Due to cultural, language, or legal barriers, members of social minority groups face challenges in access to healthcare. Equality of healthcare provision can be achieved through raised diversity ...awareness and diversity competency of healthcare professionals. The aim of this research was to explore the experiences and attitudes of healthcare professionals toward the issue of social diversity and equal access to healthcare in Croatia, Germany, Poland, and Slovenia.
The data reported come from semi-structured interviews with
= 39 healthcare professionals. The interviews were analyzed using the methods of content analysis and thematic analysis.
Respondents in all four countries acknowledged that socioeconomic factors and membership in a minority group have an impact on access to healthcare services, but its scope varies depending on the country. Underfunding of healthcare, language barriers, inadequate cultural training or lack of interpersonal competencies, and lack of institutional support were presented as major challenges in the provision of diversity-responsive healthcare. The majority of interviewees did not perceive direct systemic exclusion of minority groups; however, they reported cases of individual discrimination through the presence of homophobia or racism.
To improve the situation, systemic interventions are needed that encompass all levels of healthcare systems - from policies to addressing existing challenges at the healthcare facility level to improving the attitudes and skills of individual healthcare providers.
Drawing on data from the World Values Survey (1995-2014), and using a multilevel modeling technique, this article explores the relationship between social inequalities and religiosity for a sample of ...223,016 respondents nested in 85 countries. Mixed-effects regression models find that income inequality is a stronger determinant of individuals' religiosity in developing (lower middle-income) countries compared to developed (higher middle-income and high-income) nations. Alternatively, healthcare inequality, operationalized as the out-of-pocket share of a country's total health-related expenditures, is a stronger predictor of individual-level religiosity in high-income countries, relative to both upper and lower middle-income nations. These findings broaden our understanding of the global religious dynamics through discovering a cross-national heterogeneity in paths through which the process of secularization works in developed and developing nations.
Studies have limitedly considered children with early-identified unilateral hearing impairment (UHI), and clinical practices regarding screening, diagnostics and habilitation in this group are rarely ...documented. In this study, routines for newborns with UHI from screening to diagnostics and habilitation were explored in Norway, Sweden and Finland. An online survey was sent to hospitals responsible for the hearing diagnostics of children requesting information about their practices regarding congenital UHI. Responses covered 95% of the children born in the three included countries. The results revealed large variations in ways of organising healthcare and in clinical decisions regarding hearing screening, diagnostics and habilitation of children with congenital UHI. Finally, implications for policy making and research are also discussed.
This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes ...control was examined separately in men and women, and in urban and rural areas.
This study used Korea National Health and Nutrition Examination V (2010-2012) data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas. To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas.
The prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67-0.96, reference group = urban areas). However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60-0.92) and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46-0.99). Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37-0.75). Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40-0.94; Middle/High school, OR 0.69, 95 % CI 0.49-0.96) and women in urban areas (≤1 million won, OR 0.56, 95 % CI 0.33-0.93) (Reference group = '≥College' for education and '>3 million' Korean won for income).
After correction for individual socioeconomic status, differences by residential area were not observed. However, when the participants with good disease control were divided by region, inequality was confirmed in urban residents. Therefore, differentiated health policies to resolve individual and regional health inequalities are necessary.
A social gradient has been found in both children's behavior problems and among the users of services that treat such problems. If low-resource families are simultaneously at higher risk of having a ...child with behavior problems and less inclined to use services to address such problems, healthcare inequality and social inequity could be exacerbated. I focus on social gradients in participant characteristics in two evidence-based parent training interventions that target children who display behavior problems: Parent Management Training—Oregon Model (PMTO) and Brief Parent Training. This study extends the literature on social gradients in participant characteristics by focusing on family social and economic resources independently and in an additive cumulative risk index. I investigated potential social gradients overall in a pooled sample and in separate analyses relating social gradients to more intensive treatment. The results revealed inverse social gradients among the intervention participants compared with the Norwegian general population of families with children; intervention participants had fewer social and economic resources. The inverse social gradient was partially replicated through analyses that focused on treatment intensity. Families with fewer resources were more likely to receive high-intensity treatment; however, these associations disappeared for families with >3 cumulative risks. These results indicate that these PMTO interventions do not exacerbate social inequality by serving a high-resource population.
•The results show inverse social gradients in utilization of evidence based parent training.•Selective recruitment in primary care is an efficient way to reach low-resource families.•The primary care model seems to reduce health care disparities and social inequality.•Cumulative risk families are less inclined to utilize group intervention.
Over a century has passed since slavery was abolished in Brazil, yet quilombola communities remain socially vulnerable, especially when it comes to health. The goal of this study was to understand ...self-perceived health (SPH) in quilombola communities in Northern Minas Gerais, and the factors associated with their negative -perceived their own health. A household survey of a representative sample of quilombola communities in the study region. Validated tools were used to gather data about SPH, socioeconomic conditions, demographics, lifestyle and self-referred morbidity. Following a bivariate analysis, we proceeded to conduct a hierarchical logistics regression analysis. The prevalence of negative SPH was 46.0%. The following variables were statistically associated with negative SPH: age and years of schooling as distal variables, and high blood pressure, diabetes, arthritis, depression and back problems as proximal variables. SPH is associated with demographic and socioeconomic dimensions, and in particular with self-referred morbidity. The concept of health among the quilombola communities included in this study seems to be intimately linked to the absence of disease, especially chronic disease.
