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1.
Rivista Sperimentale di Freniatria: La Rivista della Salute Mentale ; 145(2):25-35, 2021.
Article in English | APA PsycInfo | ID: covidwho-1812699

ABSTRACT

The aim of this review is to examine the effects of the Covid-19 pandemic on health inequalities and discuss effective public policies in containing them. The Covid-19 pandemic has generated not only an unprecedented health crisis, but also a severe economic recession and rapid increase in unemployment and economic difficulties. The poorer socioeconomic classes have been most affected by SARS-CoV-2 infections and deaths due to inequalities in working, housing and area of residence conditions, psychosocial factors, as well as unequal access to health care. However, the effects of the pandemic on health inequalities can be tackled by effective policies of Covid-19 containment based on testing, tracing and isolate timely and stronger social protection measures on behalf of the most disadvantaged populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) Lo scopo di questa review e esaminare gli effetti della pandemia di Covid-19 sulle disuguaglianze sanitarie e discutere politiche pubbliche efficaci per contenerle. La pandemia di Covid-19 ha generato non solo una crisi sanitaria senza precedenti, ma anche una grave recessione economica e un rapido aumento della disoccupazione e delle difficolta economiche. Le classi socioeconomiche piu povere sono state le piu colpite dalle infezioni e dai decessi da SARS-CoV-2 a causa delle disuguaglianze nelle condizioni di lavoro, abitative e dell'area di residenza, fattori psicosociali e disuguale accesso all'assistenza sanitaria. Tuttavia, gli effetti della pandemia sulle disuguaglianze sanitarie possono essere affrontati con efficaci politiche di contenimento del Covid-19 basate su test, tracciamento e isolamento di misure di protezione sociale tempestive e piu forti a favore delle popolazioni piu svantaggiate. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

2.
Community Dentistry and Oral Epidemiology ; 49(6):503-564, 2021.
Article in English | GIM | ID: covidwho-1812552

ABSTRACT

This special section includes 7 articles discussing oral health in China. Topics discussed are: socioeconomic-related inequality in dental care utilization among preschool children in China;ten-year changes in children's oral health disparities;Prevalence of toothache in Chinese adults aged 65 years and above;edentulism and select chronic diseases among adults aged 45 years in China, 2011-2018;temporomandibular disorder subtypes, emotional distress, impaired sleep, and oral health-related quality of life in Asian patients;validation of the Chinese version of the Short-Form Health Literacy in Dentistry (HeLD) scale;impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital.

3.
Front Public Health ; 10:854146, 2022.
Article in English | PubMed | ID: covidwho-1809622

ABSTRACT

OBJECTIVES: The aim of the study is to investigate the relationship between migration background and COVID-19 vaccine intentions, exploring multiple mediation paths. We argue that the migrational and sociocultural background influences general attitudes toward health and political/public institutions. The effects of these general attitudes on vaccination intentions are mediated by fears of infection. Additionally, we analyze a migrant-only model including acculturation variables (years since migration, foreign and host country media consumption) and region of origin (European vs. Non-European). Design: The data (n = 1027) stem from an online access panel collected between March 15 and March 25, 2021. Quotas for gender and age were set according the online population of Germany. The use of an oversampling framework for first generation migrants resulted in a sample with 50% first generation migrants and 50% native Germans without migration background. Models were calculated using a Structural Equation Modeling approach. RESULTS: Migration background both increases and decreases antecedents of vaccination intentions. Being a migrant increases positive antecedents like religiosity, which in turn positively influence general attitudes and thus fears of infection and vaccination intentions. But being a migrant has also a significant direct negative association with vaccination intentions, implying missing mediators. Increasing years since migration increase host country (German) media consumption and decrease consumption of media from the country of origin. Both media variables are positively associated with political trust and health consciousness. Additionally, European compared to Non-European migrants have less political trust, fear of personal infection and lower vaccination intentions on the whole. CONCLUSIONS: The study found that vaccination intentions can be understood by applying the proposed hypothetical structure. We found complex associations of the migration and sociocultural background and COVID-19 vaccination intentions, where antecedents of vaccination intentions are both increased and decreased by migration background and migration specific factors.

