A Preliminary Assessment of Selected Social Determinants of Health in a Sample of Transgender and Gender Nonconforming Individuals in Puerto Rico

Abstract Background: Despite an abundance of information on the risk factors of SARS-CoV-2, large scale studies of long-term effects are lacking. In this paper we analyzed a large medical claims database of US based individuals to identify common long-term effects as well as their associations with various social and medical risk factors.Methods: The medical claims database was obtained from a prominent US based claims data processing company, namely Change Healthcare. In addition to the claims data, the dataset also consisted of various social determinants of health such as race, income, education level and veteran status of the individuals. A self-controlled cohort design (SCCD) observational study was performed to identify ICD-10 codes whose proportion was significantly increased in the outcome period compared to the control period to identify significant long-term effects. A logistic regression-based association analysis was then performed between identified long-term effects and social determinants of health.Results: Among the over 1.37 million COVID patients in our datasets we found 36 out of 1,724 3-digit ICD-10 codes to be statistically significantly increased in the post-COVID period (p-value <0.05). We also found one combination of ICD-10 codes, corresponding to ‘other anemias’ and ‘hypertension’, that was statistically significantly increased in the post-COVID period (p-value <0.05). Our logistic regression-based association analysis with social determinants of health variables, after adjusting for comorbidities and prior conditions, showed that age and gender were significantly associated with the multiple long-term effects. Race was only associated with ‘other sepsis’, income was only associated with ‘Alopecia areata’, while education level was only associated with ‘Maternal infectious and parasitic diseases’ (p-value <0.05). Conclusion: We identified several long-term effects of SARS-CoV-2 through a self-controlled study on a cohort of over one million patients. Furthermore, we found that while age and gender are commonly associated with the long-term effects, other social determinants of health such as race, income and education levels have rare or no significant associations.

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Explaining the Health Gap Experienced by Girls and Women in Canada: A Social Determinants of Health Perspective

Sociological Research Online ◽

10.5153/sro.2024 ◽

2009 ◽

Vol 14 (5) ◽

pp. 1-13 ◽

Cited By ~ 9

Author(s):

Cecilia Benoit ◽

Leah Shumka ◽

Kate Vallance ◽

Helga Hallgrímsdóttir ◽

Rachel Phillips ◽

...

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Health Inequities ◽

Safety Net ◽

Determinants Of Health ◽

Health Determinants ◽

Sex And Gender ◽

The Social ◽

Health Gap ◽

And Gender

In the last few decades there has been a resurgence of interest in the social causes of health inequities among and between individuals and populations. This ‘social determinants’ perspective focuses on the myriad demographic and societal factors that shape health and well-being. Heeding calls for the mainstreaming of two very specific health determinants - sex and gender - we incorporate both into our analysis of the health gap experienced by girls and women in Canada. However, we take an intersectional approach in that we argue that a comprehensive picture of health inequities must, in addition to considering sex and gender, include a context sensitive analysis of all the major dimensions of social stratification. In the case of the current worldwide economic downturn, and the uniquely diverse Canadian population spread over a vast territory, this means thinking carefully about how socioeconomic status, race, ethnicity, immigrant status, employment status and geography uniquely shape the health of all Canadians, but especially girls and women. We argue that while a social determinants of health perspective is important in its own right, it needs to be understood against the backdrop of broader structural processes that shape Canadian health policy and practice. By doing so we can observe how the social safety net of all Canadians has been eroding, especially for those occupying vulnerable social locations.

