International Journal for Equity in Health最新文献

{"title":"Do subsidies reach the sick? Implementation challenges and equity implications of pharmaceutical subsidy reform in Iran: a qualitative study.","authors":"Anahita Behzadi, Amirhossein Fatahpour, Maliheh Ghobadi, Maryam Amiresmaili","doi":"10.1186/s12939-026-02948-2","DOIUrl":"10.1186/s12939-026-02948-2","url":null,"abstract":"<p><strong>Background: </strong>Pharmaceutical subsidy reforms are commonly implemented to improve access to essential medicines, strengthen financial protection, and enhance the sustainability of health systems. In Iran, the Darooyar policy was introduced to shift pharmaceutical subsidies from subsidized foreign exchange allocation toward consumer-oriented insurance coverage. Despite its policy importance, limited evidence exists regarding the implementation challenges of this reform from the perspective of health system stakeholders.</p><p><strong>Methods: </strong>This qualitative study was conducted using an inductive thematic analysis approach. Data were collected through 27 semi-structured interviews with policymakers, pharmaceutical sector managers, insurance experts, and stakeholders involved in the regulation and implementation of the policy. Participants were selected through purposive and snowball sampling to ensure diversity in organizational affiliation and implementation experience. Data were analyzed following Braun and Clarke's six-step thematic analysis framework.</p><p><strong>Results: </strong>The findings revealed that implementation of the pharmaceutical subsidy reform in Iran was associated with complex challenges related to financing, governance, inter-organizational coordination, and implementation infrastructure. Major challenges included unstable financial resources, delayed reimbursements, liquidity shortages across the pharmaceutical supply chain, institutional fragmentation, weak coordination among responsible organizations, and insufficient monitoring and information systems. Participants also highlighted tensions between maintaining financial protection for patients and ensuring the rational use of medicines. Although the policy was perceived to have reduced reverse drug smuggling and improved insurance coverage, weaknesses in governance arrangements and implementation capacity constrained its effectiveness.</p><p><strong>Conclusion: </strong>The study demonstrates that pharmaceutical subsidy reform is not solely an economic intervention but a complex governance process whose success depends on financial sustainability, institutional transparency, implementation capacity, and coordination among health system actors. Strengthening accountability mechanisms, developing integrated monitoring systems, and improving inter-organizational coordination may enhance the effectiveness and sustainability of pharmaceutical reforms in resource-constrained health systems.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470400","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":"Unheard voices in oral health: the mouth, oral health, and barriers to accessing dental care in disadvantaged communities and Venezuelan migrants in Bogotá.","authors":"Luis Alberto Sánchez-Alfaro, María Kamila Navarro-Ramírez, Roger Keller Celeste, Richard G Watt, Michelle Stennett, Alastair Ross, Regina Mutave, Mirai Chatterjee, Starry John D'Cruz, Paulo Sávio Angeiras de Goes, David I Conway, Carol C Guarnizo-Herreño","doi":"10.1186/s12939-026-02925-9","DOIUrl":"10.1186/s12939-026-02925-9","url":null,"abstract":"<p><strong>Background: </strong>Research on barriers to oral healthcare in Colombia shows that access is restricted by the uneven geographical distribution of dental providers and high out-of-pocket costs for patients, particularly affecting poor populations, residents of marginalised areas, and people in vulnerable situations. This study aimed to explore the significance given to the mouth, oral health, and the barriers to accessing dental care based on the experiences of people belonging to disadvantaged communities and Venezuelan migrants in Bogotá, Colombia.</p><p><strong>Methods: </strong>An exploratory qualitative study with a phenomenological approach was conducted. Two data collection tools were used: field diaries and semi-structured interviews. A hermeneutic-phenomenological analysis was performed using a process that included: coding and establishing general units of meaning (initial categorisation), arranging and grouping data (relevant units of meaning); and triangulation of sources and face-to-face validation between researchers.