Understanding social inequalities in cardiac treatment through the lens of cultural health capital: a study of Danish socially disadvantaged ischemic heart patients’ lived experiences of healthcare interactions

2021 ◽  
Author(s):  
Amanda Nikolajew Rasmussen ◽  
Andrew Guise ◽  
Charlotte Overgaard
Keyword(s):  
Lived Experiences ◽  
Social Inequalities ◽  
Ischemic Heart ◽  
Health Capital ◽  
Heart Patients ◽  
Socially Disadvantaged

The role of social support in the experience of life with ischemic heart disease for socially disadvantaged patients: A qualitative study

2021 ◽  
pp. 174239532110650
Author(s):  
Amanda Nikolajew Rasmussen ◽  
Andrew Guise ◽  
Charlotte Overgaard
Keyword(s):  
Social Support ◽  
Heart Disease ◽  
Qualitative Study ◽  
Ischemic Heart Disease ◽  
Social Relationships ◽  
Social Inequalities ◽  
Ischemic Heart ◽  
Supportive Relationships ◽  
Socially Disadvantaged

Objectives Ischemic heart disease (IHD) displays wide social inequalities that are often explained with reference to lifestyle factors. However, research indicates that social support may also play an important role in social inequality in IHD. This study aims to explore the role of social support in the experience of life with IHD for socially disadvantaged patients. Methods The study was conducted as a critical hermeneutic qualitative study in Denmark between October 2018 and August 2019. Data consist of in-depth qualitative interviews with 30 socially disadvantaged patients with IHD. Results The findings showed a notable difference between the participants who were engaged in close and supportive social relationships and those who were not. Life with IHD for those who lacked supportive relationships tended to be marked by feelings of chaos, powerlessness and meaninglessness. Contrarily, those who were engaged in supportive relationships received help to navigate their life with illness, reconcile with what had happened to them, feel empowered, and gain a sense of meaning in their life. Discussion: Social support from close social relationships appears to be crucial for socially disadvantaged ischemic heart patients, and should be encouraged and facilitated in healthcare and interventions targeting this patient group.

Contradictory explanatory models of doctors and ischemic heart patients with low health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Rasmussen ◽  
C Overgaard
Keyword(s):  
Health Literacy ◽  
Low Socioeconomic Status ◽  
Cognitive Abilities ◽  
Explanatory Models ◽  
Ischemic Heart ◽  
Low Socioeconomic ◽  
Heart Patients ◽  
Socially Disadvantaged ◽  
Low Health Literacy ◽  
The Social

Abstract Background Health literacy has been used to explain the social inequalities in ischemic heart disease that exists globally. However, most conceptualizations of health literacy employ an isolated focus on the patient's cognitive abilities without considering the social context. By using the cultural health capital framework, this paper aims at exploring how differences in social dispositions influence the interaction between doctors and ischemic heart patients with low health literacy and low socioeconomic status. Methods The paper is based on 30 qualitative interviews with Danish ischemic heart patients with low health literacy and low socioeconomic status and supplementary, contextual observations. The data collection was nationwide and carried out between October 2018 and August 2019. Results The findings showed that the patients and the doctors derived from different social spheres, which meant that they had developed dissimilar habitus and therefore used different explanatory models to understand and articulate the patient's problem. The doctors were primarily oriented towards the biomedical understanding of the malfunctioning of the body and therefore less aware of the patients' psychosocial illness experience. For the patients, these contradictions resulted in feelings of not being acknowledged, lack of trust in the healthcare system and disruption of treatment. Conclusions The findings suggest that to understand barriers for treatment of socially disadvantaged ischemic heart patients it is not only relevant to look at the patient's individual cognitive abilities but also to explore class-based contradictions in explanatory models between the patients and doctors. Key messages Health literacy should be understood as something embedded in the interplay between social structures and interpersonal dynamics. Contradictions in explanatory models may help explain barriers for treatment of socially disadvantaged ischemic heart patients.

Social inequalities in overweight and obesity in 26 European countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Charafeddine ◽  
S Demarest ◽  
S Drieskens ◽  
F Renard
Keyword(s):  
Weight Status ◽  
Social Inequalities ◽  
Linear Models ◽  
Overweight And Obesity ◽  
Consistent Pattern ◽  
European Countries ◽  
Reverse Inequality ◽  
Socially Disadvantaged ◽  
And Gender ◽  
Low Educated

