scholarly journals Gender, Work, and Health for Trans Health Providers: A Focus on Transmen

ISRN Nursing ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Judith A. MacDonnell ◽  
Alisa Grigorovich
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Social Environments ◽  
Health Providers ◽  
Research Education ◽  
Trans People ◽  
Or Practice ◽  
And Gender ◽  
Work And Health

Well-documented health research points to trans people’s vulnerability to health inequities that are linked to deeply embedded structural and social determinants of health. Gender and work, as social determinants of health for trans people, both shape and are shaped by multiple factors such as support networks, social environments, income and social status, shelter, and personal health practices. There is a gap in the nursing literature in regards to research on work and health for diverse trans people and a virtual silence on the particular issues of trans-identified health providers. This qualitative study used comparative life history methodology and purposeful sampling to examine links among work, career, and health for transmen who are health providers. Semistructured interviews were completed with four Canadian transmen involved in health care professional and/or practice contexts with diverse professions, age, work, and transitioning experiences. Critical gender analysis showed that unique and gender-related critical events and influences shape continuities and discontinuities in their careerlives. This strength-based approach foregrounds how resilience and growth emerged through participants’ articulation with everyday gender dynamics. These findings have implications for nursing research, education, and practice that include an understanding of how trans providers “do transgender work” and supporting them in that process.

scholarly journals Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 164-164
Author(s):  
Yongjing Ping ◽  
Chenkai Wu ◽  
Michelle Odden ◽  
Robert Stawski ◽  
Hoda Magid
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
The United States ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Stepwise Logistic Regression ◽  
Social Environments ◽  
Social Interventions

Abstract The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.

scholarly journals Screening for poverty and intervening in a primary care setting: an acceptability and feasibility study

2019 ◽  
Vol 36 (5) ◽  
pp. 634-638
Author(s):  
Andrew D Pinto ◽  
Madeleine Bondy ◽  
Anne Rucchetto ◽  
John Ihnat ◽  
Adam Kaufman
Keyword(s):  
Primary Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Determinants Of Health ◽  
Health Concern ◽  
Evidence Based ◽  
Health Providers ◽  
Financial Benefits ◽  
The Social

Abstract Background A movement is emerging to encourage health providers and health organizations to take action on the social determinants of health. However, few evidence-based interventions exist. Digital tools have not been examined in depth. Objective To assess the acceptability and feasibility of integrating, within routine primary care, screening for poverty and an online tool that helps identify financial benefits. Methods The setting was a Community Health Centre serving a large number of low-income individuals in Toronto, Canada. Physicians were encouraged to use the tool at every possible encounter during a 1-month period. A link to the tool was easily accessible, and reminder emails were circulated regularly. This mixed-methods study used a combination of pre-intervention and post-intervention surveys, focus groups and interviews. Results Thirteen physicians participated (81.25% of all) and represented a range of genders and years in practice. Physicians reported a strong awareness of the importance of identifying poverty as a health concern, but low confidence in their ability to address poverty. The tool was used with 63 patients over a 1-month period. Although screening and intervening on poverty is logistically challenging in regular workflows, online tools could assist patients and health providers identify financial benefits quickly. Future interventions should include more robust follow-up. Conclusions Our study contributes to the evidence based on addressing the social determinants of health in clinical settings. Future approaches could involve routine screening, engaging other members of the team in intervening and following up, and better integration with the electronic health record.

scholarly journals Identifying Long-Term Effects of SARS-CoV-2 and Their Association with Social Determinants of Health in a Cohort of Over One Million COVID-19 Survivors

2021 ◽  
Author(s):  
Sumit Mukherjee ◽  
Meghana Kshirsagar ◽  
Nicholas Becker ◽  
Yixi Xu ◽  
William B Weeks ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
P Value ◽  
Long Term Effects ◽  
Medical Claims ◽  
Icd 10 ◽  
And Gender ◽  
Medical Claims Database

