Health inequalities and diabetes

Inequalities in health care exist in many countries in the world. In 2008 the then UK Secretary of State for Health commissioned the Marmot review, ‘Fair Society, Healthy Lives', to propose strategies to address health inequalities in the UK. Most of Marmot's proposals were not acted upon and in 2020, 10 years after the initial recommendations were published, Marmot found that there had been no improvement and some things were worse. In diabetes care inequalities are widespread, impacting on prevention, treatment, access to technology, screening for complications, risk of complications, morbidity and mortality. Ethnicity is a major risk factor, starkly demonstrated by the increased COVID-19 related mortality in people from minority ethnic groups with diabetes. Disadvantaged groups include, but are not limited to, those with social deprivation, intellectual and physical disabilities and severe mental illness. The decision to shelve the long-awaited white paper on tackling health inequalities, taken recently by the last Secretary of State for Health amid protests from a coalition of medical organisations, makes it unlikely that the government will take the actions proposed by Marmot. In the absence of a national strategy, responsibility to recognise and address inequalities in diabetes care falls on health care professionals, in teams and as individuals. Copyright © 2023 John Wiley & Sons.

Socio-Economic and Health Management of Pandemics Based on Forgotten Effects Theory

Intense and frequent changes increase uncertainty and complexity in decision-making. The COVID-19 pandemic exacerbates this situation. Therefore, the decision-maker seeks to reduce risks and meet these challenges. The manuscript aims to identify cause-effect relationships between variables affecting countries and changes caused by the COVID-19 pandemic and propose an algorithm to facilitate decision-making by identifying forgotten effects. The authors use thematic analysis to synthesize the semi-systematic literature review findings. The applied research uses a quantitative approach through modeling and simulation. The results highlight that the pandemic effects are associated with causes such as health care, political and economic stability, social justice, and the level of corruption. Decision-makers must prioritize the management of these variables guided by science. The main contribution is to show an algorithm that identifies forgotten effects in pandemics' socio-economic and health management, preventing future crises. In addition, the study advances the frontier of knowledge by addressing identified gaps and contributes to academia and policy makers. The most critical limitation is the number of variables included in this research. Future investigations could include analyses on the impact of climate change and sustainable development of nations and country-specific studies on the forgotten effects of the COVID-19 pandemic. © 2022 Taylor & Francis Group, LLC.

A Global South Perspective: The Intersection of COVID-19 and Intimate Partner Violence

Making matters more complicated, the COVID-19 pandemic has proven to be challenging on many fronts, with IPV taking center stage as a major global public health concern, in response to pandemic-related strategies like lockdowns.3,4 In this issue of AJPH, Fereidooni et al. (http://bit.ly/3NV9xG8) undertook an investigation that examined the prevalence of IPV during COVID-19 among Iranian women. [...]they provide empirical data documenting the impact COVID-19 public health prevention measures had on increasing IPV risk for women, with an emphasis on the Global South. [...]they found that a male partner becoming unemployed increased IPV risk for his female partner and that socioeconomic status served as a protective factor for women, both of which are true in Western countries.6 The Fereidooni et al. study serves to further the argument made in other studies that we should unify efforts to address violence against women by providing yet more evidence that IPV is a global public health problem that is not bound by hemisphere, continent, or region.7 CORRESPONDENCE Correspondence may be sent to Regardt Ferreira, School of Social Work, Tulane University, 127 Elk Place, New Orleans, LA 70112-2627 (e-mail: rferrei@tulane.edu).

The effects of the COVID-19 pandemic on the mental health of workers and the associated social-economic aspects: A narrative review.

BACKGROUND: The COVID-19 pandemic has struck nations worldwide, pushing worldwide health and socio-economic systems to extreme limits. Upon exposure to an exceeding number of patients and supply shortages, the resilience of healthcare resources has been broadly challenged. OBJECTIVE: We will firstly discuss the mental health turmoil during the COVID-19 pandemic as the primary focus of this study and delve into the mental health repercussions among the workforce. Also, we debate the risk factors, particularly highlighting the impact of social behaviors and media exposure. We examine the pandemic's impact on occupational health services. Secondly, we thoroughly discuss the effect of socio-economic and race disparities in the COVID-19 contraction and the related psychologic sequelae. Economic outcomes are also highlighted, particularly alterations in poverty rates and occupational sectors. METHODS: Peer-reviewed reports were extracted through Embase, PubMed, and Google Scholar until June 2022. RESULTS: A constellation of untoward spillover effects of the pandemic, including dramatic changes in public and workplace environments, enduring curfew, and low wages, have put socio-economic aspects of daily life under exuberant strain. Indeed, occupational and public health stakeholders presume a coinciding social crisis to occur, provided the pandemic's implications on socioeconomics and psychological wellbeing are not addressed well with evidence-based approaches and peer services. CONCLUSION: Evaluating the socio-economic and mental health impact is imperative to cope with the pandemic. Also, we should assess the predisposing and protecting factors in a broad array of life aspects associated with COVID-19.

Individual and neighborhood risk factors of hospital admission and death during the COVID-19 pandemic: a population-based cohort study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) disproportionately affects minority populations in the USA. Sweden - like other Nordic countries - have less income and wealth inequality but lacks data on the socioeconomic impact on the risk of adverse outcomes due to COVID-19. METHODS: This population-wide study from March 2020 to March 2022 included all adults in Stockholm, except those in nursing homes or receiving in-home care. Data sources include hospitals, primary care (individual diagnoses), the Swedish National Tax Agency (death dates), the Total Population Register "RTB" (sex, age, birth country), the Household Register (size of household), the Integrated Database For Labor Market Research "LISA" (educational level, income, and occupation), and SmiNet (COVID data). Individual exposures include education, income, type of work and ability to work from home, living area and living conditions as well as the individual country of origin and co-morbidities. Additionally, we have data on the risks associated with living areas. We used a Cox proportional hazards model and logistic regression to estimate associations. Area-level covariates were used in a principal component analysis to generate a measurement of neighborhood deprivation. As outcomes, we used hospitalization and death due to COVID-19. RESULTS: Among the 1,782,125 persons, male sex, comorbidities, higher age, and not being born in Sweden increase the risk of hospitalization and death. So does lower education and lower income, the lowest incomes doubled the risk of death from COVID-19. Area estimates, where the model includes individual risks, show that high population density and a high percentage of foreign-born inhabitants increased the risk of hospitalization. CONCLUSIONS: Segregation and deprivation are public health issues elucidated by COVID-19. Neighborhood deprivation, prevalent in Stockholm, adds to individual risks and is associated with hospitalization and death. This finding is paramount for governments, agencies, and healthcare institutions interested in targeted interventions.