ROLE OF SOCIAL DETERMINANTS OF HEALTH IN PSYCHOLOGICAL DISTRESS AND READINESS FOR ONLINE LEARNING AMONG COLLEGE FILIPINO STUDENTS DURING THE COVID-19 PANDEMIC: A PILOT STUDY

Due to the COVID-19 pandemic, educational institutions in the Philippines rapidly introduced widespread online learning to ensure safety of learners. The purpose of this study was to explore the possible relationship of social determinants of health with COVID-19 specific psychological distress and the readiness of Filipino students to learn online. Researchers conducted an online survey of 30 college students from the Psychology program of Ateneo de Davao University in Davao City, Philippines. Results showed that students experienced mild (53.3%) to severe (36.7%) levels of COVID-19 specific psychological distress. COVID-19 specific psychological distress and readiness for online learning was not significantly correlated, r (30) = -.18, p = .35. Among social determinants of health, only living with family members was significantly associated with readiness for online learning, r (30) = -.37, p = .046. These findings showed promising findings on how social determinants of health may be associated with distress and online learner readiness during a global pandemic. Future studies may elaborate on the subjective experiences of students. Finally, this pilot study serves as a basis for the development of school programs that address students’ mental health and promote online learning readiness of students who are experiencing unique learning circumstances.

The business of recovery: embedding health in economies after COVID-19

As the UK rebuilds and recovers after the COVID-19 pandemic, tackling socioeconomic inequalities will become increasingly pertinent. The link between health and wealth has been long established, with those at the highest risk of illness also being less likely to access healthcare. The pandemic has highlighted these disparities, with higher morbidity and mortality rates seen in deprived areas, as well as among ethnic minority communities. Leaders and clinicians across the NHS and social care have called for a ‘reset’ in the way healthcare is planned, commissioned and delivered in the UK. There is a growing need for a holistic approach to disease prevention, and it is crucial that government agencies take a strong role in addressing the wider determinants of health.

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

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.

Incidence of Arterial Hypertension in People With Periodontitis and Characterization of the Oral and Subgingival Microbiome: A Study Protocol

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. High blood pressure in particular, continues to increase throughout the global population at an increasingly fast pace. The relationship between arterial hypertension and periodontitis has been recently discussed in the context of its origins and implications. Particularly relevant is the role of the periodontal microbiome linked to persistent local and systemic inflammation, along with other risk factors and social determinants of health. The present protocol will investigate/assess the association between periodontal disease and its microbiome on the onset of hypertension, within a cohort from Mexico City. One thousand two hundred twelve participants will be studied during a 60-month period. Studies will include analysis of periodontal conditions, sampling and sequencing of the salivary and subgingival microbiome, interviews on nutritional and lifestyle habits, social determinants of health, blood pressure and anthropometric measurements. Statistical associations and several classic epidemiology and machine learning approaches will be performed to analyze the data. Implications for the generation of public policy—by early public health interventions or epidemiological surveillance approaches—and for the population empowerment—via the establishment of primary prevention recommendations, highlighting the relationship between oral and cardiovascular health—will be considered. This latter set of interventions will be supported by a carefully planned science communication and health promotion strategy. This study has been registered and approved by the Research and Ethics Committee of the School of Dentistry, Universidad Nacional Autónoma de México (CIE/0308/05/2019) and the National Institute of Genomic Medicine (CEI/2020/12). The umbrella cohort was approved by the Institutional Bioethics Committee of the National Institute of Cardiology-Ignacio Chavez (INC-ICh) under code 13-802.

An analysis of the Gender and Social Determinants of Health in Urban Poor Areas of the Most Populated Cities of Pakistan

Background: Recent surveys, studies and reviews have highlighted the impacts of social inequities on access of women and children to health services for women and children in Pakistan. Utilising mixed methods for urban slum profiles, and facility and coverage surveys in 4431 urban poor areas of the top 10 highly populated cities of Pakistan, this paper describes and analyses the complex interactions between economic, social and gender determinants of health care access and considers health policy and program options for addressing them. Results: Findings are classified into six analytic categories of (1) access to health services, (2) female workforce participation, (3) gender friendly health services, (4) access to schools and literacy, (5) social connections, and (6) autonomy of decision making. Out of a national sample of 14,531 children in urban poor areas of 10 cities, the studies found that just over half of the children are fully immunised (54%) and 14% of children had received zero doses of vaccine. There are large shortages of health facilities and female health workforce in the slums, with significant gaps in the quality of health infrastructure, which all serve to limit both demand for, and supply of, health services for women and children. Results demonstrate low availability of schools, low levels of female literacy and autonomy over decision making, limited knowledge of the benefits of vaccination, and few social connections outside the home. All these factors interact and reinforce existing gender norms and low levels of health literacy and service access. Conclusion: The Urban Slum profiles and coverage studies provide an opportunity to introduce gender transformative strategies that include expansion of a female health workforce, development of costed urban health action plans, and an enabling policy environment to support community organisation and more equitable health service delivery access.

“I was 15 when I started doing drugs with my dad”: Victimization, Social Determinants of Health, and Criminogenic Risk Among Women Opioid Intervention Court Participants

The presence and severity of childhood and adult victimization increase the likelihood of substance use disorder (SUD), crimes, antisocial behaviors, arrests, convictions, and medical and psychiatric disorders among women more than men. These problems are compounded by the impact of social determinants of health (SDH) challenges, which include predisposition to the understudied, dramatic increase in opioid dependence among women. This study examined victimization, related SDH challenges, gender-based criminogenic risk factors for female participants, and public health opportunities to address these problems. We recruited women from the first national Opioid Intervention Court, a fast-track SUD treatment response to rapidly increasing overdose deaths. We present a consensual qualitative research analysis of 24 women Opioid Intervention Court participants (among 31 interviewed) who reported childhood, adolescent, and/or adult victimization experiences in the context of substance use and recovery, mental health symptoms, heath behaviors, and justice-involved trajectories. We iteratively established codes and overarching themes. Six primary themes emerged: child or adolescent abuse as triggers for drug use; impact of combined child or adolescent abuse with loss or witnessing abuse; adult abduction or assault; trajectory from lifetime abuse, substance use, and criminal and antisocial behaviors to sobriety; role of friends and family support in recovery; and role of treatment and opioid court in recovery, which we related to SDH, gender-based criminogenic factors, and public health. These experiences put participants at risk of further physical and mental health disorders, yet indicate potential strategies. Findings support future studies examining strategies where courts and health systems could collaboratively address SDH with women Opioid Intervention Court participants.