Abstract Background: Despite an abundance of information on the risk factors of SARS-CoV-2, large scale studies of long-term effects are lacking. In this paper we analyzed a large medical claims database of US based individuals to identify common long-term effects as well as their associations with various social and medical risk factors.Methods: The medical claims database was obtained from a prominent US based claims data processing company, namely Change Healthcare. In addition to the claims data, the dataset also consisted of various social determinants of health such as race, income, education level and veteran status of the individuals. A self-controlled cohort design (SCCD) observational study was performed to identify ICD-10 codes whose proportion was significantly increased in the outcome period compared to the control period to identify significant long-term effects. A logistic regression-based association analysis was then performed between identified long-term effects and social determinants of health.Results: Among the over 1.37 million COVID patients in our datasets we found 36 out of 1,724 3-digit ICD-10 codes to be statistically significantly increased in the post-COVID period (p-value <0.05). We also found one combination of ICD-10 codes, corresponding to ‘other anemias’ and ‘hypertension’, that was statistically significantly increased in the post-COVID period (p-value <0.05). Our logistic regression-based association analysis with social determinants of health variables, after adjusting for comorbidities and prior conditions, showed that age and gender were significantly associated with the multiple long-term effects. Race was only associated with ‘other sepsis’, income was only associated with ‘Alopecia areata’, while education level was only associated with ‘Maternal infectious and parasitic diseases’ (p-value <0.05). Conclusion: We identified several long-term effects of SARS-CoV-2 through a self-controlled study on a cohort of over one million patients. Furthermore, we found that while age and gender are commonly associated with the long-term effects, other social determinants of health such as race, income and education levels have rare or no significant associations.

scholarly journals Explaining the Health Gap Experienced by Girls and Women in Canada: A Social Determinants of Health Perspective

2009 ◽  
Vol 14 (5) ◽  
pp. 1-13 ◽  
Author(s):  
Cecilia Benoit ◽  
Leah Shumka ◽  
Kate Vallance ◽  
Helga Hallgrímsdóttir ◽  
Rachel Phillips ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequities ◽  
Safety Net ◽  
Determinants Of Health ◽  
Health Determinants ◽  
Sex And Gender ◽  
The Social ◽  
Health Gap ◽  
And Gender

In the last few decades there has been a resurgence of interest in the social causes of health inequities among and between individuals and populations. This ‘social determinants’ perspective focuses on the myriad demographic and societal factors that shape health and well-being. Heeding calls for the mainstreaming of two very specific health determinants - sex and gender - we incorporate both into our analysis of the health gap experienced by girls and women in Canada. However, we take an intersectional approach in that we argue that a comprehensive picture of health inequities must, in addition to considering sex and gender, include a context sensitive analysis of all the major dimensions of social stratification. In the case of the current worldwide economic downturn, and the uniquely diverse Canadian population spread over a vast territory, this means thinking carefully about how socioeconomic status, race, ethnicity, immigrant status, employment status and geography uniquely shape the health of all Canadians, but especially girls and women. We argue that while a social determinants of health perspective is important in its own right, it needs to be understood against the backdrop of broader structural processes that shape Canadian health policy and practice. By doing so we can observe how the social safety net of all Canadians has been eroding, especially for those occupying vulnerable social locations.

scholarly journals Programs and interventions promoting health equity in LGBTQ2+ populations in Canada through action on social determinants of health

2021 ◽  
Vol 41 (12) ◽  
pp. 431-435
Author(s):  
Robert Higgins ◽  
Brian Hansen ◽  
Beth E. Jackson ◽  
Ashley Shaw ◽  
Nathan J. Lachowsky
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Inequities ◽  
Minority Language ◽  
Determinants Of Health ◽  
Structural Level ◽  
Sexual And Gender Minorities ◽  
Recent Immigrants ◽  
Gender Minorities ◽  
And Gender

Abstract Sexual and gender minorities (SGM) experience a number of health inequities. That social determinants of health drive these inequities is well-documented, but there is little evidence on the number and types of interventions across Canada that address these determinants for these populations. We conducted an environmental scan of programs in Canada that target SGM, and classified the programs based on their level of intervention (individual/interpersonal, institutional and structural). We found that few programs target women, mid-life adults, Indigenous people or ethnoracial minorities, recent immigrants and refugees, and minority language speakers, and few interventions operate at a structural level.

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