International Journal for Equity in Health最新文献

{"title":"A cross-sectional study of individual- and poly-bullying victimization and suicidal ideation among Chinese university and high school students: the roles of hopelessness and interpersonal relationships.","authors":"Zixuan Cao, Li Lu, Zi-Wei Li, Sha Lai, Zhongliang Zhou, Qing Shen, Shou Liu","doi":"10.1186/s12939-025-02472-9","DOIUrl":"https://doi.org/10.1186/s12939-025-02472-9","url":null,"abstract":"<p><strong>Background: </strong>We aim to examine the associations between poly-bullying victimization (i.e., school-, family- and cyber-bullying ever and only) and suicidal ideation (SI) among Chinese university and high school students, and the roles of interpersonal relationships and hopelessness in the interested relationships.</p><p><strong>Methods: </strong>We included 17633 participants integrating data from the 2019 mental health survey in university students in Qinghai, China (N = 5700), and the Chinese Database of Youth Health in high school students (N = 11933) in Shandong. We applied multivariate logistic regression models to explore the associations between poly-bullying victimization and SI, by gender and level of schools. Stratification analyses were conducted by levels of hopelessness and interpersonal relationships. The role of hopelessness in the relationships between poly-bullying victimization and SI in university students was evaluated by fitting mediation analyses.</p><p><strong>Results: </strong>Exposure to specific forms of bullying victimization was positively associated with SI in students from both school levels. Cyberbullying victimization only was not significantly associated with SI in university students, but with significance in both female (OR: 1.70, 95% CI: 1.26-2.30) and male (OR: 2.69, 95% CI: 2.04-3.55) high school students. In university students, the association between school bullying only and SI was greater in female (OR: 2.38, 95% CI: 1.71-3.34) than males (OR: 1.33, 95% CI: 0.85-2.09); the strongest association was exhibited between the co-occurrence of family and school bullying victimization, and SI; a dose-response relationship was observed between number of victimization and SI, particularly among males. Interpersonal relationships did not significantly moderate the relationships between poly-bullying victimization and SI among university students. Hopelessness played significant mediating role in the relationships between Family + School bullying victimization and SI (14.80% mediated) in female university students, and Family + School + Cyberbullying victimization and SI (29.40%) in males.</p><p><strong>Conclusion: </strong>The exploration-oriented study provided an intricate mechanism of gender-specific differences in SI related to poly-bullying victimization. Tailored, gender-sensitive interventions and support systems for adolescents and young adults should be designed and implemented.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"117"},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015037","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":"Migrants' experiences as health ambassadors during the COVID-19 pandemic in Norway-a qualitative study.","authors":"Marta-Johanne Svendsen, David Lackland Sam, Oddvar Kaarboe, Esperanza Diaz","doi":"10.1186/s12939-025-02480-9","DOIUrl":"https://doi.org/10.1186/s12939-025-02480-9","url":null,"abstract":"<p><strong>Background: </strong>In response to the high incidence of COVID-19 infections among migrants, and lack of information, several interventions relying on migrants to deliver information to their peers were implemented. Although these strategies seem to be effective, the experiences of the migrants disseminating health information have not been studied. The Health Ambassador Project (HA-project) was one of such projects connecting key members from migrant communities (Health Ambassadors (HAs)) with health experts and the municipality, to disseminate health information to migrants. The HA-project was conducted in Bergen, Norway, in 2021-2022. This study aims to understand the experiences of the HAs during their involvement in the HA-project, how their role affected them in positive or negative ways and how they coped with eventual difficulties in the role.</p><p><strong>Methods: </strong>We conducted individual interviews in January 2023 with seven HAs. The interviews were transcribed and analyzed using systematic text condensation.</p><p><strong>Findings: </strong>Participating in the HA-project was predominantly a positive experience for all HAs, by acquiring a sense of meaning and of being considered a valuable resource during the COVID-19 pandemic. There were positive social and professional aspects related to being able to meet other HAs and learning from each other's experiences. However, psychological distress was reported related to the responsibility of conveying correct health information about the COVID-19 pandemic to fellow migrants and fighting misinformation. Several HAs used more of their free time than was expected of them, helping people in practical ways. HAs from Ukraine joined the project in 2022 and experienced their roles as more stressful given limitations in the availability of interpretation when collaborating with the experts.</p><p><strong>Conclusion: </strong>Targeted health interventions relying on migrants to address their peers should consider the experiences of those distributing information and minimize their psychological stress.