Empowerment to reduce health disparities

2002 ◽  
Vol 30 (59_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Nina Wallerstein
Keyword(s):  
Risk Factor ◽  
Health Disparities ◽  
New Mexico ◽  
Social Determinants ◽  
Community Capacity ◽  
Youth Empowerment ◽  
Theoretical Construct ◽  
Workplace Hazards ◽  
Future Practice

This article articulates the theoretical construct of empowerment and its importance for health-enhancing strategies to reduce health disparities. Powerlessness is explored as a risk factor in the context of social determinants, such as poverty, discrimination, workplace hazards, and income inequities. Empowerment is presented and compared with social capital and community capacity as strategies to strengthen social protective factors. A case study of a youth empowerment and policy project in New Mexico illustrates the usefulness of empowerment strategies in both targeting social determinants, such as public policies which are detrimental to youth, and improving community capacities of youth to be advocates for social change. Challenges for future practice and research are articulated.

scholarly journals Creating Community Capacity through Youth Empowerment: A Case Study of Rural Nicaragua

2017 ◽  
Vol 12 (2) ◽  
pp. 61-83
Author(s):  
Carla Andrea Millares Forno ◽  
Amy E. Boren
Keyword(s):  
Young People ◽  
Youth Development ◽  
Rural Youth ◽  
Community Capacity ◽  
Sentence Completion ◽  
Youth Empowerment ◽  
Entrepreneurial Activities ◽  
Insight Into ◽  
Local Leaders

Rural youth development in Nicaragua has experienced a rebirth with the re-introduction of 4-H (4-S in Spanish) after nearly two decades in dormancy. This case study explored 4-S through the eyes of 94 young club members, ages 9 to 13. Using sentence completion methods, youth provided insight into the activities they found most interesting and important. Their responses were then compared with the socioeconomic and demographic realities of the youth. Findings reveal deep connections between youth and their communities and culture. Entrepreneurial activities, agriculture, and work were important to the young people, indicating a strong sense of responsibility for contributing to their families and communities. Understanding 4-S members’ interests and ideas can serve local leaders in developing activities that reflect members’ interests and tap into their strengths. 

Social determinants of health affecting treatment of pediatric brain tumors

2019 ◽  
Vol 24 (2) ◽  
pp. 159-165
Author(s):  
Jillian M. Berkman ◽  
Jonathan Dallas ◽  
Jaims Lim ◽  
Ritwik Bhatia ◽  
Amber Gaulden ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Brain Tumors ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Cns Tumor ◽  
Initial Symptoms ◽  
Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

Health Disparities and the Social Determinants of Health: Ethical and Social Justice Issues

2019 ◽  
pp. 265-276
Author(s):  
Sridhar Venkatapuram
Keyword(s):  
Health Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Global Justice ◽  
Social Epidemiology ◽  
Social Groups ◽  
Determinants Of Health ◽  
Housing Conditions ◽  
Early Infant ◽  
The Social

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.

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.

scholarly journals “Peace engineering in practice: A case study at the University of New Mexico”

2021 ◽  
Vol 173 ◽  
pp. 121113
Author(s):  
Ramiro Jordan ◽  
Kamil Agi ◽  
Sanjeev Arora ◽  
Christos G. Christodoulou ◽  
Edl Schamiloglu ◽  
...  
Keyword(s):  
New Mexico ◽  
University Of New Mexico ◽  
The University

scholarly journals Social and Medical Determinants of Cardiometabolic Health: The Big Picture

2015 ◽  
Vol 25 (4) ◽  
pp. 521 ◽  
Author(s):  
Gary A. Puckrein ◽  
Brent M. Egan
Keyword(s):  
Emergency Department ◽  
Health Disparities ◽  
Social Determinants ◽  
The United States ◽  
Emergency Department Visits ◽  
Cardiometabolic Health ◽  
Years Of Life Lost ◽  
Fee For Service ◽  
Cardiometabolic Diseases ◽  
Mean Cost

<p class="Pa7">Cardiometabolic diseases, including diabetes and heart disease, account for &gt;12 million years of life lost annually among Black adults in the United States. Health disparities are geographically localized, with ~80% of health disparities occurring within ~6000 (16%) of all 38,000 US ZIP codes. Socio-economic status (SES), behavioral and environmental fac­tors (social determinants) account for ~80% of variance in health outcomes and cluster geographically. Neighborhood SES is inversely associated with prevalent diabetes and hyper­tension, and Blacks are four times more likely than Whites to live in lowest SES neighbor­hoods. In ZIP code 48235 (Detroit, 97% Black, 16.2% unemployed, income/capita $18,343, 23.6% poverty), 1082 Medicare fee-for service (FFS) beneficiaries received care for type 2 diabetes (T2D) and coronary artery disease (CAD) in 2012. Collectively, these beneficiaries had 1082 inpatient admissions and 839 emergency department visits, mean cost $27,759/beneficiary and mortality 2.7%. Nationally in 2011, 236,222 Black Medicare FFS beneficiaries had 213,715 inpatient admissions, 191,346 emergency department visits, mean cost $25,580/beneficiary and 2.4% mortality. In addition to more prevalent hypertension and T2D, Blacks appear more susceptible to clinical complications of risk fac­tors than Whites, including hypertension as a contributor to stroke. Cardiometabolic health equity in African Americans requires interven­tions on social determinants to reduce excess risk prevalence of risk factors. Social-medical interventions to promote timely access to, delivery of and adherence with evidence-based medicine are needed to counterbal­ance greater disease susceptibility. Place-based interventions on social and medical determi­nants of health could reduce the burden of life lost to cardiometabolic diseases in Blacks. <em>Ethn Dis. </em>2015;25(4):521-524; doi:10.18865/ ed.25.4.521</p>

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