International journal of social determinants of health and health services最新文献

Israel's escalation of genocidal violence and apartheid policies in Gaza, particularly after October 7, 2023, has intentionally targeted health care systems as part of a strategy to annihilate Palestinian life, which has significantly degraded the lives of Palestinians living in the Gaza Strip. This exploratory study aimed to analyze the health crisis faced by the Palestinian health system following the recent Israeli war on the Gaza Strip. The study involved thirty participants from diverse professions, including doctors, nurses, midwives, hospital administrators, paramedics, pharmacists, humanitarian workers, mothers, and other health care providers from the Gaza Strip. Thematic content analysis of the interview transcripts led to the identification of five main themes: (a) collapse of health care infrastructure; (b) loss of medical personnel and resources; (c) maternal and infant health; (d) the spread of preventable and contagious diseases; and (e) mental health challenges for health care providers and patients. Establishing political freedom, ensuring human rights, and dismantling structural inequities are essential to safeguarding health and survival in Gaza. The health crisis in Gaza is a direct result of Israel's genocidal policies, and addressing this crisis requires ensuring accountability, dismantling apartheid structures, and restoring Palestinian sovereignty.

Afghan refugee women in the United States are facing mental health challenges due to COVID-19 and the 2021 Taliban takeover. Given the key role of formal support in refugees' mental health, in this study we examined the effectiveness, barriers, and facilitators of formal support from governmental and nongovernmental organizations (NGOs) by interviewing 34 Afghan refugee women and 18 refugee service providers in California. Results indicated sufficient formal support was received by women in areas like food/grocery assistance, COVID-related programs, financial aid, and referral services. However, gaps were identified in areas like support for empowerment (e.g., literacy support), support for social integration (e.g., community centers), stress mitigation and coping support (e.g., domestic violence programs), informational support (e.g., informational workshops) and instrumental support (e.g., occupational skills training). Although barriers like inefficient policies, cultural and language barriers, patriarchal norms, and limited funding negatively impact the effectiveness of formal support to women, facilitators such as increased political attention, contributions of religious communities, and strengthened NGO relationships with local providers could enhance these services. We concluded that while Afghan women's immediate needs were relatively addressed, long-term, culturally competent approaches are required for their integration and well-being, suggesting NGOs focus on cultural competence, communication, capacity building, sustainability, and collaboration.

This study explores the relationship between the degree of social democracy and population health at cross-national and U.S state levels, and the mechanisms underlying the relationship. Both cross-national and state level demonstrate a political gradient of health-as the level of social democracy increases a corresponding benefit in population health is realized; there is, in effect, a social democratic dividend. At the state level, the mechanisms underlying the social democratic dividend reveal a complex interrelated political-health-social-cultural system; a high degree of intercorrelation is found between 37 variables used to examine this system. Such a high degree of intercorrelation is consistent with a socially democratic "positive manifold," the concept that all variables are beneficially aligned toward a common goal. From a social democratic perspective, this concept is when institutions and policies best promote human flourishing and a successful society.

This study describes the characteristics of early-stage market structures between originators and first generics, analyzes factors influencing early-stage market structures, and suggests policy options to enhance market competition under the patent linkage system. Information on the active substances in originators and their corresponding generics that entered the market through the first generic exclusivity from 2015 to 2020 were retrieved. Logistic regression models were applied to elucidate the factors that determine the early-stage market structure. Forty-four pairs were identified as having generics that entered the market. Various market structures were observed upon entering the first generics. Prolonged market exclusivity for originators was shown to be linked to limited competition even after the market entry of generics. The changed behaviors of generic manufacturers were observed. Manufacturers have adopted independent market entry strategies to be granted first generic exclusivity instead of collaborating with others. Disclosing lists of originators in monopolistic markets and their ongoing exclusivity terms is required. The government could support manufacturers in adapting to the patent linkage system by providing information on patent challenges and disputes. Policy measures to enhance generic uptakes would incentivize manufacturers to be the first generic manufacturers.