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"118"},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015039","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 disparities among indigenous populations in Latin America: a scoping review.","authors":"Mariana Garza, Lucía Abascal Miguel","doi":"10.1186/s12939-025-02495-2","DOIUrl":"https://doi.org/10.1186/s12939-025-02495-2","url":null,"abstract":"<p><strong>Background: </strong>Health disparities persist among Indigenous populations in Latin America, reflecting systemic inequities and historical marginalization. These disparities span infectious diseases, malnutrition, and chronic conditions, necessitating a comprehensive understanding to inform equitable public health strategies. This scoping review aims to map health disparities affecting Indigenous populations in Latin America, identify research gaps, and inform policy recommendations.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we systematically searched PubMed, Embase, and Scielo for studies with data collected between May 2014 and May 2024. Studies were included if they examined health disparities among Indigenous populations in Latin America, contained a comparator related to disparities, and presented quantitative data. We excluded studies on oral health, risk factors, genetic disparities, health system access, and ecological studies, as well as non-research articles such as commentaries and letters to the editor. Data were synthesized narratively, summarizing key themes.</p><p><strong>Results: </strong>Of 1,116 identified articles, 35 met inclusion criteria, spanning nine Latin American countries. Most studies were cross-sectional (n = 18) or cohort-based (n = 16). Infectious diseases and malnutrition were the most studied topics, consistently showing higher incidence and mortality rates among Indigenous populations. Many papers highlighted COVID-19 disparities, with Indigenous groups experiencing higher incidence and mortality. Malnutrition, particularly stunting and anemia, was significantly more prevalent among Indigenous children and women. Studies on overweight and obesity showed mixed results. Chronic diseases, including chronic kidney disease and cardiovascular issues, showed notable disparities, while mental health and cancer were underrepresented.</p><p><strong>Conclusion: </strong>Indigenous populations in Latin America face a dual burden of infectious and chronic diseases, compounded by structural barriers such as poverty, geographic isolation, and systemic discrimination. Addressing these disparities requires culturally tailored interventions, structural reforms, and policy prioritization. This scoping review is limited by database restrictions, search term variability, language and time frame constraints, the absence of a methodological quality assessment, inconsistencies in defining Indigenous status, exclusion of grey literature, and a focus on disease prevalence rather than disparities in risk factors, diagnosis, and treatment, which may result in an incomplete representation of Indigenous health disparities in Latin America. Future research should incorporate mental health outcomes to provide a more comprehensive understanding of Indigenous health disparities.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"119"},"PeriodicalIF":4.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016386","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":"Capacity-building strategies that support correctional and justice health professionals to provide best-evidenced based healthcare for people in prison: a systematic review.","authors":"Monique Hooper, Claudia Virdun, Jane L Phillips","doi":"10.1186/s12939-025-02462-x","DOIUrl":"https://doi.org/10.1186/s12939-025-02462-x","url":null,"abstract":"<p><strong>Background: </strong>The United Nations (UN) 2015 'Mandela Rules' stipulates that people in prison will have access to equivalent healthcare to other community members. This expectation has challenged prisons in high-income countries to strengthen healthcare delivery to better meet the needs of the growing number of incarcerated First Nations and older, frailer people, many with complex healthcare needs. Yet little is known about correctional and justice health professionals' ('prison workforces') capacity to identify and support people in prisons with complex healthcare needs.</p><p><strong>Aim: </strong>To identify the post-Mandela Rules strategies that have increased the prison workforce's capacity to provide evidence-based healthcare.</p><p><strong>Methods: </strong>A systematic review. Three health and Criminal Justice databases were searched (2015-June 2024) to identify empirical data regarding the 'individual', 'organizational' and 'community' capacity-building strategies employed to improve the prison workforce's healthcare capabilities. Kirkpatrick's Model was used to assess the evaluation level, while Popay's narrative synthesis was applied to the extracted data. Findings are reported according to the PRISMA Statement.