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

In the current era of multiple, overlapping global crises, it is essential to consider the political economy of health within the broader framework of global interconnectedness. In this article, we employ the polycrisis concept to understand the impacts of the multifaceted, concurrent, and synergistic contemporary global crises on global health and health inequalities. A polycrisis occurs when crises in multiple diverse global systems become causally entangled, compounding their effects. Despite its potential relevance and analytical insights, the polycrisis concept has rarely been applied in public health research. This article fills that gap, and through reviewing the impacts of past economic, environmental, health, and political crises, we argue that the polycrisis is creating a complex web of challenges that are likely to amplify existing and future health inequalities. We conclude by discussing strategies to mitigate these impacts and suggest pathways for research to ensure that the future is not inevitably unequal.

Recent wars in Ukraine and Gaza, prosecuted with U.S. backing, have caused massive losses of life and, in Gaza, destruction of medical facilities. We performed searches using PubMed and journal websites to assess how many items addressing these wars have appeared in the leading U.S. and U.K. medical journals. We find that the U.S.-based journals (especially the New England Journal of Medicine) have carried few or no items on these wars; the U.K.-based journals have published many more.

Patient groups play an important role in health care. At the same time, the majority of Canadian groups receive payments from pharmaceutical companies, which calls into question whether they speak for the best interests of their membership or the companies that fund them. Canada lacks any mandatory reporting by either patient groups or pharmaceutical companies regarding payments between groups and companies. There are three potential sources of information on the topic of payments: (a) declarations made by groups when they file submissions to the Canadian Agency for Drugs and Technologies in Health, an organization created and funded by Canada's federal, provincial and territorial governments, about whether the agency should recommend public funding for the new drug; (b) patient groups' websites; and (c) voluntary disclosures by pharmaceutical companies on their websites. This study investigates the data available in all three sources and finds that they are incomplete and inconsistent, making any conclusions about patient groups' conflicts of interest and funding unreliable. Although increased transparency is no guarantee of independence, it is an important and necessary first step. However, relying on voluntary disclosure is not sufficient. Legislation, such as the bill passed in the province of Ontario but never implemented, mandating disclosure by companies of payments that they have made is necessary.

Post-traumatic stress disorder (PTSD) is one of the most studied, diagnosed, and treated mental health disorders in settings of war and displacement. A large body of literature has questioned the utility of the PTSD framework and its application to traumatic stress among populations experiencing wars, political violence, and displacement that is chronic and on a population level. No review has yet summarized the conceptual alternatives proposed by scholars for refugees in or from the Arab region. Our article reviews conceptual articles from the last three decades that propose alternative frameworks to understand trauma and traumatic stress among Arab refugees in the Arab region. We have identified nine articles that critiqued the applicability of PTSD framework for Arab refugees and/or provided alternative key concepts. Themes such as the individualistic nature of PTSD, the nature and longitude of traumatic stress, the "normalization of traumatic stress," and the medicalization of trauma have emerged. The articles also discuss social justice as recovery, diagnostic recommendations, and the flow of knowledge production from the Global North to the Global South. Our article expands a growing body of literature critiquing the applicability of Western psychiatric models in settings in the Global South, specifically the Arab region.

This article explores social determinants of health (SDH) in the global context and their connection to justice and human rights. Critiquing prevailing top-down approaches, it demonstrates that policy responses can be divorced from local factors necessary for addressing SDH. The authors examine health justice partnerships (HJPs) and how interdisciplinary collaboration between health and legal services can address inequality and health disparities. This discussion is timely given the Hague Declaration on Equal Access to Justice for All by 2030 formulates five pillars of people-centered justice. From the 2023 "Plan of Action" comes a "Joint Statement and Call to Action on the Rule of Law and People-Centered Justice: Renewing a Core Pillar of Democracy," creating alignment between SDH and justice approaches for coordinated action. This article demonstrates how HJPs offer a unique avenue for driving change at the community level, advocating for systemic transformations to address poverty, inequality, and injustice. By driving change from local to international levels, multiple voices provide lenses for problem solving. Using American philosopher Carol C. Gould's theory of human rights, the authors explore how joint-disciplinary perspectives and moving beyond paternalistic intervention through integrating justice, human rights, and democracy can respond to drive outcomes in SDHs.