Between 2013 and 2017, Canadian federal policymakers grappled with mandating abuse-deterrent formulations (ADFs) for oxycodone products as a response to the overdose crisis. Marketed as a safeguard against misuse and diversion, ADFs promised a technological fix to opioid-related harms, yet their population-level effectiveness remained contested. This study systematically analyzes federal parliamentary debates and committee hearings, identifying key arguments in framings to support or oppose ADF mandates. Proponents framed the crisis through the lens of individual misuse, positioning ADFs as pharmaceutical safeguards that protected "legitimate" patients while curbing illicit opioid use. Opponents challenged ADFs' effectiveness, highlighted Purdue Pharma's role in the crisis, and warned of unintended consequences, including shifts to more dangerous illicit markets. These discursive struggles reinforced a bifurcation between "legitimate" and "illegitimate" opioid use, shaping perceptions of responsibility, medical necessity, and the scope of appropriate intervention. Divergent framings reflected deeper ideological fissures over the etiology of the overdose crisis and who should be considered a justifiable opioid patient. By demonstrating how ADF debates entrenched a dichotomy between acceptable and unacceptable opioid use, this study advances theories of problem framing to demonstrate how policy debates actively shape regulatory paradigms and the boundaries of acceptable government intervention.

Gender inequalities in authorship have extensively been investigated, yet evidence on ethnic inequalities remains limited, with even fewer studies examining the intersections of the two. Our study aims to identify and measure the magnitude of intersectional (gender-by-ethnicity) inequalities among United Kingdom (U.K.)-affiliated-first authors in health inequalities research (1970-2023), and investigate how ethnic inequalities are distributed between and within gender groups over time. The study focuses on U.K. authorship due to its long health inequalities research tradition. We conducted bibliometric analysis of the health inequalities field using the Scopus database, limiting our analysis to U.K.-affiliated authors. Based on first and family names, four strategies were adopted to identify the authors' gender; the Consumer Data Research Centre's Ethnicity Estimator software was used to identify their ethnicity. Despite a decline in the representation of White male first authors over time, all other intersectional groups-especially Black/British Caribbean and Asian/British Bangladeshi authors-show markedly lower representation overall and consistently, with minimal contributions compared to their White male and female counterparts. Our findings offer a nuanced understanding of how different social groups have contributed to the U.K.'s health inequalities research field over time. Addressing these epistemic injustices is essential to enrich the field and strengthen efforts to tackle health inequalities.

This review aims to identify health promotion actions for the homeless population in the scientific literature. A bibliographic review was conducted, with searches performed in the following databases: Web of Science, Scopus, CINAHL, Embase, and Medline. The studies found were analyzed by two independent evaluators using the search strategy that screened 6,446 studies, of which 20 met the eligibility criteria. In the included studies, study design evaluations and level of evidence assessments were performed in addition to the extraction of information for data synthesis. The health promotion actions in the studies converged mainly on restoration, treatment, and prevention of health problems. The synthesis of the selected studies resulted in three categories involving sexual health, care for the promotion of physical health and a healthy lifestyle, and substance use reduction. The included studies evidenced health promotion actions that positively impact the health-disease process of people who are homeless. The importance of intensifying the development of studies for this population is emphasized, especially in developing nations.

According to the World Health Organization, the spread of misinformation and disinformation are dangerous threats to public health. The popular legitimacy of far-right politics in the United States, across Europe, and other continents constitutes a new phase that threatens to jeopardize countermeasures adopted by social, political, and scientific institutions to counter the phenomena of mis- and disinformation.

International evidence suggests differences in perinatal outcomes between migrant women and their native-born peers, but the intergeneration impact of family migration and interplay with maternal ethnicity remains unclear. This study investigates the relationships between maternal ethnicity, migration status, and perinatal outcomes using secondary analysis of data obtained by an established birth cohort study in the north of England using regression models. Pakistani migrants had higher odds of low birth weight and lower odds of macrosomia compared to white British natives. Pakistani migrants of all generations had higher odds of gestational diabetes, with odds among first-generation migrants almost double that of second-generation migrants. First-generation Pakistani migrants also had lower odds of preterm birth and Apgar score < 7 at 1 min in comparison with other groups. Lower incidence of premature birth in first-generation migrant Pakistani women is of importance. Higher odds of low birth weight and lower odds of macrosomia among Pakistani migrants compared to white British women merits further investigation. It is noteworthy that this is despite higher odds of gestational diabetes overall in this population and generational differences in among Pakistani migrants requiring further attention, with a full consideration of confounding environmental and biological factors, with a view to addressing identified inequalities.