</p><p><strong>Results: </strong>Of the 20 included articles, the highest level of evidence (level III) was generated by a mixed methods study, with most (n = 17) generating low-level (Level IV) evidence. Ten studies evaluated mental health behavioral capacity-building strategies, with limited attention given to other chronic illnesses, ageing, palliative care, or cultural needs. More complex capacity-building strategies that included individual, organizational, and community-level elements generated the best outcomes. The best individual-level capacity-building outcomes were more frequent (> 5 occasions) interactive health-related education delivered in partnership with external experts. However, the commonly employed capacity-building strategies were short didactic education sessions, which were less effective.</p><p><strong>Conclusion: </strong>If prisons are to meet the UN Mandela Rules' aspirations, more impactful individual, organizational and community-level capacity-building strategies are urgently required. Transitioning to co-designed, interactive, culturally sensitive, evidence-based approaches is crucial if the prison workforce is to better recognize and effectively respond to the needs of more culturally diverse and older, sicker populations with complex healthcare needs.</p><p><strong>Trial registration: </strong>Prospero CRD42023410564.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"115"},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982367","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":"Front-of-package labelling: A public health imperative rooted in the right to health.","authors":"Yolanda Tarisayi Radu, Sameera Mahomedy","doi":"10.1186/s12939-025-02473-8","DOIUrl":"https://doi.org/10.1186/s12939-025-02473-8","url":null,"abstract":"<p><strong>Background: </strong>Tackling the rise in non-communicable diseases stemming from the consumption of ultra-processed, nutrient-poor packaged foods is a growing health priority in South Africa. Front of package labels have emerged as an integral intervention to address the consumption of unhealthy foods that contribute to non-communicable diseases, yet laws mandating front of package labelling have faced counter arguments from the food and beverage industry. In this paper, we ground front of package labelling within the right to health, and highlight the comparative experience of countries that have implemented front of package labelling to foreshadow industry arguments against regulations published in South Africa.</p><p><strong>Methods: </strong>The study uses a doctrinal methodology to examine the content and duties of the right to health by analysing legal texts, statutes, case law, and international treaties. The study also engages legal provisions and assesses judicial decisions to ascertain the scope of the right to health and the obligations imposed on states and other duty-bearers.</p><p><strong>Results: </strong>International law, African human rights law and the South African law have the enabling framework that recognises front of package labelling as a component of the right to health. This triggers the obligation to take reasonable legislative measures to ensure realisation of the right. A human rights framing of front of package labelling is of paramount importance given the vulnerability of individuals when considered within the context of powerful corporations as determinants of health.</p><p><strong>Conclusion: </strong>The positioning of front of package labelling as a fundamental right to health issue places obligations on the government of South Africa and other governments to stem the rising burden of non-communicable diseases and provides a mechanism to improve determinants of health among vulnerable populations.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"116"},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982387","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":"A reflective analysis on the inequities in cancer diagnosis and treatment in Latin America: a call to action for public health.","authors":"Gabriela Guerron-Gomez, Mariana Rojas-Fierro, Rafael Parra-Medina, Andrés Mosquera, Marcela Gomez Suarez","doi":"10.1186/s12939-025-02457-8","DOIUrl":"https://doi.org/10.1186/s12939-025-02457-8","url":null,"abstract":"<p><p>Cancer continues to be a significant public health challenge in Latin America and the Caribbean (LAC), marked by rising incidence and mortality rates and a projection of increased burden by 2040. Despite the recognized importance of early diagnosis and treatment, the LAC region faces profound disparities in cancer care access due to socioeconomic, geographic, and educational barriers. These inequities are exacerbated by a lack of medical specialists, healthcare access limitations, and the distribution of resources, especially in rural areas. Social determinants of health (SDH) such as income level, educational attainment, and geographic location further contribute to delayed diagnoses and poor treatment outcomes. Addressing these barriers, recent initiatives emphasize strategies like telepathology networks, health education programs, and the establishment of cancer support networks to improve early diagnosis and quality of care. This review explores these SDH-based disparities in cancer care within LAC, examining innovative approaches aimed at reducing health inequities and improving outcomes for underserved populations. Through targeted interventions, the article highlights the critical need for policies promoting equitable access to cancer care as a fundamental public health objective in LAC.