A call to action for community/public health nurses: Treat structural racism as the critical social determinant of health it is

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.

Download Full-text

Public health at a crossroads: assessing teaching on economic globalization as a social determinant of health

Critical Public Health ◽

10.1080/09581596.2012.685052 ◽

2012 ◽

Vol 22 (3) ◽

pp. 281-295 ◽

Cited By ~ 4

Author(s):

Shelley K. White

Keyword(s):

Public Health ◽

Economic Globalization ◽

Social Determinant ◽

Social Determinant Of Health

Download Full-text

Borderline: The Ethics of Fat Stigma in Public Health

The Journal of Law Medicine & Ethics ◽

10.1177/1073110517750585 ◽

2017 ◽

Vol 45 (4) ◽

pp. 510-517 ◽

Cited By ~ 13

Author(s):

Cat Pausé

Keyword(s):

Public Health ◽

Social Determinant ◽

Health Campaigns ◽

Health Seeking ◽

Health Seeking Behaviors ◽

Negative Impacts ◽

Public Health Campaigns ◽

Social Determinant Of Health ◽

Fat Stigma

This article argues that public health campaigns have an ethical obligation to combat fat stigma, not mobilize it in the “war on obesity.” Fat stigma is conceptualized, and a review is undertaken of how pervasive fat stigma is across the world and across the lifespan. By reviewing the negative impacts of fat stigma on physical health, mental health, and health seeking behaviors, fat stigma is clearly identified as a social determinant of health. Considering the role of fat stigma in public health, and the arguments made for using stigmatisation in public health campaigns to promote population health, it is concluded that it is a violation of public health ethics to use stigma as a tool in combatting fatness. The article concludes by making recommendations of how public health in New Zealand can combat, rather than reinforce, fat stigma.

Download Full-text

Learner Reactions to Activities Exploring Racism as a Social Determinant of Health

Family Medicine ◽

10.22454/fammed.2019.704337 ◽

2019 ◽

Vol 51 (1) ◽

pp. 41-47

Author(s):

Syeachia N. Dennis ◽

Rachel S. Gold ◽

Frances K. Wen

Keyword(s):

Community Health ◽

Social Determinant ◽

Internalized Racism ◽

Curricular Integration ◽

Structural Racism ◽

Professional Programs ◽

Mixed Methods Evaluation ◽

Health Leadership ◽

Learner Responses ◽

Social Determinant Of Health

Background and Objectives: Racism’s impact on health has been well documented. Health professional programs are beginning to help learners understand this social determinant of health through curricular integration of education related to racism. Yet educators are hesitant to integrate these concepts into curricula because of lack of expertise or fear associated with learner responses to this potentially sensitive topic. The purpose of this study is to describe the responses of learners to learning sessions on racism as a social determinant of health (SDOH) highlighting structural, personally-mediated, and internalized racism. Methods: Two separate groups—a family and community medicine (FCM) residency program (N=23) and a community health leadership program (N=14)—participated in lectures and workshops on internalized, personally-mediated, and structural sources of racism, and tours introducing them to the local community’s historical roots of structural racism, including discussions/reflections on racism’s impact on health and health care. Mixed-methods evaluation consisted of learner assessments and reflections on the experiences. Results: FCM sessions received a positive reception with session averages of 4.15 to 4.75, based on a Likert-type scale (1=did not meet expectations to 5=exceeded expectations). Thematic analysis of community health leadership participant reflections showed thought processing connected to a better understanding of racism. Overall, themes from both programs reflected positive experiences of the sessions. Conclusions: Our preliminary study findings suggest that educators who encounter internal or external barriers to integrating racism-related concepts into curricula might find that these concepts are well received. This study lays the groundwork for further research into best practices for integration of curriculum on racism as an SDOH for medical schools, residency programs, and other related educational settings.

