26 results on '"Social Determinants"'
Search Results
2. Language-Based Disparities in Route of Hysterectomy for Benign Disease
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González Peña, Tavia, Jesse, Nicholas J., Zhao, Zhiguo, Harvey, Lara F.B., and Fajardo, Olga M.
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- 2025
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3. Seasonal influenza vaccination coverage and the social determinants of influenza vaccination among people over 50 with diabetes in Europe: Analyzing population-based SHARE data for the 2019–2020 and 2021–2022 influenza seasons
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Wang, Jiancong, Tönnies, Thaddäus, and Brinks, Ralph
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- 2025
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4. Effects of Extreme Humidity and Heat on Ventricular Arrhythmia Risk in Patients With Cardiac Devices
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Keeler, Corinna, Cleland, Stephanie E., Hill, K. Lloyd, Mazzella, Anthony J., Cascio, Wayne E., Rappold, Ana G., and Rosman, Lindsey A.
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- 2025
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5. Trajectories and social determinants of child cognitive development: a prospective cohort study from infancy through middle childhood in Dhaka, Bangladesh
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Valdes, Viviane, Sullivan, Eileen F., Tofail, Fahmida, Thompson, Lisa M., Kakon, Shahria H., Shama, Talat, Haque, Rashidul, and Nelson, Charles A.
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- 2025
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6. Food insecurity and pediatric HIV: patient perspectives on clinical solutions.
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Owens, Caroline E., Cook, Miranda, Chowdhury, Julia, Virani, Nabeeha, and Johnson, Khaliah A.
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Food insecurity is a prevalent social determinant of health for people living with HIV and is associated with suboptimal treatment outcomes. While clinic-based efforts to address food insecurity have increased over the past decade, few studies have explored the perspectives of paitents and caregivers managing chronic illnesses such as HIV. Caregiver insights are particularly critical in pediatric HIV care, where caregivers often play a central role in screening and referral processes. This study examined the experiences of adolescents and young adults living with HIV and caregivers of children with HIV, to inform screening and referral practices within a pediatric palliative care clinic in Atlanta, GA. We conducted audio-recorded, in-depth interviews (n = 14) and focus groupswith 10 patients and caregivers living with food insecurity. Thematic analysis, guided by our interview topics, revealed five key themes: (1) trust in providers, (2) coping by "making it work", (3) barriers to healthy eating, (4) challenges to medication adherence, and (5) recommendations for cross-sector resource connection. Our findings underscore the need for partnerships between clinics and community-based organizations, bolstered by structural and systems-level interventions and policies, to promote food security and well-being for pediatric patients in complex care settings. [ABSTRACT FROM AUTHOR]
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- 2025
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7. Charakteristika von Antragstellenden bei erstmaliger Feststellung einer Pflegebedürftigkeit – eine bundesweite Analyse von Pflegebegutachtungen von AOK-Versicherten ab 60 Jahren.
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Haeger, Christine, Baldenius, Till, Schnitzer, Susanne, Jürchott, Kathrin, Kuhlmey, Adelheid, Blüher, Stefan, and Schwinger, Antje
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Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2025
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8. Ethnic, socioeconomic, and demographic determinants of generalized anxiety disorder and fear of COVID-19 among teenagers in California, United States: a cross-sectional analysis.
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Kumra, Elina and Patange, Amit
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GENERALIZED anxiety disorder ,ECONOMIC conditions of students ,RACE ,SOCIAL determinants of health ,PSYCHOLOGICAL factors ,SOCIAL anxiety - Abstract
Background and objective: The COVID-19 pandemic substantially impacted mental health globally, leading to increased levels of anxiety and fear. Although it is well known that socioeconomic factors and ethnicity play a role in mental health outcomes, the intersectional effects of these determinants during the pandemic are unclear, especially among adolescents. Thus, this study sought to explore the relationship between socioeconomic factors, ethnicity, and two mental health parameters—fear of COVID-19 (FCV) and generalized anxiety disorder (GAD)—among high school students in California, United States. Methods: A cross-sectional analysis was performed with 990 high school-aged participants from the San Joaquin Valley and Santa Clara County, California, recruited via convenience/snowball sampling using an online questionnaire from 15 June to 14 August 2022. The Fear of Coronavirus Scale (FCV-19S) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure fear and anxiety, respectively. Results: The results reveal significant associations between ethnicity, socioeconomic status (i.e., family income), and FCV-19S and GAD-7 scores. Severe GAD and FCV were reported in 9.8% (n = 97) and 8.38% (n = 83) of participants. Black participants reported significantly higher levels of FCV (F = 6.867, p < 0.001) and generalized anxiety (F = 17.066, <0.001) than their counterparts Additionally, girls exhibited higher anxiety scores (t = 2.960, p = 0.003, CI = 0.23–1.15) and fear scores (t = 3.619, p = 0.001, CI = 0.40–1.37) than boys. Furthermore, fear and anxiety scores exhibited a strong positive correlation (r = 0.702, p < 0.001). Conclusion: This study suggests that gender, ethnicity, and socioeconomic factors are significantly linked to higher levels of FCV and GAD in teenagers during the pandemic. These findings underscore the importance of considering social determinants of mental health when addressing the psychological impact of COVID-19 on teenagers, particularly for vulnerable populations. [ABSTRACT FROM AUTHOR]
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- 2025
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9. A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol.
