Community health equity research & policy最新文献

Research about public health impacts of COVID-19 on post-secondary students is slowly beginning to emerge. This scoping review identified common public health challenges among post-secondary students in higher-income countries during the COVID-19 pandemic. Five databases were searched to find relevant peer-reviewed literature up to March 2022. Results were categorized according to reported public health challenges and relevant socio-economic variables. After screening, 53 articles were reviewed. Most articles were from the USA (39/53). The seven main public health challenges identified were mental health (35/53), financial instability (25/53), physical health (13/53), food insecurity (12/53), social well-being (8/53), digital access (7/53), and housing or relocation (6/53). Students with low socioeconomic status experienced heightened public health challenges. This review offers insight and opportunities for the development of longitudinal tools to support social determinants of health in post-secondary populations in high-income countries and may offer insight into similar experiences for students in other settings.

Local governments working in partnership with communities can institutionalize practices that promote health equity. We offer a case study of how one city in the US is implementing Health in All Policies (HiAP) with the explicit aim of promoting health equity. We use participant observations, original document reviews and interviews to describe how Richmond, California, is building new partnerships, programs and practices with community-based organizations and within government itself as part of the implementation of its HiAP Ordinance. We also report on indicators that were identified by community and government stakeholders for tracking progress toward improving place-based determinants of population health. We find that the responsibility for implementing Richmond's HiAP Ordinance rests on a new institution within local government and this entity is building new partnerships, promoting innovative policies and augmenting practices toward greater health equity. We also reveal how city governments and community partners can collaboratively track progress toward health equity using locally gathered data.

Scholars have long argued that the care experience is shaped by context, and by evolutions in this context. Using Vietnam as a case, we critically interrogate the literature on women's experiences with maternity care to unpack whether and if it engages with the major social, economic, and health system impacts of the Doi Moi reforms in Vietnam and with what consequences for equity. We conducted a critical interpretive synthesis of this literature in light of the social, economic, and health system transformations driven by the Doi Moi reforms. We offer three critiques: (1) an overwhelming focus on public maternity care provision in rural/mountainous regions of Vietnam, (2) a narrow focus on women's ethnic identity, and (3) a misplaced preoccupation with women's limited autonomy and agency. We argue that future research needs to consider the impact of Vietnam's shift towards market-oriented care provision, and the broader societal and health system changes impacting both rural and urban areas, as well as ethnic minority and Kinh majority populations.

Safety net hospitals (SNHs) are essential to our healthcare ecosystem, providing quality healthcare to underserved communities. These institutions offer specialized services and acute medical care to populations facing structural or systemic healthcare barriers. However, for decades, the NYS Medicaid program reimbursed hospitals less than the cost of care, resulting in several independent SNHs becoming financially distressed, with many facing closure. Recently, the Center for Medicaid and Medicare Service Innovation Center (CMSI) introduced the State All-Payer Health Equity Approaches and Development (AHEAD) Model, which aims to support the financial needs of providers while also addressing the complex medical and social circumstances of underserved communities. This article will explore how the AHEAD model can be utilized as an alternative payment method for SNHs in New York State (NYS) to improve healthcare for underserved communities.

According to the life course perspective (LCP), optimal human development and healthy aging are key goals that must start preconceptionally and continue later in life. However, older adult health and family health across generations have received very little attention in maternal and child health (MCH). Community-based participatory research (CBPR) is an important strategy for putting the LCP into action by engaging those communities most affected by health disparities. We conducted six CBPR focus groups using the LCP as the theoretical framework to capture community members' perspectives of risk and protective factors for older adult health. Perceived protective factors for older adults included socialization, support systems, and practicing wellness. Perceived risk factors included caretaking responsibilities, isolation, medical issues, and lack of support. The identified risk and protective factors for older adult health must be considered when developing public health interventions that promote health equity in aging and MCH.

