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Public health and inequities

Ambreen Sayani
The Ontario Breast Screening Program for women with a genetic predisposition to breast cancer is one of the first international models of a government-funded public health service that offers systematic genetic screening to women at a high risk of breast cancer. However, since the implementation of the program in 2011, enrolment rates have been lower than anticipated. Whilst there may be several reasons for this to happen, it does call into consideration the 'inverse equity law', whereby the more advantaged in society are the first to participate and benefit from universal health services...
May 20, 2018: Journal of Community Genetics
Anna Brydsten, Anne Hammarström, Miguel San Sebastian
BACKGROUND: Even though population health is strongly influenced by employment and working conditions, public health research has to a lesser extent explored the social determinants of health inequalities between people in different positions on the labour market, and whether these social determinants vary across the life course. This study analyses mental health inequalities between unemployed and employed in three age groups (youth, adulthood and mid-life), and identifies the extent to which social determinants explain the mental health gap between employed and unemployed in northern Sweden...
May 16, 2018: International Journal for Equity in Health
Nathalie Auger, Lucien Lemieux, Marianne Bilodeau-Bertrand, Amadou Diogo Barry, André Costopoulos
INTRODUCTION: Short and long interpregnancy intervals are associated with adverse perinatal outcomes such as miscarriage and preterm delivery, but cultural differences in interpregnancy intervals are understudied. Identifying cultural inequality in interpregnancy intervals is necessary to improve maternal-child outcomes. We assessed interpregnancy intervals for Anglophones and Francophones in Quebec. METHODS: We obtained birth records for all infants born in Quebec, 1989-2011...
May 2018: Health Promotion and Chronic Disease Prevention in Canada
Dylan B Jackson, Michael G Vaughn
Traditionally, research activities aimed at diminishing health inequalities and preventing crime have been conducted in isolation, with relatively little cross-fertilization. We argue that moving forward, transdisciplinary collaborations that employ a life-course perspective constitute a productive approach to minimizing both health disparities and early delinquent involvement. Specifically, we propose a multidimensional framework that integrates findings on health disparities and crime across the early life-course and emphasizes the role of racial and socioeconomic disparities in health...
May 12, 2018: Preventive Medicine
Ebenezer Owusu-Addo, Andre M N Renzaho, Ben J Smith
Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health (SDoH) and health inequalities. A systematic review was conducted to synthesise the evidence on CTs' impacts on SDoH and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs. Twenty-one electronic databases and the websites of 14 key organizations were searched in addition to grey literature and hand searching of selected journals for quantitative and qualitative studies on CTs' impacts on SDoH and health outcomes...
June 1, 2018: Health Policy and Planning
L C Edney, H Haji Ali Afzali, T C Cheng, J Karnon
There is limited empirical evidence of the nature of any relationship between health spending and health outcomes in Australia. We address this by estimating the elasticity of health outcomes with respect to public healthcare spending using an instrumental variable (IV) approach to account for endogeneity of healthcare spending to health outcomes. Results suggest that, based on the conditional mean, a 1% increase in public health spending was associated with a 2.2% (p < 0.05) reduction in the number of standardised Years of Life Lost (YLL)...
April 27, 2018: Health Policy
Óscar Suárez Álvarez, Ana Fernández-Feito, Henar Vallina Crespo, Elena Aldasoro Unamuno, Rafael Cofiño
It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team...
May 11, 2018: Gaceta Sanitaria
Mariana Carvalho Menezes, Ana Victoria Diez Roux, Aline Cristine Souza Lopes
OBJECTIVE: Identify the effects of food environment and self-efficacy perceptions on fruit and vegetable (FV) consumption. METHODS: A cross-sectional study with a representative sample population from a public health service in a Brazilian city. Participants (3414) aged ≥20 years were recruited from 18 Health Academy Program centres via stratified cluster sampling. Perceptions of the food environment were measured by survey; participants indicated how confident they were about FV availability in their food environment...
May 9, 2018: Appetite
Alexandra Schneider, Regina Rückerl, Marie Standl, Iana Markevych, Barbara Hoffmann, Susanne Moebus, Karl-Heinz Jöckel, Alisa Weber, Caroline Herr, Annette Heißenhuber, Uta Nennstiel-Ratzel, Stefanie Heinze, Christine Schulz, Marike Kolossa-Gehring, Hildegard Niemann, Antje Gößwald, Tamara Schikowski, Anke Hüls, Dorothee Sugiri, Annette Peters
Our environment is a major factor in determining health and well-being throughout life, from conception into old age. This overview illustrates the most important epidemiological studies and health monitoring systems in Germany, which investigate environmental influences in various population subgroups and estimate related health effects. Environmental factors examined in each study are described. The mentioned studies in children and adults build the basis for predictions and preventive measures. The number of the assessed environmental factors, the depth of the examinations as well as the (phenotypical) characterization of the study participants differ...
May 9, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Charlotte Oliveira, Ines Keygnaert, Maria do Rosário Oliveira Martins, Sónia Dias
BACKGROUND: Sexual and gender-based violence (SGBV) is a widespread public health problem and a violation of human rights rooted in gender and power inequities. Refugees, asylum-seekers and migrants living in European asylum reception facilities (EARF) are especially vulnerable to SGBV. To contribute to closing the gap on systematic and accurate evidence on SGBV, we aim to explore reported cases of SGBV, causes and preventable measures described by residents and professionals from EARF...
