scholarly journals The Health Equity Framework: A Science- and Justice-Based Model for Public Health Researchers and Practitioners

2020 ◽  
pp. 152483992095073
Author(s):  
Amy Peterson ◽  
Vignetta Charles ◽  
David Yeung ◽  
Karin Coyle
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Health Equity ◽  
Health Inequities ◽  
Well Being ◽  
Public Health Research ◽  
Life Course Perspective ◽  
Physiological Factors ◽  
Spheres Of Influence ◽  
Two Phases

In this article, we describe a science- and justice-based framework for promoting health equity designed for researchers and practitioners working across public health and social science fields. We developed the health equity framework (HEF; etr.org/healthequityframework ) in two phases of iterative development. Building on existing models, the HEF illustrates how health outcomes are influenced by complex interactions between people and their environments. The framework centers on three foundational concepts: equity at the core of health outcomes; multiple, interacting spheres of influence; and a historical and life-course perspective. Health equity is defined as having the personal agency and fair access to resources and opportunities needed to achieve the best possible physical, emotional, and social well-being. By centering population outcomes, the HEF encourages researchers and practitioners to think beyond traditional approaches that focus on individual behaviors and choices to assess and identify their gaps in acknowledging and addressing factors from multiple spheres of influence. We identified four, interacting spheres of influence that represent both categories of risk and protective factors for health outcomes as well as opportunities for strategies and interventions that address those factors. The HEF highlights the explicit and implicit interactions of multilevel influences on health outcomes and emphasizes that health inequities are the result of cumulative experiences across the life span and generations. The HEF is a practical tool for leaders and professionals in public health research and practice to reflect on and support a shift toward addressing health inequities resulting from the interplay of structural, relational, individual, and physiological factors.

scholarly journals Nature-Based Equity: An Assessment of the Public Health Impacts of Green Infrastructure in Ontario Canada

2021 ◽  
Vol 18 (11) ◽  
pp. 5763
Author(s):  
Vidya Anderson ◽  
William A. Gough ◽  
Branka Agic
Keyword(s):  
Public Health ◽  
Sustainable Development ◽  
Health Outcomes ◽  
Health Equity ◽  
Green Infrastructure ◽  
Service Use ◽  
Well Being ◽  
Environmental Stressors ◽  
Climate Resilience ◽  
The Impact

The built environment is a physical determinant of health essential to the planning and development of a more equitable society. Communities face growing challenges due to environmental stressors such as climate change, with vulnerable communities experiencing a disproportionate burden of adverse health outcomes. The interdependencies between urban planning and public health outcomes are inextricable, with respect to improving access to healthier built environments for vulnerable and marginalized groups. Widespread implementation of nature-based solutions, such as green infrastructure, provides a multi-functional strategy to support sustainable development, increase climate resilience, enhance ecological connectivity, and create healthier communities. A Health Equity Impact Assessment presents the findings of a participatory research study utilizing key informant interviews of public health unit professionals (eight) and a survey of green infrastructure volunteers and workers (36) on the impact of green infrastructure on individual and community mental and physical well-being, service use, and perceived unmet needs, using Ontario, Canada as a case study. Study findings indicate that where green infrastructure is both productive and publicly accessible, the benefits were significant for vulnerable populations. These benefits include increased social connectivity, skills development, and food security. Green infrastructure could be a viable strategy to address environmental stressors, improve health equity, and support localization of the UN Sustainable Development Goals (SDGs).

scholarly journals Health inequities and technological solutions during the first waves of the COVID-19 pandemic in high-income countries

2021 ◽  
pp. 175797592098418
Author(s):  
Muriel Mac-Seing ◽  
Robson Rocha de Oliveira
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Vulnerable Populations ◽  
Health Inequities ◽  
High Income ◽  
Control Measures ◽  
Health Priorities ◽  
Economic Systems ◽  
And Control ◽  
Political Decisions

The COVID-19 pandemic has resulted in massive disruptions to public health, healthcare, as well as political and economic systems across national borders, thus requiring an urgent need to adapt. Worldwide, governments have made a range of political decisions to enforce preventive and control measures. As junior researchers analysing the pandemic through a health equity lens, we wish to share our reflections on this evolving crisis, specifically: (a) the tenuous intersections between the responses to the pandemic and public health priorities; (b) the exacerbation of health inequities experienced by vulnerable populations following decisions made at national and global levels; and (c) the impacts of the technological solutions put forward to address the crisis. Examples drawn from high-income countries are provided to support our three points.