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Keenan, Megan, Freeman, Leanne, Santana de Lima, Ediane, Potter, Katie, Hobbs, Tim, Ballard, Ellis, and Fonagy, Peter
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YOUNG adults , *MENTAL health services , *CONSENSUS (Social sciences) , *PUBLIC health , *SOCIAL determinants of health - Abstract
Background: The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the interplay of broader health determinants. The initiative works to explore, define and implement locally relevant solutions to challenges shaping the mental health and well-being of young people. Kailo unfolds in three stages within each locale. These stages encompass: "early discovery", "deeper discovery and co-design" and "implementation". This document delves into the participatory group model building and design protocol occurring in the "deeper discovery and co-design" stage of the project. Methods: Participatory methods, such as group model building, are effective in articulating and building consensus on complex issues like the social determinants of adolescent mental health. This paper describes the protocol for application of group model building within the Kailo design process to develop causal loop diagrams and pinpoint leverage points for improving adolescent mental health. It also suggests a method for considering modifications to delivery within a unique project context and in alignment with participants' needs. This paper sets out to define the approach and clarify the objectives these engagements aim to fulfil. The method adapts existing group model building (GMB) protocols for use in a community setting. The engagements will involve groups of local young people and existing community members. To assess the success of the session's implementation post-delivery, the study utilizes existing frameworks for fidelity evaluations, which define a core and flex model. Discussion: The method described enables an integration of diverse local understandings of complex processes which provides a platform for creating co-designed interventions. This protocol can be used to further strengthen research and design through incorporating complexity and participation into the formulation of contextually relevant policies and practices. The strengths and limitations of the approach are discussed. [ABSTRACT FROM AUTHOR]
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- 2025
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10. The association between neighborhood social vulnerability and community-based rehabilitation after stroke.
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Zhang, Shuqi, Mormer, Elizabeth R., Johnson, Anna M., Bushnell, Cheryl D., Duncan, Pamela W., Wen, Fang, Pathak, Shweta, Pastva, Amy M., Freburger, Janet K., and Jones Berkeley, Sara B.
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PHYSICAL therapy services , *GENERALIZED estimating equations , *MEDICAL sciences , *OCCUPATIONAL therapy services , *OCCUPATIONAL health services - Abstract
Background: Timely rehabilitative care is vital for functional recovery after stroke. Social determinants may influence access to and use of post-stroke care but have been inadequately explored. The study examined the relationship between the Social Vulnerability Index (SVI) and community-based rehabilitation utilization. Methods: We included 6,843 adults (51.6% female; 75.1% White; mean age 70.1) discharged home after a stroke enrolled in the COMprehensive Post-Acute Stroke Services study, a pragmatic trial conducted in 40 North Carolina hospitals from 2016–2019. Rehabilitation utilization was sourced from administrative claims. Geocoded addresses were linked to 2018 Census tract SVI. Associations between SVI and 90-day rehabilitation use, adjusted for patient's clinical and socio-economic characteristics, were obtained from generalized estimating equations. We also examined the associations of SVI with therapy setting, types of therapy, intensity of visits, and time to first visit. Results: Thirty-five percent of patients had at least one physical (PT) or occupational therapy (OT) visit within 90 days, ranging from 32.4%-38.7% across SVI quintiles. In adjusted analysis, there was no dose-reponse relationship between higher summary SVI, nor most of its sub-domains, and 90-day rehabilitation use. Greater vulnerability in household composition and disability was modestly associated with -0.4% (95% CI -4.1% to 3.4%) to -4.3% (95% CI -0.8% to -7.7%) lower rehabilitation use across SVI quartiles. Greater summary and subdomain SVI was associated with higher odds of receiving therapy in the home versus outpatient clinic (OR = 1.88, 1.58 to 2.17 for Q5 vs Q1 summary SVI) and receiving both PT and OT versus a single-type therapy (1.72, 1.48 to 1.97 for Q5 vs. Q1 summary SVI). No differences were observed for therapy intensity or time to therapy. Conclusion: Use of rehabilitation care was low, and largely similar across levels of SVI and most of its subdomains. Individuals residing in areas of high SVI were more likely to receive therapy in the home and to receive dual therapy, possibly reflecting greater need among these individuals. Future studies should evaluate potential mechanisms for these findings and further identify both patient and community factors that may inform strategies to improve rehabilitation use. Clinical Trial Number: https://www.clinicaltrials.gov/ NCT02588664 [registration date: 2015–10-23]. [ABSTRACT FROM AUTHOR]
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- 2025
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11. Meat Consumption in Spain. Are we Becoming a Country of Vegetarians?