</p><p><strong>Results: </strong>Three units of meaning were identified: personal confidence and social interaction, barriers to access, and bureaucratic itineraries and dehumanisation. Although the mouth and oral health were identified as fundamental to people's lives, playing a crucial role in social interactions and self-esteem, people belonging to vulnerable and marginalised communities experience significant barriers that hinder access to oral health care. The main barriers identified were geo-economic and technological.</p><p><strong>Conclusions: </strong>The bureaucracy of the Colombian health system exacerbates the situation, contributing to the high burden of oral diseases and leaving people without timely care. Public policies must focus on reducing these barriers to ensure equity and effective exercise of the human right to oral health.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470373","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":"Healthcare experiences of refugees and asylum-seekers resettled in non-metropolitan high-income settings: a systematic review and thematic synthesis of qualitative evidence.","authors":"K J Woodward, R B Kirk, G A Borchert, N Roberts, C Pope, S Tierney","doi":"10.1186/s12939-026-02933-9","DOIUrl":"10.1186/s12939-026-02933-9","url":null,"abstract":"<p><strong>Background: </strong>To address imbalances in the distribution of refugees and asylum-seekers during resettlement in high-income countries, some governments are employing dispersal strategies to extend resettlement beyond major cities. However, with populations in non-metropolitan areas facing well-documented differences in healthcare access and outcomes compared to their city counterparts, it is essential to consider the human impact of these resettlement policies. The primary aim of this study was to understand the healthcare experiences of refugees and asylum-seekers living in rural, regional, and other non-metropolitan areas of high-income countries. The secondary aim was to identify factors that influence these experiences.</p><p><strong>Methods: </strong>A thematic synthesis of qualitative or mixed-methods studies was undertaken. We searched seven electronic databases, Medline(OvidSP), Embase(OvidSP), PsycINFO(OvidSP), CINAHL(EBSCOHost), Social Science Citation Index(Web of Science Core Collection), BIOSIS Citation Index(Web of Science) and ASSIA(Proquest), up to October 6, 2025, for articles in English reporting qualitative data on the healthcare experiences of refugees and asylum seekers. At least two reviewers contributed to all review stages, including quality assessment.</p><p><strong>Results: </strong>Seventeen articles representing fourteen studies were included, capturing the experiences of 347 refugees and asylum-seekers. We developed descriptive themes characterising everyday healthcare experiences, from which analytical themes were produced to describe underlying determinants of these experiences: The Domains of Influence, The Power of the Social, and The Rural Effect. These findings explain how the convergence of a refugee or asylum-seeker's individual, sociocultural, environmental, and political realities shape their healthcare experiences after resettlement in a rural area. They highlight how rurality and place interact with social and structural determinants of health to intensify both the supportive dimensions of small-community life and the barriers and inequities produced by limited resources, distance, and geographic isolation.</p><p><strong>Conclusions: </strong>Despite policies promoting non-metropolitan resettlement in high-income countries, research on the healthcare experiences of refugees and asylum seekers in these areas remains limited. This review both characterises these experiences and suggests factors that shape them, which can inform healthcare providers and policymakers in addressing health inequities.</p><p><strong>Registration: </strong>PROSPERO CRD42024553190.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446275","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":"Gender inequities in the economic burden of anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis in Mexico, 2005-2021.","authors":"Carlos Manuel Guerrero-López, Edson Serván-Mori, Jeanette Godínez-Alejandre, Stephen Jan, Laura Downey, Héctor Gómez-Dantés, Robyn Norton","doi":"10.1186/s12939-026-02873-4","DOIUrl":"https://doi.org/10.1186/s12939-026-02873-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis are common chronic conditions that contribute substantially to disability, recurrent care needs, and productivity losses, yet remain comparatively under-prioritised in health policy. In Mexico, these conditions disproportionately affect women, but their economic burden has not been comprehensively quantified from a gender perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To estimate the direct and indirect economic burden of anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis in Mexico among adults aged 20 years and older between 2005 and 2021, from a societal perspective and by gender.