Informal Recyclers’ Health Inequities in Vancouver, BC

2018 ◽  
Vol 28 (2) ◽  
pp. 321-343 ◽  
Author(s):  
Josie Wittmer ◽  
Kate Parizeau
Keyword(s):  
Environmental Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Service Providers ◽  
Health Inequities ◽  
Well Being ◽  
Determinants Of Health ◽  
Access To Health ◽  
Health Related

We explore informal recyclers’ perceptions and experiences of the social determinants of health in Vancouver, Canada, and investigate the factors that contribute to the environmental health inequities they experience. Based on in-depth interviews with 40 informal recyclers and 7 key informants, we used a social determinants of health framework to detail the health threats that informal recyclers associated with their work and the factors that influenced their access to health-related resources and services. Our analysis reveals that the structural factors influencing environmental health inequities included insufficient government resources for low-income urbanites; the potential for stigma, clientization, and discrimination at some health and social service providers; and the legal marginalization of informal recycling and associated activities. We conclude that Vancouver's informal recyclers experience inequitable access to health-related resources and services, and they are knowledgeable observers of the factors that influence their own health and well-being.

scholarly journals Unsafe abortion: social determinants and health inequities in a vulnerable population in São Paulo, Brazil

2012 ◽  
Vol 28 (4) ◽  
pp. 709-719 ◽  
Author(s):  
Carmen L. B. Fusco ◽  
Rebeca de Souza e Silva ◽  
Solange Andreoni
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Multinomial Logistic Regression ◽  
Health Inequities ◽  
Sao Paulo ◽  
Demographic Characteristics ◽  
Determinants Of Health ◽  
Unsafe Abortion ◽  
São Paulo

This cross-sectional population-based study in a peripheral low-income community in São Paulo, Brazil, aimed to estimate the prevalence of unsafe abortion and identify the socio-demographic characteristics associated with it and its morbidity. The article discusses the study's results, based on univariate and multiple multinomial logistic regression analyses. The final regression models included: age at first intercourse < 16 years (OR = 4.80); > 2 sex partners in the previous year (OR = 3.63); more live born children than the woman's self-reported ideal number (OR = 3.09); acceptance of the abortion due to insufficient economic conditions (OR = 4.07); black ethnicity/color (OR = 2.67); and low schooling (OR = 2.46), all with p < 0.05. The discussion used an approach to social determinants of health based on the concept and model adopted by the WHO and the health inequities caused by such determinants in the occurrence of unsafe abortion. According to the findings, unsafe abortion and socio-demographic characteristics are influenced by the social determinants of health described in the study, generating various levels of health inequities in this low-income population.

scholarly journals Health-Predictive Social-Environmental Stressors and Social Buffers Are Place Based: A Multilevel Example From San Bernardino Communities

2019 ◽  
Vol 10 ◽  
pp. 215013271983562 ◽  
Author(s):  
Kristen N. Arthur ◽  
Synnøve F. Knutsen ◽  
Rhonda Spencer-Hwang ◽  
David Shavlik ◽  
Susanne Montgomery
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Health Care Access ◽  
Household Income ◽  
Interdisciplinary Collaboration ◽  
Determinants Of Health ◽  
Community Safety ◽  
Health Related ◽  
Race Ethnicity

Significant evidence demonstrates the powerful effects social determinants have on health-related perceptions, behaviors, and health outcomes. However, these factors are often studied out of context, despite the acknowledgement that social determinants of health are place based. This research aimed to demonstrate that health-related perceptions are dependent on where one lives. Via a community-based participatory study, participants were randomly selected from 3 residential regions varying distances from a freight railyard (nearest n = 300, middle n = 338, farthest n = 327), all mostly low-income, predominately Latino areas. Interview-administered surveys with adults were collected by bilingual trained community members (87% response) in English/Spanish. Adjusted-logistic regression models assessed residential region as a predictor of stressors (perceptions of community safety, community noise disturbance, health care access, food insecurity) and buffers (3 neighborhood cohesion variables), after adjusting for household income, race/ethnicity, gender, and age. Each region experienced a unique amalgam of stressors and buffers. In general, the region closest to the railyard experienced more stressors (odds ratio [OR] = 1.58; 95% CI 1.12-2.20) and less buffers (OR = 0.69; 95% CI 0.49-0.96) than the region furthest from the railyard. More than half of participants in each region reported 2 or more stressors and 2 or more buffers. In this seemingly homogenous study population, place remained important in spite of traditionally used socioeconomic factors, such as household income and race/ethnicity. Social determinants of health should be studied with regard to their environmental context, which will require interdisciplinary collaboration to improve multilevel research methods. Including the study of social buffers will also promote sustainable, positive change to reduce health disparities.

scholarly journals A Case Study in Personal Identification and Social Determinants of Health: Unregistered Births among Indigenous People in Northern Ontario