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García-Espejo, Isabel, Díaz-Méndez, Cecilia, and Álvarez-Rodríguez, Adrián
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FOOD habits , *HOUSEHOLD budgets , *EDUCATIONAL attainment , *SOCIAL groups , *LOGISTIC regression analysis , *VEGETARIANISM - Abstract
Institutional diet recommendations suggest making changes to food habits to promote a healthier and more sustainable diet. Part of these recommendations is a reduction in meat consumption. But this conflicts with omnivorous diet models such as that found in Spain. This study investigates changes in the consumption of meat and vegetables in Spain through the use of logistic regressions and data from the Household Budget Survey (Encuesta de Presupuestos Familiares) (2006 to 2022) and the European Health Interview Survey (EHIS) in Spain (2014-2020). The results do not show the emergence of a new vegetable-based diet model. Meat consumption is linked to social groups with high occupational and educational status prevails, contrary to what has been found in other countries. Some resistance to a model change was observed. [ABSTRACT FROM AUTHOR]
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- 2025
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12. Social Determinants' Role in Pediatric Respiratory Health: Health Insights from Central Florida.
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Navas Nazario, Aledie A., Ulysse, Shedeline, Craver, Emily C., and Patel, Tanvi R.
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SOCIOECONOMIC disparities in health , *HOUSING stability , *ASTHMATICS , *ALLERGIC rhinitis , *SOCIAL determinants of health - Abstract
The article investigates the social determinants of health affecting pediatric asthma patients in central Florida, particularly those with comorbid conditions such as allergic rhinitis and eczema. Through an electronic survey distributed to parents of affected children, significant insights were gained into the prevalence of social determinants of health disparity, with a focus on parental employment status and housing instability. The study underscores the critical role of social factors in pediatric respiratory conditions and emphasizes the need for targeted interventions to address these determinants and improve health outcomes. Objectives: Despite advances in therapies and educational initiatives, pediatric allergy disorders, including asthma, allergic rhinitis, and eczema, continue to pose substantial health challenges. Understanding the social determinants of health (SDoH) linked with these conditions is a critical area of research due to their multifactorial nature. This study aimed to assess the SDoH influencing pediatric allergy disorders in central Florida, specifically examining four groups of children: with asthma only, with eczema only, with both asthma and eczema, and a control group without these conditions. Methods: An electronic survey was distributed to parents of children diagnosed as having asthma, eczema, or both, who received evaluations at Nemours Children's Health in Orlando, Florida. The patients were categorized into four groups: asthma only, eczema only, co-occurring asthma and eczema, and a control group. A subgroup consisted of patients with asthma and allergic rhinitis. Results: The survey revealed a significant prevalence of SDoH disparities, with 61.2% of respondents reporting at least one factor. A notable distinction emerged in parental employment status (P < 0.001). In the group of patients with allergic rhinitis, housing instability was an important factor. Conclusions: Investigating the central Florida pediatric population provided crucial insights into the social determinants affecting pediatric allergy disorders. The study highlighted significant health disparities, particularly in parental employment status and housing instability, underscoring the critical role of social factors in these conditions. These findings emphasize the need for targeted interventions addressing social determinants to improve health outcomes for children with allergy disorders. [ABSTRACT FROM AUTHOR]
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- 2025
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13. Resilience in the first year of surviving a stroke in Nigeria.
