scholarly journals Applying a Population Health Equity Framework in the Clinical Setting—Incorporating Social and Behavioral Determinants of Health Into Estimations of Risk

2020 ◽  
Vol 3 (10) ◽  
pp. e2021771
Author(s):  
Chau Trinh-Shevrin
Keyword(s):  
Population Health ◽  
Health Equity ◽  
Clinical Setting ◽  
Determinants Of Health ◽  
Behavioral Determinants

Population health planning for health equity

2011 ◽  
Vol 17 (4) ◽  
pp. 327 ◽  
Author(s):  
Helen Keleher
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Equity ◽  
Health Planning ◽  
Determinants Of Health ◽  
Data Sources ◽  
Health Plans ◽  
Health Care Planning ◽  
Population Planning ◽  
Sound Foundation

Australia’s health reform documents make reference to the need to address health equity and strengthen population health planning. They make a stronger case about the need to address equity than policy documents that have preceded them. However, they do not make clear that health care is one of many determinants of health and equity, and that planning for health care, social care and social health outcomes are necessary for effectiveness. In other words, population health planning is much more than health care planning. Population health plans vary in their intent and design, depending on the population catchment for the plan, the remit of the organisations involved and the paradigms from which the plan is written. A stronger vision is necessary if population health plans are to affect health inequities. Comprehensive population planning is necessarily intersectoral with engagement across a wide cross-section of government department policies, portfolios and data sources, with a focus on the determinants of health and inequity, and a sound foundation of social values. This paper unpacks the elements of population health planning, the data sources that may be used and their interrogation in terms of the determinants of health, and presents core principles that distinguish population health planning from other types of planning to ensure that planning is comprehensive and able to be actioned.

scholarly journals Drought in Ethiopia: A Population Health Equity Approach to Build Resilience for the Agro-Pastoralist Community

2019 ◽  
Vol 11 (2) ◽  
pp. 42
Author(s):  
Selim M. Khan ◽  
James Gomes
Keyword(s):  
Health Outcomes ◽  
Population Health ◽  
Health Equity ◽  
Grey Literature ◽  
Health Inequity ◽  
Health Interventions ◽  
Determinants Of Health ◽  
Bibliographic Databases ◽  
Health Issues ◽  
Leverage Points

BACKGROUND: A devastating drought is ravaging Africa, with Ethiopia being the worst-hit country. Ethiopia’s economy is predominantly reliant on rain-fed farming and livestock. The agriculture sector contributes up to 85% of the country’s livelihoods. The drought has threatened agro-economy and health of over 15 million agro-pastoralist population who herd the largest livestock in Africa. Some governments announced its commitment in the UN to extend support for the drought-affected people. The Sendai framework for Disaster Risk Reduction prioritizes proactive rather than reactive relief response that can promote health resilience. Applying population health matrices can serve the purpose by exploring the determinants of health, their impacts on the differential health outcomes for population sub-groups and to improve the overall health of the population by addressing the health inequity. OBJECTIVE: This study aims to identify the critical population health outcomes, underlying determinants, and the leverage points for actions that can guide effective policies and interventions for building health resilience for the vulnerable agro-pastoralist population in Ethiopia. METHODS: Two researchers searched nine academic and grey literature bibliographic databases for drought literature and related health interventions. We used the PRISMA checklist to synthesize data and Hamilton tools to evaluate individual study quality. We analyzed data employing disaster vulnerability and WHO’s social determinants of health and health equity frameworks. Socioeconomic, political and cultural backgrounds are examined to identify policy and leverage points for effective population health interventions. RESULTS: Health issues are diverse that revolve around the major determinants of health such as food security, infrastructure, health systems, disaster preparedness, household productivity-income, livestock dependence and access to the market economy. These determinants are further affected by socioeconomic, political and cultural contexts. Despite dire vulnerability and health inequity, some potentials evolved from recent public health field practices as the leverage points for policy actions and interventions. CONCLUSION: The recommended interventions can be implemented through an interdisciplinary population health approach to get the maximum impacts on health resilience. Evidence gathered from the worst drought niche in Africa can be useful to tackle similar droughts induced health issues in other parts of the continent. Future intervention research on the ground can generate robust evidence for action to build health resilience.

