scholarly journals Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Ziersch ◽  
Emily Miller ◽  
Melanie Baak ◽  
Lillian Mwanri
Keyword(s):  
Rural Communities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Rural Areas ◽  
Social Connectedness ◽  
South Australia ◽  
Determinants Of Health ◽  
Rural Setting ◽  
Snowball Sampling ◽  
Health And Wellbeing

Abstract Background There has been a recent focus on resettlement of migrants and refugee in rural settings in Australia and elsewhere. Rural resettlement is seen as an opportunity to revitalise rural communities, to fill the needs of employers in these areas, and to provide a welcoming community within which new arrivals can integrate and settle. However, challenges to rural resettlement have been identified including difficulties securing employment, discrimination and social isolation. These challenges can affect resettlement outcomes including health and wellbeing, though relatively little research has examined these links. In this paper we explored experiences of people from refugee background settling in a rural Australian town, examining interconnections between social determinants of health (SDH) and integration. Methods Face-to-face interviews were conducted with 44 participants from Southeast Asia and Africa in a rural setting in South Australia, covering experiences of resettlement and impacts on health and wellbeing. Participants were recruited through existing connections within the community and snowball sampling. Audio recorded data were transcribed verbatim and analysed using framework thematic analysis. Results The study findings revealed a mixture of settlement experiences for participants across a range of elements of SDH and integration. A sense of safety and some elements of social connectedness and support were key enablers for integration and health and wellbeing, with main challenges including limitations in employment opportunities, mismatched education provision, experiences of discrimination and constrained access to services. Conclusions Challenges experienced by refugees resettled in rural areas can affect integration, health and wellbeing and subsequent onward migration intentions. Attention to broader socioeconomic, cultural and environmental conditions, alongside tailored settlement support policies and practices for individual rural resettlement sites, is required to support integration and health and wellbeing.

Conclusion

2020 ◽  
pp. 421-426
Author(s):  
Adrian Bonner
Keyword(s):  
Young People ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Children And Families ◽  
Local Authorities ◽  
Health And Wellbeing ◽  
Large Numbers ◽  
Health Model

This concluding chapter explains that in order to develop interrelationships and interdependencies across the various domains within a social determinants of health rainbow model, there needs to be a good understanding and respect for each of these contributions to the health and wellbeing of people and their communities. In the ten-year period of austerity preceding the COVID-19 crisis, many local authorities have radically reduced their social and health services for children and families and young people, concentrating solely on those with the most acute need, those whom they have a legal obligation to support. Indeed, local government has 'retreated from its historical position as the front-line of defence against social evils'. There remain major concerns about local authorities' ability to support their communities in the post-COVID-19 period. Ultimately, although there are large numbers of reports and reviews aimed at local commissioning policies and practices, there is very little evidence to support the interrelated and interdependent approaches utilising a social determinants of health model that specifically addresses 'wicked issues'.

scholarly journals Frailty in older adults and their association with social determinants of Health. The SABE Colombia Study

2019 ◽  
pp. 89-101 ◽  
Author(s):  
José M Ocampo Chaparro ◽  
Carlos A Reyes Ortiz ◽  
Ximena Castro Flórez ◽  
Fernando Gómez
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Determinants Of Health ◽  
Cross Sectional ◽  
Childhood Health ◽  
The Social ◽  
Urban And Rural Areas ◽  
The Relationship

Objective: To estimate the prevalence of frailty and evaluate the relationship with the social determinants of health in elderly residents in urban and rural areas of Colombia. Methods: The SABE (Health, Wellbeing, and Aging) Colombia project is a cross-sectional study, carried out in 2014-2015, involving 24,553 men and women aged 60 years and older who live in the community in Colombia. For this analysis, we used data from 4,474 participants included as a subsample with grip strength measurements. The frailty syndrome was diagnosed according to the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). The independent variables were grouped as (a) biological and genetic flow, (b) lifestyle (adverse conditions in childhood) (c) social networks and community, and (d) socio-economic, cultural and environmental conditions. Multiple logistic and linear regression analyses were used to assess the prognostic value of frailty for the outcomes of interest. Results: The prevalence of frailty was 17.9%. The factors significantly associated with frailty were older age, being women, living in rural areas, having low education, a greater number of medical conditions, insufficient current income, childhood health problems and a poor economic situation in childhood. Conclusions: Our results support the need to include frailty prevention programs, to improve the socioeconomic health conditions of infants to avoid future development of frailty.

scholarly journals Double Burden of Rural Migration in Canada? Considering the Social Determinants of Health Related to Immigrant Settlement Outside the Cosmopolis

2019 ◽  
Vol 16 (5) ◽  
pp. 678 ◽  
Author(s):  
Asiya Patel ◽  
Jennifer Dean ◽  
Sara Edge ◽  
Kathi Wilson ◽  
Effat Ghassemi
Keyword(s):  
Rural Communities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inclusion ◽  
Determinants Of Health ◽  
Future Research ◽  
Rural Migration ◽  
Foreign Born ◽  
Double Burden ◽  
The Social

