources to ensure health-saving activities. The identified determinants of the preservation of individual and public health can act as a theoretical basis for the development of a scientific and practical methodology aimed at solving problems of improving health through the potential of interdisciplinary interaction of specialists in various fields of activity.
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Affiliation(s)
- I A Kirshchina
- Perm State Pharmaceutical Academy of Minzdrav of Russia, 614990, Perm, Russia,
| | - T V Shestakova
- Perm State Pharmaceutical Academy of Minzdrav of Russia, 614990, Perm, Russia
| | - A V Soloninina
- Perm State Pharmaceutical Academy of Minzdrav of Russia, 614990, Perm, Russia
| | - A E Krasheninnikov
- Pirogov Russian National Research Medical University of Minzdrav of Russia, 117997, Moscow, Russian Federation
- The National Scientific Center of the Farmakonadzor, 143026, Moscow, Russia
| | - R U Habriev
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
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Bakirova EA, Galiullin DA, Shulaev AV, Kitaeva EA, Galiullin AN. [DETERMINANTS OF QUALITY OF LIFE AND MORBIDITY IN THE ADULT POPULATION]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:761-765. [PMID: 36282643 DOI: 10.32687/0869-866x-2022-30-5-761-765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/06/2022] [Indexed: 06/16/2023]
Abstract
In the Russian Federation, the number of working-age population is growing annually: in 2014, the number of able-bodied population was 33.8 million people(23.5%), while in 2018 this figure increased to 37.3 million (25.9%) [6]. In the Republic of Tatarstan, at the beginning of 2019 the number of able-bodied citizens reached 986 thousand people(26.0%). The purpose of this study was to analyze the determinants of the adult living standarts and the impact of these determinants on morbidity rates. A survey of 897 people using the SF-36 international questionnaire "SF-36 Health Status Survey". The majority of the working-age population under study was aged 60-64 (30%) and 65-69 (26%), aged 55-59 and 70-74 were 12% and 18% respectively. The smallest number of those under study was aged 75-79 (8%) and 80 and older (6%). Thus, our research has shown that the living standarts of over working-age population living in a large metropolis tends to significantly decrease depending on the age and gender. There was discovered a high level of prevalence of medical and social risk factors in these individuals, which are involved in the formation of the determinant of living standarts. For the first time, it was revealed that in people over the working age, the intensity of morbidity depends on the level of determinants of living standarts. The data obtained make it possible to develop measures to improve the quality of life of people over the working age and reduce their morbidity.
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Affiliation(s)
- E A Bakirova
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
| | - D A Galiullin
- Kazan State Medical University of Minzdrav of Russia, 420012, Kazan, Russia
- City Clinical Hospital No. 16, 420061, Kazan, Russia
| | - A V Shulaev
- Kazan State Medical University of Minzdrav of Russia, 420012, Kazan, Russia
| | - E A Kitaeva
- Kazan State Medical University of Minzdrav of Russia, 420012, Kazan, Russia
| | - A N Galiullin
- Kazan State Medical University of Minzdrav of Russia, 420012, Kazan, Russia
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August E, Tadesse L, O'Neill MS, Eisenberg JNS, Wong R, Kolars JC, Bekele A. What is Global Health Equity? A Proposed Definition. Ann Glob Health 2022; 88:50. [PMID: 35860038 DOI: 10.5334/aogh.3754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022] Open
Abstract
The term “global health equity” has become more visible in recent years, yet we were unable to find a formal definition of the term. Our Viewpoint addresses this gap by offering a discussion of this need and proposing a definition. We define global health equity as mutually beneficial and power-balanced partnerships and processes leading to equitable human and environmental health outcomes (which we refer to as “products”) on a global scale. Equitable partnerships actively work against racism and supremacy. Such partnerships foster processes with these same dynamics; for example, sharing lead authorship responsibilities with meaningful roles for host country researchers to frame relevant questions and to provide context and interpretation for the research findings. Equitable products, such as access to technology and tailored delivery of interventions effective in the specific context, are the fruits of these partnerships and processes.