4.
Wellcome Open Research ; 6(36), 2021.
Article in English | CAB Abstracts | ID: covidwho-1780280

ABSTRACT

Background: When the novel coronavirus - SARS-CoV-2 - started to spread globally, there was a call for social and behavioral scientists to conduct research to explore the wider socio-cultural contexts of coronavirus disease 2019 (COVID-19), to understand vulnerabilities, as well as to increase engagement within communities to facilitate adoption of public health measures. In this manuscript, we describe the protocol for a study conducted in Indonesia, Nepal, and Vietnam. In the study, we explore how the COVID-19 pandemic is affecting individuals and their communities. We focus on the wider health and economic impacts of COVID-19, in particular emerging and increased burden on mental health, as well as new or deepened vulnerabilities in the communities. The introduction of vaccines has added another layer of complexity and highlights differences in acceptance and inequalities around access.

5.
Health Expect ; 2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1779233

ABSTRACT

INTRODUCTION: Regular reviews of medications, including prescription reviews and adherence reviews, are vital to support pharmacological effectiveness and optimize health outcomes for patients. Despite being more likely to report a long-term illness that requires medication when compared to their white counterparts, individuals from ethnic minority communities are less likely to engage with regular medication reviews, with inequalities negatively affecting their access. It is important to understand what barriers may exist that impact the access of those from ethnic minority communities and to identify measures that may act to facilitate improved service accessibility for these groups. METHODS: Semi-structured interviews were conducted between June and August 2021 using the following formats as permitted by governmental COVID-19 restrictions: in person, over the telephone or via video call. Perspectives on service accessibility and any associated barriers and facilitators were discussed. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Health Research Authority (ref: 21/HRA/1426). RESULTS: In total 20 participants from ethnic minority communities were interviewed; these participants included 16 UK citizens, 2 refugees and 2 asylum seekers, and represented a total of 5 different ethnic groups. Three themes were developed from the data regarding the perceived barriers and facilitators affecting access to medication reviews and identified approaches to improve the accessibility of such services for ethnic minority patients. These centred on (1) building knowledge and understanding about medication reviews; (2) delivering medication review services; and (3) appreciating the lived experience of patients. CONCLUSION: The results of this study have important implications for addressing inequalities that affect ethnic minority communities. Involving patients and practitioners to work collaboratively in coproduction approaches could enable better design, implementation and delivery of accessible medication review services that are culturally competent. PATIENT OR PUBLIC CONTRIBUTION: The National Institute for Health Research Applied Research Collaboration and Patient and Public Involvement and Engagement group at Newcastle University supported the study design and conceptualization. Seven patient champions inputted to ensure that the research was conducted, and the findings were reported, with cultural sensitivity.

6.
Pakistan Journal of Medical Sciences ; 38(4):1056-1063, 2022.
Article in English | CAB Abstracts | ID: covidwho-1771792

ABSTRACT

The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.

7.
JMIR Res Protoc ; 11(3): e32538, 2022 Mar 18.
Article in English | MEDLINE | ID: covidwho-1770901

ABSTRACT

BACKGROUND: Digital health interventions refer to interventions designed to support health-related knowledge transfer and are delivered via digital technologies, such as mobile apps. Digital health interventions are a double-edged sword: they have the potential to reduce health inequalities, for example, by making treatments available remotely to rural populations underserved by health care facilities or by helping to overcome language barriers via in-app translation services; however, if not designed and deployed with care, digital health interventions also have the potential to increase health inequalities and exacerbate the effects of the digital divide. OBJECTIVE: The aim of this study is to review ways to mitigate the digital divide through digital health intervention design, deployment, and engagement mechanisms sensitive to the needs of digitally excluded populations. METHODS: This protocol outlines the procedure for a systematic scoping review that follows the methodology recommended by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidance. The following databases will be searched for primary research studies published in English from October 1, 2011, to October 1, 2021: Cochrane Library, Epistemonikos, NICE Evidence, PROSPERO, PubMed (with MEDLINE and Europe PMC), and Trip. In addition, the following sources of gray literature will be searched: Conference Proceedings Citation Index, Health Management Information Consortium, International HTA Database, OpenGrey, The Grey Literature Report, Google Scholar Basic Search UK, MedNar Deep Web Search Engine, and Carrot2. We will select publications that meet the following inclusion criteria: primary research papers that evaluated digital health interventions that describe features of digital health intervention design and deployment that enable or hinder access to and engagement with digital health interventions by adults from demographic groups likely to be affected by the digital divide (eg, older age, minority ethnic groups, lower income, and lower education level). A random selection of 25 publications identified from the search will be double screened by four reviewers. If there is >75% agreement for included/excluded publications, the team will continue to screen all the identified publications. For all included publications, study characteristics will be extracted by one author and checked for agreement by a second author, with any disagreements resolved by consensus among the study team. Consultation digital health intervention design and deployment, and digital health intervention users will also be conducted in parallel. RESULTS: The review is underway and is anticipated to be completed by September 2022. CONCLUSIONS: The results will have implications for researchers and policy makers using digital health interventions for health improvement peripandemic and post pandemic, and will inform best practices in the design and delivery of digital health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/32538.

