If I was minister of health I would prioritise addressing all health inequalities.
Ontology highlight
ABSTRACT:
SUBMITTER: Pillai Johnson H
PROVIDER: S-EPMC8361384 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Publications
If I was minister of health I would prioritise addressing all health inequalities.
Journal of the Royal Society of Medicine 20201210 8
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Project description:ObjectivesAs a case study of the impact of universal versus targeted interventions on population health and health inequalities, we used simulations to examine (1) whether universal or targeted manipulations of collective efficacy better reduced population-level rates and racial/ethnic inequalities in violent victimization; and (2) whether experiments reduced disparities without addressing fundamental causes.MethodsWe applied agent-based simulation techniques to the specific example of an intervention on neighborhood collective efficacy to reduce population-level rates and racial/ethnic inequalities in violent victimization. The agent population consisted of 4000 individuals aged 18 years and older with sociodemographic characteristics assigned to match distributions of the adult population in New York City according to the 2000 U.S. Census.ResultsUniversal experiments reduced rates of victimization more than targeted experiments. However, neither experiment reduced inequalities. To reduce inequalities, it was necessary to eliminate racial/ethnic residential segregation.ConclusionsThese simulations support the use of universal intervention but suggest that it is not possible to address inequalities in health without first addressing fundamental causes.
| S-EPMC4126171 | biostudies-literature
Project description: Not available
| S-EPMC7159084 | biostudies-literature
Project description: Not available
| S-EPMC558519 | biostudies-literature
Project description:IntroductionFood insecurity and health are inextricably linked. Since 2008, Scotland has witnessed a proliferation of both food insecurity and emergency food provision. There is a recognised commitment from Scottish Government to 'end the need for food banks', however, the food aid landscape was 'turbo-charged' during COVID-19 leading to intense expansion and diversification of food-based projects, including the development of community food pantries (CFPs). These 'new' models are relatively under-researched, meaning we do not adequately understand their potential or realised impacts on food insecurity and health. This study aims to fill that gap.MethodsA qualitative methodology was used to collect and analyse data from in-depth interviews with 10 representatives from both operational and policy settings related to food insecurity in Scotland. In addition, we conducted an analysis of policy documentation from Scottish Government related to tackling food insecurity to understand how CFPs fit into its overall strategy to transition away from food bank use.ResultsWe found there were variations in conceptualisations of CFPs and how they operate, challenges related to addressing food insecurity at a community level and varied narratives around the role of community level interventions in tackling health inequalities. Choice and access to services were viewed as central components to the pantry model. However, there were significant challenges faced by CFPs, including territorialism, funding and food supply. Articulations of health were often multi-layered and complicated with strong recognition of the social determinants as well as acknowledgement of the limitations of tackling food insecurity and health inequalities solely at the community level.ConclusionsDespite a commitment to transition away from emergency food provision, CFPs in Scotland appear to face many of the same issues as food banks, particularly those which impact health. Urgent critique of their reliance on surplus food redistribution is required alongside investigation of how these 'new' models are experienced by the people who access them. Further expansion of these models should be viewed with caution and in the same vein as traditional emergency food provision: a symptom of, rather than a solution to, the problem of food insecurity.
| S-EPMC11490137 | biostudies-literature
Project description:BackgroundHPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake.Methods and findingsA rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake.ConclusionsDespite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities in childhood and adolescent vaccination programmes.
| S-EPMC3441494 | biostudies-literature
Project description:ObjectiveTo obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition.DesignCross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition.SettingHousehold surveys in Bangladesh from 1996 to 2014.ParticipantsChildren under the age of 5 years.ResultsA decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight.ConclusionsOur findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.
| S-EPMC10200495 | biostudies-literature
Project description: Not available
| S-EPMC8649492 | biostudies-literature
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| S-EPMC7451859 | biostudies-literature
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| S-EPMC1444821 | biostudies-literature
Project description:Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.
| S-EPMC5547285 | biostudies-other