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1.
Int J Equity Health ; 21(Suppl 3): 193, 2023 01 24.
Article in English | MEDLINE | ID: covidwho-2235792

ABSTRACT

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in 'Pathfinder' countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants.


Subject(s)
COVID-19 , Health Equity , Humans , Social Determinants of Health , Pandemics , Health Status Disparities , World Health Organization , Health Policy
2.
Lancet ; 400(10349): 352-353, 2022 07 30.
Article in English | MEDLINE | ID: covidwho-2184626

Subject(s)
Health Equity , Humans , Taxes
3.
BMJ ; 379: o2377, 2022 10 12.
Article in English | MEDLINE | ID: covidwho-2064122
4.
PLoS One ; 17(7): e0270344, 2022.
Article in English | MEDLINE | ID: covidwho-1951543

ABSTRACT

International financial organisations like the International Monetary Fund (IMF) play a central role in shaping the developmental trajectories of fiscally distressed countries through their conditional lending schemes, known as 'structural adjustment programmes'. These programmes entail wide-ranging domestic policy reforms that influence local health and welfare systems. Using novel panel data from 187 countries between 1990 and 2017 and an instrumental variable technique, we find that IMF programmes lead to over 70 excess deaths from respiratory diseases and tuberculosis per 100,000 population and that IMF-mandated privatisation reforms lead to over 90 excess deaths per 100,000 population. Thus structural adjustment programmes, as currently designed and implemented, are harmful to population health and increase global infectious disease burdens.


Subject(s)
Communicable Diseases , Financial Management , Communicable Diseases/epidemiology , Humans , Social Welfare
6.
American Journal of Public Health ; 112(4):535-537, 2022.
Article in English | ProQuest Central | ID: covidwho-1777117

ABSTRACT

[...]the gradient got steeper between 2000 and 2014;inequalities in health increased. [...]from around 2008, there was no improvement in life expectancy-even a decline-for the poorer two income quartiles. [...]my comment that the society has been doing badly.

7.
R Soc Open Sci ; 8(10): 211454, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1684942

ABSTRACT

A summary of our analyses in Greater Manchester (GM), and the northwest (NW) region, might be: the NW is like England as a whole only more so. The life expectancy drop in England in 2020 was 1.2 years in men and 0.9 years in women-shocking, but not as high as in the NW. COVID-19 mortality rates were high in England; 25% higher in the NW. Inequalities in mortality are high in England; bigger in the NW. The title, Build Back Fairer, is a deliberate echo of the Build Back Better mantra, showing that the levels of social, environmental and economic inequality in society are damaging health and well-being. As the UK emerges from the pandemic, it would be a tragic mistake to re-establish the status quo that existed pre-pandemic-a status quo marked in England, over the decade from 2010, by a stagnation of health improvement that was more marked than in any rich country other than Iceland and the USA; by widening health inequalities; and by a fall in life expectancy in the most deprived 10% of areas outside London. That stagnation, those social and regional inequalities, and deterioration in health for the most deprived people are markers of a society that is not meeting the needs of its members.

8.
9.
Lancet Psychiatry ; 9(2): 169-182, 2022 02.
Article in English | MEDLINE | ID: covidwho-1641764

ABSTRACT

Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), and promote mental wellbeing and resilience. However, only a small proportion of people with mental disorders receive minimally adequate treatment. Compared with treatment, there is even less coverage of interventions to prevent the associated impacts of mental disorders, prevent mental disorders from arising, or promote mental wellbeing and resilience. This implementation failure breaches the right to health, has increased during the COVID-19 pandemic, and results in preventable suffering, broad impacts, and associated economic costs. In this Health Policy paper, we outline specific actions to improve the coverage of PMH interventions, including PMH needs assessments, collaborative advocacy and leadership, PMH practice to inform policy and implementation, training and improvement of population literacy, settings-based and integrated approaches, use of digital technology, maximising existing resources, focus on high-return interventions, human rights approaches, legislation, and implementation research. Increased interest in PMH in populations and governments since the onset of the COVID-19 pandemic supports these actions. Improved implementation of PMH interventions can result in broad health, social, and economic impacts, even in the short-term, which support the achievement of a range of policy objectives, sustainable economic development, and recovery.


Subject(s)
COVID-19 , Health Policy , Mental Disorders/therapy , Mental Health Services/organization & administration , Mental Health Services/standards , Mental Health/standards , Public Health/standards , Humans
10.
Sci Rep ; 11(1): 23161, 2021 11 30.
Article in English | MEDLINE | ID: covidwho-1545640

