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Pathways towards Health Equity: Tackling Social Determinants of Health to Eliminate Health Disparities

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 11643

Special Issue Editors


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Guest Editor
Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland Baltimore, MD 21201, USA
Interests: social determinants of health including social cohesion and capital of vulnerable populations; social epidemiology; health inequalities; racial differences; longitudinal studies; patient reported outcomes

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Guest Editor
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
Interests: social and cultural determinants of health including social cohesion and capital and religious involvement applied to HIV, chronic disease, and substance use outcomes

Special Issue Information

A vast body of research has shown that the health of a population is determined to a lesser extent by individual lifestyles and biology, but more profoundly by historical and socially determined conditions such as the socioeconomic position and social relationships among individuals and across neighborhoods. The study of social conditions and how these conditions influence and determine the health of populations is a subject of interest and importance for public health in general. The WHO Commission on Social Determinants of Health showed that health inequities are the result of complex systems operating at global, national, and local levels. The position of a person in the social hierarchy within complex systems affects the conditions in which they grow, learn, live, work, and age, which then structures one’s chances of avoiding disease or producing good health and well-being. The study of social factors in times of economic recession and health crisis such as the current pandemic is of special interest to guide policies and interventions that reduce health inequalities. There is now a plethora of studies documenting racial, gender, religious, immigrant, and other disparities across social groups. As we emerge from the current COVID-19 pandemic, during which existing health disparities have been truly exposed, we need to identify solutions that have worked, or are being proposed to eliminate health disparities and achieve health equity. To decrease health inequalities, it is important to concentrate on the social factors which determine how people grow, live, work, and age.

For this Special Issue, we invite the submission of papers that describe interventions that are being conceptualized, developed, implemented, and/or evaluated that intervene through one or more social determinants (e.g., racism, socioeconomic conditions, social capital, gender inequality, racial capitalism, religious discrimination, and intergenerational trauma) in one or more population groups. We are particularly interested in papers that intervene across levels including neighborhood or societal, and/or across multiple systems including government/political or cultural (e.g., the church, schools, health departments). Interventions can take many forms, including but not limited to art/music, curriculum, community organization activities, or economic revitalization projects. We are especially interested in papers that also describe how health equity principles were included in the conceptualization or design and evaluation of interventions, the intended target audience, and a discussion of other contexts where the work can possibly extend. Authors are encouraged to think broadly about how their work might influence populations across multiples ociopolitical or geographic contexts (e.g., How might an anti-racism intervention created for Black children in France inform, or be adapted to address racism experienced by Black children in the USA? How might addressing gender inequality among Muslim women in Indonesia be relevant for Muslim women in the United Kingdom?).

Dr. Ester Villalonga-Olives
Dr. Yusuf Ransome
Guest Editors

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

  • social determinants of health
  • social factors
  • social epidemiology
  • health inequalities
  • disparities
  • structural racism
  • interventions
  • programs
  • community organization
  • policies
  • social ecological model

Published Papers (4 papers)

