scholarly journals Public health crisis in the refugee community: little change in social determinants of health preserve health disparities

2021 ◽  
Author(s):  
I Feinberg ◽  
M H O’Connor ◽  
A Owen-Smith ◽  
S R Dube
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Limited English Proficiency ◽  
Determinants Of Health ◽  
Health Crisis ◽  
Health And Wellbeing ◽  
Public Health Crisis ◽  
Refugee Community ◽  
Structural Inequities

Abstract Structural inequities and lack of resources put vulnerable refugee communities at great risk. Refugees flee their country of origin to escape persecution and flee from war, famine and torture. Resettled refugee communities become particularly vulnerable during times of crisis due to limited English proficiency and poor social determinants of health (SDOH), which create barriers to attaining and sustaining health and wellbeing for themselves and their families. The purpose of this case study was to evaluate SDOH among a refugee community in the Southeastern United States. We surveyed the community twice during a 1-year period to assess various elements of SDOH. Among a primarily African and Southeast Asian refugee community, 76% reported difficulty paying for food, housing and healthcare during the first round of surveys. During the second round of surveys at the beginning of the Coronavirus pandemic, 70% reported lost income; 58% indicated concern about paying bills. There was little change during the 12-month study period, showing that SDOH are an enduring measure of poor health and wellbeing for this vulnerable refugee community.

scholarly journals Exploring the local policy context for reducing health inequalities in children and young people: an in depth qualitative case study of one local authority in the North of England, UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eleanor Holding ◽  
Hannah Fairbrother ◽  
Naomi Griffin ◽  
Jonathan Wistow ◽  
Katie Powell ◽  
...  
Keyword(s):  
Child Health ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Qualitative Case Study ◽  
Determinants Of Health ◽  
Local Policy ◽  
Inequalities In Health ◽  
The North

Abstract Background Improving children and young people’s (CYP) health and addressing health inequalities are international priorities. Reducing inequalities is particularly pertinent in light of the Covid-19 outbreak which has exacerbated already widening inequalities in health. This study aimed to explore understandings of inequality, the anticipated pathways for reducing inequalities among CYP and key factors affecting the development and implementation of policy to reduce inequalities among CYP at a local level. Methods We carried out a qualitative case study of one local government region in the North of England (UK), comprising semi structured interviews (n = 16) with service providers with a responsibility for child health, non-participant observations of key meetings (n = 6 with 43 participants) where decisions around child health are made, and a local policy documentation review (n = 11). We employed a novel theoretical framework, drawing together different approaches to understanding policy, to guide our design and analysis. Results Participants in our study understood inequalities in CYP health almost exclusively as socioeconomically patterned inequalities in health practices and outcomes. Strategies which participants perceived to reduce inequalities included: preventive support and early intervention, an early years/whole family focus, targeted working in local areas of high deprivation, organisational integration and whole system/place-based approaches. Despite demonstrating a commitment to a social determinants of health approach, efforts to reduce inequalities were described as thwarted by the prevalence of poverty and budget cuts which hindered the ability of local organisations to work together. Participants critiqued national policy which aimed to reduce inequalities in CYP health for failing to recognise local economic disparities and the interrelated nature of the determinants of health. Conclusions Despite increased calls for a ‘whole systems’ approach to reducing inequalities in health, significant barriers to implementation remain. National governments need to work towards more joined up policy making, which takes into consideration regional disparities, allows for flexibility in interpretation and addresses the different and interrelated social determinants of health. Our findings have particular significance in light of Covid-19 and indicate the need for systems level policy responses and a health in all policies approach.

Conclusion

2020 ◽  
pp. 421-426
Author(s):  
Adrian Bonner
Keyword(s):  
Young People ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Children And Families ◽  
Local Authorities ◽  
Health And Wellbeing ◽  
Large Numbers ◽  
Health Model

This concluding chapter explains that in order to develop interrelationships and interdependencies across the various domains within a social determinants of health rainbow model, there needs to be a good understanding and respect for each of these contributions to the health and wellbeing of people and their communities. In the ten-year period of austerity preceding the COVID-19 crisis, many local authorities have radically reduced their social and health services for children and families and young people, concentrating solely on those with the most acute need, those whom they have a legal obligation to support. Indeed, local government has 'retreated from its historical position as the front-line of defence against social evils'. There remain major concerns about local authorities' ability to support their communities in the post-COVID-19 period. Ultimately, although there are large numbers of reports and reviews aimed at local commissioning policies and practices, there is very little evidence to support the interrelated and interdependent approaches utilising a social determinants of health model that specifically addresses 'wicked issues'.

Remote Pedagogy: Teaching Social Determinants of Health Using Case Study Simulation

2020 ◽  
Vol 101 (12) ◽  
pp. e150-e151
Author(s):  
Denise Ludwig ◽  
Sri Nandamudi ◽  
Janna Pacey ◽  
Kelly Machnik ◽  
Aziizur Molla ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health

Case Study

2011 ◽  
pp. 217-236
Author(s):  
Gail Heaberg
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Research ◽  
Development Process ◽  
Health Needs ◽  
Determinants Of Health ◽  
Health Innovation

Research Matchmaker is a public health innovation that will lead to community centered research focused on social determinants of health. Research Matchmaker has been developed to bring communities, practitioners and researchers together to focus on community determined health needs. The rationale and development process is discussed.

scholarly journals Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Ziersch ◽  
Emily Miller ◽  
Melanie Baak ◽  
Lillian Mwanri
Keyword(s):  
Rural Communities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Rural Areas ◽  
Social Connectedness ◽  
South Australia ◽  
Determinants Of Health ◽  
Rural Setting ◽  
Snowball Sampling ◽  
Health And Wellbeing

Abstract Background There has been a recent focus on resettlement of migrants and refugee in rural settings in Australia and elsewhere. Rural resettlement is seen as an opportunity to revitalise rural communities, to fill the needs of employers in these areas, and to provide a welcoming community within which new arrivals can integrate and settle. However, challenges to rural resettlement have been identified including difficulties securing employment, discrimination and social isolation. These challenges can affect resettlement outcomes including health and wellbeing, though relatively little research has examined these links. In this paper we explored experiences of people from refugee background settling in a rural Australian town, examining interconnections between social determinants of health (SDH) and integration. Methods Face-to-face interviews were conducted with 44 participants from Southeast Asia and Africa in a rural setting in South Australia, covering experiences of resettlement and impacts on health and wellbeing. Participants were recruited through existing connections within the community and snowball sampling. Audio recorded data were transcribed verbatim and analysed using framework thematic analysis. Results The study findings revealed a mixture of settlement experiences for participants across a range of elements of SDH and integration. A sense of safety and some elements of social connectedness and support were key enablers for integration and health and wellbeing, with main challenges including limitations in employment opportunities, mismatched education provision, experiences of discrimination and constrained access to services. Conclusions Challenges experienced by refugees resettled in rural areas can affect integration, health and wellbeing and subsequent onward migration intentions. Attention to broader socioeconomic, cultural and environmental conditions, alongside tailored settlement support policies and practices for individual rural resettlement sites, is required to support integration and health and wellbeing.

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