ABSTRACT

The COVID-19 pandemic exposes and amplifies pre-existing inequalities even in places with relatively well-controlled outbreaks such as Hong Kong. This study aimed to explore whether the socioeconomically disadvantaged fare worse via various types of worry in terms of their mental health and well-being. Between September and October 2020, 1067 adults in Hong Kong were recruited via a cross-sectional population-wide telephone survey. The inter-relationship between deprivation, types of worry, mental health disorders, and subjective well-being was assessed using structural equation modelling. Results showed significant total effects of deprivation on worries about being infected (p = 0.002), economic activities and livelihood (p < 0.001), and personal savings (p < 0.001), as well as mental health disorders (p < 0.001) and subjective well-being (p < 0.001). Specifically, worry about economic activities and livelihood partly mediated the total effect of deprivation on mental health disorders (p = 0.004), whereas worry about personal savings and worry about economic activities and livelihood partially mediated the total effect of deprivation on subjective well-being (p = 0.007 and 0.002, respectively). Socioeconomic inequality, particularly in mental health and well-being, could be exacerbated via people's economic concerns during the pandemic, which was largely induced by the COVID-19 containment measures rather than the pandemic per se given the relatively low COVID-19 incidence in Hong Kong.


Subject(s)
COVID-19 , Adolescent , Adult , Humans , Mental Health , Middle Aged , Pandemics
11.
Curr Psychol ; : 1-11, 2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1439762

ABSTRACT

The COVID-19 pandemic has substantially induced worries and affected individual mental health and subjective well-being. Nonetheless, a high level of social capital could potentially protect individuals who suffer from mental health problems and thus promote their subjective well-being, especially under the social distancing policies during the pandemic. To this end, based on a random sample of 1053 Hong Kong adults, structural equation modeling was applied to study the path relationships between the worries of COVID-19, social capital, mental health problems, and subjective well-being. The study found that worries during the pandemic were associated with mental health and subjective well-being, through social capital as a mediator. Moreover, social capital exhibited a stronger influence on mental health and subjective well-being in the economically inactive group than in the economically active group. This study highlights the important role of social capital during the COVID-19 pandemic. While Hong Kong's COVID-19 response has primarily focused on disease prevention, it must be noted that social services and mutual-help activities are also crucial for people to withstand the crisis.

12.
Child Adolesc Ment Health ; 26(3): 267-268, 2021 09.
Article in English | MEDLINE | ID: covidwho-1393845
13.
Emerg Infect Dis ; 27(11): 2874-2877, 2021 11.
Article in English | MEDLINE | ID: covidwho-1381377

ABSTRACT

Although coronavirus disease (COVID-19) outbreaks have been relatively well controlled in Hong Kong, containment remains challenging among socioeconomically disadvantaged persons. They are at higher risk for widespread COVID-19 transmission through sizable clustering, probably because of exposure to social settings in which existing mitigation policies had differential socioeconomic effects.


Subject(s)
COVID-19 , Hong Kong/epidemiology , Humans , Incidence , SARS-CoV-2 , Socioeconomic Factors
15.
Int J Environ Res Public Health ; 18(15)2021 08 02.
Article in English | MEDLINE | ID: covidwho-1335082

ABSTRACT

The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72-3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32-2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.


Subject(s)
COVID-19 , Multimorbidity , Hong Kong/epidemiology , Humans , Poverty , SARS-CoV-2 , Socioeconomic Factors , Syndemic
16.
The Lancet ; 398(10295):110-111, 2021.
Article in English | ScienceDirect | ID: covidwho-1300210
17.
SSM Popul Health ; 15: 100827, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1269343

ABSTRACT

The ongoing COVID-19 pandemic has spotlighted the role of America's overcrowded prisons as vectors of ill health, but robust analyses of the degree to which high rates of incarceration impact population-level health outcomes remain scarce. In this paper, we use county-level panel data from 2927 counties across 43 states between 1983 and 2014 and a novel instrumental variable technique to study the causal effect of penal expansion on age-standardised cause-specific and all-cause mortality rates. We find that higher rates of incarceration have substantively large effects on deaths from communicable, maternal, neonatal, and nutritional diseases in the short and medium term, whilst deaths from non-communicable disease and from all causes combined are impacted in the short, medium, and long run. These findings are further corroborated by a between-unit analysis using coarsened exact matching and a simulation-based regression approach to predicting geographically anchored mortality differences.

19.
East Mediterr Health J ; 27(3): 217-219, 2021 Mar 23.
Article in English | MEDLINE | ID: covidwho-1158926

ABSTRACT

Evidence has shown that some of the major causes of health inequities arise from the conditions in which people are born, grow, live, work and age, in addition to a wider set of forces and systems shaping individuals' and societies' health and well-being. Such conditions are known as the 'social determinants of health'. However, efforts to address these determinants have remained challenging and unsatisfactory in many parts of the world, including in the Eastern Mediterranean Region. Policies to contain the ongoing COVID-19 pandemic have further exposed and amplified the existing and even created new dimensions in social and health inequities, as we elaborate further below. Meanwhile, the pandemic offers a unique opportunity to tackle inequities and build back fairer.


Subject(s)
COVID-19/epidemiology , Health Equity/organization & administration , Africa, Northern/epidemiology , Health Policy , Health Status Disparities , Humans , Middle East/epidemiology , Pandemics , SARS-CoV-2 , Social Determinants of Health , Socioeconomic Factors
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