2019 ◽  
Vol 16 (4) ◽  
pp. 567 ◽  
Author(s):  
Chris Sanders ◽  
Kristin Burnett
Keyword(s):  
Social Determinants Of Health ◽  
Indigenous People ◽  
Social Determinants ◽  
Low Income ◽  
Well Being ◽  
Personal Identification ◽  
Determinants Of Health ◽  
Birth Registration ◽  
Northern Ontario

Under international law, birth registration is considered a human right because it determines access to important legal protections as well as essential services and social supports across the lifespan. Difficulties related to birth registration and the acquisition of personal identification (PID) are largely regarded as problems specific to low-income countries. For Indigenous people in northern and rural Canada, however, lack of PID, like birth certificates, is a common problem that is rooted in the geography of the region as well as historical and contemporary settler colonial policies. This communication elucidates the complicated terrain of unregistered births for those people living in northern Ontario in order to generate discussion about how the social determinants of health for Indigenous people in Canada are affected by PID. Drawing on intake surveys, qualitative interviews and participant observation field notes, we use the case study of “Susan” as an entry point to share insights into the “intergenerational problem” of unregistered births in the region. Susan’s case speaks to how unregistered births and lack of PID disproportionately impacts the health and well-being of Indigenous people and communities in northern Ontario. The implications and the need for further research on this problem in Canada are discussed.

scholarly journals Pushing poverty off limits: quality improvement and the architecture of healthcare values

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Polly Mitchell ◽  
Alan Cribb ◽  
Vikki Entwistle ◽  
Guddi Singh
Keyword(s):  
Quality Improvement ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Deprivation ◽  
Ethical Dilemmas ◽  
Determinants Of Health ◽  
Ethical Challenges ◽  
The Social ◽  
Significant Burden ◽  
Health Related

Abstract Background Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative (PSI) into paediatric practice using the discourse and methodology of healthcare quality improvement (QI). Discussion Whilst suggesting that interventions like the PSI are a potentially valuable extension of clinical roles, which take advantage of the unique affordances of clinical settings, we argue that there is a tendency for such settings to continuously reproduce a narrower set of norms. We illustrate how the framing of an initiative as QI can help legitimate and secure funding for practical efforts to help address social ends from within clinical service, but also how it can constrain and disguise the value of this work. A combination of methodological emphases within QI and managerialism within healthcare institutions leads to the prioritisation, often implicitly, of a limited set of aims and governing values for healthcare. This can act as an obstacle to a genuine broadening of the clinical agenda, reinforcing norms of clinical practice that effectively push poverty ‘off limits.’ We set out the ethical dilemmas facing clinicians who seek to navigate this landscape in order to address poverty and the social determinants of health. Conclusions We suggest that reclaiming QI as a more deliberative tool that is sensitive to these ethical dilemmas can enable managers, clinicians and patients to pursue health-related values and ends, broadly conceived, as part of an expansive range of social and personal goods.

scholarly journals Social inequalities and access to health: challenges for society and the nursing field

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Regina Celia Fiorati ◽  
Ricardo Alexandre Arcêncio ◽  
Larissa Barros de Souza
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inequalities ◽  
Determinants Of Health ◽  
Critical Hermeneutics ◽  
Access To Health ◽  
The Social ◽  
Dialectical Relationship ◽  
The Right ◽  
The Life Course

Objective to present a critical reflection upon the current and different interpretative models of the Social Determinants of Health and inequalities hindering access and the right to health. Method theoretical study using critical hermeneutics to acquire reconstructive understanding based on a dialectical relationship between the explanation and understanding of interpretative models of the social determinants of health and inequalities. Results interpretative models concerning the topic under study are classified. Three generations of interpretative models of the social determinants of health were identified and historically contextualized. The third and current generation presents a historical synthesis of the previous generations, including: neo-materialist theory, psychosocial theory, the theory of social capital, cultural-behavioral theory and the life course theory. Conclusion From dialectical reflection and social criticism emerge a discussion concerning the complementarity of the models of the social determinants of health and the need for a more comprehensive conception of the determinants to guide inter-sector actions to eradicate inequalities that hinder access to health.

Using Community-Level Mental Health Surveillance Data to Examine the Relationship of Depression Prevalence to Social Determinants of Health and Access to Mental Health Services

2013 ◽  
Vol 32 (1) ◽  
pp. 43-57 ◽  
Author(s):  
Shawn R. Currie ◽  
Kirsten Fiest ◽  
Lindsay Guyn
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Community Level ◽  
Determinants Of Health ◽  
Treatment Access ◽  
Depression Prevalence

The effect of social determinants of health on depression prevalence and treatment access was examined using community survey and administrative data on mental health service users in the Calgary Health Region (CHR). Consistent with national prevalence data, depression was significantly associated with female gender, younger age, and health risk factors such as smoking, hypertension, and obesity. The prevalence of depression causing interference in daily functioning across 19 social districts (subregions within the CHR) was significantly related to community-level indicators of single-parent status, low-income families, and low educational achievement in each district. Disparities in treatment access were also found with persons living in the most impoverished districts having the lowest rates of accessing professional mental health services.

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