Health equity

OBJECTIVE: To synthesize recommendations on assessing and managing behavioral and psychological symptoms of dementia (BPSDs) in existing clinical guidelines on dementia care to learn from and adapt recommendations to a Canadian context and language for describing BPSDs. DESIGN: Systematic review. SETTING AND PARTICIPANTS: Moderate to high-quality clinical practice guidelines on dementia care that made 1 or more recommendations on BPSD assessment or management...

Antimicrobial resistance (AMR) is a serious health issue shared across all One Health domains. Wildlife species represent a key intersection of the animal and environmental domains. They are a relevant but understudied reservoir and route of spread for AMR throughout the environment. Most wildlife AMR research thus far has focused on avian species, terrestrial mammals, and a selection of aquatic and marine species. Pathogens often identified in terrestrial wildlife include enteric zoonotic organisms such as Eschericia coli and Salmonella spp, in addition to nonenterics such as Staphylococci...

BACKGROUND: Racial disparities in lung cancer screening (LCS) are well established. Black Veterans are among those at the highest risk for developing lung cancer but are less likely to complete LCS. We sought to identify barriers and facilitators to LCS uptake among Black Veterans. PATIENTS AND METHODS: A qualitative study using semistructured interviews was conducted with 32 Black Veterans to assess for barriers, facilitators, and contextual factors for LCS and strategies to improve screening...

OBJECTIVE: This paper evaluates ChatGPT's accuracy and consistency in providing information on ankyloglossia, a congenital oral condition. Assessing alignment with expert consensus, the study explores potential implications for patients relying on AI for medical information. METHODS: Statements from the 2020 clinical consensus statement on ankyloglossia were presented to ChatGPT, and its responses were scored using a 9-point Likert scale. The study analyzed the mean and standard deviation of ChatGPT scores for each statement...

BACKGROUND: A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. OBJECTIVE: This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico...

No abstract text is available yet for this article.

Nurse informaticists (NIs) play a pivotal role in addressing health-related social needs through integrating technology into electronic health records. NIs navigate regulatory landscapes, emphasizing screening for social determinants of health during hospital encounters. This article underscores NIs' strategic contributions to optimizing data collection, supporting health equity, and utilizing innovative technologies to bridge gaps in healthcare outcomes.

BACKGROUND: In England, digital technologies are exploited to transform the way health and social care is provided and encompass a wide range of hardware devices and software that are used in all aspects of health care. However, little is known about the extent to which health care providers differ in digital health technology capabilities and how this relates to geographical and regional differences in health care capacities and resources. OBJECTIVE: This paper aims to identify the set of digital technologies that have been deployed by the National Health Services clinical commissioning groups (NHS CCGs) in England...

PURPOSE OF REVIEW: Although many environmental exposures (e.g., air pollution) are geographically patterned and persist as a result of historic economic policies (e.g., redlining), the impact of reproductive and social policies on maternal and child health remains incompletely understood. Reproductive and social policies are increasingly important for maternal and child health equity, particularly following the 2022 US Supreme Court decision in Dobbs v Jackson Women's Health Organization ("Dobbs decision"), which restricted access to abortion...

BACKGROUND: As populations age globally, cooperation across multi-sector stakeholders is increasingly important to service older persons, particularly those with high and complex health and social needs. One such population is older people entering society after a period of incarceration in prison. The 'ageing epidemic' in prisons worldwide has caught the attention of researchers, governments and community organisations, who identify challenges in servicing this group as they re-enter the community...

INTRODUCTION: Obesity is a preventable chronic condition and a risk factor for poor health and early mortality. Weight stigma and weight-neutral medicine are popular topics in social media that are often at odds with current medical guidelines on obesity treatment and prevention. This conflict may erode the public's trust in science, impede research progress on preventing obesity in marginalized groups, and uphold the ongoing and historical lack of diversity among nutrition trainees. METHODS: The authors conducted a series of student-led dialogue sessions with nutrition graduate students in Boston, Massachusetts, from March to May 2023 to understand perceptions of obesity research, health equity, and racism and discrimination...

