International Journal for Equity in Health最新文献

{"title":"Exploring good mental health for people with intellectual disabilities: a qualitative interview study with mental health experts.","authors":"Sophie Komenda-Schned, Paula Moritz, Sarah Jasmin Landskron, Alma Rosa Herscovici, Charlotte Schomburg, Julia Lehner, Brigitte Lueger-Schuster, Luis Salvador-Carulla, Elisabeth Lucia Zeilinger","doi":"10.1186/s12939-025-02540-0","DOIUrl":"10.1186/s12939-025-02540-0","url":null,"abstract":"<p><strong>Background: </strong>Most mental health research focuses on mental disorders, with a paucity of studies exploring good mental health. Widely used definitions of good mental health (e.g., WHO's) include several aspects of positive human functioning as predisposing to mental health. According to diagnostic criteria, people with intellectual disabilities (ID) are impaired in their functioning levels (e.g., intellectual functioning, adaptive skills). Existing definitions of good mental health may therefore not be applicable to an ID population.</p><p><strong>Objective: </strong>We aimed to explore the perspectives of experts on good mental health in people with ID to shed light on the constitutive factors of good mental health in this population.</p><p><strong>Methods: </strong>Semi-structured expert interviews with open-ended questions (N = 12) were conducted with psychiatrists, psychologists, psychotherapists, and psychiatric nurses, working either academically or in practice with this population. Inductive, reflexive thematic analysis was applied to analyze and synthesize the data.</p><p><strong>Results: </strong>Four themes regarding components of good mental health in people with ID were derived: (1) Absence of Mental Illness, (2) Physical Health, (3) Psychosocial Functioning, and (4) Social Environment. Psychosocial functioning was divided into five subthemes, namely: (1) Emotional Competence, (2) Self-Concept, (3) Experience of Meaning, (4) Self-Determination, and (5) Personal Growth.</p><p><strong>Conclusions: </strong>According the participants of this study, the constitutive factors of good mental health are similar for people with and without ID. The importance of needs-based, individualized support and an appropriate social environment was particularly emphasized for people with ID, to facilitate positive human functioning and promote good mental health.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"172"},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palestinian dermatology: exploring policies, challenges, and opportunities in fragile and conflict-affected settings.","authors":"Sari Taha","doi":"10.1186/s12939-025-02551-x","DOIUrl":"10.1186/s12939-025-02551-x","url":null,"abstract":"<p><strong>Background: </strong>Contributions to global dermatology from the Arab World in general, and Palestine in particular, have been limited. The protracted conflict-related challenges and the fragile health system are barriers to development in national dermatological practice and research. This commentary discusses these challenges and proposes contextual solutions.</p><p><strong>Main body: </strong>The healthcare system has failed to provide affordable, accessible, and effective dermatological services. Limited patient access to health services can be ascribed to disorganized primary care and inadequate referral coordination across levels of care, leading patients to seek private dermatological services. This is exacerbated by a shortage of dermatologists and poor dermatological practices among healthcare professionals. Moreover, the limited production of dermatological research is attributed to the shortage of specialized human resources, the poor research infrastructure, and the lack of interest in dermatological research. However, two educational developments have been introduced, but are unlikely to result in significant overall progress in dermatological practice and research: a new dermatology residency training and a skincare academy with a bachelor's program affiliated with a major Palestinian university.</p><p><strong>Conclusions: </strong>Efforts to strengthen local dermatological care should capitalize on the recent developments to build capacity in primary care, enhance coordination with specialized services, and improve the new residency program design.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"170"},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Messages dissemination regarding covid-19 by street posters: the case of the ultra-Orthodox community in Israel.","authors":"Sima Zalcberg-Block","doi":"10.1186/s12939-025-02445-y","DOIUrl":"10.1186/s12939-025-02445-y","url":null,"abstract":"<p><strong>Background: </strong>Religious minority groups posed challenges to health authorities in Western countries, by violating guidelines for fighting Covid-19, many times from lack of access to relevant health information. This phenomenon occurred among the ultra-Orthodox (Haredi) population in Israel - a religious minority whose many members violated Israeli Ministry of Health guidelines, causing high rates of infection.</p><p><strong>Objective: </strong>The study aims to examine messages dissemination regarding Covid-19, among the ultra-Orthodox community in Israel, via an alternative-\"traditional\"-communication channel used by this community over the years: street posters (pashkevils).</p><p><strong>Method: </strong>Thematic analysis of 20 pashkevils collected during the first year of Covid-19.</p><p><strong>Results: </strong>Findings revealed three major discourses emerging via these pashkevils: A medical support discourse, calling for compliance with medical authority guidelines; An oppositional discourse, expressing strong objection toward medical authority guidelines; and a theological discourse, explaining the pandemic in theological terms, mainly related to immodesty.</p><p><strong>Conclusion: </strong>Findings provide insights regarding the ability of religious leadership to take action to influence the health of the ultra-Orthodox community by disseminating messages and controlling access to information; the intersection of communication, religion, and health; the importance of identifying communication channels unique to religious minorities in order to learn their perspectives regarding health behaviors; and to use these channels for culturally adapted information dissemination.