There is a large and growing body of research acknowledging the existence of health disparities between foreign-born and native-born populations in many high immigrant-receiving countries. Significant attention has been paid to the role of physical and social environments in the changing health status of immigrants over time. However, very limited attention has been given to these issues within the context of rural geographies, despite global evidence that immigrants are increasingly settling outside of traditional gateway cities and into rural communities. This paper presents the results of a scoping review aimed at assessing the state of knowledge on the health impacts of immigrant migration into rural communities in Canada. Guided by Arksey and O’Malley’s scoping protocol, we conduct a review of academic literature in Canada related to rural migration. A total of 25 articles met inclusion criteria which included access to the social determinants of health. Findings identified a paucity of research directly connecting rural settlement to health but the literature did emphasize five distinct social determinants of health for rural residing immigrants: social inclusion, culturally-appropriate services, gender, employment, and housing. This paper concludes with an identification of research gaps and opportunities for future research into whether rural-residing immigrants face a double burden with respect to health inequity.

scholarly journals Public health crisis in the refugee community: little change in social determinants of health preserve health disparities

2021 ◽  
Author(s):  
I Feinberg ◽  
M H O’Connor ◽  
A Owen-Smith ◽  
S R Dube
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Limited English Proficiency ◽  
Determinants Of Health ◽  
Health Crisis ◽  
Health And Wellbeing ◽  
Public Health Crisis ◽  
Refugee Community ◽  
Structural Inequities

Abstract Structural inequities and lack of resources put vulnerable refugee communities at great risk. Refugees flee their country of origin to escape persecution and flee from war, famine and torture. Resettled refugee communities become particularly vulnerable during times of crisis due to limited English proficiency and poor social determinants of health (SDOH), which create barriers to attaining and sustaining health and wellbeing for themselves and their families. The purpose of this case study was to evaluate SDOH among a refugee community in the Southeastern United States. We surveyed the community twice during a 1-year period to assess various elements of SDOH. Among a primarily African and Southeast Asian refugee community, 76% reported difficulty paying for food, housing and healthcare during the first round of surveys. During the second round of surveys at the beginning of the Coronavirus pandemic, 70% reported lost income; 58% indicated concern about paying bills. There was little change during the 12-month study period, showing that SDOH are an enduring measure of poor health and wellbeing for this vulnerable refugee community.

scholarly journals The Lived Experience of Nursing Appalachia

2020 ◽  
Vol 20 (2) ◽  
pp. 108-132
Author(s):  
Evelyn P Brewer ◽  
Florence M. Weierbach ◽  
Rebecca Adkins Fletcher ◽  
Katherine C. Hall ◽  
Wendy Nehring
Keyword(s):  
Rural Communities ◽  
Lived Experience ◽  
Social Marketing ◽  
Rural Areas ◽  
Cultural Context ◽  
Best Practice ◽  
Marketing Strategies ◽  
Rural Setting ◽  
Snowball Sampling ◽  
South Central

Purpose: Research in rural areas presents special challenges for sampling and recruitment. Examples of considerations include smaller sampling population, privacy concerns, and the rural context. The purpose of this article is to discuss the results of sampling and recruitment strategies within this study. Sample: Nurses form a central hub of health care in rural communities. However, little is known about the lived experience of nurses serving in this capacity. This study explored stories of nurses in a six-county area of three adjoining states in rural South Central Appalachia. Method: Recruitment for the study was completed using state boards of nursing social marketing strategies and snowball sampling. Findings: Sampling and recruitment efforts enlisted 15 participants. The sample was deemed representative of the population as participants represented diverse employment contexts, education preparation levels, licensure duration, and multiple generations. Conclusions: Understanding implications of rural setting and cultural context are critical to successful recruitment and sampling. Privacy considerations may still be concerning, however, multiple de-identification strategies serve to help lessen this risk. Social marketing strategies failed to recruit the needed number of participants secondary to the fact that participants from only one state were recruited in this manner. Smaller population pool limitations were eased by snowball sampling, an approved recruitment method in qualitative research. Future researchers should be cognizant of the influence of rurality norms and cultural context on recruitment and sampling efforts. Social marketing proved less successful than snowball sampling strategies. Further research is needed to develop best practice for rural recruitment and sampling via social marketing. Finally, time and resource commitment for participation can be a barrier. Flexibility in scheduling interviews, location of interview sites, and the availability of audio/phone interviews served to facilitate agreement to participate. Key words: rural, nursing, Appalachia, research, sampling, recruitment  

Mobile Health Interventions to Support Caregivers of Older Adults: An Equity-Focused Systematic Review (Preprint)

2021 ◽  
Author(s):  
Anna Garnett ◽  
Melissa Northwood ◽  
Justine Ting ◽  
Ruheena Sangrar
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Social Determinants Of Health ◽  
Mobile Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Health Technologies ◽  
Health And Wellbeing ◽  
The Social ◽  
The Impact

