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Health of Marginalized People
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Health of Marginalized People

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 June 2019) | Viewed by 80421

Special Issue Editor

Prof. Dr. Stuart Gilmour

E-Mail Website
Guest Editor
Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan
Interests: quantitative health systems assessment; statistics; simulation; modeling; epidemiology; public health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on the health of marginalized people in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph. 

Although health for all has been a fundamental goal of the World Health Organization since the Declaration of Alma Ata in 1978, there are many populations or social groups for whom this goal remains a distant dream. Social, cultural, or legal practices that marginalize people can affect their health, either directly through violence and environmental hazards, or indirectly through discrimination, stigma, and loss of access to prevention and treatment services. Although the factors that lead to marginalization of people and social groups can be complex and beyond the power of public health policy-makers or environmental management agencies to change, understanding the health challenges that marginalized people face is essential for health and social systems to react to their needs and overcome the special health problems they face. This Special Issue aims to present the latest research on the health challenges facing marginalized people and the practical policies and interventions that can improve their health.

This Special Issue is open to any subject area related to the health of marginalized people. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Stuart Gilmour
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • marginalization
  • stigma
  • discrimination
  • public health
  • health geography
  • health inequality
  • health disparity
  • health and the law
  • minority health
  • prison health
  • migrant health
  • health for all
  • risk factors
  • social determinants of health
  • LGBTIQ health
  • ethnicity and health
  • social epidemiology

Published Papers (16 papers)

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Editorial

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5 pages, 259 KiB  
Editorial
Progress towards Health for All: Time to End Discrimination and Marginalization
by Stuart Gilmour, Phuong Le Mai, Phuong Nguyen, Bibha Dhungel, Maki Tomizawa and Huy Nguyen
Int. J. Environ. Res. Public Health 2020, 17(5), 1696; https://doi.org/10.3390/ijerph17051696 - 5 Mar 2020
Cited by 13 | Viewed by 3361
Abstract
Although it has been more than 40 years since “health for all” was presented as a focus in the Alma Ata declaration [...] Full article
(This article belongs to the Special Issue Health of Marginalized People)

