Transitioning economies, plant closures and affected communities: identifying potential pathways to health inequities

2021 ◽  
Author(s):  
Kathryn Browne–Yung ◽  
Anna Ziersch ◽  
Sharon Friel ◽  
Toby Freeman ◽  
Fran Baum
Keyword(s):  
Health Inequities ◽  
Plant Closures

Concurrent Session: Gender & Health Inequities

2008 ◽  
Author(s):  
Joy Johnson ◽  
Jan Angus ◽  
Barb Clow ◽  
Blye Frank
Keyword(s):  
Health Inequities ◽  
Concurrent Session

“Scrap-Heap Storiesˮ: Oral Narratives of Labour and Loss in Scottish Mining and Manufacturing

2020 ◽  
Vol 31 (2-2018) ◽  
pp. 8-21
Author(s):  
Arthur McIvor
Keyword(s):  
Working Class ◽  
Lived Experience ◽  
Oral History ◽  
Job Loss ◽  
Sense Of Self ◽  
Oral Narratives ◽  
Industrial Work ◽  
Working Lives ◽  
Plant Closures ◽  
The Impact

This article is an attempt to comprehend deindustrialisation and the impact of plant downsizing and closures in Scotland since the 1970s through listening to the voices of workers and reflecting on their ways of telling, whilst making some observations on how an oral history methodology can add to our understanding. It draws upon a rich bounty of oral history projects and collections undertaken in Scotland over recent decades. The lush description and often intense articulated emotion help us as academic “outsidersˮ to better understand how lives were profoundly affected by plant closures, getting us beyond statistical body counts and overly sentimentalised and nostalgic representations of industrial work to more nuanced understandings of the meanings and impacts of job loss. In recalling their lived experience of plant run-downs and closures, narrators are informing and interpreting; projecting a sense of self in the process and drawing meaning from their working lives. My argument here is that we need to listen attentively and learn from those who bore witness and try to make sense of these diverse, different and sometimes contradictory stories. We should take cognisance of silences and transgressing voices as well as dominant, hegemonic narratives if we are to deepen the conversation and understand the complex but profound impacts that deindustrialisation had on traditional working-class communities in Scotland, as well as elsewhere.

scholarly journals Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes

2021 ◽  
pp. 193229682199317
Author(s):  
Karolina Leziak ◽  
Eleanor Birch ◽  
Jenise Jackson ◽  
Angelina Strohbach ◽  
Charlotte Niznik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mobile Health ◽  
Low Income ◽  
Self Regulation ◽  
Health Inequities ◽  
Comparison Method ◽  
Rapid Expansion ◽  
Self Management ◽  
Postpartum Women ◽  
Design Elements

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.

scholarly journals Development of a checklist to guide equity considerations in health technology assessment

2021 ◽  
Vol 37 ◽  
Author(s):  
Maria Benkhalti ◽  
Manuel Espinoza ◽  
Richard Cookson ◽  
Vivian Welch ◽  
Peter Tugwell ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Literature Search ◽  
Health Inequities ◽  
Health Technology ◽  
Decision Makers ◽  
Added Value ◽  
Pilot Test

Abstract Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value. Conclusions ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

scholarly journals Evidence‐based priorities of under‐served pregnant and parenting adolescents: addressing inequities through a participatory approach to contextualizing evidence syntheses

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Dion ◽  
Aime Klevor ◽  
Amy Nakajima ◽  
Neil Andersson
Keyword(s):  
Social Services ◽  
Adolescent Mothers ◽  
Priority Setting ◽  
Service Providers ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Health Inequities ◽  
Participatory Approach ◽  
Perinatal Health ◽  
Evidence Based

Abstract Purpose This study describes an interdiscursive evidence-based priority setting process with pregnant and parenting adolescents and their services providers. Methods A mixed methods literature review identified studies reporting on perinatal outcomes and experiences of adolescents during pregnancy to 12 months post-partum published in Canada after 2000. We also calculated relative risks for common perinatal risk factors and outcomes for adolescents compared to adult populations from 2012 to 2017 based on data from a provincial database of maternal and newborn outcomes. Two trained peer researchers identified outcomes most relevant to their peers. We shared syntheses results with four service providers and 13 adolescent mothers accessing services at a community service organization, who identified and prioritized their areas of concern. We repeated the process for the identified priority issue and expanded upon it through semi-structured interviews. Results Adolescent mothers face higher rates of poverty, abuse, anxiety and depression than do adult mothers. Adolescents prioritized the experience of judgment in perinatal health and social services, particularly as it contributed to them being identified as a child protection risk. Secondary priorities included loss of social support and inaccessibility of community resources. The experience of judgment in adolescent perinatal health literature was summarized around: being invisible, seen as incapable and seen as a risk. Adolescent mothers adapted these categories, emphasizing organizational and social barriers. Conclusions Young marginalized women are disproportionately affected by inequities in perinatal outcomes, yet their perspectives are rarely centered in efforts to address these inequities. This research addresses health inequities by presenting a robust, transparent and participatory approach to priority setting as a way to better represent the perspectives of those who carry the greatest burden of health inequities in evidence syntheses. In our work, marginalized adolescent parents adapted published literature around the experience and consequences of social stigma on perinatal outcomes, shifting our understanding of root causes and possible solutions.

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