Abstract Background Previous studies have shown inequalities in overweight and obesity in disfavor of the socially disadvantaged groups. This study examines the extent of these inequalities in 26 European countries. Methods Data from the 2017 EU Statistics on Income and living Conditions (EU-SILC) were used (18 years and older, n = 482,595). A body mass index of 25.0 to 29.9 kg/m2 was classified as overweight and 30.0 and more as obese. Educational level (EL) was used as socioeconomic indicator. Generalized linear models were fitted to compute low-versus high absolute (RD) and relative (RR) inequality. Absolute inequality amplitude (RDA) was calculated as RD/Prevalence. Results Among men, average EU inequalities for overweight were slightly in disfavor of the low educated (RR = 1.05, RDA=5%). A mixed inequality pattern was observed across countries, as the risk of overweight was higher among high educated men in most Eastern countries, in contrast to other parts of Europe (RR from 0.74 to 1.19, RDA from -27% to 20%). Male obesity showed more pronounced inequalities (RR = 1.22, RDA=18%), and a consistent pattern of higher risk among the low educated and wide variation across countries (RR from 1.20 to 2.18, RDA from 16% to 49%). Among women, significant inequalities in overweight were observed (RR = 1.23, RDA=21%), with a consistent pattern of higher risk among the lowest EL, and substantial variation across countries (RR from 1.06 to 1.53, RDA from 7% to 36%). Inequalities were even larger for female obesity, with average RR and RDA reaching 1.49 and 35%, and wider variation (RR from 1.35 to 2.77, RDA from 12% to 88%). Conclusions Social inequalities in weight status are widespread in Europe, but vary substantially between countries. Inequalities are larger among women. For male overweight, a reverse inequality is observed in most Eastern countries. This study allows countries to benchmark the inequalities observed nationally to the situation in other EU countries. Key messages Social inequalities in weight status are widespread in Europe. The pattern of social inequalities in overweight and obesity varies substantially by country and gender.

Characterization of coronary artery obstruction and related findings in ischemic heart patients using cardiac scintigraphy

2014 ◽  
Vol 9 (2) ◽  
pp. 87
Author(s):  
Yousif MohamedY Abdallah ◽  
MohamedAhmed Ali ◽  
EltayebWagiallah Eltayeb ◽  
MohamedE Gar-Elnabi
Keyword(s):  
Coronary Artery ◽  
Ischemic Heart ◽  
Heart Patients ◽  
Artery Obstruction

scholarly journals A Pilot Study Concerning Psychological and Psychiatric Problems among Ischemic Heart Patient

2019 ◽  
Vol 2 (1) ◽  
pp. 01-07
Author(s):  
Saeed Shoja Shafti
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Cardiac Events ◽  
Social Interventions ◽  
Heart Patients ◽  
Psychological Medicine ◽  
Psychiatric Complications ◽  
Psychiatric Problems

Introduction: Psychosocial stresses and psychiatric problems may make worse the prognosis of patients with ischemic heart disease. Therefore assessing their incidence among this group of patients may perhaps enhance our perception concerning their dynamic significance in the field of psychological medicine. Method and Materials: 101 patients with diagnosed ischemic heart disease, in the coronary care unit of a general hospital, had been interviewed by a psychiatrist to find that is there any meaningful association between psychiatric complications or psychosocial strains and ischemic cardiac events. Results: Ischemic events were meaningfully more prevailing amongst patients with both biological risk factors and psychiatric problems. Moreover, the quantity of patients suffering from psychiatric difficulties was significantly more than patients without psychiatric complications. Besides, there was a significant alteration between male and female patients as regards the category of psychosocial stress. Seventy- nine percent of psychosocial stresses had been experienced by patients who had psychiatric complications. Besides, while more dysthymic illness was evident in the acute assembly of patients, more major or minor depressive disorder was noticeable in the chronic group of cardiac patients; a variance which looked significant. Conclusion: The high incidence of psycho-social stresses and psychiatric problems among ischemic heart patients, which may act as co-factors in triggering the pathogenicity of organic risk factors, ask for enough care for recognition, checking, and controlling of them, by way of reasonable clinical and psycho-social interventions.

scholarly journals Enactments of Curriculum Policies in Greek Secondary Education: Regulative Discourses and the Reproduction of Social Inequalities

2021 ◽  
Vol 5 (2) ◽  
pp. 57-70
Author(s):  
Sofia Koutsiouri ◽  
Ioulia Antoniou ◽  
Anna Tsatsaroni
Keyword(s):  
Performance Management ◽  
Social Inequalities ◽  
Ethnically Diverse ◽  
Structured Interviews ◽  
Critical Research ◽  
Socially Disadvantaged ◽  
Diverse Student Populations ◽  
Diverse Student ◽  
Curriculum Policies ◽  
State Schools

Many critical research studies have documented the complex ways in which global policies on school curricula are reshaped at national and local levels. This paper focuses on the discourses which regulate the recontextualizations of global policies in local school settings. The paper presents an empirical study on the enactments of language curricula in the Greek school education system. Using Bernstein’s theory of knowledge pedagogization, we analyze data produced by semi-structured interviews and classroom observations in five lower secondary state schools with socially and ethnically diverse student populations, in the inner city of Athens. Our findings show that, while the socially disadvantaged schools are regulated by discourses on inclusion, in the more advantaged schools of the study regulative discourses are related to performance management concerns. The paper points to the potential implications of such discourses, claiming that challenging educational inequalities requires to identify and act upon the discourses regulating teachers’ practices.

scholarly journals The Challenge of Inequality in University Education: Is the District Quota Scheme Addressing Socio-Economic Disparities in Access to University Education in Uganda?

