scholarly journals Social Determinants of Health Influencing the New Zealand COVID-19 Response and Recovery: A Scoping Review and Causal Loop Diagram

Systems ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Sudesh Sharma ◽  
Mat Walton ◽  
Suzanne Manning
Keyword(s):  
New Zealand ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Scoping Review ◽  
Health Inequities ◽  
Determinants Of Health ◽  
Causal Loop Diagram ◽  
Loop Diagram ◽  
Causal Loop ◽  
Response And Recovery

The Coronavirus pandemic of 2019–20 (COVID-19) affected multiple social determinants of health (SDH) across the globe, including in New Zealand, exacerbating health inequities. Understanding these system dynamics can support decision making for the pandemic response and recovery measures. This study combined a scoping review with a causal loop diagram to further understanding of the connections between SDH, pandemic measures, and both short- and long-term outcomes in New Zealand. The causal loop diagram showed the reinforcing nature of structural SDH, such as colonization and socio-economic influences, on health inequities. While balancing actions taken by government eliminated COVID-19, the diagram showed that existing structural SDH inequities could increase health inequities in the longer term, unless the opportunity is taken for socio-economic policies to be reset. Such policy resets would be difficult to implement, as they are at odds with the current socio-economic system. The causal loop diagram highlighted that SDH significantly influenced the dynamics of the COVID-19 impact and response, pointing to a need for purposeful systemic action to disrupt the reinforcing loops which increase health inequities over time. This will require strong systems leadership, and coordination between policy makers and implementation at local level.

scholarly journals Reported Māori consumer experiences of health systems and programs in qualitative research: a systematic review with meta-synthesis

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Suetonia C. Palmer ◽  
Harriet Gray ◽  
Tania Huria ◽  
Cameron Lacey ◽  
Lutz Beckert ◽  
...  
Keyword(s):  
Systematic Review ◽  
Qualitative Research ◽  
New Zealand ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequities ◽  
Determinants Of Health ◽  
Aotearoa New Zealand ◽  
Consumer Experiences

Abstract Background Persistent inequities in health experiences and outcomes are observed for Māori compared to non-Māori in Aotearoa New Zealand. We conceptualised factors associated with Māori consumer experiences of health programs and services and characterise how the recommendations arising from qualitative research inform strategies to address inequities. Methods In this systematic review, electronic literature searching was conducted in February 2018. Qualitative studies reporting Māori consumer experiences of health services and programs in Aotearoa New Zealand were eligible. Māori consumer experiences of health services were mapped to the WHO Commission of Social Determinants of Health (CSDH) conceptual framework on health inequities as related to: (i) the socioeconomic and political context; (ii) socioeconomic positioning; or (iii) intermediary factors that increase exposure to health-compromising conditions. Recommendations to improve consumer experiences were mapped to the CSDH framework for tackling social determinants of health inequities as policy directions on: (i) unequal consequences of illness (individual interaction); (ii) risks of exposure to health-damaging factors (community); (iii) exposures to health-damaging factors (public policies); and (iv) mitigating effects of socioeconomic and political stratification (environment). Results Fifty-four studies were included. Māori consumer experiences mapped to social determinants of health inequities were most frequently related to direct interactions with health services and programs, particularly patient-clinician interactions (communication, relationships) and cultural competencies of clinicians and the system. Key recommendations by researchers mapped to potential strategies to address inequity were identified at all levels of the political, social and health system from individual interactions, community change, and broader public and system-level strategies. Recommendations were predominantly focused on actions to reduce risks of exposure to health-damaging factors including health literacy interventions, increased resources in cultural competencies and Māori capacity in health service development and workforce. Conclusions Māori consumer experiences of health services and programs are an important informer of variables that impact health inequity. Strategies to tackle health inequities informed by Māori consumer experiences can be drawn from existing empirical research. Future qualitative exploration of how socioeconomic, political and public policies influence Māori consumer experiences of health services and programs could inform a broader range of structural policies to address health inequities.

scholarly journals Meaningful Information in the Age of Big Data: A Scoping Review on Social Determinants of Health Data Collection for Electronic Health Records

2019 ◽  
Author(s):  
Kelsey Berg ◽  
Chelsea Doktorchik ◽  
Hude Quan ◽  
Vineet Saini
Keyword(s):  
Big Data ◽  
Data Collection ◽  
Electronic Health Records ◽  
Social Determinants Of Health ◽  
Health Systems ◽  
Social Determinants ◽  
Scoping Review ◽  
Determinants Of Health ◽  
Health Records ◽  
Automated Technology