Health inequalities are differences in health between groups in society. Despite them being preventable they persist on a grand scale. At the beginning of 2024, the Institute of Health Equity revealed in their report titled: Health Inequalities, Lives Cut Short, that health inequalities caused 1 million early deaths in England over the past decade. While the number of studies on the prevalence of health inequalities in the UK has burgeoned, limited emphasis has been given to exploring the factors contributing to these (widening) health inequalities. In this commentary article I will describe how the Government's relentless pursuit of economic growth and their failure to implement the necessary regulatory policies to mitigate against the insecurity and health effects neoliberal free market capitalism (referred to as capitalism herein) causes in pursuit of innovation, productivity and growth (economic dynamism) is one key driver underpinning this social injustice. I contend that if the priority really is to tackle health inequalities and ensure health for all then there is an imperative need to move beyond regulation alone to mitigate the worst effects of capitalist production; the goal of the economy has to change to fully restore the balance between economic growth and public health.

Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.

TB remains a significant global health challenge despite being preventable and curable. The Global Plan to End TB 2023-2030 is underpinned by a rights-based, public health and people-centred approach to ending TB. Lebanon is a low TB endemic country, where for the first time a community, rights, and gender (CRG) assessment of the national TB response was conducted in 2024. Despite the universal availability and cost-free access to TB care in Lebanon, systemic barriers continue to hinder patient accessibility. Low disease awareness, transportation costs, financial challenges, and pervasive stigma frequently compel individuals to conceal their TB diagnosis, thereby undermining contact tracing and treatment adherence. Beyond medical treatment, TB patients receive minimal psychosocial or financial support, disproportionately affecting key vulnerable groups who are already marginalized in Lebanese society. Insufficient community engagement and chronic funding shortages further weaken the Lebanese TB response. While Lebanon upholds advanced medical protocols, its outdated TB laws fail to protect crucial patient rights, including privacy, confidentiality, and informed consent. Gender disparities also persist, with a lack of gender-specific data to inform policies, and inadequate sensitization among healthcare personnel (e.g., transgender women, women with HIV, women who use drugs). There is a pressing need for accountability mechanisms for TB program implementers and labor protections to prevent workplace discrimination against TB patients. Strengthening the National TB Program and addressing the structural deficiencies in Lebanon through targeted interventions, legal reforms, and a gender-inclusive, rights-based approach is essential to ensuring available, accessible, acceptable and quality TB services in Lebanon.

ObjectiveTo examine whether remitting behavior among Mexican immigrants in the Bronx is associated with increased food insecurity and lower dietary quality, with a particular focus on potential gender differences in these associations.DesignDescriptive and bivariate statistics are shown, and binary logistic multivariate regression models are computed.SettingData come from a study exploring the social networks, dietary behaviors and outcomes of Mexican immigrants recruited from a Catholic Church in the Bronx between January 2019 and June 2019.Participants81 Mexican immigrants 18 years or older living in the Bronx, New York City.ResultsA statistically significant (p < .1) relationship was not found between sending remittances and food insecurity; however, we found that women remitters had higher odds than men remitters of having low dietary quality (p < .060). We also found that a higher Body Mass Index was associated with higher odds of experiencing low and very low food security (p < .037).ConclusionsFurther research with nationally representative data is needed to investigate the full extent of the association between remittances and nutritional outcomes of remitters.

A central component of the Public Health 3.0 model is building partnerships between local public health departments and other community organizations/stakeholders, including public and private hospitals, as a means of promoting data sharing, service coordination, and collective action. Evidence suggests that such partnerships remain challenging and infrequent. This qualitative study used in-depth interviews to identify barriers and facilitators to building effective collaboration between local health departments (LHDs) and hospitals. We purposively recruited LHD officials (n = 12) across the United States. A directed qualitative content analysis of the interview transcripts revealed five barriers and five facilitators to building effective collaboration between the two entities. Perceived barriers included competition, inconsistent participation and engagement, communication breakdown, time constraints, and lack of financial and human resources. Perceived facilitators included finding common ground, well-established relationships, aligning and leveraging resources, open communication, and leadership commitment. Findings highlight challenges and opportunities to promote effective collaboration between LHDs and hospitals.