Assessing baccalaureate nursing students’ knowledge and attitudes of social determinants of health after a health equity simulation

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Quyen Phan ◽  
Naomi Johnson ◽  
JoAnna Hillman ◽  
Daniel Geller ◽  
Laura P. Kimble ◽  
...  
Keyword(s):  
Nursing Students ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Baccalaureate Nursing ◽  
Baccalaureate Nursing Students ◽  
Determinants Of Health ◽  
Marginalized Populations ◽  
Knowledge And Attitudes ◽  
The Impact

AbstractObjectiveFor nursing students, competency in population health management involves acquiring knowledge and forming attitudes about the impact of the social determinants of health (SDoH) on health equity. The purpose of this pilot study was to assess nursing students’ knowledge and attitudes about the SDoH and health equity following a focused simulation activity.MethodBaccalaureate nursing students (N=182) participated in a ninety-minute health equity simulation and a post-simulation debrief. Forty-four students (23%) completed a 19-item post-simulation survey.ResultsSixty-four percent of participants reported positive attitude change in working with marginalized populations caused by the SDoH, and 89% reported being knowledgeable about the role of the registered nurse in addressing health equity. Seventy-five percent reported enhanced knowledge of the SDoH through the health equity simulation.ConclusionUsing health equity simulation may be effective in enhancing students’ knowledge, as well as their attitudes in caring for the health of marginalized populations by addressing the SDoH.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

600 Social Determinants and Their Impact on Burn Surgery Outcomes

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S151-S152
Author(s):  
Luis H Quiroga ◽  
Tomer Lagziel ◽  
Mohammed Asif ◽  
Raymond Fang ◽  
Grace F Rozycki ◽  
...  
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Hospital Charges ◽  
Burn Patients ◽  
Increased Risk ◽  
History Of

Abstract Introduction To our knowledge, no studies have been conducted assessing the social determinants of health and the impact on the outcomes for burn patients. Such studies are needed considering burn injuries are associated with high costs, severe psychological impact, and a high burden placed on the healthcare systems. The burden is hypothesized to be aggravated by the increasing amount of diabetes and obesity seen in the general population which put patients at increased risk for developing chronic wounds. Studies have shown that several socioeconomic status (SES) factors are associated with increased risk of burns, but none have documented the outcomes of burn patients based on their social determinants of health. In our study, we will be comparing patients in the burn ICU (BICU) to patients in the surgical ICU (SICU). The purpose of this comparison is to evaluate whether the same social determinants of health have similar influences in both groups. Methods We performed a retrospective analysis of population group data from patients admitted to the BICU and SICU from January 1, 2016, to November 18, 2019. The primary outcomes were length-of-stay (LOS), mortality, 30-day-readmission, and hospital charges. Pearson’s chi-square test for categorical variables and t-test for continuous variables were used to compare population health groups. Results We analyzed a total of 487 burn and 510 surgical patients. When comparing BICU and SICU patients, we observed significantly higher mean hospital charges and LOS in burn patients with a history of mental health (mean difference: $42,756.04, p=0.013 and 7.12 days, p=0.0085), ESRD ($57,8124.7, p=0.0047 and 78.62 days, p=0.0104), sepsis ($168,825.19, p=< 0.001 and 20.68 days, p=0.0043), and VTE ($63,9924.1, p=< 0.001 and 72.9 days, p=0.002). Also, higher mortality was observed in burn patients with ESRD, STEMI, sepsis, VTE, and diabetes mellitus. Burn patients with a history of mental health, drug dependence, heart failure, and diabetes mellitus also had greater 30-day-readmissions rates. Conclusions This study sheds new knowledge on the considerable variability that exists between the different population health groups in terms of outcomes for each cohort of critically ill patients. It demonstrates the impacts of population health group on outcomes. These population groups and social determinants have different effects on BICU versus SICU patients and this study provides supporting evidence for the need to identify and develop new strategies to decrease overspending in healthcare. Further research to develop relevant and timely interventions that can improve these outcomes.