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Ojagbemi, Akin, Bello, Toyin, Elugbadebo, Olufisayo, Alabi, Morufat, Owolabi, Mayowa, and Baiyewu, Olusegun
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PSYCHOLOGICAL resilience , *RESEARCH funding , *SCIENTIFIC observation , *MULTIPLE regression analysis , *SEX distribution , *HYPERTENSION , *AGE distribution , *DESCRIPTIVE statistics , *LONGITUDINAL method , *QUALITY of life , *STROKE patients , *ALCOHOLISM , *CONFIDENCE intervals , *MENTAL depression , *EDUCATIONAL attainment - Abstract
Objectives: There is a knowledge gap on resilience and its impact on mental health of Africans who survive a stroke. We describe the trajectory of psychological resilience and its association with depression and quality of life (QoL) across the first poststroke year in Nigeria. Method: Prospective observational study of 150 survivors of a first ever stroke. Resilience was ascertained at 3 time-points prospectively over 12 months using the 25-items Resilience Scale (RS). Depression and QoL were also assessed at baseline and follow-up, respectively using the centre for epidemiologic studies depression scale (CES-D 10) and health related quality of life in stroke patients (HRQOLISP-26). Associations were investigated using regression models and presented as adjusted odds ratios (OR) and Wald test coefficients within 95% confidence intervals (CI). Results: Resilience improved across time points of measurement (p < 0.001). In multivariate logistic regression analyses adjusted for the effect of age, education, alcohol use, and hypertension, higher resilience was associated with male sex (OR = 5.3, 95% CI= 1.7, 17.2), younger age (OR = 4.8, 95% CI = 1.5,15.7), and baseline hypertension (OR= 0.2, 95% CI ≤ 0.1,0.8). In similarly adjusted mixed effect linear regression analyses, higher resilience was associated with improvement in depression (months 12= −4.2, 95% CI= −5.6, −2.8) and quality of life (months twelve = 5.2, 95% CI = 2.2, 8.2) overtime. Conclusion: Resilience, which was associated with better mental health and wellbeing of stroke survivors, was less likely with hypertension. Results suggest an important role for control of vascular risk factors as part of resilience interventions to promote poststroke recovery. [ABSTRACT FROM AUTHOR]
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- 2025
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14. Social Determinants of Health, Tribal Payments, and Probability of Contracting COVID-19 in American Indian and Alaska Native Peoples.
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Henderson, Austin, MacLehose, Richard F., Manson, Spero M., and Buchwald, Dedra
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ALASKA Natives ,RISK assessment ,CROSS-sectional method ,SOCIAL determinants of health ,HUMAN services programs ,RESEARCH funding ,DESCRIPTIVE statistics ,SURVEYS ,GOVERNMENT programs ,SOCIODEMOGRAPHIC factors ,DATA analysis software ,CONFIDENCE intervals ,NATIVE Americans ,COVID-19 - Abstract
Little is known about the relationships between demographic and economic social determinants of health and the probability of contracting COVID-19 in American Indian and Alaska Native (AI/AN) peoples. In addition, we do not know if and how tribal payments, unique to AI/AN peoples, are associated with the probability of contracting COVID-19. We surveyed 767 AI/AN patients of five geographically disparate health organizations that primarily served AI/AN peoples in urban settings between January and May of 2021. We used univariate modified Poisson regressions to estimate the influence of age, gender, household composition, education, household income, and tribal payments on risk of contracting COVID-19, with results presented as both risk and risk difference. Fifteen percent of the sample contracted COVID-19, and individuals who lived in households with two or more generations had an 11-percentage point elevated risk of contracting COVID-19 compared to those who lived alone. Twenty-seven percent of participants received tribal payments; receipt was associated with seven percentage points (change from 18% probability to 11% probability) lower risk of contracting COVID-19. Our findings showed interventions specifically designed to reduce the spread of COVID-19 in multigenerational households, and regular tribal payments may help improve health outcomes in urban AI/AN populations. [ABSTRACT FROM AUTHOR]
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- 2025
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15. Advancing Equity in Health Care Among Dalits and Tribal People in India: The Progress, Current Realities, and the Way Forward.