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"169"},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health inequities in medical crowdfunding: a systematic review.","authors":"Yingying Cai, Syafila Kamarudin, Xiaoyu Jiang, Baiyu Zhou","doi":"10.1186/s12939-025-02543-x","DOIUrl":"10.1186/s12939-025-02543-x","url":null,"abstract":"<p><strong>Background: </strong>Medical crowdfunding has emerged as a popular strategy to offset healthcare expenses in contexts of limited insurance coverage. While often framed as a democratizing and accessible financial tool, growing evidence indicates that success is unevenly distributed, raising concerns about its role in exacerbating health inequities.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines, drawing from PubMed, CINAHL, Embase, Web of Science, and Scopus. Of 1,462 screened records, 33 studies met the inclusion criteria. Guided by the PROGRESS framework, we extracted data on socioeconomic determinants of health disparities. An inductive content analysis was employed to identify how equity was assessed across studies.</p><p><strong>Results: </strong>We identified three key categories of metrics used to assess equity in medical crowdfunding: funding outcomes, campaign visibility, and donor participation. Across these domains, substantial disparities were observed. Campaigns in rural or economically disadvantaged areas tended to have lower success rates. Racial and ethnic inequities were consistently documented, with non-white individuals receiving fewer and smaller donations than white counterparts. Gender disparities were complex, especially in transgender-related campaigns. Socioeconomic status and educational attainment were significantly associated with outcomes, accompanied by differences in access to social capital and the ability to craft persuasive narratives. In regions with high medical debt or limited insurance coverage, more crowdfunding campaigns appeared, but with lower overall success. These inequities were shaped and reinforced by platform algorithms and design features that privileged users with preexisting advantages.</p><p><strong>Conclusions: </strong>Rather than serving as a corrective to healthcare access gaps, medical crowdfunding often reflects and reinforces structural inequities. These findings challenge its portrayal as an equitable financing solution and highlight the need for policy interventions to ensure fairer access to healthcare resources.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"166"},"PeriodicalIF":4.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and inequalities in stunting and underweight among children aged 0-59 months in Ghana, 1993-2022.","authors":"Augustus Osborne, Camilla Bangura, Umaru Sesay, Bright Opoku Ahinkorah","doi":"10.1186/s12939-025-02519-x","DOIUrl":"10.1186/s12939-025-02519-x","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"168"},"PeriodicalIF":4.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Still we rise: research on bias and discrimination will endure.","authors":"Gregg S Gonsalves","doi":"10.1186/s12939-025-02537-9","DOIUrl":"10.1186/s12939-025-02537-9","url":null,"abstract":"<p><p>This is a commentary on Reisner et al's Analyzing multiple types of discrimination using implicit and explicit measures, comparing target vs. Dominant groups, in a study of smoking/vaping among community health center members in Boston, Massachusetts (2020-2022). This manuscript is a study of the intersection of multiple forms of discrimination-racism, sexism, heterosexism, cissexism, ageism, and sizeism-and measures of implicit and explicit bias in the context of current smoking and vaping behavior among patients from targeted versus dominant groups at community health centers in Boston, Massachusetts (USA) from 2020 to 2022. The authors used logistic regression to assess smoking and vaping behavior with each type of discrimination, and then extended this analysis employing a meta-regression approach to better understand relationships across all types of discrimination under consideration in their study. Recently, the grant from the US National Institutes of Health, which supported this research was terminated in progress for ideological reasons by the current US administration under President Donald J. Trump for simply focusing on discrimination. While this study was among the first to be terminated by the Trump administration, hundreds of grants from the NIH and other US research funders have been cancelled in the first half of 2025. Reisner et al's paper is an important piece of research, but it represents the start of a sophisticated inquiry into discrimination and bias, and future work by this team and in this area of research is necessary and sadly, now impossible to do with federal scientific funding. Work on discrimination and bias has always faced obstacles, but the scope and scale of attacks on science in the US require all scientists to push back against this censorship and political interference in the funding and conduct of research.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"167"},"PeriodicalIF":4.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-drawing the map: a case study of decolonized research methods & methodologies.","authors":"Maya Stevens-Uninsky, Najuwa Gallant, Tashreeq Chatting, Deborah D DiLiberto, Russell de Souza, Lawrence Mbuagbaw","doi":"10.1186/s12939-025-02539-7","DOIUrl":"10.1186/s12939-025-02539-7","url":null,"abstract":"<p><strong>Background: </strong>Decolonized research methodologies aim to challenge existing power structures and amplify community voices, yet there is little guidance on their practical application. This study documents the methodological process, adaptations, and outcomes of applying decolonized research methods in a qualitative exploratory study on adolescent sexual and reproductive health in Freedom Park, South Africa.</p><p><strong>Methods: </strong>This study is a methods documentation of lessons learned in an exploratory study. We applied a decolonized methodology, which incorporated elements of PAR, Indigenous, and co-design research approaches, engaging a Community Advisory Committee to collaboratively design research and data collection methods.