Prescribing Housing: A Scoping Review of Health System Efforts to Address Housing as a Social Determinant of Health

Author(s):  
Jamison Koeman ◽  
Roshanak Mehdipanah
2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Juli Carrere ◽  
Alexia Reyes ◽  
Laura Oliveras ◽  
Anna Fernández ◽  
Andrés Peralta ◽  
...  

Abstract Background Housing is a social determinant of health. Extensive research has highlighted its adverse effects on health. However, less is known about the effects of cohousing typology on health, which has the potential to create lively social networks and healthy communities and environments. We report the findings of a scoping study designed to gather and synthesise all known evidence on the relationship between cohousing and wellbeing and health. Method Using the scoping review method, we conducted a literature review in PubMed, ProQuest, Scopus, Web of Science, Science Direct and JSTOR in May 2019 and selected articles published from 1960 onwards, with no geographical limit and no design restrictions. Retrieved articles underwent three sequential screening phases. The results were described through a narrative synthesis of the evidence. Results Of the 2560 articles identified, we selected 25 full-text articles analysing 77 experiences. All of them were conducted in high-income countries. Ten studies analysed the impact of cohousing on physical and mental health or quality of life and wellbeing. Eight of the 10 studies found a positive association. In addition, 22 studies analysed one or more psychosocial determinants of health (such as social support, sense of community and physical, emotional and economic security) and most found a positive association. Through these determinants, quality of life, wellbeing and health could be improved. However, the quality of the evidence was low. Discussion The cohousing model could enhance health and wellbeing mediated by psychosocial determinants of health. However, extreme caution should be exercised in drawing any conclusions due to the dearth of data identified and the designs used in the included studies, with most being cross-sectional or qualitative studies, which precluded causal-based interpretations. Because housing is a major social determinant of health, more evidence is needed on the impact of this model on health through both psychosocial and material pathways.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259223
Author(s):  
Céline Miani ◽  
Lisa Wandschneider ◽  
Jana Niemann ◽  
Stephanie Batram-Zantvoort ◽  
Oliver Razum

Background The relevance of gender as a social determinant of health and its role in the production of health inequalities is now broadly acknowledged. However, the plethora of existing approaches to capture gender, which often stem from disciplines outside of epidemiology, makes it difficult to assess their practicality and relevance for a given research purpose. We conducted a scoping review to 1) map the evidence of how gender can be operationalised in quantitative epidemiology and 2) design a tool to critically evaluate the measures identified. Methods We identified peer-reviewed articles in electronic databases (PubMed, Embase and PsycINFO). Eligible sources described the quantitative operationalisation of the social dimension of gender. With the help of a newly developed checklist, we assessed their relevance from an analytical perspective (e.g. intersectionality) and their potential for implementation in epidemiology. Results Gender measures principally assessed gender roles and norms, gender-based discrimination and violence, and structural gender (in)equality. Of the 344 measures included in this review, the majority lacked theoretical foundation, and tended to reinforce the binary understanding of gender through stereotypes of femininity and masculinity. Only few measures allowed for an intersectional approach and a multilevel understanding of gender mechanisms. From a practical point of view, gender measures demonstrated potential for use in varied populations and contexts. Conclusions A range of gender measures are readily available for epidemiological research, addressing different levels and dimensions of gender as a social construct. With our theory-informed, practice-driven scoping review, we highlighted strengths and limitations of such measures and provided analytical tools for researchers interested in conducting intersectional, gender-sensitive analyses.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
Dheepa Rajan

Abstract The presentation will discuss housing as a social determinant of health. It will highlight how housing links to health system performance and thus demonstrate how contextual factors, usually placed outside the health system's boundaries, impact on intermediate outcomes and final goals.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julie Maslowsky ◽  
C. Emily Hendrick ◽  
Haley Stritzel

Abstract Background Early childbearing is associated with adverse health and well-being throughout the life course for women in the United States. As education continues to be a modifiable social determinant of health after a young woman gives birth, the association of increased educational attainment with long-term health for women who begin childbearing as teenagers is worthy of investigation. Methods Data are from 301 mothers in the National Longitudinal Survey of Youth 1979 who gave birth prior to age 19. We estimated path models to assess women’s incomes, partner characteristics, and health behaviors at age 40 as mediators of the relationship between their educational attainment and self-rated general health at age 50. Results After accounting for observed background factors that select women into early childbearing and lower educational attainment, higher levels of education (high school diploma and GED attainment vs. no degree) were indirectly associated with higher self-rated health at age 50 via higher participant income at age 40. Conclusions As education is a social determinant of health that is amenable to intervention after a teen gives birth, our results are supportive of higher educational attainment as a potential pathway to improving long-term health outcomes of women who begin childbearing early.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Faride Sadat Jalali ◽  
Parisa Bikineh ◽  
Sajad Delavari

