scholarly journals Right to Health and the Social Determinants of Health in the Face of COVID-19. Tthe Spanish Experience after Austerity Policies

2021 ◽  
pp. 220-241
Author(s):  
Carlos Lema Añón
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Systems ◽  
Right To Health ◽  
Determinants Of Health ◽  
The Face ◽  
Care Systems ◽  
The Right ◽  
The Impact

The COVID-19 pandemic has particularly affected Spain in 2020. Although the specific causes and Spain’s response—as well as the aspects to be improved—are yet to be evaluated, many experts agree that this crisis has magnified some of the problems of the Spanish health system, highlighting the problems derived from the cuts in the capacities of the health and public health systems. We assess the current situation from the perspective of the right to health in its twofold dimension: health care and social determinants. For this purpose, we look into the configuration of the right to health in Spain and how the economic crisis and austerity policies affected it. In particular, we consider the impact both on institutional health care systems and in terms of social determinants of health. Finally, we make several proposals for strengthening the right to health.

scholarly journals Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Issues ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Health Questionnaire ◽  
Improvement Project ◽  
The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

scholarly journals Social prescription for those living with dementia; does MedTech have a role to play?

2021 ◽  
pp. 75
Author(s):  
Keyword(s):  
Primary Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Engagement ◽  
Health Care Systems ◽  
Determinants Of Health ◽  
Biomedical Model ◽  
Positive Health ◽  
Care Systems ◽  
Do So

Ageing is the major risk factor for dementia and nearly every country has seen its life expectancy rise from the beginning of the 21st century. Remaining socially connected has positive health and social implications and may be even more significant for marginalized group of people like those living with dementia. If appropriately used, social prescriptions can help deliver value-based social engagement and primary care by maximising the utilisation of resources and addressing social determinants of health, decreasing dependency on the biomedical model and thus providing a way for health care systems to deal with social determinants of health. More frequently, however, those seeking access to these programmes do not tend to do so simply due to lack of understanding and knowledge of the availability of such services. So, provision of social activities involves more than developing a program and hoping people will attend, and considering the particular situations of those living with dementia as marginalised group of people, and taking into account that there is no treatment for dementia, societies need to move toward social prescription, integrating appropriate MedTech support- targeting on those living with dementia- into such programs.

scholarly journals Social Determinants of Maternal Health in Afghanistan: A Review

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Said Ahmad Maisam Najafizada ◽  
Ivy Lynn Bourgeault ◽  
Ronald Labonté
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Local Economy ◽  
Determinants Of Health ◽  
Social Infrastructure ◽  
The Impact

Introduction: Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature.Methods: This narrative review was conducted using Arksey and O’Malley’s framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. Results: A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Conclusion: Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations’ long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

Denying the Right to Health

2017 ◽  
Author(s):  
Patricia Illingworth ◽  
Wendy E. Parmet
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The United States ◽  
Right To Health ◽  
The European Union ◽  
Access To Health ◽  
The Status ◽  
Care Systems ◽  
The Right ◽  
Universal Health

Many nations claim to respect the right to health, which requires states to provide access to necessary health care without discrimination of any kind. Nevertheless, most states that purport to recognize the right to health discriminate against some classes of newcomers, especially unauthorized immigrants. This chapter reviews the status of immigrants’ right to health under international law and then turns to an examination of immigrants’ access to health insurance in Canada and the European Union. The chapter demonstrates that even in nations that are widely believed to have universal health care systems, many classes of immigrants are left without access to the means to pay for needed health care. As in the United States, these exclusions impact the health of newcomers and natives alike.

Bridging human rights and social determinants of health: Argentina, Chile, Paraguay, and Uruguay

2019 ◽  
Vol 13 (1) ◽  
pp. 3-17
Author(s):  
Juan Smart ◽  
Alejandra Letelier
Keyword(s):  
Human Rights ◽  
Health Status ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Right To Health ◽  
Determinants Of Health ◽  
Human Right ◽  
Content Type ◽  
Health And Human Rights ◽  
The Right

Purpose The purpose of this paper is to do a systematic assessment and testing of identified human rights norms alongside social determinant approaches in relation to identified health issues of concern in four Latin American countries (Argentina, Chile, Paraguay and Uruguay) to show how social determinants and human rights frameworks improve population health. Design/methodology/approach To do so, in the first part the authors analyze the inequalities both between and within each of the selected countries in terms of health status and health determinants of the population. Then, in the second section, the authors analyze the level of recognition, institutionalisation and accountability of the right to health in each country. Findings From the data used in this paper it is possible to conclude that the four analysed countries have improved their results in terms of health status, health care and health behaviours. This improvement coincides with the recognition, institutionalisation and creation of accountability mechanisms of human rights principles and standards in terms of health and that a human rights approach to health and its relation with other social determinants have extended universal health coverage and health systems in the four analysed countries. Originality/value Despite of the importance of the relation between human rights and social determinants of health, there are few human right scholars working on the issues of social determinants of health and human rights. Most of the literature of health and human rights has been focussed specific relations between specific rights and the right to health, but less human right scholar working on social determinants of health. On the other hand, just a few epidemiologists and people working on social medicine have actually started to use a universal human rights frame and discourse. In fact, according to Vnkatapuram, Bell and Marmot: “while health and human rights advocates have from the start taken a global perspective, social medicine and social epidemiology have been slower to catch up”.

scholarly journals An Electronic Medical Record-Derived Individualized Performance Metric to Measure Risk-Adjusted Adherence with Perioperative Prophylactic Bundles for Health Care Disparity Research and Implementation Science

2020 ◽  
Vol 11 (03) ◽  
pp. 497-514
Author(s):  
Michael H. Andreae ◽  
Stephan R. Maman ◽  
Abrahm J. Behnam
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Social Determinants ◽  
Individual Performance ◽  
Determinants Of Health ◽  
Health Care Disparity ◽  
The Impact ◽  
Individual Clinician

Abstract Background Health care disparity persists despite vigorous countermeasures. Clinician performance is paramount for equitable care processes and outcomes. However, precise and valid individual performance measures remain elusive. Objectives We sought to develop a generalizable, rigorous, risk-adjusted metric for individual clinician performance (MIP) derived directly from the electronic medical record (EMR) to provide visual, personalized feedback. Methods We conceptualized MIP as risk responsiveness, i.e., administering an increasing number of interventions contingent on patient risk. We embedded MIP in a hierarchical statistical model, reflecting contemporary nested health care delivery. We tested MIP by investigating the adherence with prophylactic bundles to reduce the risk of postoperative nausea and vomiting (PONV), retrieving PONV risk factors and prophylactic antiemetic interventions from the EMR. We explored the impact of social determinants of health on MIP. Results We extracted data from the EMR on 25,980 elective anesthesia cases performed at Penn State Milton S. Hershey Medical Center between June 3, 2018 and March 31, 2019. Limiting the data by anesthesia Current Procedural Terminology code and to complete cases with PONV risk and antiemetic interventions, we evaluated the performance of 83 anesthesia clinicians on 2,211 anesthesia cases. Our metric demonstrated considerable variance between clinicians in the adherence to risk-adjusted utilization of antiemetic interventions. Risk seemed to drive utilization only in few clinicians. We demonstrated the impact of social determinants of health on MIP, illustrating its utility for health science and disparity research. Conclusion The strength of our novel measure of individual clinician performance is its generalizability, as well as its intuitive graphical representation of risk-adjusted individual performance. However, accuracy, precision and validity, stability over time, sensitivity to system perturbations, and acceptance among clinicians remain to be evaluated.

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