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cost-of-illness analysis from a societal perspective. Direct costs were estimated by combining condition-specific prevalence from the Global Burden of Disease Study 2021 (GBD 2021) with normative per-case treatment costs derived from national clinical guidelines and official cost sources. Indirect costs were valued using three complementary approaches: the Human Capital Approach (HCA), based on predicted annual labour income from nationally representative employment surveys; a GDP-per-capita benchmark (1 DALY = 1 GDP per capita); and a willingness-to-pay approach using the value of a statistical life year (VSLY) transferred to Mexico following OECD methods. All costs were expressed in 2021 international dollars (Int$).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between 2005 and 2021, the four disorders accounted for 28.8 million DALYs lost. Migraine was the most prevalent condition, but depressive disorders generated the highest direct costs (Int$310.5 billion) and the largest share of indirect costs (41.1%). Indirect costs totalled Int$106.8 billion under the HCA, Int$582.2 billion under the GDP-per-capita valuation, and Int$2.9 trillion under the willingness-to-pay approach. Under the GDP-per-capita benchmark, the combined economic burden of the four disorders reached approximately Int$1.2 trillion over the study period. Women consistently bore a greater burden than men across all four conditions and under all valuation methods; total indirect costs borne by women were 2.0 times higher for anxiety disorders, 2.1 times higher for depressive disorders, 2.2 times higher for migraine, and 3.8 times higher for rheumatoid arthritis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis impose a substantial and unequally distributed economic burden in Mexico. The persistent excess burden among women indicates that these high-disability chronic disorders should be understood not only as a public health problem, but also as a health equity concern. More gender-responsive priority setting, stronger continuity of care, and better financial protection may help reduce both disability and its downstream economic consequences in Mexico and other LMICs with s","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating sexual healthcare: a qualitative study on experiences, STI knowledge, and information sources among migrant men who have sex with men in the Netherlands.","authors":"Chrissy P B Moonen, Christian J P A Hoebe, Casper D J den Heijer, Jill Buursma, Marita I L S Werner, Ymke J Evers, Nicole H T M Dukers-Muijrers","doi":"10.1186/s12939-026-02938-4","DOIUrl":"10.1186/s12939-026-02938-4","url":null,"abstract":"<p><strong>Background: </strong>Migrant men who have sex with men (mMSM) may face barriers in accessing sexual healthcare and information, contributing to health disparities, as they are at increased risk of exposure to sexually transmitted infections (STIs), including HIV, hepatitis B, and hepatitis C. To better understand how healthcare systems can be made more equitable and responsive to mMSM's needs, this qualitative study explored (1) mMSM's experiences with sexual healthcare in their countries of origin and in the Netherlands, (2) STI and prevention knowledge, and (3) sources of sexual health information.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 15 mMSM aged 16 years and older from Eastern Europe, South/Central America, Asia, and Africa between December 2023 and April 2024. mMSM were recruited purposively by sexual health nurses at Dutch Public Health Service STI clinics in South Limburg, via snowball sampling and flyers until data saturation was reached. Interviews were transcribed verbatim and thematically analysed in ATLAS.ti using deductive and inductive coding by two independent researchers. Intercoder agreement was reached through consensus.</p><p><strong>Results: </strong>mMSM reported limited and fragmented access to sexual healthcare in their country of origin, often shaped by stigma, taboos, and limited information, rather than uniformly poor care. Awareness of common STIs, particularly HIV, was high, although depth and accuracy of knowledge varied, while knowledge of hepatitis C was minimal or absent. Most participants were aware of HIV pre-exposure prophylaxis (PrEP) and hepatitis B vaccination, although detailed knowledge of correct use and underlying conditions was often limited or fragmented. In contrast, awareness and knowledge of post-exposure prophylaxis (PEP) were limited. Main sexual health information sources included general internet search engines, sexual health professionals, and the interpersonal social network, with differences in perceived reliability and accessibility between these sources.