Research

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9 pages, 986 KiB  
Article
Suicide Mortality in Foreign Residents of Japan
by Stuart Gilmour, Haruko Hoshino and Bibha Dhungel
Int. J. Environ. Res. Public Health 2019, 16(17), 3013; https://doi.org/10.3390/ijerph16173013 - 21 Aug 2019
Cited by 8 | Viewed by 3421
Abstract
Suicide is a major public health issue in Japan, with very high rates of death compared to other countries in the Asia Pacific. Foreigners living in Japan may be at increased risk of suicide, but little is known about how their risk of [...] Read more.
Suicide is a major public health issue in Japan, with very high rates of death compared to other countries in the Asia Pacific. Foreigners living in Japan may be at increased risk of suicide, but little is known about how their risk of suicide differs from that of their country of origin or Japanese nationals. We used data on suicide mortality from the Japan Vital Registration System for the period 2012–2016 to analyze risk of suicide mortality in Japan for Japanese, Korean, Chinese, and other nationalities living in Japan, adjusting for age and separately by sex. We estimated standardized mortality rates using both the Japanese population as a reference, and also the population of the home nation of the foreign residents. We found that Korean nationals living in Japan have significantly higher mortality rates than Japanese nationals, and that the suicide mortality rate of Korean nationals living in Japan is higher than in their home country, but that this is not the case for Chinese or other nationals resident in Japan. Koreans living in Japan have a very high risk of mortality due to suicide which may reflect the special social, economic, and cultural pressures they face as a marginalized population in Japan. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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20 pages, 593 KiB  
Article
Mental Health Risk Factors and Parole Decisions: Does Inmate Mental Health Status Affect Who Gets Released
by Kimberly A. Houser, E. Rely Vîlcică, Christine A. Saum and Matthew L. Hiller
Int. J. Environ. Res. Public Health 2019, 16(16), 2950; https://doi.org/10.3390/ijerph16162950 - 16 Aug 2019
Cited by 13 | Viewed by 7465
Abstract
Parole decision—the decision to release an incarcerated individual from prison conditionally—is one of the most critical decisions across justice systems around the world. The decision carries with it significant consequences: for the freedom of the individual awaiting release (the parolee); for the safety [...] Read more.
Parole decision—the decision to release an incarcerated individual from prison conditionally—is one of the most critical decisions across justice systems around the world. The decision carries with it significant consequences: for the freedom of the individual awaiting release (the parolee); for the safety of the community in which they will return; and for the correctional system overall, especially its organizational capacity. The current study attempts to add to the parole decision-making literature by specifically analyzing the role that mental health factors may play in explaining parole decisions. Research to date is inconclusive on whether or not mental illness is a risk factor for criminal behavior; despite this, individuals with mental health problems generally fare worse on risk assessment tools employed in justice decisions. The study relies on a 1000+ representative sample of parole-eligible individuals in Pennsylvania, United States. To increase reliability, the analyses test for several mental health factors based on information from different sources (i.e., self-reported mental health history; risk assessment tool employed by the Parole Board; and risk assessment tool employed by the Department of Corrections). To address validity concerns, the study controls for other potential correlates of parole decisions. Although the multivariate models explained a considerable amount of variance in parole decisions, the inclusion of mental health variables added relatively little to model fit. The results provide insights into an understudied area of justice decision making, suggesting that despite the stigmatization of mental illness among criminal justice populations, parole board members in Pennsylvania, United States, appear to follow official guidelines rather than to consider more subjective notions that poor mental health should negate parole release. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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18 pages, 307 KiB  
Article
Willingness to Use and Adhere to HIV Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in China
by Liping Peng, Wangnan Cao, Jing Gu, Chun Hao, Jibin Li, Dannuo Wei and Jinghua Li
Int. J. Environ. Res. Public Health 2019, 16(14), 2620; https://doi.org/10.3390/ijerph16142620 - 23 Jul 2019
Cited by 37 | Viewed by 4876
Abstract
This study aimed to investigate the levels of willingness to use pre-exposure prophylaxis (PrEP) and intention to adhere to PrEP and to further explore factors associated with PrEP uptake among men who have sex with men (MSM) in China. A total of 524 [...] Read more.