2021 ◽  
Vol 11 (3) ◽  
pp. 110
Author(s):  
Godfrey Bagonza ◽  
Yuda Taddeo Kaahwa ◽  
Nicholas Itaaga
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Social Inequalities ◽  
Economic Status ◽  
University Education ◽  
Quantitative And Qualitative Research ◽  
Socially Disadvantaged ◽  
The Social ◽  
Low Income Families ◽  
The Government

Access to university education is one of the fundamental educational questions in contemporary educational debates. This is because university education is seen as having an array of benefits to individuals, their households, and their nations. However, the challenge of inequality in terms of gender, income, location, and socio-economic status has constrained some individuals and households to access quality university education. In 2005 the government of Uganda introduced the District Quota Scheme to address the social inequalities in accessing university education. This study examined how the District Quota Scheme is addressing the rural-urban divide in access to university; how the District Quota Scheme has increased access to university education for children with parents who have low levels of education; and whether the District Quota Scheme is improving access to university education for children from low-income families. Following the social constructivist research paradigm and integrating both quantitative and qualitative research methods, the study found a change in access to university education by students from rural areas, students whose parents have lower levels of education, and those from low-income families as a result of introducing the District Quota Scheme. The study recommends that the government of Uganda and other stakeholders in the higher education sector should address the structural challenges to ensure that mainly the socially disadvantaged students take the biggest advantage of this scheme. 

scholarly journals Physical inactivity as a risk factor to mortality by ischemic heart disease during economic and political crisis in Brazil

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10192
Author(s):  
Diego Augusto Santos Silva
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Mortality Rate ◽  
Ischemic Heart Disease ◽  
Social Inequalities ◽  
Ischemic Heart ◽  
Political Crisis ◽  
Male Population ◽  
Political Crises ◽  
Low Levels

Background To investigate the burden of mortality due to ischemic heart disease (IHD) attributable to low levels of physical activity in the Brazilian population (aged ≥ 25 years) before, during and after economic and political crises (2007–2017). Methods This study was focused on IHD as a cause of death. The International Statistical Classification of Diseases (10th revision) codes related to IHD have been mapped. The data used for the physical activity estimates of the present study refer to surveys with random sampling carried out in the Brazilian territory that considers all domains of physical activity. The contribution of physical activity for mortality due to IHD was estimated using a comparative risk assessment approach. In addition, we verified the association between mortality due to IHD attributable to low levels of physical activity according to the Socio-demographic Index of the Brazilian states. Results For males it was estimated that in 2007 and 2017 there were, respectively, 9,585 and 11,821 deaths due to IHD as a result low physical activity. For females there were 8,689 deaths in 2007 and 10,779 deaths in 2017 due to IHD attributable to low physical activity. From 2007 to 2017, there was 12.0% (for males) and 16.0% (for females) of reduction in age-adjusted mortality rate due to IHD attributable to low physical activity. This reduction was not observed in the Northern and Northeastern regions of Brazil for the male population. Brazilian states with better socioeconomic conditions showed greater reductions in age-adjusted mortality rate due to IHD attributable to low physical activity (male: ρ = −0.74; female: ρ = −0.54) Conclusion The fiscal austerity policies implemented and the lower investment in social programs in the period of economic and political crisis highlighted the social inequalities between Brazilian geographic regions for the burden of mortality due to IHD attributable to low levels of physical activity.

scholarly journals Explaining Inequalities of Homeschooling in Germany during the first COVID-19 Lockdown

2021 ◽  
Author(s):  
Elif Sari ◽  
Felix Bittmann ◽  
Christoph Homuth
Keyword(s):  
Social Inequalities ◽  
Educational Opportunity ◽  
Panel Study ◽  
Social Background ◽  
Parental Engagement ◽  
School Closure ◽  
Technical Equipment ◽  
Highly Educated ◽  
Socially Disadvantaged ◽  
Low Educated

Current studies suggest that the COVID-19 pandemic is worsening existing social inequalities in the field of education worldwide. We argue that the pandemic is especially challenging for students from socially disadvantaged and educationally deprived homes as parental engagement and resources are hugely important to guide and support the learning process during the school closure period.To examine how well parents were able to help their children with schoolwork during the homeschooling period in Germany, we used data from the German National Educational Panel Study (NEPS) collected during the first homeschooling period in May/June 2020. Taking known mechanisms of inequality of educational opportunity into account, we explore the effects of parents’ aspirations and cultural, social, and economic capital on the ability to help their children.Our results show that although the majority of parents were able to provide good support with schoolwork, we found the expected inequalities due to social background. Low educated parents are twice as likely to be unable to provide sufficient support compared to highly educated parents. In our multivariate analyses, family resources show a significant positive effect on the likelihood that parents were able to help.Moreover, regardless of the social or cultural capital endowment of the parents, good technical equipment in the household is associated with a higher probability of support. Thus, ensuring technical home equipment could be a way to promote an educationally supportive learning environment across all social groups.

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