Suicide is a critical public health issue disproportionately affecting Indigenous communities in Canada, especially children. Research on child suicide remains scarce, resulting in a limited understanding of its risk and protective factors. Identified risk dimensions include mental and behavioral health, relational issues, and significant adverse childhood experiences like abuse, and bullying. Studies on Indigenous youth and adults also emphasize the effects of colonization, public policy on child welfare, and systemic racism. The lack of research specifically addressing Indigenous child suicidality underscores the urgent need for tailored research. This article presents findings from a study engaging First Nations and Inuit educators, revealing factors linked to suicidal distress among Indigenous children. Through reflexive thematic analysis, three major themes emerged: the proximal emotional toll of distal risk factors, the impact of adverse childhood experiences, and the role of material deprivation in enhancing risk. Insights from educators are vital for developing targeted interventions to improve prevention efforts.

Drug company funding can create conflicts of interest that compromise the integrity of patient organizations, a problem studied primarily in Western Europe and North America. To address this research gap, we conducted a case study in Poland, a Central European country. Between 2012 and 2020, 33 companies reported payments worth €13 729 644 to 273 patient organizations in Poland. The funding was highly concentrated, with the top ten recipients amassing 46.2 percent of the total amount. Cancer patient organizations were the primary recipients, receiving 37.5 percent. The funding focused on patient organizations' educational activities, constituting 40.4 percent of the total. For the ten companies reporting payments consistently from 2012 to 2020, we detected an increase in both the value of individual payments and the overall value of the funding. Additionally, some patient organizations formed exclusive, or nearly exclusive, ties with single companies. Overall, our study reveals important similarities between Poland and Western countries in the reported distribution of drug company payments to patient organizations. It also highlights priority areas for further research, including the evolution and structure of the financial connections.

This study examined the factors influencing women's susceptibility to sexually transmitted infections (STIs) in Pakistan from an intersectional feminist perspective. The research analyzed sexual behavior, spouse-related dynamics, patriarchal structure, and socioeconomic and demographic factors to understand the complex realities faced by women in this societal context using the 2017-2018 Pakistan Demographic and Health Survey. In applying intersectional feminist perspectives, statistical analyses, including chi-squared tests and multivariate logistic regressions, were employed to explore the factors influencing reported STI levels. The findings revealed that 35.8 percent of women reported experiencing STIs within the past year. Contrary to expectations, women who exhibited sexual empowerment were prone to report STIs, highlighting the impact of power dynamics and gender norms on women's sexual health. In addition, there was a negative correlation between women's participation in decision making regarding contraceptive use and the reporting of STIs, suggesting that women's autonomy in reproductive choices does not necessarily lead to improved sexual health outcomes. To effectively combat this issue, this article presents an integrated approach that challenges negative masculine attitudes, promotes healthy sexual behaviors, and emphasizes communication and shared responsibility for sexual health within marital relationships. Interventions should prioritize fostering marital fidelity, enhancing communication between partners, and empowering women to make conversant decisions about contraception.

This article aims to evaluate the effect of enrolling in supplementary private health insurance on household debt, medical spending, and medical service use among South Koreans experiencing a health shock. Using data from the Korean Welfare Panel Study from 2009 through 2017, we compared household debt and health service use for those with and without private supplemental health insurance after experiencing a health shock. We found no significant differences in household debt or the financial burden of a health shock between those with and without supplemental health insurance coverage following a shock. Households with supplemental coverage used more medical services compared to households without supplementary coverage and incurred additional medical expenses.