This study aimed to investigate the levels of willingness to use pre-exposure prophylaxis (PrEP) and intention to adhere to PrEP and to further explore factors associated with PrEP uptake among men who have sex with men (MSM) in China. A total of 524 MSM were recruited from Chengdu, China. Half of the participants had heard of PrEP, and the awareness rate varied from 33.8%, 30.7%, and 7.1% for daily oral PrEP, on-demand PrEP, and long-acting injectable PrEP (LAI-PrEP), respectively. The overall willingness to use any type of PrEP in the next six months was 84.9% if PrEP is effective and provided for free. Participants were less likely to say that they would use PrEP if they used a condom consistently with their regular partners. However, participants were more likely to say that they would use PrEP if they had casual partners in the past month and had higher HIV prevention literacy. The majority of participants intended to adhere to PrEP prescription. More than forty percent (43.1%) of the participants reported that they might reduce condom use if they took PrEP. We found that the overall willingness to use PrEP was high among MSM living in China, but willingness varied across the different types of PrEP. Full article
(This article belongs to the Special Issue Health of Marginalized People)
12 pages, 542 KiB  
Article
Primary Care Networks and Eritrean Immigrants’ Experiences with Health Care Professionals in Switzerland: A Qualitative Approach
by Carla Wallimann and Andreas Balthasar
Int. J. Environ. Res. Public Health 2019, 16(14), 2614; https://doi.org/10.3390/ijerph16142614 - 23 Jul 2019
Cited by 5 | Viewed by 3664
Abstract
Growing migration in European countries has simultaneously increased cultural diversity in health care. Migrants’ equal access to health care systems and migrant friendly health care have therefore become relevant topics. Findings gathered in recent years have mainly focussed on the perspective of care [...] Read more.
Growing migration in European countries has simultaneously increased cultural diversity in health care. Migrants’ equal access to health care systems and migrant friendly health care have therefore become relevant topics. Findings gathered in recent years have mainly focussed on the perspective of care providers, whereas this study includes migrant perspectives. It explores the primary care network of Eritrean immigrants in Switzerland as well as their experiences of interacting with health professionals. Semi-structured face-to-face interviews with intercultural interpreters from Eritrea were conducted. On the basis of a thematic analysis, the study identified the important informal and formal contacts in these Eritrean immigrants’ primary care networks and the specific forms of support each actor provides. In this network, encounters with health professionals were predominately expressed positively. The main barriers reported were language difficulties and intercultural understanding. On the basis of the participants’ statements, six key lessons for practice have been derived. These lessons are specifically important for facilitating Eritrean immigrants’ access to the Swiss health care system. Nevertheless, they are also relevant for other groups of migrants in European countries. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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15 pages, 944 KiB  
Article
Assessment of a Voluntary Non-Profit Health Insurance Scheme for Migrants along the Thai–Myanmar Border: A Case Study of the Migrant Fund in Thailand
by Nareerut Pudpong, Nicolas Durier, Sataporn Julchoo, Pigunkaew Sainam, Beena Kuttiparambil and Rapeepong Suphanchaimat
Int. J. Environ. Res. Public Health 2019, 16(14), 2581; https://doi.org/10.3390/ijerph16142581 - 19 Jul 2019
Cited by 15 | Viewed by 4683
Abstract
Access to health care and financial protection for migrants can be promoted through diverse health insurance schemes, designed to suit migrants’ needs within a specific context. The Migrant Fund (M-Fund) is a voluntary, non-profit health insurance scheme operating along the Thai–Myanmar border in [...] Read more.
Access to health care and financial protection for migrants can be promoted through diverse health insurance schemes, designed to suit migrants’ needs within a specific context. The Migrant Fund (M-Fund) is a voluntary, non-profit health insurance scheme operating along the Thai–Myanmar border in Thailand since 2017 and aims to protect the health of migrants uncovered by existing government insurance schemes. A qualitative evaluation was conducted between December 2018 and March 2019 to determine M-Fund’s operational impacts, provide recommendations for improvement, and draw suggestions about its role in protecting migrant health. In-depth interviews with 20 individuals and 5 groups were conducted in three categories: (1) International, national, and local partners; (2) M-Fund clients; and (3) M-Fund staff. Interview information was triangulated with findings from other informants, a document review, and researchers’ observations. Despite covering a small number of 9131 migrants, the M-Fund has contributed to improving access to care for migrants, raised awareness about migrant health protection, and reduced the financial burden for public hospitals. The M-Fund acts as a safety-net initiative for those left behind due to unclear government policy to protect the health of undocumented/illegal migrants. Despite clear merits, the issue of adverse selection to the scheme is a critical challenge. Evidence from this evaluation is useful to inform the future design of government insurance schemes for migrants. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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18 pages, 336 KiB  