Abstract Background: Electronic Health Records (EHRs) are key tools for integrating patient data into health information systems (IS). Advances in automated data collection methodology, particularly the collection of social determinants of health (SDOH), provide opportunities to advance health promotion and illness prevention through advanced analytics (i.e. “Big Data” techniques). We ask how current data collection processes in EHRs permit SDOH data to flow throughout health systems. Methods: Using a scoping review framework, we searched through medical literature to identify current practices in SDOH data collection within EHR systems. We extracted relevant information on data collection methodology, specifically focusing on uses of automated technology. We discuss our findings in the context of research methodology and potential for health equity. Results: Practitioners collect a variety of SDOH data at point of care through EHR, predominantly via embedded screening tools and clinical notes, and primarily capturing data on financial security, housing status, and social support. Health systems are increasingly using digital technology in data collection, including natural language processing algorithms. However overall use of automated technology is limited to date. End uses of data pertain to improving system efficiency, patient care-coordination, and addressing health disparities. Discussion & Conclusion: EHRs can realistically promote collection and meaningful use of SDOH data, although EHRs have not extensively been used to collect and manage this type of information. Future applied research on systems-level application of SDOH data is necessary, and should incorporate a range of stakeholders and interdisciplinary teams of researchers and practitioners in fields of health, computing, and social sciences.

scholarly journals Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review

2019 ◽  
Vol 34 (5) ◽  
pp. 720-730 ◽  
Author(s):  
Ashti Doobay-Persaud ◽  
Mark D. Adler ◽  
Tami R. Bartell ◽  
Natalie E. Sheneman ◽  
Mayra D. Martinez ◽  
...  
Keyword(s):  
Medical Education ◽  
Social Determinants Of Health ◽  
Undergraduate Medical Education ◽  
Social Determinants ◽  
Scoping Review ◽  
Determinants Of Health ◽  
The Social

Health Equity and Development: the Commission on Social Determinants of Health

2010 ◽  
Vol 18 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Michael Marmot ◽  
Ruth Bell
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequities ◽  
Determinants Of Health ◽  
Political Agenda ◽  
The Political ◽  
The Social ◽  
The Face ◽  
Taking Action ◽  
Health Agenda

From the start, the WHO Commission on Social Determinants of Health built its case for taking action on the social determinants of health, unashamedly, on principles of social justice. Quite simply, the Commission stated that health inequities in the sense of avoidable and preventable differences in health between countries, and between groups within countries according to income, occupation, education, ethnicity or between men and women, are unjust. Taking this position has brought praise and blame: praise for the Commission’s boldness in putting fairness on the global health agenda1 in the face of the dominant global model of economic growth as an end in itself, and blame for the Commission’s unworldliness in apparently not recognising that economic arguments push the political agenda.

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 Revisiting the social determinants of health agenda from the global South

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Borde
Keyword(s):  
Social Determinants Of Health ◽  
Latin American ◽  
Social Determinants ◽  
Social Inequalities ◽  
Disease Process ◽  
Health Inequities ◽  
Social Medicine ◽  
Determinants Of Health ◽  
The Social

Abstract Background One of the most marked characteristics of the global social structure is the existence of substantial social inequalities in wealth, which also find expression in health inequalities between and within countries. In an effort to provide an overview of the conceptual debates shaping the mobilisation around social determinants of health and health inequities, two of the most influential approaches in the field are compared: the WHO Commission on Social Determinants of Health approach (CSDH), strongly influenced by European Social Medicine, and the Latin American Social Medicine and Collective Health (LASM-CH) Social determination of the health-disease process approach, hitherto largely invisibilized. Methods A comprehensive literature review was conducted in three databases (Lilacs, Scielo, Medline/Pubmed), reference lists of selected papers, and citations in Google Scholar, including book titles. Results It is argued that the debates shaping the SDH agenda do not merely reflect terminological and conceptual differences, but essentially different ethical-political proposals that define the way health inequities are understood and proposed to be transformed. Conclusions While the health equity and SDH agenda probably also gained momentum due to the broad political alliance it managed to consolidate, it is necessary to make differences explicit as this allows for an increase in the breadth and specificity of the debate, facilitating the recognition of contextually relevant proposals towards the reduction of health inequities. Key messages Debates shaping the SDH agenda do not merely reflect terminological or conceptual differences, but distinct ethical-political proposals. Differences need to be discussed and made explicit to guide the development of contextually relevant efforts to reduce health inequities.

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