8.
Int J Environ Res Public Health ; 19(6)2022 03 19.
Article in English | MEDLINE | ID: covidwho-1765725

ABSTRACT

Meaningful inclusion of young people's perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people's perceptions of what influences their opportunities to be healthy within their local area and their understandings of health inequalities. Three interlinked qualitative focus group discussions, each lasting 90 to 100 min, with the same six groups of young people (n = 42) aged 13-21, were conducted between February and June 2021. Participants were recruited from six youth groups in areas of high deprivation across three geographical locations in England (South Yorkshire, the North East and London). Our study demonstrates that young people understand that health inequalities are generated by social determinants of health, which in turn influence behaviours. They highlight a complex interweaving of pathways between social determinants and health outcomes. However, they do not tend to think in terms of the social determinants and their distribution as resulting from the power and influence of those who create and benefit from health and social inequalities. An informed understanding of the causes of health inequalities, influenced by their own unique generational experiences, is important to help young people contribute to the development of pro-equity policies of the future.

9.
Cardiology Clinics ; 2022.
Article in English | ScienceDirect | ID: covidwho-1763611
10.
Public Health Nutr ; 25(4): 1038-1044, 2022 04.
Article in English | MEDLINE | ID: covidwho-1758082

ABSTRACT

OBJECTIVE: Food insecurity (FI) affects approximately 11·1 % of US households and is related to worsened infant outcomes. Evidence in lower income countries links FI and infant mortality rates (IMR), but there are limited data in the USA. This study examines the relationship between FI and IMR in North Carolina (NC). DESIGN: NC county-level health data were used from the 2019 Robert Woods Johnson Foundation County Health Rankings. The dependent variable was county-level IMR. Eighteen county-level independent variables were selected and a multivariable linear regression was performed. The independent variable, FI, was based on the United States Department of Agriculture's Food Security Supplement to the Current Population Survey. SETTING: NC counties. PARTICIPANTS: Residents of NC, county-level data. RESULTS: The mean NC county-level IMR was 7·9 per 1000 live births compared with 5·8 nationally. The average percentage of county population reporting FI was 15·4 % in the state v. 11·8 % nationally. Three variables statistically significantly predicted county IMR: percent of county population reporting FI; county population and percent population with diabetes (P values, respectively, < 0·04; < 0·05; < 0·03). These variables explained 42·4 % of the variance of county-level IMR. With the largest standardised coefficient (0·247), FI was the strongest predictor of IMR. CONCLUSIONS: FI, low birth weight and diabetes are positively correlated with infant mortality. While correlation is not causation, addressing FI as part of multifaceted social determinants of health might improve county-level IMR in NC.


Subject(s)
Income , Infant Mortality , Family Characteristics , Food Insecurity , Humans , Infant , North Carolina/epidemiology , United States
11.
SSM Qual Res Health ; 2: 100072, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1757848

ABSTRACT

COVID-19 disproportionately affects racial and ethnic minority groups as well as people in jails and immigration detention centers in the United States. Between April and August of 2020, the mean monthly COVID-19 case ratio for ICE detainees was 13.4 times that of the general U.S. population. This study aims to understand the experiences of detained asylum seekers during the pandemic and to provide insight into COVID-19's impact on this population's health. This qualitative study employed first-person, in-depth narratives obtained from 12 asylum seekers, all of whom were detained in immigration detention centers or prisons during the initial surge of the COVID-19 pandemic and were subsequently released. Detained asylum seekers reported inadequate medical care, obstacles to receiving care, an inability to social distance, poor hygiene, restricted movement, and a lack of infection control-- all which increased their risk of contracting and spreading COVID-19 and exacerbated health inequalities brought to the forefront by the pandemic. Advocating for improved disease prevention and screening, prompt access to health care and treatment, cohorting of infectious cases, and community alternatives to detention to decrease the detained immigrant population sizes are crucial to halt communicability of the virus and its subsequent morbidity and mortality in this vulnerable population.

