Invited Commentary: Religion as a Social Determinant of Health

2019 ◽  
Vol 189 (12) ◽  
pp. 1461-1463 ◽  
Author(s):  
Ichiro Kawachi
Keyword(s):  
Health Outcomes ◽  
Social Determinant ◽  
Religious Practices ◽  
It Service ◽  
Broad Agreement ◽  
Wide Range ◽  
The Life Course ◽  
Harmful Effects ◽  
Social Determinant Of Health ◽  
Service Attendance

Abstract There is broad agreement that religion is a social determinant of health. In the article by Chen and VanderWeele (Am J Epidemiol. 2018;187(11):2355–2364), the authors took an outcome-wide approach to demonstrate associations between religious practices early in the life course (regular service attendance and prayer/mediation) and a wide range of health endpoints and behaviors later on. Is religion a panacea? The study adds to the evidence that religious practices are correlated with a broad swath of health outcomes. However, more work is needed to translate that evidence into practicable advice for individuals and for society. The following tasks remain. 1) We must sharpen our understanding of which elements of religious practices promote health. (Specifically, is it service attendance, prayer, or both? Could a nonreligious person achieve the same benefit via regular participation in a secular group, like a choir?). 2) We should improve our understanding of the different contexts in which religion is likely to have beneficial, as well as potentially harmful, effects.

scholarly journals Mechanisms linking teenage mothers’ educational attainment with self-reported health at age 50

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julie Maslowsky ◽  
C. Emily Hendrick ◽  
Haley Stritzel
Keyword(s):  
Educational Attainment ◽  
Well Being ◽  
The United States ◽  
Social Determinant ◽  
Early Childbearing ◽  
Partner Characteristics ◽  
Higher Educational Attainment ◽  
The Life Course ◽  
Social Determinant Of Health

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.

scholarly journals Reactions to Diversity: Using Theater to Teach Medical Students about Cultural Diversity

2016 ◽  
Vol 3 ◽  
pp. JMECD.S37986 ◽  
Author(s):  
Kimberley D Ivory ◽  
Paul Dwyer ◽  
Georgina Luscombe
Keyword(s):  
Medical Students ◽  
Health Outcomes ◽  
Diversity Training ◽  
Social Determinant ◽  
Cultural Humility ◽  
Future Health ◽  
Perceptions And Attitudes ◽  
Interactive Exercises ◽  
Social Determinant Of Health

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.

scholarly journals Inequities in mental health and mental healthcare between international immigrants and locals in Chile: a narrative review

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Alice Blukacz ◽  
Báltica Cabieses ◽  
Niina Markkula
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Social Vulnerability ◽  
Mental Healthcare ◽  
Health Inequities ◽  
Social Determinant ◽  
Narrative Review ◽  
Review Of The Literature ◽  
International Migrants ◽  
Social Determinant Of Health

Abstract Mental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care. In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants’ mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare. Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability. Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants’ access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion. International migration, social determinants of mental health, mental health inequities, social vulnerability, review.

GED Privatization as a Social Determinant of Health

2016 ◽  
Vol 75 (1) ◽  
pp. 21-32 ◽  
Author(s):  
Janet Page-Reeves ◽  
Enrique Cardiel
Keyword(s):  
New Mexico ◽  
Health Outcomes ◽  
Social Determinant ◽  
Neoliberal Restructuring ◽  
The Relationship ◽  
Social Determinant Of Health ◽  
Improve Health

This article explores a novel place-based effort to improve health outcomes in a ten-square block neighborhood in Albuquerque, New Mexico by assisting people with obtaining a GED. Research conducted as a community-engaged study documents the history and preliminary outcomes of the initiative and how, in the context of the recent privatization of the GED, the welfare of individuals intersects with neoliberal politics. This research offers a timely investigation of the relationship between health and education in the context of ongoing neoliberal restructuring.

Research on the Economic Organization Environmental Impact

2017 ◽  
Vol 68 (3) ◽  
pp. 599-601
Author(s):  
Dan Paul Stefanescu ◽  
Oana Roxana Chivu ◽  
Claudiu Babis ◽  
Augustin Semenescu ◽  
Alina Gligor
Keyword(s):  
Economic Activity ◽  
Economic Organization ◽  
Economic Activities ◽  
Environmental Implications ◽  
Minimal Impact ◽  
Wide Range ◽  
Material Environment ◽  
Negative Effect ◽  
Harmful Effects

Any economic activity carried out by an organization, can generate a wide range of environmental implications. Particularly important, must be considered the activities that have a significant negative effect on the environment, meaning those which pollute. Being known the harmful effects of pollution on the human health, the paper presents two models of utmost importance, one of the material environment-economy interactions balance and the other of the material flows between environmental factors and socio-economic activities. The study of these models enable specific conditions that must be satisfied for the economic processes friendly coexist to the environment for long term, meaning to have a minimal impact in that the residues resulting from the economic activity of the organization to be as less harmful to the environment.

scholarly journals Post-traumatic stress impact on health outcomes in Gulf War Illness

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Mary Jeffrey ◽  
Fanny Collado ◽  
Jeffrey Kibler ◽  
Christian DeLucia ◽  
Steven Messer ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Short Form ◽  
Gulf War ◽  
Ptsd Symptoms ◽  
Symptom Presentation ◽  
Trauma Symptoms ◽  
Post Traumatic Stress ◽  
Gulf War Illness ◽  
Cut Point ◽  
Wide Range