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Kuttiatt, Vijesh Sreedhar, Rahul, Arya, Choolayil, Anoop, and Kumar, Ashwani
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SOCIAL classes -- India ,HEALTH services accessibility ,COMMUNITY health services ,MEDICAL care use ,SOCIAL determinants of health ,MEDICAL education ,AT-risk people ,CULTURE ,PRIMARY health care ,HEALTH care reform ,RURAL population ,GOVERNMENT programs ,HEALTH equity ,HEALTH promotion ,PUBLIC health ,DISCRIMINATION (Sociology) ,POVERTY ,SOCIAL isolation - Abstract
The caste system and resulting social exclusion are important social determinants of health inequity in India. This article critically analyzes the influence of the caste system on health inequity in India, starting with a historical perspective and moving to the current status. The article argues that the caste system has deprived Dalits and tribal people in India of achieving health equity. The programs to promote health are often disease-specific and not culturally informed, leading to poor attention at the policy level to the intersecting disadvantages that make Dalits and tribal communities vulnerable, resulting in poor health. The authors suggest strengthening and promoting primary care, improving health access for Dalit and tribal populations, and the need for pivotal changes in the medical education system, shifting the emphasis from specialized care to training family physicians to be oriented toward community health needs, keeping health equity in perspective. [ABSTRACT FROM AUTHOR]
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- 2025
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16. Water insecurity is human: why social science must be at the core of water security research and practice
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Amber Wutich
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water insecurity ,hybridity ,MAD water ,social science ,social determinants ,Environmental technology. Sanitary engineering ,TD1-1066 - Abstract
Many water scholars believe we are at an inflection point in which new approaches to water research and management are needed, and I agree. Water insecurity is fundamentally driven by human behavior and is socially determined. To address this, the emerging science of water security can build on well-established and theoretically-robust findings from social science. Foundational work establishes the formative role of human social structures in producing water insecurity, particularly for populations experiencing poverty, racial/ethnic minoritization, and political exclusion. While infrastructural and legal/regulatory reforms are essential to advance water security, they have failed vulnerable populations in patterned, predictable ways globally. New research highlights how social and engineered infrastructures that are hybrid, modular, adaptive, and decentralized can improve water security for the most vulnerable populations. However, reliance on such systems is inherently a feature of unjust, inequitable water governance. Social scientists have a valuable role to play in explaining these dynamics, addressing water system failures, and developing more equitable water solutions.
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- 2025
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17. Interrelationships between social exclusion, mental health and wellbeing in adolescents: insights from a national Youth Survey
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K. Filia, S. M. Teo, N. Brennan, T. Freeburn, D. Baker, V. Browne, A. Watson, J. Menssink, A. Prasad, E. Killackey, P. D. McGorry, S. M. Cotton, and C. X. Gao
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adolescent mental health ,prevention and early intervention ,social determinants ,social exclusion ,youth survey ,youth wellbeing ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Aims Adolescence is a critical developmental phase during which young people are vulnerable to the experiences of mental ill-health and social exclusion (consisting of various domains including education and employment, housing, finances and social supports and relationships). The aims of this study were to (i) obtain an understanding of the relationships between social exclusion, mental health and wellbeing of young people; and (ii) identify potentially modifiable targets, or population groups that require greater or targeted supports. Methods Data were obtained from the Mission Australia 2022 Youth Survey, Australia’s largest annual population-wide survey of young people aged 15–19 years (n = 18,800). Participants’ experiences of social exclusion in different domains were explored (e.g., prevalence, co-occurrence and controlling for differences in demographic characteristics). Multivariable linear regression models were used to map the relationships between social exclusion domains and mental health and wellbeing, controlling for confounding factors where necessary. Results Sixty per cent of all young people experienced social exclusion in at least one domain, 25% in multiple. Young people who identified as gender diverse, Indigenous, living in a remote/rural or socio-economically disadvantaged area and with a culturally diverse background were more likely to report social exclusion. A strong association was seen between all domains of social exclusion and poor mental health (e.g., higher psychological distress and loneliness, reduced personal wellbeing, reduced sense of control over their life and a more negative outlook on the future). Notably, difficulties in socialising and obtaining social support were critical factors linked to increased psychological distress and reduced wellbeing. Conclusions Findings underscore the need to address multiple domains of social exclusion concurrently, and in collaboration with youth mental healthcare. Prevention efforts aimed at early identification and intervention should be prioritised to support young people vulnerable to social exclusion. Screening approaches are needed to identify individuals and groups of young people in need of support, and to facilitate care coordination across multiple providers.