The Role of Citizen Science in Promoting Health Equity

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Lisa G. Rosas ◽  
Patricia Rodriguez Espinosa ◽  
Felipe Montes Jimenez ◽  
Abby C. King
Keyword(s):  
Public Health ◽  
Citizen Science ◽  
Health Equity ◽  
Healthy Eating ◽  
Mobile Applications ◽  
Health Inequities ◽  
Annual Review ◽  
Publication Date ◽  
Scientific Process

While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend ( a) expanding the focus on topics important for health equity, ( b) increasing the diversity of people serving as citizen scientists, ( c) increasing the integration of citizen scientists in additional research phases, ( d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and ( e) strengthening the rigor of methods to evaluate impacts on health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Did people really drink bleach to prevent COVID-19? A tale of problematic respondents and a guide for measuring rare events in survey data

2020 ◽  
Author(s):  
Leib Litman ◽  
Zohn Rosen ◽  
Cheskie Rosenzweig ◽  
Sarah L. Weinberger-Litman ◽  
Aaron J. Moss ◽  
...  
Keyword(s):  
Public Health ◽  
Best Practices ◽  
Health Outcomes ◽  
Survey Research ◽  
Iron Content ◽  
Heart Attack ◽  
Public Health Research ◽  
Similar Rate ◽  
The Impact ◽  
The Relationship

AbstractSociety is becoming increasingly dependent on survey research. However, surveys can be impacted by participants who are non-attentive, respond randomly to survey questions, and misrepresent who they are and their true attitudes. The impact that such respondents can have on public health research has rarely been systematically examined. In this study we examine whether Americans began to engage in dangerous cleaning practices to avoid Covid-19 infection. Prior findings reported by the CDC have suggested that people began to engage in highly dangerous cleaning practices during the Covid-19 pandemic, including ingesting household cleansers such as bleach. In a series of studies totaling close to 1400 respondents, we show that 80-90% of reports of household cleanser ingestion are made by problematic respondents. These respondents report impossible claims such as ‘recently having had a fatal heart attack’ and ‘eating concrete for its iron content’ at a similar rate to ingesting household cleaners. Additionally, respondents’ frequent misreading or misinterpreting the intent of questions accounted for the rest of such claims. Once inattentive, mischievous, and careless respondents are taken out of the analytic sample we find no evidence that people ingest cleansers to prevent Covid-19 infection. The relationship between dangerous cleaning practices and health outcomes also becomes non-significant once problematic respondents are taken out of the analytic sample. These results show that reported ingestion of household cleaners and other similar dangerous practices are an artifact of problematic respondent bias. The implications of these findings for public health and medical survey research, as well as best practices for avoiding problematic respondents in surveys are discussed.

Explicit incorporation of equity considerations into economic evaluation of public health interventions

2009 ◽  
Vol 4 (2) ◽  
pp. 231-245 ◽  
Author(s):  
RICHARD COOKSON ◽  
MIKE DRUMMOND ◽  
HELEN WEATHERLY
Keyword(s):  
Public Health ◽  
Economic Evaluation ◽  
Health Outcomes ◽  
Health Equity ◽  
Health Gain ◽  
Background Information ◽  
Economic Evaluations ◽  
Value Judgment ◽  
Health Gains ◽  
Egalitarian Value

AbstractHealth equity is one of the main avowed objectives of public health policy across the world. Yet economic evaluations in public health (like those in health care more generally) continue to focus on maximizing health gain. Health equity considerations are rarely mentioned. Health economists rely on the quasi-egalitarian value judgment that ‘a QALY is a QALY’ – that is QALYs are equally weighted and the same health outcome is worth the same no matter how it is achieved or to whom it accrues. This value judgment is questionable in many important circumstances in public health. For example, policy-makers may place rather little value on health outcomes achieved by infringing individual liberties or by discriminating on the basis of age, sex, or race. Furthermore, there is evidence that a majority of the general public wish to give greater weight to health gains accruing to children, the severely ill, and, to a lesser extent, the socio-economically disadvantaged. This paper outlines four approaches to explicit incorporation of equity considerations into economic evaluation in public health: (i) review of background information on equity, (ii) health inequality impact assessment, (iii) analysis of the opportunity cost of equity, and (iv) equity weighting of health outcomes. The first three approaches can readily be applied using standard methods of health technology assessment, where suitable data are available; whereas approaches for generating equity weights remain experimental. The potential benefits of considering equity are likely to be largest in cases involving: (a) interventions that target disadvantaged individuals or communities and are also relatively cost-ineffective and (b) interventions to encourage lifestyle change, which may be relatively ineffective among ‘hard-to-reach’ disadvantaged groups and hence may require re-design to avoid increasing health inequalities.

The ‘other’ within: Striving for health equity in the Maldives Eva-Maria

2021 ◽  
Vol 16 (2) ◽  
pp. 18-38
Author(s):  
Eva-Maria Knoll
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Spatial Organization ◽  
Health Inequities ◽  
The Other ◽  
National Consciousness ◽  
The Public ◽  
Making Sense ◽  
Blood Disorder ◽  
Anthropological Fieldwork

Relations within are quintessential in anthropological fieldwork — and in archipelagos in particular. The domestic sea is incorporated in the national consciousness connecting an archipelagic nation but distinguishing individual islands with a strong emphasis on the centre. The Maldivian archipelago displays this spatial organization of a socio-political and economic centre and a dependent island periphery. In the national consciousness, the capital island, Male', contrasts with “the islands” — a distinction which is particularly evident in the public health sphere, where striving for health equity encounters geographical and socio-political obstacles. Using the topic of the inherited blood disorder thalassaemia as a magnifying lens, this paper asks how different actors are making sense of health inequities between central and outer islands in the Maldivian archipelago. Intra-archipelagic and international mobilities add to the complexities of topological relations, experiences, and representations within this multi-island assemblage. Yet, my study of archipelagic health relations is not confined to a mere outside look at the construction of the ‘island other’ within the archipelagic community. It is a situated investigative gaze on disjunctures, connections, and entanglements, reflecting my methodological-theoretical attempt to unravel my own involvement in island–island relations and representations — my being entangled while investigating entanglements.