Download Full-text

Digital Disenfranchisement and COVID-19: Broadband Internet Access as a Social Determinant of Health

Health Promotion Practice ◽

10.1177/15248399211014490 ◽

2021 ◽

pp. 152483992110144

Author(s):

Jody Early ◽

Alyssa Hernandez

Keyword(s):

Public Health ◽

Digital Divide ◽

Social Determinant ◽

Broadband Internet ◽

Digital Equity ◽

Key Points ◽

Racial Injustice ◽

Equity And Inclusion ◽

Negative Health Outcomes ◽

Social Determinant Of Health

According to the Pew Research Center, approximately one quarter of American adults do not have access to broadband internet. This number does not account for the millions of people who are underconnected or lacking a stable internet connection. Although digital disparity in America is not new, the COVID-19 (coronavirus disease 2019) pandemic has increased our societal dependence on the internet and widened the digital divide. Access to broadband internet has become a basic need in this connected society, linking people to vital resources, such as jobs, education, health care, food, and information. However, it is still an overlooked and understudied issue in public health. In this article, we highlight five key points for why advocating for the expansion of affordable and accessible internet for all should be a priority issue for public health and health promotion. Recent studies offer evidence that digital disenfranchisement contributes to negative health outcomes, economic oppression, and racial injustice. Now more than ever, health advocacy to promote digital equity and inclusion is critical to our meaningful progress toward health equity.

Download Full-text

Public Health in the Information Age: Recognizing the Infosphere as a Social Determinant of Health (Preprint)

10.2196/preprints.19311 ◽

2020 ◽

Author(s):

Jessica Morley ◽

Josh Cowls ◽

Mariarosaria Taddeo ◽

Luciano Floridi

Keyword(s):

Public Health ◽

Social Media ◽

Health Information ◽

Service Providers ◽

Mobile Apps ◽

Social Determinant ◽

State Control ◽

Ethical Concerns ◽

Media Companies ◽

Social Determinant Of Health

UNSTRUCTURED Since 2016, social media companies and news providers have come under pressure to tackle the spread of political mis- and disinformation (MDI) online. However, despite evidence that online health MDI (on the web, on social media, and within mobile apps) also has negative real-world effects, there has been a lack of comparable action by either online service providers or state-sponsored public health bodies. We argue that this is problematic and seek to answer three questions: why has so little been done to control the flow of, and exposure to, health MDI online; how might more robust action be justified; and what specific, newly justified actions are needed to curb the flow of, and exposure to, online health MDI? In answering these questions, we show that four ethical concerns—related to paternalism, autonomy, freedom of speech, and pluralism—are partly responsible for the lack of intervention. We then suggest that these concerns can be overcome by relying on four arguments: (1) education is necessary but insufficient to curb the circulation of health MDI, (2) there is precedent for state control of internet content in other domains, (3) network dynamics adversely affect the spread of accurate health information, and (4) justice is best served by protecting those susceptible to inaccurate health information. These arguments provide a strong case for classifying the quality of the infosphere as a social determinant of health, thus making its protection a public health responsibility. In addition, they offer a strong justification for working to overcome the ethical concerns associated with state-led intervention in the infosphere to protect public health.

Download Full-text

Six ways to help fix energy hardship in New Zealand

Policy Quarterly ◽

10.26686/pq.v17i4.7323 ◽

2021 ◽

Vol 17 (4) ◽

pp. 65-72

Author(s):

Kimberley O’Sullivan ◽

Helen Viggers

Keyword(s):

Energy Source ◽

New Zealand ◽

Social Determinant ◽

Housing Quality ◽

Policy Action ◽

Measurement Strategy ◽

Social Determinant Of Health ◽

Critical Social

Energy hardship is caused by the interaction of factors including housing quality, appliance efficiency, energy source and price, and occupant needs and income. Multiple policy approaches are needed to address these varied causes of energy hardship, and the lack of an official definition and a measurement strategy in Aotearoa should not preclude policy action to address this critical social determinant of health. Here we outline six ways to help fix energy hardship in New Zealand.

Download Full-text