INTRODUCTION: The U.S. safety net, which provides critical aid to households with low income, is composed of a patchwork of separate programs, and many people with low income benefit from accessing <1 program. However, little is known about multiprogram take-up, that is, participation conditioned on eligibility. This study examined individual and multiprogram take-up patterns and sociodemographic factors associated with multiprogram take-up of U.S. safety net programs. METHODS: The Assessing California Communities' Experiences with Safety Net Supports study interviewed Californians and reviewed their 2019 tax forms between August 2020 and May 2021...

No abstract text is available yet for this article.

Neurodevelopmental disability in children covers a vast array of congenital and acquired long-term conditions associated with brain or neuromuscular impairments that impact function. While some presentations of neurodevelopmental disability align with diagnostic labels, many do not, leaving children whose conditions don't fit neatly under diagnostic labels struggling to access services or families and professionals feeling pressured to assign a diagnostic label in order to access services. In this paper, we (1) discuss the evidence showing that there is often a mismatch between a child's neurodevelopmental diagnosis, or lack of diagnosis, and function, (2) comment on the inequities exacerbated by diagnosis-based approaches for services, and (3) highlight the potential benefits of using a function and participation-based approach for providing services to children with neurodevelopmental disabilities...

Urban park green spaces (UPGS) are a crucial element of social public resources closely related to the health and well-being of urban residents, and issues of equity have always been a focal point of concern. This study takes the downtown area of Nanchang as an example and uses more accurate point of interest (POI) and area of interest (AOI) data as analysis sources. The improved Gaussian two-step floating catchment area (G2SFCA) and spatial autocorrelation models are then used to assess the spatial and social equity in the study area, and the results of the two assessments were coupled to determine the optimization objective using the community as the smallest unit...

OBJECTIVE: To investigate how missing data in the patient problem list may impact racial disparities in the predictive performance of a machine learning (ML) model for emergency department (ED) triage. MATERIALS AND METHODS: Racial disparities may exist in the missingness of EHR data (eg, systematic differences in access, testing, and/or treatment) that can impact model predictions across racialized patient groups. We use an ML model that predicts patients' risk for adverse events to produce triage-level recommendations, patterned after a clinical decision support tool deployed at multiple EDs...

In December 2023, the US Food and Drug Administration and the UK Medicines and Healthcare Products Regulatory Agency granted the first regulatory approval for genome therapy for sickle cell disease. This approval brings hope to those suffering from this debilitating genetic disease. However, several barriers may hinder global patient access, including high treatment costs, obtaining informed consent for minors, inadequate public health infrastructure, and insufficient regulatory oversight. These barriers reflect the structural inequalities inherent in global health governance, where patient access often depends on social and institutional arrangements...

The Getting It Right First Time (GIRFT) programme is a quality improvement initiative covering the National Health Service in England. The programme aims to standardise clinical practices and improve patient and system level outcomes by utilising data-driven insights and clinically-led recommendations. There are GIRFT workstreams for every medical and surgical specialty, including urology. Defining features of the GIRFT methodology are that it is clinically led by experienced clinicians, data-driven, and specialty specific...

BACKGROUND: The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. METHODS: Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis...

BACKGROUND: Kenya aims to achieve universal health coverage (UHC) by 2030 and has selected the National Health Insurance Fund (NHIF) as the 'vehicle' to drive the UHC agenda. While there is some progress in moving the country towards UHC, the availability and accessibility to NHIF-contracted facilities may be a barrier to equitable access to care. We estimated the spatial access to NHIF-contracted facilities in Kenya to provide information to advance the UHC agenda in Kenya. METHODS: We merged NHIF-contracted facility data to the geocoded inventory of health facilities in Kenya to assign facility geospatial locations...