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- 2025
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18. Geographic disparities in physical and mental health comorbidities and socioeconomic status of residence among Medicaid beneficiaries in Utah
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Roberta Z. Horth, Srimoyee Bose, Carl Grafe, Navina Forsythe, and Angela Dunn
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physical health ,mental health ,Medicaid ,GIS ,social determinants ,comorbidity ,Public aspects of medicine ,RA1-1270 - Abstract
To examine the relationship between socioeconomic deprivation and complex needs, defined as mental and physical comorbidities, we conducted a cross-sectional retrospective cohort analysis of adult Utah Medicaid beneficiaries. Our analysis included Medicaid beneficiaries with geocoded addresses aged ≥18 years in Utah (N = 157,739). We geocoded beneficiary addresses and assigned them to census block groups. We compared the socioeconomic status of block groups (Singh’s area deprivation index) with the proportion of complex needs, defined based on cluster analysis as 1 physical condition with depression or ≥ 2 physical with ≥1 mental health condition. Spatial mapping was performed of prevalence quantiles grouped by count overlaid with Medicaid-covered mental health facilities. Prevalence of complex needs was 18.9% (n = 29,742); beneficiaries with >3 emergency department visits had 12.8 odds of having complex needs; 39.7% of beneficiaries with >$5,000 in annual costs had complex needs. Common comorbid conditions among beneficiaries with complex needs were hypertension (56.0%), hyperlipidemia (35.5%), depression (68.8%), anxiety (56.2%), drug use (16.0%), and alcohol use disorders (15.2%). Census block groups with higher deprivation had a higher proportion of complex needs (ρ = 0.21, p
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- 2025
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19. The Sociology of Race: Du Bois’s Challenge to Biological Explanations of Racial Inequality
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Roberts, Dorothy E., Morris, Aldon D., book editor, Schwartz, Michael, book editor, Johnson-Odim, Cheryl, book editor, Allen, Walter, book editor, Hunter, Marcus Anthony, book editor, Brown, Karida L., book editor, and Green, Dan S., book editor
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- 2025
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20. Improving Social Determinants of Health via the Workplace.
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Harris, Jeffrey R. and Hannon, Peggy A.
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SOCIAL determinants of health , *HEALTH services accessibility , *NUTRITION services , *INDUSTRIAL relations , *FOOD security - Abstract
Synopsis : Social determinants of health (SDOH), such as food security and healthcare access, are key to maintaining and improving health. Publicly funded safety-net programs, such as Medicaid and the Supplemental Nutrition Assistance Program, address SDOH. Many low-wage employees are program-eligible, but there are substantial participation gaps. Providing information and assistance boosts program participation, and there are third-party organizations ready to aid employers in doing so. In an ideal world, everyone with a job would have the resources to thrive on their pay and benefits, but many do not. Employers could help bridge these gaps via promoting these programs via the workplace. [ABSTRACT FROM AUTHOR]- Published
- 2025
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21. Heart failure and cardiomyopathy mortality trends and disparities among obese populations: A 20-year United States study.
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Yeo, Yong-Hao, San, Boon-Jian, Ahmad, Ela, Tan, Min-Choon, Sin, Yuh-Miin, Jani, Milena, and Bloomingdale, Richard J.
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HEART failure , *DEATH rate , *CARDIOMYOPATHIES , *COMORBIDITY , *AFRICAN Americans - Abstract
Our study aimed to assess the heart failure/cardiomyopathy-related population-level mortality trends among patients with obesity in the United States and disparities across demographics. We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among adults aged ≥25 from 1999 to 2019. Heart failure/cardiomyopathy were listed as the main causes of death, with obesity as a contributing cause. We calculated age-adjusted mortality rates (AAMR) per 100,000 individuals and estimated the average annual percent change (AAPC). We also evaluated the social vulnerability of United States counties (2014–2018). There were 29,334 deaths related to heart failure/cardiomyopathy among patients with comorbid obesity. The overall AAMR increased from 0.41 in 1999 to 0.94 in 2019, with an AAPC of 3.78 (95 % CI, 3.41–4.14). The crude mortality rate increase for heart failure/cardiomyopathy was greater in individuals with comorbid obesity than in those without. Males had a higher AAMR than females (0.78 vs 0.55). African Americans also had higher AAMR than Whites (1.35 vs 0.62). The AAMR was higher in rural areas than in urban regions (0.76 vs 0.66). The overall AAMR was higher in counties with social vulnerability index-Quartile 4 (SVI-Q4) (most vulnerable) (1.08) compared to SVI-Q1 (least vulnerable) (0.63) with a risk ratio of 1.71 (95 % CI: 1.61–1.83). Heart failure/cardiomyopathy mortality in individuals with comorbid obesity was rising. Males, African Americans, and individuals from rural regions had higher AAMR than their counterparts. [ABSTRACT FROM AUTHOR]
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- 2025
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22. Disparities in Medication Prescriptions and Post-Tracheostomy Outcomes in Pediatric Patients.