Abstract Background Direct out-of-pocket payments (OOP) are among the most important financing mechanisms in many health systems, especially in developing countries, adversely affecting equality and leading vulnerable groups to poverty. Therefore, this scoping review study was conducted to identify the strategies involving OOP reduction in health systems. Methods Articles published in English on strategies related to out-of-pocket payments were Searched and retrieved in the Web of Science, Scopus, PubMed, and Embase databases between January 2000 and November 2020, following PRISMA guidelines. As a result, 3710 papers were retrieved initially, and 40 were selected for full-text assessment. Results Out of 40 papers included, 22 (55%) and 18 (45%) of the study were conducted in developing and developed countries, respectively. The strategies were divided into four categories based on health system functions: health system stewardship, creating resources, health financing mechanisms, and delivering health services.As well, developing and developed countries applied different types of strategies to reduce OOP. Conclusion The present review identified some strategies that affect the OOP payments According to the health system functions framework. Considering the importance of stewardship, creating resources, the health financing mechanisms, and delivering health services in reducing OOP, this study could help policymakers make better decisions for reducing OOP expenditures.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frederik Booysen ◽  
Ferdi Botha ◽  
Edwin Wouters

AbstractSocial determinants of health frameworks are standard tools in public health. These frameworks for the most part omit a crucial factor: the family. Socioeconomic status moreover is a prominent social determinant of health. Insofar as family functioning is poorer in poor families and family structure and functioning are linked to health, it is critical to consider the pathways between these four constructs. In this correspondence, we reflect on how empirical studies of this conceptual nexus mirror two causal models. We conclude by reflecting on future directions for research in this field.


2021 ◽  
Author(s):  
Zahra Zarei Jelyani ◽  
Sadra Valiee ◽  
Mohammad Kia ◽  
Ali jajarmizadeh ◽  
Sajad Delavari

Abstract Introduction: Generally, in Epidemics, such as COVID-19, health care workers (HCWs) faces many problems which lead to a shortage and weakening of human resources in the health system. Therefore, using effective strategies to retain human resources is one of the most important issues during outbreaks. This study aims to collect and classify the proposed interventions to strengthen human health resources and their sustainability during epidemics through scoping review.Methods: In this scoping review study, 2300 studies were retrieved through searching international databases –PubMed, Embase, Scopus and Web of Science. The retrieved studies were screened, and finally, 50 studies were included for analysis. The strategies were classified using inductive qualitative content analysis.Results: Most of the studies were conducted in the United States and the United Kingdom. The target population in 39 studies was all health workers; five studies were on physicians, five studies on nurses, and only one study on dentists. The proposed interventions were classified into five categories: preparation, protection, support, treatment, and feedback. Discussion: Most studies focused on providing interventions in one or two dimensions of human resources, but these interventions were summarized and categorized in this review. Therefore, this study has a holistic view of various dimensions of strengthening and maintaining human health resources during epidemics by providing a thematic map. Considering that human beings are multidimensional, policymakers and managers of the health system should use a set of interventions that simultaneously cover different aspects of their needs to strengthen and maintain HCWs.


2016 ◽  
Vol 3 ◽  
pp. JMECD.S37986 ◽  
Author(s):  
Kimberley D Ivory ◽  
Paul Dwyer ◽  
Georgina Luscombe

Training medical students to understand the effects of culture and marginalization on health outcomes is important to the future health of increasingly diverse populations. We devised and evaluated a short training module on working with diversity to challenge students’ thinking about the role of both patient and practitioner culture in health outcomes. The workshop combined didactic teaching about culture as a social determinant of health using the cultural humility model, interactive exercises, and applied theater techniques. We evaluated changes in the students’ perceptions and attitudes over time using the Reaction to Diversity Inventory. There was initial significant improvement. Women and students with no past diversity training responded best. However, scores largely reverted to baseline over 12 months.


2019 ◽  
Author(s):  
Jodyn E Platt ◽  
Minakshi Raj ◽  
Matthias Wienroth

BACKGROUND In the past decade, Lynn Etheredge presented a vision for the Learning Health System (LHS) as an opportunity for increasing the value of health care via rapid learning from data and immediate translation to practice and policy. An LHS is defined in the literature as a system that seeks to continuously generate and apply evidence, innovation, quality, and value in health care. OBJECTIVE This review aimed to examine themes in the literature and rhetoric on the LHS in the past decade to understand efforts to realize the LHS in practice and to identify gaps and opportunities to continue to take the LHS forward. METHODS We conducted a thematic analysis in 2018 to analyze progress and opportunities over time as compared with the initial <i>Knowledge Gaps and Uncertainties</i> proposed in 2007. RESULTS We found that the literature on the LHS has increased over the past decade, with most articles focused on theory and implementation; articles have been increasingly concerned with policy. CONCLUSIONS There is a need for attention to understanding the ethical and social implications of the LHS and for exploring opportunities to ensure that these implications are salient in implementation, practice, and policy efforts.


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