BACKGROUND Caregivers provide crucial support to older adults so they can remain safely in their homes as they age. Over time, caregivers’ own health can be negatively impacted by their caregiving role. The social determinants of health, such as gender and socioeconomic status, can influence assuming a caregiving role as well as the impacts of caregiving on the caregiver. While programs exist to support caregivers, uptake of these services does not match the need for services expressed by caregivers. Research suggests that supportive interventions offered via mobile health technologies have the potential to increase caregiver accessibility of supportive services. However, a knowledge gap exists regarding the extent to which the social determinants of health are considered in the design, implementation, and evaluation of mobile health (mHealth) interventions intended to support caregivers of older adults. Furthermore, a comprehensive review of the impact of mHealth interventions in this population does not exist. OBJECTIVE To conduct a systematic review to: (1) determine how health inequities are considered in the design, implementation, and evaluation of mHealth interventions for caregivers of older adults using Cochrane-Equity's PROGRESS-Plus framework; and (2) synthesize evidence of the impacts of caregiver-focused mHealth interventions. METHODS A systematic review was conducted in five databases and articles published between January 2010 and June 2021 were included if they evaluated or explored the impacts of mHealth interventions on the health and wellbeing of informal caregivers of older adults. mHealth interventions were defined as those that caregivers of older adults accessed via mobile or wireless devices. RESULTS A total of 28 articles met the inclusion criteria and were included in the systematic review. The interventions evaluated by the included studies sought to help caregivers make connections with services, facilitate the caregiving process, and promote the caregivers’ health and wellbeing. The PROGRESS-Plus framework factors were mainly considered in the results, discussion, and limitations sections of included studies. Some PROGRESS-Plus factors such as sexual orientation, religion and occupation, received little to no consideration in all phases of intervention design, implementation, or evaluation. Overall, findings of this review suggest that mHealth interventions were positively received by users. Such interventions may have the potential to reduce caregiver burden and positively impact caregivers’ physical and mental health while supporting them in their caregiving role. Study findings highlight the importance of available supports to help facilitate caregivers’ use of mHealth interventions particularly early on as well as the use of appropriate language and text. CONCLUSIONS Successful uptake and spread of mHealth interventions to support caregivers of older adults will depend on creating opportunities for inclusive involvement of a broad range of stakeholders at all stages of design, implementation, and assessment. CLINICALTRIAL PROSPERO CRD42021239584; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239584

Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the “Social” in Social Determinants of Health

2022 ◽  
Vol 43 (1) ◽  
Author(s):  
Julianne Holt-Lunstad
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Connectedness ◽  
Health Indicators ◽  
Determinants Of Health ◽  
Public Health Issue ◽  
Annual Review ◽  
Publication Date ◽  
Social Connection

There is growing interest in and renewed support for prioritizing social factors in public health both in the USA and globally. While there are multiple widely recognized social determinants of health, indicators of social connectedness (e.g., social capital, social support, social isolation, loneliness) are often noticeably absent from the discourse. This article provides an organizing framework for conceptualizing social connection and summarizes the cumulative evidence supporting its relevance for health, including epidemiological associations, pathways, and biological mechanisms. This evidence points to several implications for prioritizing social connection within solutions across sectors, where public health work, initiatives, and research play a key role in addressing gaps. Therefore, this review proposes a systemic framework for cross-sector action to identify missed opportunities and guide future investigation, intervention, practice, and policy on promoting social connection and health for all. 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 Students’ understanding of social determinants of health in a community-based curriculum: a general inductive approach for qualitative data analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sachiko Ozone ◽  
Junji Haruta ◽  
Ayumi Takayashiki ◽  
Takami Maeno ◽  
Tetsuhiro Maeno
Keyword(s):  
Data Analysis ◽  
Medical Students ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Rural Areas ◽  
Qualitative Data ◽  
Determinants Of Health ◽  
Qualitative Data Analysis ◽  
Community Based ◽  
Inductive Approach

Abstract Background A community-based medical education (CBME) curriculum may provide opportunities to learn about the social determinants of health (SDH) by encouraging reflection on context, but the categories that students can learn about and their level of reflection are unclear. We aimed to analyze medical students’ understanding and level of reflection about SDH in a CBME curriculum. Methods Study design: General inductive approach for qualitative data analysis. Education Program: All 5th-year and 6th-year medical students at the University of Tsukuba School of Medicine in Japan who completed a mandatory 4-week clinical clerkship in general medicine and primary care during October 2018 and May 2019 were included. The curriculum included 3 weeks of rotations in community clinics and hospitals in suburban and rural areas of Ibaraki Prefecture. On the first day, students learned about SDH through a lecture and a group activity. As an SDH assignment, they were instructed to prepare a structural case description using the Solid Facts framework based on encounters during the curriculum. On the final day, they submitted the structural reflection report. Analysis: Content analysis was based on the Solid Facts framework. Levels of reflection were categorized as reflective, analytical, or descriptive. Results We analyzed 113 SDH case descriptions and 118 reports. On the SDH assignments, the students frequently reported on social support (85%), stress (75%), and food (58%), but less frequently on early life (15%), unemployment (14%), and social gradient (6%). Of the 118 reports, 2 were reflective, 9 were analytical, and 36 were descriptive. The others were not evaluable. Conclusions The CBME curriculum enabled medical students to understand the factors of SDH to some extent. Further work is needed to deepen their levels of reflection.

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