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Reddy, Pooja D., Raman, Akshaya, Eljamri, Soukaina, Shaffer, Amber, and Padia, Reema
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CHILD patients , *PATIENT experience , *GRANULATION tissue , *RACE , *TRANSITIONAL care - Abstract
Granulation tissue formation and tracheitis are common pediatric tracheostomy complications. Ciprofloxacin/dexamethasone is frequently prescribed, but the influence of social determinants on this topic is unexplored.This study extends a prior cohort study of pediatric tracheostomy patients at a single academic institution from 2016 to 2020. Social determinants of health, including race, insurance status, and residence characteristics, including Area Deprivation Index (ADI), were evaluated. Logistic regression, Wilcoxon rank-sum, and log-rank tests (α = .05) analyzed relationships between these determinants and prescriptions and post-tracheostomy outcomes.This cohort included 182 patients; 98/182 (53.9%) were male, and 140/182 (76.9%) were White, non-Hispanic. Non-White race was associated with increased odds of receiving nebulized ciprofloxacin/dexamethasone (OR = 2.80, 95% CI = 1.25-6.29). In those with tracheal culture results available (n = 63), Staphylococcus aureus was more common with public insurance (29/47, 7 with MRSA, 61.7%) compared with private (5/16, 3 with MRSA, 31.3%; OR = 3.54, 95% CI = 1.05-11.9). ADI was greater in the 7 patients with Streptococcus pneumoniae (median = 95, IQR = 88-99) compared to without (median = 77, IQR = 65-81,
P = .003). Patients with tracheitis lived further from our center (median = 44.7 miles, IQR = 27.7-91.4 miles) compared with those who did not develop tracheitis (median = 33.4 miles, IQR = 12.0-85.2 miles,P = .02). Antibiotic resistance was more prevalent in children discharged home (14/35, 40.0%) than to transitional care (3/28, 10.7%; OR = 5.56, 95% CI = 1.40-22.0) and was associated with longer hospital stays (median = 70 days, range = 34-152 vs median = 35 days, range = 15-75 days,P = .02). Non-White patients experience increased odds of decannulation over time compared with White patients (HR = 2.85, 95% CI = 1.21-6.70). Discharge locations and ADI were associated with dressing choice post-tracheostomy.This study revealed racial disparities in ciprofloxacin/dexamethasone usage, residence-related differences in tracheal culture results, and ADI-related dressing choices, which highlight the need for tailored, equitable care to optimize outcomes.4 [ABSTRACT FROM AUTHOR]- Published
- 2025
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23. Integrating Social Determinants With the Interpersonal Theory of Suicide in a Study of Bipolar Outpatients.
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Mulligan DJ, Taylor A, and Lamis DA
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- Humans, Female, Male, Adult, Middle Aged, Risk Factors, Psychological Theory, Suicidal Ideation, Interpersonal Relations, Socioeconomic Factors, United States, Social Isolation psychology, Bipolar Disorder psychology, Outpatients psychology, Suicide psychology, Social Determinants of Health
- Abstract
Introduction: Bipolar disorder, socioeconomic deprivation, and social isolation are major risk factors for suicide. The interpersonal theory of suicide (IPTS) posits perceived burdensomeness and thwarted belongingness as proximal causes of suicidal thoughts and behaviors, while the social determinants of health (SDOH) framework highlights distal socioeconomic factors. Studies of suicidality in bipolar disorder have used the IPTS and the SDOH framework, but few have integrated them to explore connections between distal and proximal factors., Methods: This study examined perceived burdensomeness and thwarted belongingness as mediators of the relationship between cumulative socioeconomic risk and suicide risk. Participants were 171 outpatients in a United States (U.S.) bipolar clinic (mean age = 39.0, 69.6% female, 73.7% Black/African American)., Results: Cumulative socioeconomic risk, perceived burdensomeness, and thwarted belongingness were positively associated with suicide risk. Perceived burdensomeness mediated the relationship between cumulative socioeconomic risk and suicide risk, but thwarted belongingness did not., Conclusion: Findings broadly suggest the IPTS and the SDOH framework can be fruitfully integrated to guide research and prevent suicide. The pathway from cumulative socioeconomic risk to suicide risk via perceived burdensomeness warrants further attention, particularly for individuals diagnosed with bipolar disorder. Implications for future studies of the IPTS, SDOH, and suicidality are discussed., (© 2025 American Association of Suicidology.)