</p><p><strong>Results: </strong>We used the research processes of this study to demonstrate how decolonized methodologies can be applied and integrated into research. The Community Advisory Committee's involvement resulted in a unique adaptation of body mapping that was culturally relevant, and prioritized anonymity, community context, and participant comfort. The research process emphasized reciprocity, non-hierarchical collaboration, and collective knowledge production, challenging traditional Western research paradigms. Participants were highly engaged, and the adapted method facilitated open discussions on sexual and reproductive health topics that might otherwise be stigmatized.</p><p><strong>Conclusions: </strong>This study illustrates how decolonized methodologies can be effectively implemented through community co-design, centering local knowledge while addressing power imbalances in research. The findings highlight the importance of self-determination in research design and the potential for adapted participatory methods to enhance data validity and community impact. Future research should continue to explore and document practical applications of decolonized methodologies to inform ethical and contextually appropriate research practices.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"165"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does global capitation prospective payment promote integrated delivery networks? Evidence from China's compact county medical communities.","authors":"Longyan Cui, Gang Yin, Gao Lan Xin Dai, Hongbing Tao","doi":"10.1186/s12939-025-02490-7","DOIUrl":"10.1186/s12939-025-02490-7","url":null,"abstract":"<p><strong>Background: </strong>Compact county medical communities (CCMCs) have emerged as a key strategy to strengthen primary healthcare delivery in China. The objective of this study was to assess the impact of the global capitation prospective payment (GCP) reform on CCMCs performance.</p><p><strong>Methods: </strong>This research collected data from 2018 to 2022 across three pilot regions in China. Using interrupted time series analysis (ITSA), we assessed how the implementation of GCP affected CCMCs development.</p><p><strong>Results: </strong>The ITSA results show that the average length of stay at the lead hospital decreased by 0.105 days (P < 0.001) after the reform in pilot A, while the average hospital cost increased by 62.272 yuan per month (P < 0.05). The lead hospital in Pilot B had a decrease in average inpatient costs of 54.203 yuan per month (P < 0.001). Conversely, Pilot C's the lead hospital had an increase in average inpatient costs of 26.610 yuan per month (P < 0.001), and the average length of stay at the lead hospital increased by 0.028 days (P < 0.05).</p><p><strong>Conclusion: </strong>GCP has reasonably promoted the benign development of CMCCs. However, the diversity of strategies and operations has resulted in a different focus on effectiveness. Based on local resource endowments, future reforms should pay more attention to the synchronization of payment reforms and organizational changes.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"164"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in inpatient treatment and expenditures among lung cancer patients under tiered social health insurance: a population-based study in China.","authors":"Yaoyun Zhang, Yu He, Qing Wang, Ying Meng, Xinxin Xia, Xiaokang Ji, Qingbo Zhao, Yongchao Wang, Yifu Zhao, Chao Lv, Liming Zhu, Ding Wang, Suping Ling, Fuzhong Xue, Jin Xu","doi":"10.1186/s12939-025-02533-z","DOIUrl":"10.1186/s12939-025-02533-z","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"163"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring perceptions on vulnerabilities and resilience to scabies among street children: a qualitative study in Ethiopia.","authors":"Desta Ayode, Bewunetu Zewude, Gail Davey, Shahaduz Zaman, Getnet Tadele","doi":"10.1186/s12939-025-02529-9","DOIUrl":"10.1186/s12939-025-02529-9","url":null,"abstract":"<p><strong>Background: </strong>Scabies is a Neglected Tropical Disease (NTD) and a significant public health concern in resource-limited settings. While the prevalence and burden of scabies in Ethiopia have been well documented among the general population, little attention has been given to the perspectives of street children on their vulnerability to this condition. This study aims to explore street children's views on their perceived susceptibility to scabies, the role of gender in this vulnerability, and their resilience strategies.</p><p><strong>Methods: </strong>A qualitative ethnographic study was conducted from March to May 2024 across three Ethiopian cities: Addis Ababa, Hawassa, and Adama. Data were collected through in-depth interviews (IDIs), participatory group discussions (PGDs), key informant interviews (KIIs), and non-participant observations. To ensure diverse representation of informants, a purposive sampling approach was used to recruit 66 street children, 15 parents, and 15 key informants. Thematic analysis was employed to analyze and interpret the data.</p><p><strong>Findings: </strong>Although some street children could describe typical scabies symptoms, the study uncovered widespread misconceptions and limited understanding of the causes and prevention of the disease. Many children viewed scabies as contagious and linked to poor personal hygiene, but did not mention mites as agents, and considered scabies an inevitable consequence of street life. Participants believed scabies was prevalent among street children due to overcrowding, and close contact with infected peers. Male street children reported higher perceived vulnerability than their female counterparts, attributing this to differences in working conditions, access to hygiene facilities, and societal attitudes. Peer support networks, support from charities, and personal resilience were seen as key factors in coping with the condition.</p><p><strong>Conclusions: </strong>Peer-led, integrated health education interventions are crucial in reducing street children's vulnerability to scabies. These efforts should actively engage street children and their support networks. Additionally, gender-specific interventions should be developed to address the unique vulnerabilities of male and female street children, tailoring health communication accordingly.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"162"},"PeriodicalIF":4.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}