12.
13.
Journal of Planning Literature ; 37(1):133-133, 2022.
Article in English | Web of Science | ID: covidwho-1755735
14.
Working Papers - Economic Research Southern Africa|2021. (852):34 pp. 35 ref. ; 2021.
Article in English | CAB Abstracts | ID: covidwho-1755692

ABSTRACT

The 1918 influenza - the Spanish flu - killed an estimated 6% of South Africans. Not all were equally affected. Mortality rates were particularly high in districts with a large share of black and coloured residents. To investigate why this happened, we transcribed 39,482 death certificates from the Cape Province. Using a novel indicator - whether a doctor's name appears on the death certificate - we argue that the unequal health outcomes were a consequence of unequal access to healthcare. Our results show that the racial inequalities in health outcomes that existed before October 1918 were exacerbated during the pandemic. Access to healthcare, as we expected, worsened for black and coloured residents of the Cape Province. Unexpectedly, however, we found that other inequalities were unchanged, or even reversed, notably age, occupation and location. Living in the city, for instance, became a health hazard rather than a benefit during the pandemic. These surprising results contradict the general assumption that all forms of inequality are exacerbated during a crisis. Our analyses suggest explanations for the widening racial gap in healthcare access during the 1918 pandemic, from both the demand and the supply side. We could find, however, no evidence of racial prejudice. Our findings confirm the importance of taking race into account in studying the effects of the 2020 Covid-19 pandemic or other world crises.

15.
J Soc Econ Dev ; : 1-15, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-1748368

ABSTRACT

In this paper, we attempt to show how the novel coronavirus disease (COVID-19) has disrupted routine health services in India and has created further inequalities in the society. By taking a few examples of non-COVID diseases and conditions like immunization, maternal health services, tuberculosis and non-communicable diseases, this paper shows how these services have been disrupted by the pandemic. The paper argues that these disruptions have not emerged only as a result of the current crisis, but because of the paradigm shifts in the healthcare delivery in the country towards privatization which have disproportionately marginalized particular sections of the society. The paper concludes by stating that if adequate measures are not taken now to transform the health system and strengthen the public healthcare system, it might lead to catastrophic consequences in the future, especially for the marginalized sections.

16.
Triplec-Communication Capitalism & Critique ; 20(1):62-81, 2022.
Article in English | Web of Science | ID: covidwho-1743819

ABSTRACT

Literature now exists on how the media reports on health inequalities. One compelling concept as to the sources and impacts of health inequalities is "social murder" as articulated by Friedrich Engels in his 1845 volume, The Condition of the Working Class in England, whereby the capitalist economic system sent workers prematurely to the grave to serve the profit motives of the bourgeoisie. There is a reemergence of the concept in the academic literature in response to growing social and health inequalities, but is this material being reported to the public? We examine news content since the turn of the 21st century and find a significant increase since 2017 in reporting that evokes the social murder concept in relation to the Gren-fell Tower Fire, the COVID-19 pandemic, and the imposition of austerity in Canada and the UK. We consider these developments in relation to journalists' roles and their reporting on health inequalities.

17.
Int J Environ Res Public Health ; 19(6)2022 03 15.
Article in English | MEDLINE | ID: covidwho-1742462

ABSTRACT

People experiencing homelessness have higher rates of mental ill-health and substance use and lower access to health services compared to the general population. The COVID-19 pandemic led to changes in service delivery across health and social care services, with many adopting virtual or telephone support for service users. This paper explores the experiences of access to community-based mental health and substance use support for people experiencing homelessness during the COVID-19 pandemic. Qualitative telephone interviews were conducted with 10 women and 16 men (ages 25 to 71) who self-identified as experiencing homelessness in North East England between February and May 2021. With five individuals with lived experience, results were analysed using inductive reflexive thematic analysis. Reactive changes to support provision often led to inadvertent exclusion. Barriers to access included: physical locations, repetition of recovery stories, individual readiness, and limited availability. Participants suggested creating services reflective of need and opportunities for choice and empowerment. Community mental health and substance use support for people experiencing homelessness should ensure the support is personalised, responsive to need, inclusive, and trauma-informed. The findings of this research have important implications for mental health and substance use policy and practice for individuals who experience homelessness during a public health crisis.


