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

For-profit nursing home (NH) chains have become increasingly financialized in order to maximize short-term profits. This descriptive case study focused on the wealth extraction from a mid-sized for-profit California NH chain, from its founding in 1999 until its sale in 2021. The chain had individual founders/owners, a private equity owner, and a real estate group owner. The aims were to analyze the chain's (a) history and profits, organizational structure, and board; (b) management, operations, and strategies; (c) financial status; and (d) quality outcomes. Qualitative and quantitative data were collected and analyzed from multiple public and private sources. The company grew to 63 NHs and related companies with an estimated enterprise value of US$1.3 billion in 2020, while making substantial profits for its owners. The private equity owners had a strong, direct influence on the chain's organizational structure, board, management, operations, strategies, and financial controls from 2016-2020. Its cost controls appeared to be associated with a negative impact on NH nurse staffing levels, nursing wages, turnover rates, resident complaints, penalties, and litigation. Future research should study NH policies that improve ownership and financial transparency while ensuring that government funds are used for NH residents and care providers.

In India, poor child health is a pertinacious issue. This article investigates the impact of water and sanitation, maternal health care service utilization (MHCSU) and breastfeeding practices on under-five child health outcomes (CHOs) in India using the two rounds of the Indian Demographic and Health Survey (DHS), 2015-2016 and 2019-2021. In 2019-2021, unprotected sources of drinking water were associated with an increased prevalence of under-five wasting. Unimproved sanitation facilities were likely to increase the prevalence of under-five stunting; however, unlike in DHS 2015-2016, it had no statistically significant effect on wasting and underweight (2019-2021). Mothers who had not received at least four antenatal care visits were more likely to have stunted and underweight children (2019-2021). The absence of early initiation of breastfeeding was associated with an increased prevalence of under-five wasting and underweight but did not influence CHOs (2015-2016). In 2019-2021, the absence of exclusive breastfeeding for the initial six months was associated with increased odds of stunting and underweight among children. To improve CHOs, policymakers must focus on providing financial, material, and human resources along with soft knowledge to provide hygiene education and promote MHCSU, breastfeeding practices, engagement with frontline health workers and women's empowerment.

Despite being one of the largest organized industries in India, the tea plantation sector faces a significant crisis, especially in Assam. The workers, especially women, are some of the most underpaid, exacerbating their marginalization. Through an extensive review of existing literature, this study aims to explore the social disparities experienced by female tea workers, contributing to their health disparities. The article illuminates the urgent need for comprehensive policies aimed at improving their well-being. It explores why, despite assurances of adequate health care under the Tea Plantation Act of 1951, there continues to be a rise in reported diseases among female laborers in Assam's tea gardens. This investigation will not only focus on their health but will also explore various aspects of their lives to fully understand the factors impacting their overall health. The primary objective of the study is to illustrate how labor-particularly "female labor"-in the tea industry is coerced by management to produce surplus value at the expense of their sanitation, hygiene, and health.

China has aimed to establish a universal health care system through a comprehensive health reform since 2009. However, knowledge about the association between basic social insurances and preventive care utilization (PCU) among Chinese older adults, especially as primary coverage, remains limited. This study investigates these associations using data from the 2018 Chinese Longitudinal Healthy Longevity Survey. We analyzed 9,952 older adults with major medical coverage from urban employee/resident insurance (UE/URBMI), cooperative medical programs (New Rural Cooperative Medical System; NCMS), or self-payment (SP). Propensity score matching (PSM) enhanced comparability between UE/URBMI or NCMS and a control group with SP coverage. Subsequent logistic regression examined associations between major medical expense coverage and PCU for older adults with NCMS + SP (n = 6,580) and UE/URBMI + SP (n = 5,248) groups, respectively. NCMS participants had higher odds of reporting PCU compared to SP users (odds ratio: 1.57, 95% CI: 1.40-1.75, P < .001). Conversely, no significant association was observed in the UE/URBMI + SP group (odds ratio: 1.08, 95% CI: 0.93-1.24, P > .05). This study highlights diverse associations between health insurance types and PCU among older adults. Empirical results suggest sustained government-led health insurance reform may need to continue progressing to strengthen financial incentives for PCU within the social insurance framework.

Precarious employment (PE) is a major determinant of population health and contributor to health and social inequities. The purpose of this article is to synthesize and critically appraise available evidence on labor market initiatives addressing PE identified through a systematic review. Of the 21 initiatives reviewed, grouped into four categories-labor market policies, legislation, and reforms; union strategies; apprenticeships and other youth programs; social protection programs-10 showed consistently positive outcomes and 11 a combination of negative, mixed, or inconclusive outcomes. In addition to reviewing the key findings, we discuss public health implications and recommendations related to PE and the implementation and evaluation of initiatives. Given the wide diversity of initiatives, implementation approaches, evaluation methods, and socioeconomic and historical contexts characterizing the labor markets of the countries studied, we refrain from making recommendations regarding the most effective initiatives to address PE. Instead, we discuss several implications concerning the four types of initiatives to further support those searching for solutions to address PE. We strongly recommend tailoring adopted initiatives to local contexts to match a country's specific PE problems and unique labor market and socioeconomic context.

Low employment quality and precarious employment have been associated with adverse mental health outcomes, yet the extent to which this association may be explained by the experience of unemployment "scarring" has not yet been explored. From a life course perspective, understanding this possible confounding is necessary. Drawing on the United Kingdom's Understanding Society dataset and using latent class analysis, we derived a typology of employment quality across six dimensions and assessed the links between individuals' employment quality, unemployment history, and mental well-being and psychological distress. Our results show that precarious types of employment as well as a higher quality "protected part-time" were linked to low mental well-being, though important gender differences were noted. Accounting for past unemployment did not fully explain these associations. No such adverse associations were observed for increased psychological distress. Our results help further the understanding of employment quality as a social determinant of health and highlight the need for both life course and gender-sensitive research in this area.

Black Canadians frequently experience significant challenges when attempting to access mental health care, resulting in discrepancies in mental health outcomes. This article describes a scoping review that aimed to understand the range and nature of research conducted on the mental health of black Canadians and to identify the gaps in this literature. An established methodological framework guided the scoping review process. We searched research databases (CINAHL, Embase, Global Health, MEDLINE, PsycINFO, Scopus, Sociological Abstracts, and Web of Science) and grey literature sources for peer-reviewed articles and grey reports on the health of black Canadians. Of the 14 121 articles screened, 43 were included in the review. Our review found spiritual support, resilience, collective culture, and culturally congruent support as facilitators of positive mental health of black people in Canada, while stigmatization, misconceptions, low uptake of mental services, and difficulties accessing mental health services were the most significant barriers. Strategies for improving the mental health of black people in Canada center on social, emotional, and community support. Our findings indicate the need for black stakeholder involvement in awareness creation and knowledge improvement, which will help to dispel the myths and misconceptions about mental health in black populations.

Acknowledging and valuing the lived experiences of scholars from the Global South is crucial for more nuanced, refined, and equitable approaches to and interpretations of research. The sheer lack of Tibetan scholars authoring and leading studies within the Tibetan diaspora is especially concerning. The paucity of Tibetan scholars in tuberculosis (TB) discourse is a marker and product of the colonization of academic global health and of global inequities in opportunity and credibility. The lack of Tibetan voices, advocates and scholars alike, in the TB discourse creates ambiguities and misinterpretations, and a general unwillingness to dig deeper into the social, cultural, economic, and historical contexts under which TB thrives in this community. It also symbolizes the lack of opportunity faced by many scholars based in the Global South. Efforts to decolonize global health must also parallel efforts to address other related injustices.