</p><p><strong>Conclusions: </strong>Availability of sexual healthcare alone does not ensure equitable access for mMSM; barriers such as language, trust, and information gaps persist, highlighting the need for culturally responsive, stigma-free care and targeted prevention education.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420721","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":"'It's not just about food': Living with celiac disease as a woman.","authors":"Narges Naderi, Bardia Amidi, Javad Yoosefi Lebni, Saleh Azadbakht","doi":"10.1186/s12939-026-02947-3","DOIUrl":"10.1186/s12939-026-02947-3","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CeD) is a chronic autoimmune condition requiring lifelong adherence to a gluten-free diet. This disease is associated with a considerable psychosocial burden, particularly among women. Despite the relatively high prevalence of CeD in Iran, there is limited data on the lived experiences of Iranian women living with the condition.</p><p><strong>Objective: </strong>To explore the lived experiences and challenges of women living with CeD in Lorestan Province, Iran.</p><p><strong>Methods: </strong>A qualitative phenomenological study was conducted in 2025. Twenty women with a confirmed diagnosis of CeD participated in semi-structured face-to-face or telephone interviews. The data were analyzed using Colaizzi's seven-step method with the support of MAXQDA software. Trustworthiness was ensured employing Guba and Lincoln's criteria.</p><p><strong>Results: </strong>Participants described living with CeD as a multidimensional burden that extended far beyond food restrictions. They experienced notable psychological distress, including sadness, anxiety, and helplessness, mainly due to living with a long-term condition that is often misunderstood by others. Limited awareness among family members and friends often led to tension and strain in relationships. In addition, participants reported experiencing stigma and mockery, and many felt they had to keep their illness secret, which led to feeling socially isolated. The participants also reported considerable challenges in maintaining a strict gluten-free diet. The high cost, limited access, and poor quality of gluten-free products contributed to financial strain and, in some cases, dependence on others. Furthermore, a delayed diagnosis and inconsistent medical advice added to participants' uncertainty and reduced their trust in healthcare providers. These experiences affected their daily routines, family responsibilities, and social life. Thus, CeD affected nearly every part of women's personal, social, and family life.</p><p><strong>Conclusion: </strong>CeD has a major impact on women's mental health, social life, finances, and family relationships. To address these issues, care should be more patient-centered and involve collaboration among different healthcare professionals. Improved training for healthcare providers and stronger psychological and social support can help patients manage the condition. Policy-level actions are also required to increase the availability and affordability of gluten-free products.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420765","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":"Timeliness gap in non‑EPI Childhood vaccination in urban China: a five-city study of socioeconomic determinants and caregiver preferences.","authors":"Linchen Chu, Kangning Sheng, Jiajun Li, Kan Chen, Yi Zhou, Hongni Wang, Liuren Zhang, Jing Wu, Chuanxi Fu","doi":"10.1186/s12939-026-02945-5","DOIUrl":"10.1186/s12939-026-02945-5","url":null,"abstract":"<p><strong>Background: </strong>Delays in receiving vaccinations lead to higher vaccine-preventable disease risk. We quantified the prevalence and drivers of delayed uptake of fee‑based, non-Expanded Program on Immunization (non-EPI) childhood vaccines in urban China.</p><p><strong>Methods: </strong>A multicentre clinic-based survey with an embedded discrete-choice experiment (DCE) was conducted from May to July 2024 in 15 immunisation clinics across five provincial capitals in China. Caregivers of children aged 0-6 years provided verified vaccination information, socio demographic data, scores on a 12 item Caregiver Timely Vaccination Scale, and responses to a DCEwith four attributes (price, waiting time, calendar delay, adverse event [AE] risk). Delayed vaccination was defined as receipt of at least one non-EPI dose 30 days or more after the recommended schedule.Weighted logistic regression identified correlates; mixed logit models generated marginal utilities and willingness to pay (WTP).