Article
Race and 1918 Influenza Pandemic in the United States: A Review of the Literature
by Helene Økland and Svenn-Erik Mamelund
Int. J. Environ. Res. Public Health 2019, 16(14), 2487; https://doi.org/10.3390/ijerph16142487 - 12 Jul 2019
Cited by 51 | Viewed by 8223
Abstract
During epidemics, the poorest part of the population usually suffers the most. Alfred Crosby noted that the norm changed during the 1918 influenza pandemic in the US: The black population (which were expected to have higher influenza morbidity and mortality) had lower morbidity [...] Read more.
During epidemics, the poorest part of the population usually suffers the most. Alfred Crosby noted that the norm changed during the 1918 influenza pandemic in the US: The black population (which were expected to have higher influenza morbidity and mortality) had lower morbidity and mortality than the white population during the autumn of 1918. Crosby’s explanation for this was that black people were more exposed to a mild spring/summer wave of influenza earlier that same year. In this paper, we review the literature from the pandemic of 1918 to better understand the crossover in the role of race on mortality. The literature has used insurance, military, survey, and routine notification data. Results show that the black population had lower morbidity, and during September, October, and November, lower mortality but higher case fatality than the white population. The results also show that the black population had lower influenza morbidity prior to 1918. The reasons for lower morbidity among the black population both at baseline and during the herald and later waves in 1918 remain unclear. Results may imply that black people had a lower risk of developing the disease given exposure, but when they did get sick, they had a higher risk of dying. Full article
(This article belongs to the Special Issue Health of Marginalized People)
12 pages, 309 KiB  
Article
Exploring Generational Differences of British Ethnic Minorities in Smoking Behavior, Frequency of Alcohol Consumption, and Dietary Style
by Senhu Wang and Shuanglong Li
Int. J. Environ. Res. Public Health 2019, 16(12), 2241; https://doi.org/10.3390/ijerph16122241 - 25 Jun 2019
Cited by 13 | Viewed by 3716
Abstract
Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010–2012) [...] Read more.
Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010–2012) and wave 5 (2013–2015) of the United Kingdom Household Longitudinal Study on smoking behavior, frequency of alcohol consumption, and dietary style from 59,189 White British, 1690 Indians, 960 Pakistanis, 555 Bangladeshis, 1060 Black Caribbeans, and 1059 Black Africans, adjusted for demographic characteristics, socioeconomic status and ethnic identity. Results: While we find little evidence for generational differences in dietary style, second-generation Indians, Pakistanis, and Black Caribbeans have a significantly higher probability of smoking than the first-generation, and all second-generation minorities are significantly more likely to consume alcohol than their first-generation counterparts. Such generational differences in alcohol consumption are partly explained by second-generation minorities’ weakened ethnic identity and higher socioeconomic status. Conclusions: This study facilitates a better understanding of minority generational differences in health behaviors and the role of socioeconomic status and ethnic identity, highlighting the need for future policy interventions to target certain second-generation ethnic minorities who have adopted certain host society unhealthy lifestyles. Full article
(This article belongs to the Special Issue Health of Marginalized People)
12 pages, 640 KiB  
Article
“Beyond Safer Injecting”—Health and Social Needs and Acceptance of Support among Clients of a Supervised Injecting Facility
by Vendula Belackova, Edmund Silins, Allison M. Salmon, Marianne Jauncey and Carolyn A. Day
Int. J. Environ. Res. Public Health 2019, 16(11), 2032; https://doi.org/10.3390/ijerph16112032 - 7 Jun 2019
Cited by 5 | Viewed by 7591
Abstract
Health and social issues in aging populations of people who inject drugs (PWID) tend to aggregate, despite risky injecting practices decreasing with age. Identifying needs and avenues of support is becoming increasingly important. We described the health and social situation among clients of [...] Read more.