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"113"},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999898","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":"Dismantling inequities to end the black maternal mortality crisis in the United States.","authors":"Ameneh Safarzadeh","doi":"10.1186/s12939-025-02488-1","DOIUrl":"https://doi.org/10.1186/s12939-025-02488-1","url":null,"abstract":"<p><p>Black maternal mortality in the United States remains alarmingly high-Black women are still more than three times as likely to die from pregnancy-related causes than White women. This crisis is not due to individual choices or access alone, but to deeply rooted structural inequities, including systemic racism, policy exclusion, and the neglect of Black-led care models. While efforts like Medicaid expansion and the Black Maternal Health Momnibus Act aim to address these gaps, they often fall short by relying on narrow, one-size-fits-all solutions. This commentary uses Critical Health Equity theory and the Intersectionality-Based Policy Analysis (IBPA) framework to examine how current policies may unintentionally reinforce the very inequities they seek to eliminate. It argues that achieving real equity in maternal health requires more than reform-it calls for a fundamental shift in who holds power, whose knowledge is valued, and how care is delivered. A new framework is proposed that centers Black leadership, supports community-led research, and promotes culturally safe, justice-oriented care.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"114"},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991545","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":"How accessible are the websites of health services for people who have had a stroke?","authors":"Melita J Giummarra, Eleanor Brown, Tanya A Rose, Natasha A Lannin, Brooke Parsons, Emma Power","doi":"10.1186/s12939-025-02459-6","DOIUrl":"https://doi.org/10.1186/s12939-025-02459-6","url":null,"abstract":"<p><strong>Background: </strong>After sudden onset conditions (e.g., stroke), people commonly search for information online about healthcare and health services. Accessible websites are important for people with support needs, such as aphasia, to maximise their access to health service information. The accessibility of stroke-related health service websites against the Web Content Accessibility Guidelines (WCAG) and stroke-related access needs is not known. Therefore, the present study examined website accessibility of Australian health organisations, and their services, that provide post-stroke healthcare.</p><p><strong>Method: </strong>A cross-sectional descriptive study design was used to identify relevant health services in Victoria and South Australia. Organisation homepages and service webpages were assessed for WCAG errors and alerts using the WAVE® Web Accessibility Evaluation Tool. A 16-item stroke accessibility checklist was used to document accessibility issues for people with stroke-related communication, cognitive and sensory processing impairments. The checklist assessed webpage navigation, readability and formatting. Publication of an accessibility statement or policy on the website was recorded. Issues were classified according to perceivability, understandability, operability and robustness (POUR) domains.</p><p><strong>Results: </strong>A total of 185 webpages (126 homepages and 59 service-specific webpages) were evaluated against WCAG standards. Most webpages (n = 150, 81.1%) had at least one WCAG error (Median = 5 errors); the most prevalent being empty links that could not be read by a screen reader (n = 92, 49.7%). Checklist evaluations were completed for 105 webpages. Only 17 websites had an accessibility statement. Nearly all webpages had a reading level above Flesch-Kincaid Grade 6. Problems with readability, line height, font size, paragraph length, and bolding of key information were common. All had issues with 'perceivability' and 'understandability', and all but one website had operability issues. Only 10% of webpages contained robustness errors that could lead to compatibility issues across various browsers, devices, and assistive technologies. Government organisation websites had significantly fewer POUR accessibility issues than private sector sites.</p><p><strong>Conclusions: </strong>Health services should take concerted steps towards ensuring that their websites are accessible for all healthcare consumers, including people with language, cognitive and visual processing impairments, which are common after stroke. Online service information provides a key role in enabling stroke survivors to access information and make decisions about their healthcare.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"112"},"PeriodicalIF":4.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006109","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":"Strengthening equity and anti-racism in women's care: a quality improvement initiative reducing institutional maternal mortality in Brazil.","authors":"Santiago Nariño, Jussara Francisca de Assis Dos Santos, Tayna Brito, Livia Sanches Pedrilio, Paulo Borem, Claudia Garcia de Barros, Sebastian Vernal","doi":"10.1186/s12939-025-02452-z","DOIUrl":"https://doi.org/10.1186/s12939-025-02452-z","url":null,"abstract":"<p><strong>Background: </strong>Circumstances that lead to maternal death are complex and multifactorial, including inequity and racism issues. Quality improvement (QI) strategies have demonstrated success in improving maternal outcomes. The Collaborative Abraço de Mãe (CAM) reduced the institutional maternal mortality rate (iMMR) by 34.2% from the baseline rate in 19 Brazilian maternity hospitals.