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- 2025
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24. Cardiovascular Risk Assessment and Prevention in Cardio-Oncology: Beyond Traditional Risk Factors.
- Author
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Makram OM, Nain P, Vasbinder A, Weintraub NL, and Guha A
- Subjects
- Humans, Risk Assessment methods, Heart Disease Risk Factors, Risk Factors, Cardiology, Cardio-Oncology, Cardiovascular Diseases prevention & control, Neoplasms complications, Medical Oncology methods
- Abstract
This review goes beyond traditional approaches in cardio-oncology, highlighting often-neglected factors impacting patient care. Social determinants, environment, health care access, and gut microbiome significantly influence patient outcomes. Powerful tools like multi-omics and wearable technologies offer deeper insights into real-world experiences. The future lies in integrating these advancements with established practices to achieve precision cardio-oncology care. By crafting tailored therapies and continuously updating comprehensive management plans based on real-time data, we can unlock the full potential of personalized care for all patients., Competing Interests: Disclosure A. Guha and N.L. Weintraub are supported by the American Heart Association-Strategically Focused Research Network Grant in Disparities in Cardio-Oncology (#847740, #863620). A. Guha is also supported by the Department of Defense Prostate Cancer Research Program's Physician Research Award (#HT94252310158)., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2025
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25. Moving beyond biology: the critical role of social and structural determinants in atopic dermatitis.
- Author
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Polaskey MT and Chovatiya R
- Subjects
- Humans, Health Services Accessibility, Incidence, Socioeconomic Factors, Healthcare Disparities, Quality of Life, Residence Characteristics, Dermatitis, Atopic epidemiology, Social Determinants of Health, Severity of Illness Index
- Abstract
Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease with a substantial global burden and negative impact on quality of life. While genetics and pathophysiology are key to understanding AD, emerging evidence indicates that social and structural determinants of health (SDOH and StDOH) strongly influence the condition's onset, severity, and outcomes. SDOH, such as economic stability, education quality and access, healthcare quality and access, neighborhood environment, and social/community context, shape individual risk and disease experience. StDOH, including government processes, economic policies, social/public policies, and cultural/societal values, further act as upstream forces that directly and indirectly influence AD outcomes. In this review, we synthesize current knowledge on the impacts of SDOH and StDOH on AD incidence, severity, and disparities. Embracing a biopsychosocial model is crucial to elucidate the etiology, epidemiology, and optimal management of AD. Future research should adopt a holistic approach, moving beyond a purely biological perspective to consider the intricate interplay of social and structural determinants in understanding and managing AD., (© 2024 The Author(s). International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)
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- 2025
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26. An Interdisciplinary Perspective on Improving Cancer Care in the State of Mississippi as an Example of Cancer Care Improvements in the Global South.
- Author
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Jones ML, Vijayakumar S, Nittala MR, and Brunson CD
- Abstract
Cancer disparities, a critical public health issue, particularly in states such as Mississippi, where socioeconomic factors significantly influence health outcomes, require our collective attention. This paper delves into the multifaceted nature of cancer disparities through a macro-level analysis of cancer data, specifically focusing on Mississippi as a microcosm of broader national and global trends. Two key indices, the Socio-Demographic Index (SDI) and the Social Deprivation Index (SDeI), provide valuable insights. The former offers a macro-level understanding of the socioeconomic factors that shape health and cancer outcomes. The latter quantifies disadvantages in small areas, identifying regions that need scientific, policy, and administrative support. The poor health care and cancer care (CC) outcomes in Mississippi are well documented and detailed here. However, SDI and SDeI data are not yet available in Mississippi. With biological, technological, and clinical research design advancements and other new innovative strategies emerging in the past decade in CC, a 'leapfrogging' of CC outcomes in Mississippi is within our reach. To achieve this goal, an interdisciplinary approach (IDA) addressing and solving the challenges faced in Mississippi is required. The IDA team must include disciplines that can determine SDI and SDeI for Mississippi and tie those findings to successfully apply new technological advances and innovations efficiently and cost-effectively by building infrastructure and developing implementation strategies. This can serve as a pilot demonstration project that will also help other similar regions within the United States, as well as the Global South., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Jones et al.)
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- 2025
- Full Text
- View/download PDF
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