Health and social issues in aging populations of people who inject drugs (PWID) tend to aggregate, despite risky injecting practices decreasing with age. Identifying needs and avenues of support is becoming increasingly important. We described the health and social situation among clients of a long-running supervised injecting facility (SIF) in Sydney, Australia. An interviewer-administered survey (n = 182) assessed current housing status, employment, physical and mental health, incarceration history, drug use, engagement in drug treatment, health service utilization, and willingness to accept support. Results were compared to the information provided at initial visit. Up to half of the participants transitioned between lower- and higher-risk health and social indicators over time. Willingness to accept support was greatest amongst those with higher self-perceived need. Support for mental health was a low priority, despite the high self-reporting of mental health issues. SIF clients are open to support for health and social issues, despite ongoing active drug use. Lower-threshold services such as SIFs are well-positioned to recognize and respond to deteriorating health and social issues for PWID. Facilitating care and treatment remains a challenge when the services to which people are being referred are higher-threshold with a more rigid approach. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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17 pages, 342 KiB  
Article
Goals and Principles of Providers Working with People Experiencing Homelessness: A Comparison Between Housing First and Traditional Staircase Services in Eight European Countries
by Marta Gaboardi, Michela Lenzi, Francesca Disperati, Massimo Santinello, Alessio Vieno, Aurélie Tinland, Maria J. Vargas-Moniz, Freek Spinnewijn, Branagh R. O’Shaughnessy, Judith R. Wolf, Anna Bokszczanin, Roberto Bernad, Ulla Beijer, José Ornelas, Marybeth Shinn and HOME-EU Consortium Study Group
Int. J. Environ. Res. Public Health 2019, 16(9), 1590; https://doi.org/10.3390/ijerph16091590 - 7 May 2019
Cited by 20 | Viewed by 5810
Abstract
The implementation and adaptation of the Housing First (HF) model represented profound changes the structure and delivery, goals, and principles of homeless services. These features of homeless services directly influence providers, their work performance and the clients’ outcomes. The present research, conducted in [...] Read more.
The implementation and adaptation of the Housing First (HF) model represented profound changes the structure and delivery, goals, and principles of homeless services. These features of homeless services directly influence providers, their work performance and the clients’ outcomes. The present research, conducted in eight European countries, investigated how social providers working in HF or TS (Traditional Staircase) describe and conceptualize the goals and the principles of their services. Data were collected through 29 focus group discussions involving 121 providers. The results showed that HF and TS had similar and different goals for their clients in the following areas: support, social integration, satisfaction of needs, housing, and well-being. HF providers emphasized clients’ autonomy and ability to determine their personal goals, with housing being considered a start on the path of recovery, while TS were more focused on individual clients’ basic needs with respect to food, health and finding temporary accommodations. HF providers privileged the person-centered approach and housing as a right, while TS providers were more focused on helping everyone. Implications of the results are discussed as suggestions both for practice and for research. Full article
(This article belongs to the Special Issue Health of Marginalized People)
16 pages, 336 KiB  
Article
A Qualitative Exploration of Fijian Perceptions of Diabetes: Identifying Opportunities for Prevention and Management
by Catherine Dearie, Shamieka Dubois, David Simmons, Freya MacMillan and Kate A. McBride
Int. J. Environ. Res. Public Health 2019, 16(7), 1100; https://doi.org/10.3390/ijerph16071100 - 27 Mar 2019
Cited by 5 | Viewed by 4172
Abstract
Rates of diabetes are high in many communities of Pacific Island peoples, including people from Fiji. This qualitative study explores knowledge and attitudes towards diabetes among i-Taukei Fijians to facilitate the cultural tailoring of diabetes prevention and management programs for this community. Fijians [...] Read more.
Rates of diabetes are high in many communities of Pacific Island peoples, including people from Fiji. This qualitative study explores knowledge and attitudes towards diabetes among i-Taukei Fijians to facilitate the cultural tailoring of diabetes prevention and management programs for this community. Fijians aged 26 to 71 years (n = 15), residing in Australia, participated in semi-structured interviews; 53% (n = 8) were male. Interviews were audio-recorded, transcribed verbatim, then thematically analyzed. Diabetes is recognized as an important and increasing health problem requiring action in the i-Taukei Fijian community. Widespread support for culturally appropriate lifestyle interventions utilizing existing societal structures, like family networks and church groups, was apparent. These structures were also seen as a crucial motivator for health action. Intervention content suggestions included diabetes risk awareness and education, as well as skills development to improve lifestyle behaviors. Leveraging existing social structures and both faith and family experiences of diabetes within the Fijian community may help convert increased awareness and understanding into lifestyle change. Ongoing in-community support to prevent and manage diabetes was also regarded as important. We recommend building upon experience from prior community-based interventions in other high-risk populations, alongside our findings, to assist in developing tailored diabetes programs for Fijians. Full article