</p><p><strong>Results: </strong>Among 1 292 valid caregiver-child pairs, the delay prevalence was 23.7% (95%CI: 21.3-26.1). Delay risk increased with monthly household income < ¥10 000 (adjusted OR: 1.24, 95% CI: 1.11-1.38), an unpleasant prior vaccination experience (1.11, 1.01-1.23) and a caregiver's delay history (1.22, 1.10-1.36), and less likely when knowledge was adequate (0.33, 0.25-0.43). The timely scale discriminated delayed from timely caregivers (+ 1.0 mean score). In the DCE, AE risk dominated all other attributes (66.3% relative importance): lowering the stated risk from 5% to 3% increased predicted uptake by 74% points. Reducing queue time from 30 min to 10 min added 24 points. Caregivers were willing to pay ¥106 (≈ US $14) per 1% AE‑risk reduction but only ¥4 for a 10‑day improvement in calendar timeliness.</p><p><strong>Conclusions: </strong>Delayed vaccination drives non-EPI under timeliness in urban China. Embedding delay metrics and the brief 3 C screen in routine dashboards, supported by sharper AE‑risk communication and fast‑track queues, could close the gap and advance Immunization Agenda 2030 targets.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420797","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":"Long-term trends and factors associated with migrant participation in Korea's National Health Screening Program: a nationwide retrospective population-based study.","authors":"Woojin Jang, Hyeon-Kyoung Cheong, YongJoo Rhee, In-Hwan Oh","doi":"10.1186/s12939-026-02941-9","DOIUrl":"10.1186/s12939-026-02941-9","url":null,"abstract":"<p><strong>Background: </strong>Migrant health is an increasingly important future determinant of population health in Korea due to growing migrant numbers. Preventive care inequalities affecting migrants may receive limited attention, however because of relative health advantages at their time of arrival and because downstream adverse outcomes may not yet be apparent in this group. In this context, Korea's National Health Screening Program (NHSP), which is largely free at the point of use, provides a valuable window into early disparities in preventive care participation. We aimed to quantify 15-year disparities in Korea's National Health Screening Program (NHSP) participation between migrants and non-migrants, identify associated factors, and assess the persistence of these gaps, even among long-term enrollees after covariate adjustment.</p><p><strong>Methods: </strong>In this retrospective population-based cohort study using linked nationwide administrative data from the Korean National Health Insurance Service and National Health Screening Program records, 1,244,820 migrants and 2,050,771 non-migrants eligible in 2022 were analyzed. Annual participation trends from 2008 to 2022 were examined using crude and age-standardized rates. Multivariable logistic regression among individuals continuously enrolled for ≥ 10 years assessed the independent association of migrant status with ever having undergone screening by 2022.</p><p><strong>Results: </strong>Age-standardized participation rates were consistently lower among migrants throughout 2008-2022. In 2022, crude participation was 40.3% among migrants and 53.5% among the non-migrant comparison group, whereas age-standardized rates were 31.5% and 38.8%, respectively. Among long-term enrollees, migrants had significantly lower adjusted odds of ever having undergone screening by 2022 (adjusted OR 0.18, 95% CI 0.18-0.19).</p><p><strong>Conclusions: </strong>Screening participation disparities persisted throughout the study period and remained evident even among migrants continuously enrolled in National Health Insurance for more than a decade. After multivariable adjustment, this disparity was more pronounced than the crude comparisons suggested. In the context of Korea's ongoing demographic change, these findings underscore the importance of early identification and management of migrant screening inequalities. Migrant-tailored, multilingual, and navigation-supported strategies are needed to reduce the risk of preventive care gaps becoming more deeply rooted health inequalities.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420734","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":"Financial strain and sleep problems in the United Kingdom: longitudinal patterns by race-ethnicity.","authors":"Lei Chai, Cheng Chow, Kazumi Tsuchiya","doi":"10.1186/s12939-026-02931-x","DOIUrl":"10.1186/s12939-026-02931-x","url":null,"abstract":"<p><strong>Background: </strong>Financial strain is a well-established risk factor for poor sleep, yet few studies have examined whether this association varies by race-ethnicity, particularly using longitudinal data. This study investigates the relationship between financial strain and multiple dimensions of sleep, including sleep quality, sleep disturbance, daytime dysfunction, sleep latency, and sleep medication use, across White, Black, Mixed, Asian, and Other racial-ethnic groups.