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Gender, Work, and Health for Trans Health Providers: A Focus on Transmen

ISRN Nursing ◽

10.5402/2012/161097 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Judith A. MacDonnell ◽

Alisa Grigorovich

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Social Environments ◽

Health Providers ◽

Research Education ◽

Trans People ◽

Or Practice ◽

And Gender ◽

Work And Health

Well-documented health research points to trans people’s vulnerability to health inequities that are linked to deeply embedded structural and social determinants of health. Gender and work, as social determinants of health for trans people, both shape and are shaped by multiple factors such as support networks, social environments, income and social status, shelter, and personal health practices. There is a gap in the nursing literature in regards to research on work and health for diverse trans people and a virtual silence on the particular issues of trans-identified health providers. This qualitative study used comparative life history methodology and purposeful sampling to examine links among work, career, and health for transmen who are health providers. Semistructured interviews were completed with four Canadian transmen involved in health care professional and/or practice contexts with diverse professions, age, work, and transitioning experiences. Critical gender analysis showed that unique and gender-related critical events and influences shape continuities and discontinuities in their careerlives. This strength-based approach foregrounds how resilience and growth emerged through participants’ articulation with everyday gender dynamics. These findings have implications for nursing research, education, and practice that include an understanding of how trans providers “do transgender work” and supporting them in that process.

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Programs and interventions promoting health equity in LGBTQ2+ populations in Canada through action on social determinants of health

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.41.12.04 ◽

2021 ◽

Vol 41 (12) ◽

pp. 431-435

Author(s):

Robert Higgins ◽

Brian Hansen ◽

Beth E. Jackson ◽

Ashley Shaw ◽

Nathan J. Lachowsky

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Health Inequities ◽

Minority Language ◽

Determinants Of Health ◽

Structural Level ◽

Sexual And Gender Minorities ◽

Recent Immigrants ◽

Gender Minorities ◽

And Gender

Abstract Sexual and gender minorities (SGM) experience a number of health inequities. That social determinants of health drive these inequities is well-documented, but there is little evidence on the number and types of interventions across Canada that address these determinants for these populations. We conducted an environmental scan of programs in Canada that target SGM, and classified the programs based on their level of intervention (individual/interpersonal, institutional and structural). We found that few programs target women, mid-life adults, Indigenous people or ethnoracial minorities, recent immigrants and refugees, and minority language speakers, and few interventions operate at a structural level.

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Individual and community experience of rising burden of non-communicable diseases in two case districts of Nepal: a qualitative exploration

Global Health Promotion ◽

10.1177/17579759211001718 ◽

2021 ◽

pp. 175797592110017

Author(s):

Sudesh R. Sharma ◽

Anna Matheson ◽

Danielle Lambrick ◽

James Faulkner ◽

David W. Lounsbury ◽

...

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Rural Areas ◽

Economic Status ◽

Geographical Location ◽

Communicable Diseases ◽

Determinants Of Health ◽

Non Communicable Diseases ◽

Policy Level ◽

And Gender

Introduction: Non-communicable diseases (NCDs) are a rapidly emerging global health challenge with multi-level determinants popularly known as social determinants. The objective of this paper is to describe the individual and community experiences of NCDs in the two case districts of Nepal from a social determinants of health perspective. Method: This study adopted qualitative study design to identify the experiences of NCDs. Sixty-three interviews were conducted with key informants from different sectors pertinent to NCD prevention at two case districts and at the policy level in Nepal. Twelve focus group discussions were conducted in the selected communities within those case districts. Data collection and analysis were informed by the adapted Social Determinants of Health Framework. The research team utilised the framework approach to carry out the thematic analysis. The study also involved three sense-making workshops with policy level and local stakeholders. Results: Three key themes emerged during the analysis. The first theme highlighted that individuals and communities were experiencing the rising burden of NCDs and metabolic risks in both urban and rural areas. The other two themes elaborated on the participant’s experiences based on their socio-economic background and gender. Disadvantaged populations were more vulnerable to the risk of NCDs. Further, being female put one into an even more disadvantaged position in experiencing NCD risks and accessing health services. Conclusion: The findings indicated that key social determinants such as age, geographical location, socio-economic status and gender were driving the NCD epidemic. There is an urgent need to take action on social determinants of health through multi-sectoral action, thus also translating the spirit of the recommendations made a decade ago by the Commission on Social Determinants of Health in addressing a complex challenge like NCDs in Nepal.

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