Abstract Background Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation. Methods Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson Trauma Scale value and performing heteroscedastic t-tests across all measures. Results Overall analyses returned two symptom-based subgroups differing significantly across all health and trauma symptoms. These subgroups supported PTSD symptomatology as a means to subgroup veterans. Hierarchical models showed that GWI and levels of PTSD symptoms both impact measures of physical, social, and emotional consequences of poor health (ΔR2 = 0.055–0.316). However, GWI appeared to contribute more to fatigue measures. Cut-point analysis retained worse health outcomes across all measures for GWI with PTSD symptoms compared to those without PTSD symptoms, and healthy controls. Significant differences were observed in mental and emotional measures. Conclusions Therefore, this research supports the idea that comorbid GWI and PTSD symptoms lead to worse health outcomes, while demonstrating how GWI and PTSD symptoms may uniquely contribute to clinical presentation.

scholarly journals Access to Healthcare for Immigrant Children in Canada

2020 ◽  
Vol 17 (9) ◽  
pp. 3320
Author(s):  
Bukola Salami ◽  
Alleson Mason ◽  
Jordana Salma ◽  
Sophie Yohani ◽  
Maryam Amin ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Service Providers ◽  
Social Determinant ◽  
Immigrant Children ◽  
Access To Healthcare ◽  
Cultural Barriers ◽  
Immigrant Parents ◽  
Financial Barriers ◽  
University Of Alberta ◽  
The University

Immigrants experience poorer health outcomes than nonimmigrants in Canada for several reasons. A central contributing factor to poor health outcomes for immigrants is access to healthcare. Previous research on access to healthcare for immigrants has largely focused on the experience of immigrant adults. The purpose of this study was to investigate how immigrants access health services for their children in Alberta, Canada. Our study involved a descriptive qualitative design. Upon receiving ethics approval from the University of Alberta Research Ethics Board, we invited immigrant parents to participate in this study. We interviewed 50 immigrant parents, including 17 fathers and 33 mothers. Interviews were audio recorded, transcribed, and analyzed according to the themes that emerged. Findings reveal that systemic barriers contributed to challenges in accessing healthcare for immigrant children. Participants identified several of these barriers—namely, system barriers, language and cultural barriers, relationship with health professionals, and financial barriers. These barriers can be addressed by policymakers and service providers by strengthening the diversity of the workforce, addressing income as a social determinant of health, and improving access to language interpretation services.

scholarly journals Legal needs of patients attending an urban family practice in Hamilton, Ontario, Canada: an observational study of a legal health clinic

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Gina Agarwal ◽  
Melissa Pirrie ◽  
Dan Edwards ◽  
Bethany Delleman ◽  
Sharon Crowe ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Outcomes ◽  
Family Practice ◽  
Healthcare Setting ◽  
Social Determinant ◽  
Care Physician ◽  
Health Clinic ◽  
Legal Services ◽  
Future Health ◽  
Urban Family

Abstract Background Individuals living in poverty often visit their primary care physician for health problems resulting from unmet legal needs. Providing legal services for those in need may therefore improve health outcomes. Poverty is a social determinant of health. Impoverished areas tend to have poor health outcomes, with higher rates of mental illness, chronic disease, and comorbidity. This study reports on a medical-legal collaboration delivered in a healthcare setting between health professionals and lawyers as a novel way to approach the inaccessibility of legal services for those in need. Methods In this observational study, patients aged 18 or older were either approached or referred to complete a screening tool to identify areas of concern. Patients deemed to have a legal problem were offered an appointment at the Legal Health Clinic, where lawyers provided legal advice, referrals, and services for patients of the physicians. Fisher’s exact test was used to compare populations. Binary logistic regression was used to determine the factors predicting booking an appointment with the clinic. Results Eighty-four percent (n = 648) of the 770 patients screened had unmet legal needs and could benefit from the intervention, with an average of 3.44 (SD = 3.42) legal needs per patient screened. Patients with legal needs had significantly higher odds of attending the Legal Health Clinic if they were an ethnicity that was not white (OR = 2.48; 95% CI 1.14–5.39), did not have Canadian citizenship (OR = 4.40; 95% CI 1.48–13.07), had housing insecurity (OR = 3.33; 95% CI 1.53–7.24), and had difficulty performing their usual activities (OR = 2.83; 95% CI 1.08–7.43). As a result of the clinic consultations, 58.0% (n = 40) were referred to either Legal Aid Ontario or Hamilton Community Legal Clinic, 21.74% (n = 15) were referred to a private lawyer; one case was taken on by the clinic lawyer. Conclusion The Legal Health Clinic was found to fulfill unmet legal needs which were abundant in this urban family practice. This has important implications for the future health of patients and clinical practice. Utilizing a Legal Health Clinic could translate into improved health outcomes for patients by helping overcome barriers in accessing legal services and addressing social causes of adverse health outcomes.

scholarly journals Conceptual causal models of socioeconomic status, family structure, family functioning and their role in public health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frederik Booysen ◽  
Ferdi Botha ◽  
Edwin Wouters
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
Family Functioning ◽  
Family Structure ◽  
Empirical Studies ◽  
Social Determinant ◽  
Causal Models ◽  
Family Socioeconomic Status ◽  
The Family ◽  
Social Determinant Of Health

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.

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