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Chen J, Kan M, Ratnasekera P, Deol LK, Thakkar V, Davison KM. Blood Chromium Levels and Their Association with Cardiovascular Diseases, Diabetes, and Depression: National Health and Nutrition Examination Survey (NHANES) 2015-2016. Nutrients 2022; 14. [PMID: 35807870 DOI: 10.3390/nu14132687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, there is no global consensus about the essentiality of dietary chromium. To provide evidence to this debate, an examination of blood chromium levels and common chronic health conditions was undertaken. Using a subsample from the 2015−2016 US National Health and Nutrition Examination Survey (n = 2894; 40 years+), chi-square and binary logistic regression analyses were conducted to examine blood chromium levels (0.7−28.0 vs. <0.7 µg/L) and their associations with cardiovascular diseases (CVDs; self-report), diabetes mellitus (DM; glycohemoglobin ≥5.7%), and depression (Patient Health Questionnaire-9 score ≥5), while controlling for socio-demographic (age/sex/income/education/relationship status) and health-related (red blood cell folate/medications/co-morbidities/body mass index (BMI)/substance use) factors. The sample was almost evenly distributed between men and women (n = 1391, 48.1% (men); n = 1503, 51.9% (women)). The prevalence estimates of low blood chromium levels tended to be higher among those with CVDs (47.4−47.6%) and DM (50.0−51.6%). Comparisons between those with low vs. normal blood chromium levels indicate men have increased odds of CVDs (adjusted odds ratio (aOR) = 1.86, 95% confidence interval (CI): 1.22−2.85, p < 0.001) and DM (aOR = 1.93, 95% CI: 1.32−2.83, p < 0.001) and lower odds of depression (aOR = 0.42, 95% CI: 0.22−0.77, p < 0.05). Dietary chromium may be important in the prevention and management of CVDs and DM for men. Continued exploration of chromium’s role in chronic diseases, including differences by biological factors, is needed.
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Smith LB, Yang Z, Golberstein E, Huckfeldt P, Mehrotra A, Neprash HT. The effect of a public transportation expansion on no-show appointments. Health Serv Res 2022; 57:472-481. [PMID: 34723394 PMCID: PMC9108053 DOI: 10.1111/1475-6773.13899] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To test whether there were fewer missed medical appointments ("no-shows") for patients and clinics affected by a significant public transportation expansion. STUDY SETTING A new light rail line was opened in a major metropolitan area in June 2014. We obtained electronic health records data from an integrated health delivery system in the area with over three million appointments at 97 clinics between 2013 and 2016. STUDY DESIGN We used a difference-in-differences research design to compare whether no-show appointment rates differentially changed among patients and clinics located near versus far from the new light rail line after it opened. Models included fixed effects to account for underlying differences across clinics, patient zip codes, and time. DATA EXTRACTION METHODS We obtained data from an electronic health records system representing all appointments scheduled at 97 outpatient clinics in this system. We excluded same-day, urgent care, and canceled appointments. PRINCIPAL FINDINGS The probability of no-show visits differentially declined by 0.5 percentage points (95% confidence interval [CI]: -0.9 to -0.1), or 4.5% relative to baseline, for patients living near the new light rail compared to those living far from it, after the light rail opened. The effects were stronger among patients covered by Medicaid (-1.6 percentage points [95% CI: -2.4 to -0.8] or 9.5% relative to baseline). CONCLUSIONS Improvements to public transit may improve access to health care, especially for people with low incomes.
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Affiliation(s)
| | - Zhiyou Yang
- Health Policy Research Center, Mongan Institute, Massachusetts General HospitalBostonMassachusettsUSA
| | - Ezra Golberstein
- University of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Peter Huckfeldt
- University of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | | | - Hannah T. Neprash
- University of Minnesota School of Public HealthMinneapolisMinnesotaUSA
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Matheson K, Seymour A, Landry J, Ventura K, Arsenault E, Anisman H. Canada's Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes. Int J Environ Res Public Health 2022; 19:6455. [PMID: 35682038 DOI: 10.3390/ijerph19116455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022]
Abstract
The policies and actions that were enacted to colonize Indigenous Peoples in Canada have been described as constituting cultural genocide. When one considers the long-term consequences from the perspective of the social and environmental determinants of health framework, the impacts of such policies on the physical and mental health of Indigenous Peoples go well beyond cultural loss. This paper addresses the impacts of key historical and current Canadian federal policies in relation to the health and well-being of Indigenous Peoples. Far from constituting a mere lesson in history, the connections between colonialist policies and actions on present-day outcomes are evaluated in terms of transgenerational and intergenerational transmission processes, including psychosocial, developmental, environmental, and neurobiological mechanisms and trauma responses. In addition, while colonialist policies have created adverse living conditions for Indigenous Peoples, resilience and the perseverance of many aspects of culture may be maintained through intergenerational processes.
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Dadaczynski K, Sykes S, Bíró É, Kósa K. Editorial: The Social-Ecological Context of Health Literacy. Front Public Health 2022; 10:897717. [PMID: 35558540 PMCID: PMC9087034 DOI: 10.3389/fpubh.2022.897717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/07/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany.,Centre for Applied Health Science, Leuphana University of Lueneburg, Lueneburg, Germany
| | - Susie Sykes
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Karolina Kósa
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Watts C, Burton S, Freeman B. Conducting tobacco industry informant interviews: lessons and implications for commercial determinants of health research. Health Promot Int 2022; 37:daab169. [PMID: 34634798 DOI: 10.1093/heapro/daab169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Investigating and exposing tobacco industry tactics to oppose and interfere with tobacco control policymaking is crucial to advancing public health. Whilst past investigations of tobacco industry activities have largely focused on secondary sources of information, such as publicly available tobacco industry documents, the collection of first-hand evidence from key informants has been an under-utilized method in tobacco industry monitoring. This article provides a detailed account of a methodological approach to systematically recruit former tobacco company employees as key informants for a study that aimed to gather information on the marketing tactics tobacco companies use in the Australian retail channel. Given the success of our study methodology in uncovering new information about tobacco company practices, we propose that key informant interviews with former industry employees should be a priority method for research investigating the role of commercial actors in influencing public health outcomes. To offer guidance to researchers who may wish to undertake a similar methodological approach, we also provide a reflective account of the elements of success and the lessons learned from this research.