</p><p><strong>Objective: </strong>To present the integration of anti-racism and equity strategies implemented during the CAM.</p><p><strong>Methods: </strong>A QI report assessing the CAM focused on strengthening the awareness of obstetric teams about ethnic-racial inequalities and institutional racism as social determinants of maternal outcomes. A mixed methods approach was used to understand the overall impact of the intervention. Measures included the Anti-Racist Leadership Survey and interviews (individual and grouped). Qualitative and quantitative data were applied simultaneously but independently, followed by a triangulated comparison to define convergences.</p><p><strong>Results: </strong>The domain with the highest average score was emotional resources and communication; the lowest was fundamental knowledge and translation of the knowledge in action. Interviews evidenced three categories: (A) equity and anti-racism training contributed to a more profound recognition of race and racism awareness, leading to a change in culture; (B) Priority change ideas and actions focusing on anti-racism and equity were demonstrated in several ways among the leaders; and (C) Challenges when equity is centralised in the care model. Triangulations revealed two convergences: (i) Evidence of a better understanding of ethnic-racial inequalities, institutional racism, and racism recognition by the leaders and participating institutions, and (ii) Resistance when trying to bring new content to the clinical staff, as well as a lack of tools when dealing with the emotional resources needed to confront interpersonal racism.</p><p><strong>Conclusion: </strong>With a significant reduction in iMMR, the CAM reveals that a QI intervention addressing inequities and racism issues is a feasible and promising approach to improve maternal outcomes within an equity-oriented model of care.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"111"},"PeriodicalIF":4.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979153","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":"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).","authors":"Sari L Reisner, Nykesha Johnson, Jarvis T Chen, Maddalena Marini, Merrily E LeBlanc, Kenneth H Mayer, Apriani Oendari, Donna M Bright, Sharon Callender, Guale Valdez, Tanveer Khan, Nancy Krieger","doi":"10.1186/s12939-025-02456-9","DOIUrl":"https://doi.org/10.1186/s12939-025-02456-9","url":null,"abstract":"<p><strong>Background: </strong>In the United States (U.S.), the physical and mental health sequelae of diverse types of discrimination are far-reaching, severe, and contribute to population health inequities, with this work informing research on discrimination and health in both the Global North and Global South. To date, limited population health research has examined the joint impacts of discrimination measures that are explicit (i.e., self-report) and implicit (i.e., automatic mental representations), both singly and for multiple types of discrimination.</p><p><strong>Methods: </strong>Between May 28, 2020-August 4, 2022, we conducted Life + Health, a cross-sectional population-based study regarding six types of discrimination-racism, sexism, heterosexism, cissexism, ageism, and sizeism-with 699 participants (US-born, ages 25-64) from three community health centers in Boston, Massachusetts. Participants completed a Brief Implicit Association Test (B-IAT) and self-reported survey. Spearman's correlation coefficient was estimated to assess the strength and direction of discrimination types across target/dominant groups; logistic regression models were fit to assess the association of each type of discrimination with smoking/vaping following by random-effects meta-regression modeling to pool effects across discrimination types.</p><p><strong>Results: </strong>Mean age was 37.9 years (SD = 11.2 years). Overall, 31.6% were people of color; 31.8% identified as transgender or nonbinary/genderqueer; 68.6% were sexual minority. For education, 20.5% had some college/vocational school or no college. Current cigarette/vaping was reported by 15.4% of the study population. Implicit and explicit measures were generally correlated with one another, but associations varied across discrimination types and for target/dominant groups. In random-effects meta-regression modeling, explicit compared to implicit discrimination measures were associated with a 1.18 (95% CI = 1.00-1.39) greater odds of smoking/vaping among dominant group members, but no such difference was observed among target group members.</p><p><strong>Conclusion: </strong>Implicit and explicit discrimination measures yielded distinct yet complementary insights, highlighting the importance of both. Meta-regression provided evidence of health impacts across discrimination types. Future research on discrimination and health, in diverse country contexts, should consider using both implicit and explicit measures to analyze health impacts across multiple types of discrimination.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"110"},"PeriodicalIF":4.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021948","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}