</p><p><strong>Methods: </strong>Data were drawn from Waves 4, 7, 10, and 13 of the UK Household Longitudinal Study (N = 36,544 individuals; 114,164 person-years). Fixed-effects regression models were applied to assess within-person changes over time.</p><p><strong>Results: </strong>Financial strain was associated with poorer outcomes across all sleep dimensions. These associations varied by race-ethnicity: they were stronger among Asian individuals than among their White counterparts. Further disaggregation revealed that this pattern was particularly pronounced among Pakistani individuals but not among other Asian subgroups.</p><p><strong>Conclusions: </strong>By revealing subgroup-specific disparities, particularly among Pakistani individuals, this study underscores the importance of tailoring public health strategies to address the combined effects of financial strain and racial-ethnic identity, thereby advancing equity in sleep health and overall well-being.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411662","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":"Restoring self-esteem and quality of life through multidisciplinary care: a cross-sectional evaluation of the Panzi One-Stop Centre model among rape survivors in Eastern Democratic Republic of Congo.","authors":"Samuel Kasereka Musisiva, Géant Chuma Basimine, Juvenal Bazilashe Mukungu Balegamire, Ida Andersen, Adelaide Blavier","doi":"10.1186/s12939-026-02936-6","DOIUrl":"10.1186/s12939-026-02936-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual violence in conflict settings is a major public health and social justice issue with long-lasting psychological consequences. In the Democratic Republic of Congo (DRC), the Panzi One-Stop Centre model provides integrated medical, psychosocial, legal, and socio-economic support to rape survivors. However, evidence on how different combinations of services are associated with psychosocial well-being and equity in health outcomes remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional study in July 2025 among 314 rape survivors who had received care between 2022 and 2024 in Eastern DRC. Self-esteem and life satisfaction were assessed using validated scales. Sociodemographic data and care pathways were collected through structured interviews. Standardised scores were analyzed using correlation and regression analyses, while analysis of variance (ANOVA) was used to compare mean standardised scores between pillars. General linear models (GLMs) were used to examine associations between sociodemographic factors, care configuration, self-esteem, and life satisfaction. Standardized regression coefficients (β) are reported throughout.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Average life satisfaction was low, whereas self-esteem was moderately low, with substantial variability across participants. Survivors who were classified in care configurations including a combination of three care pillars (medical, psychosocial and socio-economic support), trend to show the slightly higher observed psychosocial well-being scores, although confidence intervals (CI) overlapped across several subgroups. Medical-only care was associated with comparatively lower observed scores. Employment was positively associated with self-esteem, whereas perceived social support appeared to be more consistently associated with life satisfaction than with self-esteem. A positive association was observed between the number of care pillars utilised and both self-esteem and life satisfaction. Care configurations including the socio-economic pillar tended to display a more pronounced positive relationship between self-esteem and life satisfaction. However, subgroup comparisons should be interpreted cautiously because several groups had small sample sizes and overlapping confidence intervals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Integrated multidisciplinary care was positively associated with psychosocial well-being among survivors. Variations observed across different combinations of care pillars suggest that equitable access to holistic services may be related to differences in recovery indicators. These findings highlight the potential relevance of ensuring the continuity and availability of multidisciplinary services for survivors of sexual violence in conflict-affected settings. However, given the cross-sectional nature of the study, these findings should be interpreted as descriptive associations rather than evidence of causal effects","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411654","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}