(This article belongs to the Special Issue Health of Marginalized People)
9 pages, 288 KiB  
Article
Analysis of the Differential Relationship between the Perception of One’s Life and Coping Resources among Three Generations of Bedouin Women
by Orna Braun-Lewensohn, Sarah Abu-Kaf, Khaled Al-Said and Ephrat Huss
Int. J. Environ. Res. Public Health 2019, 16(5), 804; https://doi.org/10.3390/ijerph16050804 - 5 Mar 2019
Cited by 15 | Viewed by 2711
Abstract
Bedouin society has undergone rapid changes over the past decade. The younger generation of Bedouin women is better educated, which has enabled them to enter different professions, increased their incomes and elevated their social status. We examined the sense of coherence (SOC) and [...] Read more.
Bedouin society has undergone rapid changes over the past decade. The younger generation of Bedouin women is better educated, which has enabled them to enter different professions, increased their incomes and elevated their social status. We examined the sense of coherence (SOC) and its components of meaningfulness, manageability and comprehensibility as well as the use of coping strategies among Bedouin women from three age groups. We also investigated the coping resources and strategies before determining the relationships between these variables in the three groups. One hundred ninety-six women participated in the study. Differences were found mostly between the oldest age group (61 years and older) and the two younger groups (21–40 and 41–60 years old). The oldest women reported less meaningfulness and used less positive reframing, planning, humor and acceptance. In terms of coping strategies, venting was used more by the youngest group whereas behavioral disengagement was used more by the oldest group. In the younger groups, SOC and its components were positively correlated with the use of coping strategies that are considered to be adaptive and with emotional support. However, the correlations between these factors were negative among the oldest group, which points to non-adaptive coping strategies used by these women. These results are discussed in light of the salutogenic, stress-appraisal and coping theories. Full article
(This article belongs to the Special Issue Health of Marginalized People)
12 pages, 707 KiB  
Article
Improving Dietary Behavior Among Ethnic Minority Women in Denmark: A Feasibility Study Based on a Participatory and Culturally Adapted Intervention
by Anna Vera Jørring Pallesen, Stine Byberg and Maria Kristiansen
Int. J. Environ. Res. Public Health 2019, 16(5), 795; https://doi.org/10.3390/ijerph16050795 - 5 Mar 2019
Cited by 3 | Viewed by 2689
Abstract
The Danish Heart Foundation and the non-governmental organization Neighborhood Mothers have co-developed a culturally adapted intervention seeking to promote healthy dietary behaviour among ethnic minority women. This feasibility study explores the potential of the intervention to reach ethnic minority women using health promotion [...] Read more.
The Danish Heart Foundation and the non-governmental organization Neighborhood Mothers have co-developed a culturally adapted intervention seeking to promote healthy dietary behaviour among ethnic minority women. This feasibility study explores the potential of the intervention to reach ethnic minority women using health promotion initiatives. Participants attended instructor courses or cooking events, where culturally adapted, healthy recipes were introduced and meals prepared. Feasibility was explored using a mixed-method approach. Surveys were completed by 59 volunteers and 150 participants at five instructor courses and 21 cooking events. Individual interviews and focus group discussions were conducted with volunteers and participants after completion of the intervention. After the intervention, 61% of the 150 participants had high levels of knowledge about dietary recommendations, 96% intended to cook healthy dishes in the future and 84% intended to incorporate measuring equipment into their daily cooking routine. Participants with a high level of knowledge reported intention to change dietary behaviour more often than participants with lower levels of knowledge. Interviews confirmed that the participants cooked healthy dishes after participating, and incorporated knowledge about healthy food practices into their daily cooking. Few participants used measuring equipment. The intervention proved to be feasible as a health promotion initiative targeting a hard-to-reach population. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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13 pages, 277 KiB  
Article
A Comparative Sociology of Gypsy Traveller Health in the UK
by Miranda Millan and David Smith
Int. J. Environ. Res. Public Health 2019, 16(3), 379; https://doi.org/10.3390/ijerph16030379 - 29 Jan 2019
Cited by 17 | Viewed by 8044
Abstract