Conclusion

2019 ◽  
pp. 183-192
Author(s):  
Fran Baum
Keyword(s):  
Public Health ◽  
Human Health ◽  
Population Health ◽  
Health Equity ◽  
Good Governance ◽  
Well Being ◽  
Planetary Health ◽  
Essential Tool

This chapter distills the contents of the book into six central messages: (1) reducing inequities is the central, vital mechanism for building population health; (2) human health is intimately connected to planetary health and needs to be viewed as part of the broader ecosystem; (3) how we govern is vitally important to how healthy, sustainable and equitable we are: good governance is centrally concerned with the involvement of all sectors to promote health and reduce inequities; (4) regulation is a powerful and essential tool for public health; (5) new ways of measuring progress are important; (6) ubiquitous leadership is required for health, equity, and well-being. The chapter elaborates on each of these and then ends with a consideration of the importance of maintaining hope and acting with courage.

scholarly journals Should social enterprises complement or supplement public health provision?

2019 ◽  
Vol 15 (4) ◽  
pp. 495-518
Author(s):  
Sammia Poveda ◽  
Melinda Gill ◽  
Don Rodney Junio ◽  
Hannah Thinyane ◽  
Vanessa Catan
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Services ◽  
Health Outcomes ◽  
Self Regulation ◽  
Skills Training ◽  
Well Being ◽  
The Philippines ◽  
Social Enterprises ◽  
Content Type

Purpose This paper aims to explore how stable employment, company culture and tailored health, digital and core skills training provided by a social enterprise (SE) in the Philippines affect survivors of exploitation. Research shows survivors experience adverse social conditions and physical and mental health outcomes caused by their exploitative experience. Stable, decent employment has been identified as critical to their recovery and reintegration. This paper discusses the SE’s impact on the employees’ physical, mental and social health and behaviour. Based on our findings, the authors discuss the contribution of SE in improving health outcomes and providing health services and conclude that SEs should not replace but complement public health government programmes. Design/methodology/approach This paper uses mixed methods, presenting data from a longitudinal survey (household income, mental health and social well-being) and a follow-up qualitative study, which uses in-depth interviews and participatory videos to explore survey findings. Findings The quantitative analysis demonstrates positive, but gradual, changes in sexual and reproductive health behaviour; personal empowerment; and trauma, anxiety and depressive symptoms. The qualitative findings show how improvements in executive functioning, self-regulation and self-esteem occur incrementally over time. As their self-efficacy improves, employees need to avoid being overly dependent on the SE, to support their autonomy; therefore, access to complementary public health services is fundamental. Originality/value This paper focusses, to the authors’ knowledge, on a unique SE, which hires survivors of exploitation, without losing their competitiveness in the market.

Environmental Health Equity: A Concept Analysis

2019 ◽  
Vol 38 (1) ◽  
pp. 183-202 ◽  
Author(s):  
Teresa Dodd-Butera ◽  
Margaret Beaman ◽  
Marissa Brash
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Health Equity ◽  
Environmental Ethics ◽  
Policy Development ◽  
Interprofessional Collaboration ◽  
Public Health Practice ◽  
Well Being ◽  
Concept Analysis ◽  
Step Method

Public health practice and ethics address both individual and environmental health, in order to optimize the well-being of an entire population. Consideration of environmental health equity (EHE) is an evolving component of environmental ethics and public health, with evidence of disparities in exposure to vulnerable communities. Related terms for studying EHE include elements of justice, social determinants of health (SDOH), disparities, and environmental racism. The unequal protection from environmental exposures, specifically considering vulnerable and marginalized populations is significant to science, society, and health. Analyzing the environmental impact includes examining equity principles to assist policy and decision-making in the public arena, in order to address unfair burdens placed on vulnerable populations. However, the lack of a common and precise term for the idea makes it to instruct and evaluate the experiences of inequities in diverse populations. The purpose of this research is to use a concept analysis to examine the idea, utility, and conditions surrounding “EHE” for use in public health, nursing, environmental ethics, policy development, and interprofessional collaboration. A concept analysis will be conducted following the eight-step method developed by Walker and Avant (2011). Data sources will include empirical and descriptive literature; and the results will identify defining attributes of the concept. A set of operationalized standards for EHE is established through this concept analysis. This study proposes an examination of the concept in order to assess and evaluate the ethics and experiences in EHE, and determine how this impacts population health outcomes.

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