scholarly journals The Care and Prevention in the United States Demonstration Project: A Call for More Focus on the Social Determinants of HIV/AIDS

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 28S-33S ◽  
Author(s):  
Maria De Jesus ◽  
David R. Williams
2018 ◽  
Vol 38 (4) ◽  
pp. 225-234
Author(s):  
Lindsay Rosenfeld ◽  
Jessica M. Kramer ◽  
Melissa Levin ◽  
Kimberly Barrett ◽  
Dolores Acevedo-Garcia

Optimal child development is supported by services, policies, a social determinants of health (SDOH) frame, and meaningful participation (as defined by the International Classification of Functioning, Disability, and Health–Children and Youth [ICF-CY]). This scoping review describes the social determinants that may affect the participation of young children aged 0 to 3 years with developmental disabilities (DD) in the United States. Scoping review of studies including U.S. children with DD aged 0 to 3 years, from 2000 to 2016, were used. 5/979 studies met inclusion criteria. Two researchers independently coded studies to align them with both ICF-CY and SDOH. Studies found determinants of participation stemming from the child (e.g., individual) and multiple contexts: immediate, community, and policy. The emergent literature continues to primarily focus on child determinants but suggests participation of young children with DD is affected by social determinants stemming from the community and policy contexts. The literature underrepresents children from racial/ethnic minority backgrounds.


Author(s):  
Wendy E. Parmet

This chapter studies the social determinants of health in the United States, focusing on one important but often overlooked social determinant: law. It explains how law influences social determinants and why law should itself be viewed as an important social determinant, one that can both magnify or diminish health disparities. Law can affect population health in numerous ways. Most obviously, laws create, empower, and restrain state, local, and federal public health agencies; regulate the delivery of healthcare; and seek to promote population health by regulating unsafe practices and activities, such as smoking. Health laws, however, are not the only laws that affect health. Laws that affect employment, income inequality, housing, the built environment, and education may also impact health. The chapter then considers some defining features of US law that may play a role in creating or perpetuating health disparities both within the US and between the US and other nations of the Organisation for Economic Cooperation and Development. It also reviews some recent initiatives in the US, many but not all undertaken via law, to address social determinants, and it looks at the barriers that remain to ameliorating social determinants through law, as well as some reasons for optimism.


2019 ◽  
Vol 26 (2) ◽  
pp. 9-18
Author(s):  
Ryan I. Logan

Community health workers (CHWs) participate in advocacy as a crucial means to empower clients in overcoming health disparities and to improve the health and social well-being of their communities. Building on previous studies, this article proposes a new framework for conceptualising CHW advocacy, depending on the intended impact level of CHW advocacy. CHWs participate in three ‘levels’ of advocacy, the micro, the macro, and the professional. This article also details the challenges they face at each level. As steps are taken to institutionalise these workers throughout the United States and abroad, there is a danger that their participation in advocacy will diminish. As advocacy serves as a primary conduit through which to empower clients, enshrining this role in steps to integrate these workers is essential. Finally, this article provides justification for the impacts of CHWs in addressing the social determinants of health and in helping their communities strive towards health equity.


Author(s):  
Elizabeth H. Bradley ◽  
Lauren A. Taylor

This chapter describes the principles of grand strategy as applied to global health and public health. It analyzes President George W. Bush's program, called the President's Emergency Plan for AIDS Relief (known as PEPFAR). Developed largely in secret and placed outside the traditional USAID bureaucracy, the PEPFAR program pole vaulted the United States into a leadership role in global health. The chapter then highlights how the use of grand strategic principles resulted in a highly successful, if still limited, global health intervention. The Bush Administration articulated explicit goals, or ends, and connected those to the larger ecology of national interests related to demonstrating American morality, and protecting the United States from the threat of pandemic HIV/AIDS. However, PEPFAR as a strategy was incomplete. It failed to address critical root causes of the spread of HIV/AIDS—the social and economic conditions in which such pathogens emerge and spread.


2018 ◽  
Vol 46 (4) ◽  
pp. 838-840 ◽  
Author(s):  
Daniel E. Dawes

There is much discourse and focus on the social determinants of health, but undergirding these multiple intersecting and interacting determinants are legal and political determinants that have operated at every level and impact the entire life continuum. The United States has long grappled with advancing health equity via public law and policy. Seventy years after the country was founded, lawmakers finally succeeded in passing the first comprehensive and inclusive law aimed at tackling the social determinants of health, but that effort was short-lived. Today the United States is faced with another fork in the road relative to the advancement of health equity. This article draws on lessons from history and law to argue that researchers, providers, payers, lawmakers and the legal community have a moral, economic and national security imperative to address not only the negative outcomes of health disparities, but also the imbalance of inputs resulting from laws and policies which fail to employ an equity lens.


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