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Affiliation(s)
- Christina Watts
- Faculty of Medicine and Health, The Daffodil Centre, The University of Sydney, A joint venture with Cancer Council NSW, Sydney, Australia
| | - Suzan Burton
- School of Business, Western Sydney University, Sydney, Australia
| | - Becky Freeman
- Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, Australia
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Pasupathy R, Gho J, Duhart B, Queen C. Alcohol consumption messages in Korean dramas: the globalization of South Korean drinking norms. Glob Health Promot 2022; 29:57-65. [PMID: 35360998 DOI: 10.1177/17579759221080746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
South Korea has one of the highest rates of monthly alcohol consumption, high-risk drinking, and alcohol-related problems. Global viewers of Korean dramas consume messages about the cultural norms regarding alcohol consumption. There is limited data on the portrayal of alcohol in Korean dramas. The purpose of this embedded mixed methods study is to explore the nature of the portrayal of alcohol consumption in Korean dramas. Content analysis was conducted on a random selection of six drama series. The portrayal of alcohol consumption is ubiquitous, with a reference to alcohol approximately every 12 minutes of programming. The primary messages include the ritualistic importance of alcohol, the over consumption of alcohol by males and females, alcohol as a stress reliever, alcohol as a relationship facilitator, intoxication as a positive valence, unrealistic consequences of intoxication, males as reliable caretakers of intoxicated females, and nondepiction of driving while intoxicated. The results of this study further our understanding of the frequency of the portrayal of alcohol and the prevailing messages about alcohol consumption and intoxication in Korean dramas.
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Affiliation(s)
| | | | - Brittany Duhart
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Courtney Queen
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Henkhaus LE, Gonzales G, Buntin MB. An Algorithm Using Administrative Data to Measure Adverse Childhood Experiences (ADM-ACE). Health Serv Res 2022; 57:963-972. [PMID: 35275403 PMCID: PMC9264467 DOI: 10.1111/1475-6773.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To develop an algorithm using administrative data to measure adverse childhood experiences (ADM-ACE) within routinely collected health insurance claims and enrollment data. DATA SOURCES We used claims and enrollment data from Tennessee's Medicaid program (TennCare) in 2018. STUDY DESIGN We studied five types of ACEs: maltreatment and peer violence, foster care and family disruption, maternal mental illness, maternal substance use disorder, and abuse of the mother. We used diagnosis and procedure codes, prescription drug fills, and enrollment files to develop the ADM-ACE, which we applied to measure the prevalence of ACEs and to examine prevalence by demographic characteristics among our sample of children in TennCare. We compared ADM-ACE prevalence to child welfare records and survey results from Tennessee. DATA COLLECTION/EXTRACTION METHODS Our study sample included children aged 0-17 years who were linked to their mothers if also enrolled in TennCare in 2018 (N=763,836 children). PRINCIPAL FINDINGS Approximately 19.2% of children in TennCare had indicators for ADM-ACEs. The prevalence of ACEs was higher among children who were younger (p<0.001), non-Hispanic White or Black (compared to Hispanic) (p<0.001), and children residing in rural vs. urban counties (p<0.001). The prevalence of maltreatment identified through the ADM-ACE (1.6%) falls between the percent of children in Tennessee who were reported to child welfare authorities and the percent for whom reports of maltreatment were substantiated. Comparison with survey reports from Tennessee parents suggests an advantage in measuring maternal mental illness with the ADM-ACE using health insurance claims data. CONCLUSIONS The ADM-ACE can be applied to health encounter data to study and monitor the prevalence of certain ACEs, their association with health conditions, and the effects of policies on reducing exposure to ACEs or improving health outcomes for children with ACEs.
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Affiliation(s)
- Laura E Henkhaus
- Data Science Institute, Vanderbilt University, 2301 Vanderbilt Place, PMB #407791, Nashville, TN
| | - Gilbert Gonzales
- Department of Medicine, Health, and Society, Vanderbilt University, 2301 Vanderbilt Place, PMB #351665, Nashville, TN
| | - Melinda B Buntin
- Department of Health Policy, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1200, Nashville, TN
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