PurposeMicro hospitals are a new form of for-profit health-care facility with rapid expansion in some parts of the country. They continue to grow in Texas without in-depth public understanding or ...explicit policy guidance on their role in the health-care system. Our project aims to define socioeconomic and demographic characteristics of areas served by micro and regular hospitals, and by doing so help assess micro hospitals' impact in expanding health-care access for disadvantaged populations in Texas.Methodology/ApproachWe (1) estimated hospital service areas (catchment areas) with a spatial model based on advanced Geographic Information System (GIS) methods using a proprietary ESRI traffic network; (2) assigned population socioeconomic measures to the catchment areas from the 2014–2018 American Community Survey 5-Year Estimates, weighted with an empirically tested Gaussian distribution; (3) used two-tailed t-tests to compare means of population characteristics between micro and regular hospital catchment areas; and (4) conducted logistic regressions to examine relationships between selected population variables and the associated odds of micro hospital presence.FindingsWe found micro hospitals in Texas tend to serve a population less stressed in health-care access compared to those who are more in need as measured by various dimensions of disadvantages.Research Limitations/ImplicationsOur analysis takes a cross sectional look at the population characteristics of micro hospital service areas. Even though the initial geographic choices of micro hospitals may not reflect the long-term population changes in specific neighborhoods, our analysis can provide policy makers a tool to examine health-care access for disadvantaged populations at given point in time. As the population socioeconomic characteristics have long been associated with health-care inequality, we hope our analysis will help foster structural policy considerations that balance growing health-care delivery innovations and their social accountability.Originality/Value of PaperWe used GIS based spatial modeling to dynamically capture the potential patient basis by travel time calculated with a street network dataset, rather than using the traditional static census tract to define hospital service areas. By integrating both spatial and nonspatial dimensions of healthcare access, we demonstrated that the policy considerations on the implications of equal opportunity for health-care access need to take into account the social realities and lived experiences of those experiencing the most vulnerability in our society, rather than a conceptual “equality” existing in the spatial and market abstraction.
Introduction: Suicide is a common cause of death in the world. Its expression in indigenous populations is a public health problem due to the fact that suicide rates are higher
among them than in the ...general population, preferably affecting low income, unemployed young men who are involved in substance abuse. The magnitude of the problem and its impact on the original populations, even in danger of extinction, allowed the study to expand its comprehension regarding the subject matter, and propose research studies and suitable interventions that can lead to possible solutions. Objective: Annalise completed suicide in indigenous populations based on a social health determination. Methodology: The study conducted a review of the state-of-the-art regarding suicide in indigenous populations from 1993 to 2013; 57 articles were selected because of their quality and pertinence, and they were analyzed in the light of social health determinations.
Results: Critical process matrixes where outlined which describe protective destructive processes surrounding suicide in indigenous populations. Conclusion: The approach used in this study allowed the identification of structural conditions of violence that affect indigenous people's well-being, who are the main participators in completed suicide in these populations.
El suicidio es causa frecuente de muerte en el mundo, su expresión en los pueblos indígenas es un problema de salud pública dadas las tasas de suicidio más altas en ellos que en población general afectando preferentemente a hombres jóvenes, de bajo nivel socioeconómicos, desempleados, y consumidores de sustancias. Dada la magnitud del problema y el impacto sobre pueblos originarios incluso en peligro de extinción, se buscó ampliar las comprensiones sobre el tema, posibilitando plantear investigaciones e intervenciones apropiadas que ayuden en la solución.Objetivo: Analizar el suicidio consumado por población indígena, desde la determinación social de la salud.Metodología: Se realizó un estado del arte sobre suicidio en pueblos indígenas, período 1993 – 2013; 57 artículos fueron seleccionados por su calidad y pertinencia, y analizados a la luz de la determinación social en salud.Resultados: Se delinearon las matrices de procesos críticos que describen procesos protectores y destructivos alrededor del suicidio en pueblos indígenas.Conclusión: El enfoque empleado permitió identificar condiciones estructurales de violencia que impactan el bienestar de los indígenas y son partícipes principales en el fenómeno del suicidio consumado en estos pueblos.
Introdução: O suicídio é uma causa frequente de morte no mundo, sua expressão nos povos indígenas é um problema de saúde pública, porque as taxas de suicídio são mais altas neles do que na população em geral, afetando principalmente os homens jovens de baixo nível. Socioeconômicos, desempregados e utentes de substâncias. A magnitude do problema e o impacto sobre os povos nativos, incluindo aqueles em perigo de extinção, nos permitiu ampliar nossa compreensão sobre o assunto e propor pesquisas e intervenções apropriadas para orientar possíveis soluções. Objetivo: Analisar o suicídio consumado pela população indígena, a partir da determinação social da saúde. Metodologia: Uma revisão do estado da arte sobre o suicídio em povos indígenas foi realizada entre 1993 e 2013;57 artigos foram selecionados por sua qualidade e relevância, e analisados à luz da determinação social em saúde. Resultados: Matrizes de processos críticos que descrevem processos protetores e destrutivos em torno do suicídio em povos indígenas foram delineados. Conclusão: O enfoque empregado permitiu identificar condições estruturais de violência que impactam o bem-estar dos indígenas, partícipes principais no fenómeno do suicídio consumado nestes povos.
Introduction McQueeney, Kevin
A City without Care,
05/2023
Book Chapter
This chapter provides a summary of the book’s topic and main arguments; the time period covered; crucial turning points in the creation and perpetuation of healthcare inequality in New Orleans; ...relevant background information; and literature review. The chapter places the manuscript in the larger context of scholarship on the African American health and healthcare history, racial health disparities, and the Long Civil Rights Movement. The chapter also provides a brief preview of each chapter and discusses the sources used.
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