scholarly journals From fringe to centre-stage: experiences of mainstreaming health equity in a health research collaboration

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ana Porroche-Escudero ◽  
Jennie Popay ◽  
Fiona Ward ◽  
Saiqa Ahmed ◽  
Dorkas Akeju ◽  
...  
Keyword(s):  
Health Equity ◽  
Health Inequalities ◽  
National Health ◽  
Health Research ◽  
Research Collaboration ◽  
Determinants Of Health ◽  
Gender Mainstreaming ◽  
Health Improvement ◽  
Structural Determinants ◽  
Applied Health Research

Abstract Background Action to address the structural determinants of health inequalities is prioritized in high-level initiatives such as the United Nations Sustainable Development Goals and many national health strategies. Yet, the focus of much local policy and practice is on behaviour change. Research shows that whilst lifestyle approaches can improve population health, at best they fail to reduce health inequalities because they fail to address upstream structural determinants of behaviour and health outcomes. In health research, most efforts have been directed at three streams of work: understanding causal pathways; evaluating the equity impact of national policy; and developing and evaluating lifestyle/behavioural approaches to health improvement. As a result, there is a dearth of research on effective interventions to reduce health inequalities that can be developed and implemented at a local level. Objective To describe an initiative that aimed to mainstream a focus on health equity in a large-scale research collaboration in the United Kingdom and to assess the impact on organizational culture, research processes and individual research practice. Methods The study used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n = 131 respondents including Public Advisers, university, National Health Service (NHS), and local and document review. Results utilizing Extended Normalization Process Theory (ENPT) and gender mainstreaming theory, the evaluation illuminated (i) the processes developed by Collaboration for Leadership in Applied Health Research and Care North West Coast to integrate ways of thinking and acting to tackle the upstream social determinants of health inequities (i.e. to mainstream a health equity focus) and (ii) the factors that promoted or frustrated these efforts. Conclusions Findings highlight the role of contextual factors and processes aimed at developing and implementing a robust strategy for mainstreaming health equity as building blocks for transformative change in applied health research.

scholarly journals Towards Health Equity in a National Autism Strategy: A Lens on Disparities, Barriers, and Solutions

2021 ◽  
Vol 1 (1) ◽  
pp. 62-72
Author(s):  
Kaela Scott ◽  
Megan Krasnodembski ◽  
Shivajan Sivapalan ◽  
Bonnie Brayton ◽  
Neil Belanger ◽  
...  
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Panel Discussion ◽  
Determinants Of Health ◽  
The Public ◽  
Autistic People ◽  
People First ◽  
The Government ◽  
Services And Supports

Health equity allows people to reach their full health potential and access and receive care that is fair and suitable to them and their needs regardless of where they live, what they have, or who they are. To achieve health equity, equity in healthcare focuses on the role of the health system to provide timely and appropriate care. When viewed in the context of a National Autism Strategy, this extends to ensuring access to the resources that each Autistic person requires to meet their health needs, such as an autism diagnosis, services, and supports. Based on the equity panel discussion held at the Canadian Autism Leadership Summit 2020, this article reflects on the current disparities and barriers to achieving health equity in a National Autism Strategy, and outlines ways to address them. Disparities to equitable care within the autism community extend from the level of support needs of an individual to how those intersect with several key determinants of health including: geography, culture, gender, and socioeconomic status. Notably, barriers arise due to a “lack of” theme, including lack of awareness, knowledge, access, and voice. Four reoccurring ideas were identified for how to address inequities in health care for Autistic people. First, allocate resources for regional or in-community endeavours; second, improve Autistic representation and connection; third, establish a community of allies to advocate and collaborate; and fourth, establish leadership within the community and government to make disability a priority for Canada. To achieve equity in health care in a National Autism Strategy, we need to look at the intersectionality of autism with the key determinants of health. Moreover, to effectively engage with the government, health professionals, and the public, the autism community should strive to find a unified and diverse voice. And finally, conversation must turn to action. 

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