Subject(s)
COVID-19 , Homeless Persons , Substance-Related Disorders , Adult , Aged , COVID-19/epidemiology , Female , Homeless Persons/psychology , Humans , Male , Mental Health , Middle Aged , Pandemics , Social Work , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology
18.
Social Medicine ; 15(1):54-60, 2022.
Article in English | Scopus | ID: covidwho-1738185

ABSTRACT

The indigenous American Indian/ Alaskan Native (AI/AN) communities in North America have experienced inequitably higher rates of Covid-19 related morbidity, hospitalisation, and mortality than the majority, non-Hispanic white population. These inequalities are the result of centuries of racism and oppression. Mainstream health services have struggled financially to survive the crisis and are poorly positioned or trained to meet the needs of tribal members. The Indian Health Service, being both poorly funded and often suspect, largely failed to mitigate the impact of Covid-19 on these vulnerable communities. There is an urgent need for the expansion of indigenous led health providers. © 2022, Social Medicine Publishing Group. All rights reserved.

19.
Preventing Chronic Disease ; 18(1), 2021.
Article in English | GIM | ID: covidwho-1726662

ABSTRACT

The objective of this essay is to describe the COVID-19 Comprehensive Response Plan for the Marshallese Community in northwest Arkansas. Although no REACH funding is spent on COVID-19 activities, the community-engaged capacity developed through REACH implementation has provided a strong foundation for the COVID-19 Comprehensive Response Plan. Marshallese in northwest Arkansas have experienced disproportionate rates of COVID-19 infections, hospitalizations, and deaths. These high rates may be due in part to the high incidence of type 2 diabetes in the Marshallese community, a condition that increases the risk of complications and death from COVID-19. Community-based partners funded through a CDC REACH award have built a strong collaborative foundation to address chronic diseases and associated risk factors in the Marshallese community. We have leveraged that collaboration to address COVID-19 disparities through the development and implementation of a COVID-19 Comprehensive Response Plan based on CDC recommendations. Our Comprehensive Response Plan includes increased testing, contact tracing, enhanced case management, and health education. Simultaneously, partners have shifted to remote delivery of health education efforts as we continue to address type 2 diabetes in the Marshallese community. The COVID-19 Comprehensive Response Plan demonstrates how CBPR infrastructure created by the REACH program can be leveraged to reduce health disparities and implement critical CDC recommendations beyond individual grant awards.

20.
J Epidemiol Community Health ; 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1723844

ABSTRACT

BACKGROUND: Adults with intellectual disabilities (ID) may be at higher risk of COVID-19 death. We compared COVID-19 infection, severe infection, mortality, case fatality and excess deaths, among adults with, and without, ID. METHODS: Adults with ID in Scotland's Census, 2011, and a 5% sample of other adults, were linked to COVID-19 test results, hospitalisation data and deaths (24 January 2020-15 August 2020). We report crude rates of COVID-19 infection, severe infection (hospitalisation/death), mortality, case fatality; age-standardised, sex-standardised and deprivation-standardised severe infection and mortality ratios; and annual all-cause mortality for 2020 and 2015-2019. FINDINGS: Successful linkage of 94.9% provided data on 17 203 adults with, and 188 634 without, ID. Adults with ID had more infection (905/100 000 vs 521/100 000); severe infection (538/100 000 vs 242/100 000); mortality (258/100 000 vs 116/100 000) and case fatality (30% vs 24%). Poorer outcomes remained after standardisation: standardised severe infection ratio 2.61 (95% CI 1.81 to 3.40) and mortality ratio 3.26 (95% CI 2.19 to 4.32). These were higher at ages 55-64: 7.39 (95% CI 3.88 to 10.91) and 19.05 (95% CI 9.07 to 29.02), respectively, and in men, and less deprived neighbourhoods. All-cause mortality was slightly higher in 2020 than 2015-2019 for people with ID: standardised mortality ratio 2.50 (95% CI 2.18 to 2.82) and 2.39 (95% CI 2.28 to 2.51), respectively. CONCLUSION: Adults with ID had more COVID-19 infections, and worse outcomes once infected, particularly adults under 65 years. Non-pharmaceutical interventions directed at formal and informal carers are essential to reduce transmission. All adults with ID should be prioritised for vaccination and boosters regardless of age.

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