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Research

8 pages, 650 KiB  
Communication
Social Determinants of Health and Child Maltreatment Prevention: The Family Success Network Pilot
by Michelle Johnson-Motoyama, Deborah Moon, Nancy Rolock, David Crampton, C. Bailey Nichols, Hanna Haran, Yiran Zhang, Yasuyuki Motoyama, Eric Gonzalez and Nicole Sillaman
Int. J. Environ. Res. Public Health 2022, 19(22), 15386; https://doi.org/10.3390/ijerph192215386 - 21 Nov 2022
Cited by 4 | Viewed by 2203
Abstract
Child maltreatment is a highly prevalent public health concern that contributes to morbidity and mortality in childhood and short- and long-term health consequences that persist into adulthood. Past research suggests that social determinants of health such as socioeconomic status and intergenerational trauma are [...] Read more.
Child maltreatment is a highly prevalent public health concern that contributes to morbidity and mortality in childhood and short- and long-term health consequences that persist into adulthood. Past research suggests that social determinants of health such as socioeconomic status and intergenerational trauma are highly correlated with child maltreatment. With support from the U.S. Children’s Bureau, the Ohio Children’s Trust Fund is currently piloting the Family Success Network, a primary child maltreatment prevention strategy in Northeast Ohio that seeks to address these social determinants through pillars of service that include family coaching, financial assistance, financial education, parenting education, and basic life skills training. This study highlights the initial development phase of a pilot study. Plans for in-depth process and outcome evaluations are discussed. The project seeks to improve family functioning and reduce child protective services involvement and foster care entry in an economically disadvantaged region. Full article
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16 pages, 1864 KiB  
Article
Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX
by Ryan J. Petteway and Lourdes A. González
Int. J. Environ. Res. Public Health 2022, 19(13), 8187; https://doi.org/10.3390/ijerph19138187 - 4 Jul 2022
Cited by 3 | Viewed by 3218
Abstract
The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research [...] Read more.
The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research on racial health inequities—SDH-related or otherwise—continues to grow, communities of color remain grossly underrepresented as public health researchers and practitioners. Additionally, although SDH are experienced in a very local sense, much research and practice fails to more deeply and thoroughly engage and center local community knowledges. Thus, much work around SDH and racial health inequities presents, ironically, as structurally racist itself—being done/led mostly by White scholars and in ways that do not “center the margins”. Moreover, in the context of public health practice, youth perspective is seldom centered within local health department (LHD) community SDH assessment efforts. With these challenges in mind, this paper introduces and discusses the development of the youth health equity and action research training (yHEART) program as a model for public health researchers/practitioners to engage public health critical race praxis (PHCRP) to better understand and respond to local SDH in communities of color. Specifically, we highlight the significance of PHCRP principles of “voice” and “social construction of knowledge” in advancing antiracism in research and LHD practice related to local SDH. First, we articulate core conceptual and theoretical groundings that informed the yHEART program’s development and animate its ongoing training and research activities. Second, we outline the program’s core training components and overall process, and provide some brief illustrative examples of work completed during the program’s first iteration—yHEART PDX, Vol.I: Youth Participatory Research on Local Social Determinants of Health. We then close with a discussion that reflects on program strengths, challenges, and implications for SDH and racial health equity research/practice in light of growing calls for an antiracist public health. Full article
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11 pages, 344 KiB  
Article
Investigation of Differences in Allostatic Load among Black Men by Level of Educational Attainment: High School Graduates Experience the Highest Levels of Stress
by Charles R. Rogers, Justin X. Moore, Danielle R. Gilmore, Ethan Petersen, Ellen Brooks, Carson Kennedy and Roland J. Thorpe, Jr.
Int. J. Environ. Res. Public Health 2022, 19(6), 3580; https://doi.org/10.3390/ijerph19063580 - 17 Mar 2022
Cited by 6 | Viewed by 2383
Abstract
Allostatic load (AL)—the biological assessment of long-term exposure to stress—may explain mortality-rate disparities among non-Hispanic Black (Black) men. We aimed to investigate AL among Black men with equivalent education status after controlling for income. A cross-sectional study was employed to investigate AL among [...] Read more.
Allostatic load (AL)—the biological assessment of long-term exposure to stress—may explain mortality-rate disparities among non-Hispanic Black (Black) men. We aimed to investigate AL among Black men with equivalent education status after controlling for income. A cross-sectional study was employed to investigate AL among 4113 Black men who participated in the National Health and Nutrition Examination Survey between 1999–2018. A summation of 8 biomarker factors were used to compute AL, differences in socio-demographic characteristics by education status were evaluated, and health behaviors that may influence AL were examined. To determine the high-risk thresholds for each AL component, we examined each component’s distribution among NHB men for whom complete biomarker data were available in the NHANES sample. High-risk thresholds were determined as either (1) above the 75th percentile for body mass index (BMI), diastolic blood pressure (DBP), glycated hemoglobin, systolic blood pressure (SBP), total cholesterol, and serum triglycerides; or (2) below the 25th percentile for serum albumin and serum creatinine. Modified Poisson regression models were used to estimate prevalence ratios and their associated 95% confidence intervals for high AL risk while adjusting for potential confounders. Black men with a high school diploma/GED had a greater prevalence of high AL compared with Black men who had other levels of education, and a slightly higher prevalence of high AL compared with Black men who had less than a high school education. Black men with college degrees had a lower prevalence of high AL than Black men with the lowest levels of educational attainment. Researchers must further examine the hidden costs stemming from the interplay between discrimination associated with being Black in America and systemic racism in the educational system—which may be preventing Black men from achieving optimal health. Full article
12 pages, 396 KiB  
Article
Relationship between Everyday Discrimination and Substance Use among Adolescents in Northern Chile
by Alejandra Caqueo-Urízar, Alfonso Urzúa, Patricio Mena-Chamorro, Jerome Flores, Matías Irarrázaval, Ellen Graniffo and David R. Williams
Int. J. Environ. Res. Public Health 2021, 18(12), 6485; https://doi.org/10.3390/ijerph18126485 - 16 Jun 2021
Cited by 3 | Viewed by 2403
Abstract
Substance use is a public health problem that affects the normal physical, neurological, and psychological development of adolescents. Apparently, discrimination is an important variable for explaining the initiation and continued use of alcohol and marijuana. Since most research focused on discrimination based on [...] Read more.
Substance use is a public health problem that affects the normal physical, neurological, and psychological development of adolescents. Apparently, discrimination is an important variable for explaining the initiation and continued use of alcohol and marijuana. Since most research focused on discrimination based on factors, such as race, ethnicity, sexual orientation, or gender faced by minority groups, studies on discrimination faced by the general population remain scarce. This cross-sectional study described the relationship between everyday discrimination and alcohol and marijuana use-related behaviors among Chilean adolescents. It included 2330 students between 12 and 20 years of age from educational establishments in the city of Arica. To evaluate substance use, specifically alcohol and marijuana, the Child and Adolescent Evaluation System (SENA) was used. The Everyday Discrimination scale was used to evaluate discrimination. Age and everyday discrimination can predict up to 11% of the variance in substance use. Reducing the incidence of everyday discrimination may help reduce heavy alcohol and marijuana consumption among adolescents. Full article
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