May 9, 2018: Globalization and Health
Louise Delany, Louise Signal, George Thomson
BACKGROUND: International trade and investment agreements can have positive outcomes, but also have negative consequences that affect global health and influence fundamental health determinants: poverty, inequality and the environment. This article proposes principles and strategies for designing future international law to attain health and common good objectives. ARGUMENT: Basic principles are needed for international trade and investment agreements that are consistent with the common good, public health, and human rights...
May 8, 2018: BMC Public Health
Carolin Hagelskamp, David Schleifer, Chloe Rinehart, Rebecca Silliman
Participatory budgeting (PB)-a democratic process where ordinary residents decide directly how to spend part of a public budget-has gained impressive momentum in US municipalities, spreading from one pilot project in Chicago's 49th ward in 2009 to 50 active PB processes across 14 cities in 2016-2017. Over 93,600 US residents voted in a PB process in 2015-2016, deciding over a total of about $49.5 million and funding 264 projects intended to improve their communities. The vast majority of US PB processes take place in large urban centers (e...
May 7, 2018: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Said Ahmad Maisam Najafizada, Ivy Lynn Bourgeault, Ronald Labonté
Gender equity can be a neglected issue in health system reforms. This paper explores the multiple layered gender dynamics of the Afghan Community Health Worker (CHW) Program within broader health system reforms in Afghanistan using a qualitative research design. We interviewed policy makers, health managers, CHWs and community members in 16 sites in 2013 and 2014. We found that gendered societal norms interact and influence the Afghan CHW program in a dynamic way. Gendered social norms around the division of labour tend to privilege women in terms of access to resources at the community level, but it is men who hold leadership positions that ultimately decide how the resources are to be distributed...
May 7, 2018: Global Public Health
Ana V Pejcic, Georgi Iskrov, Mihajlo Michael Jakovljevic, Rumen Stefanov
The aim of this study was to compare orphan drug access in a sample of Balkan countries: five EU Member States (Bulgaria, Croatia, Greece, Romania, Slovenia) and two EU Candidates (Serbia, Montenegro). The comparative analysis was based on a cross-sectional study and included medicinal products with an active orphan designation and market authorisation on January 1, 2017. Access to orphan drugs is an ongoing challenge in these countries. Three clusters of countries were identified in terms of orphan drug access: Greece and Slovenia, making the top tier, Romania, Bulgaria, and Croatia, being in the middle, and EU Candidates, Serbia and Montenegro, forming the bottom tier, where a substantial number of EU market approved orphan drugs was not even registered...
April 26, 2018: Health Policy
Ginny Lane, Marwa Farag, Judy White, Christine Nisbet, Hassan Vatanparast
There are knowledge gaps related to understanding the development of chronic disease risks in children, especially with regards to risk differentials experienced by immigrants and refugees. The Healthy Immigrant Children study employed a mixed-methods cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3-13 who had been in Canada for less than five years. We collected quantitative data on socio-economic status, food security, physical activity, diet, bone and body composition, and anthropometric measurements...
May 4, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Gabriele Bolte, Christiane Bunge, Claudia Hornberg, Heike Köckler
Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification)...
May 3, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Daniela de Assumpção, Caroline Senicato, Regina Mara Fisberg, Ana Maria Canesqui, Marilisa Berti de Azevedo Barros
OBJECTIVE To verify whether there is an association between the quality of the diet and the inclusion of women in the labor market and whether the education level would modify this association. We have analyzed the differences according to education level and evaluated whether the insertion or not in the market modifies the association between the quality of the diet and education level. METHODS This is a cross-sectional population-based study that has used data from the Campinas Health Survey (2008 ISACamp)...
2018: Revista de Saúde Pública
E Tessier, F Warburton, C Tsang, S Rafeeq, N Boddington, M Sinnathamby, R Pebody
England's influenza vaccination programme targets persons with clinical risk factors, pregnant women, those aged 65 years and older and children. Low vaccine uptake amongst primary school children was previously found to be significantly associated with increasing deprivation, Black or Minority Ethnic (BME) and certain religions. It is unknown whether these population predictors are associated with vaccine uptake in other groups. GP level data for target groups during the 2015/16 and 2016/17 seasons were linearly regressed against various factors to determine potential predictors associated with variation in uptake...
April 28, 2018: Vaccine
Wei Ouyang, Bing Gao, Hongguang Cheng, Zengchao Hao, Ni Wu
Fine particulate matter (PM2.5 ) pollution exposure has an adverse impact on public health, and some vulnerable social groups suffer from unfair exposure. Few studies have been conducted to estimate and to compare the exposure and inequality of different residential demographics at multiple time scales. This study assessed the exposures level of age and education subgroups on the whole city and the exposure inequalities of these subgroups within a concentration interval area for PM2.5 pollution at multiple time scales in Beijing in 2015...
April 20, 2018: Science of the Total Environment
Renee Butkus, Joshua Serchen, Darilyn V Moyer, Sue S Bornstein, Susan Thompson Hingle
Women comprise more than one third of the active physician workforce, an estimated 46% of all physicians-in-training, and more than half of all medical students in the United States. Although progress has been made toward gender diversity in the physician workforce, disparities in compensation exist and inequities have contributed to a disproportionately low number of female physicians achieving academic advancement and serving in leadership positions. Women in medicine face other challenges, including a lack of mentors, discrimination, gender bias, cultural environment of the workplace, imposter syndrome, and the need for better work-life integration...
April 17, 2018: Annals of Internal Medicine
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