Intersection of minority health, health disparities, and social determinants of health with psychopharmacology and substance use.

Researchers suggest focusing on social determinants of health might have greater impact atreducing health disparities than individual-level approaches. The goal of this research was to compareperceived best practices to reduce racial and ethnic health disparities with the actual activities of stateoffi ces of minority health. Persons in charge of each state office of minority health responded to an onlinequestionnaire (N = 41, 82 percent response rate). Officers believed addressing social determinats of healthwould have greatest impact at reducing disparities yet devoted most resources to individual-level variables.Though state offices of minority health are under-resourced, officers must continue identifying innovative,collaborative methods to intervene on social determinants of health.

Download Full-text

Social determinants of health affecting treatment of pediatric brain tumors

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.4.peds18594 ◽

2019 ◽

Vol 24 (2) ◽

pp. 159-165

Author(s):

Jillian M. Berkman ◽

Jonathan Dallas ◽

Jaims Lim ◽

Ritwik Bhatia ◽

Amber Gaulden ◽

...

Keyword(s):

African American ◽

Health Disparities ◽

Brain Tumors ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Cns Tumor ◽

Initial Symptoms ◽

Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

Download Full-text

Health Disparities and the Social Determinants of Health: Ethical and Social Justice Issues

The Oxford Handbook of Public Health Ethics ◽

10.1093/oxfordhb/9780190245191.013.24 ◽

2019 ◽

pp. 265-276

Author(s):

Sridhar Venkatapuram

Keyword(s):

Health Disparities ◽

Social Determinants Of Health ◽

Social Determinants ◽

Global Justice ◽

Social Epidemiology ◽

Social Groups ◽

Determinants Of Health ◽

Housing Conditions ◽

Early Infant ◽

The Social

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.

Download Full-text