This paper presents findings from a series of health-related studies undertaken between 2012 and 2017 with Romany Gypsies and Irish Travellers living in different locations and in various forms of accommodation in southern England. These set out to develop a sociological understanding of [...] Read more.
This paper presents findings from a series of health-related studies undertaken between 2012 and 2017 with Romany Gypsies and Irish Travellers living in different locations and in various forms of accommodation in southern England. These set out to develop a sociological understanding of the factors impacting on the health and wellbeing of members of those communities and to consider the extent health status is shaped by ethno-cultural and/or socioeconomic factors, and the interplay and direction of causal processes between them. The relative influences of cultural and structural factors in generating health inequalities have important implications for engaging marginalised populations in health services and preventative programmes. This paper will present survey and qualitative data on Gypsies’ and Travellers’ health beliefs and practices to understand how those beliefs and practices have developed in different social contexts as responses to deeper social mechanisms, and share commonalities with other marginalised and excluded social groups. In policy terms this indicates the need for health interventions that are applied proportionate to the level of disadvantage experienced thus ensuring equality and fairness while accounting for diversity and difference. Full article
(This article belongs to the Special Issue Health of Marginalized People)
15 pages, 346 KiB  
Article
Prevalence and Factors Associated with Inconsistent Condom Use among Men Who Have Sex with Men (MSM) Who Use Mobile Geo-Social Networking Applications in Greater Tokyo
by Adam O Hill, Benjamin R Bavinton and Gregory Armstrong
Int. J. Environ. Res. Public Health 2018, 15(12), 2815; https://doi.org/10.3390/ijerph15122815 - 10 Dec 2018
Cited by 15 | Viewed by 4490
Abstract
This study examined the prevalence and factors associated with inconsistent condom use among men who have sex with men (MSM) who use gay mobile geo-social networking applications (gay mobile apps) in Greater Tokyo. Among a sample of 1657 MSM recruited through advertisements on [...] Read more.
This study examined the prevalence and factors associated with inconsistent condom use among men who have sex with men (MSM) who use gay mobile geo-social networking applications (gay mobile apps) in Greater Tokyo. Among a sample of 1657 MSM recruited through advertisements on gay mobile apps, inconsistent condom use was reported by over one-third (37%) of participants with regular male partners, 18% with casual male partners, and 20% with female partners. In multiple regression analysis, inconsistent condom use with both regular and casual male partners was more commonly reported among participants without a university education, and among participants reporting lower self-efficacy for safer sex. Inconsistent condom use with casual male partners was more commonly reported among participants living in the central 23 wards of Tokyo. Inconsistent condom use with regular male partners was more commonly reported among participants who identified as a member of the gay community, and who only had male partners. These results indicate that a substantial proportion of Greater Tokyo gay mobile app users use condoms inconsistently, particularly with regular partners, and may be at risk for HIV. This paper provides useful information to help design tailored strategies to reduce inconsistent condom use. Full article
(This article belongs to the Special Issue Health of Marginalized People)

Review

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12 pages, 303 KiB  
Review
Marginalisation, Ebola and Health for All: From Outbreak to Lessons Learned
by Clare Shelley-Egan and Jim Dratwa
Int. J. Environ. Res. Public Health 2019, 16(17), 3023; https://doi.org/10.3390/ijerph16173023 - 21 Aug 2019
Cited by 3 | Viewed by 3677
Abstract
The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear [...] Read more.
The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear that lessons from the past can be quickly forgotten—or be incomplete in the first instance. In this article, we seek to understand the health challenges facing marginalised people by elaborating on the multiple dimensions of marginalisation in the case of the West Africa Ebola epidemic. We trace and unpack modes of marginalisation, beginning with the “outbreak narrative” and its main components and go on to examine other framings, including the prioritisation of the present over the past, the positioning of ‘Us versus Them’; and the marginalisation—in responses to the outbreak—of traditional medicine, cultural practices and other practices around farming and hunting. Finally, we reflect on the ‘lessons learned’ framing, highlighting what is included and what is left out. In conclusion, we stress the need to acknowledge—and be responsive to—the ethical, normative framings of such marginalisation. Full article
(This article belongs to the Special Issue Health of Marginalized People)
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