International Journal for Equity in Health最新文献

{"title":"The Gendered Well-being Assessment: addressing trauma, complex needs & social determinants of health.","authors":"Denise Ruprai, Simon Pemberton, Richard Summers","doi":"10.1186/s12939-025-02553-9","DOIUrl":"10.1186/s12939-025-02553-9","url":null,"abstract":"<p><p>Women's Centres in the UK provide crucial support to women with complex needs, who are often excluded from statutory services, frequently acting as a service of 'last resort'. A major challenge when working with this population is the lack of a holistic, validated, and gender-responsive assessment tool to measure needs comprehensively and systematically. This paper introduces the Gendered Well-being Assessment (GWA), a trauma-informed quality-of-life assessment designed for women with complex needs outside the criminal justice system. The GWA aims to support early intervention, enhance multi-agency collaboration, whilst offering a structured framework for case management. A comprehensive scoring algorithm combines contemporary research on accumulative complex trauma, complex needs, and toxic stress physiology with an overall aim to highlight unmet needs to avoid preventable harm and improve overall quality of life. The assessment takes account of the interconnectedness of needs, and across 5 key domains, and 12 sections create a comprehensive overview of the breadth and depth of needs. Unlike fragmented assessments, the GWA integrates multiple validated tools into a single framework, ensuring credibility within multi-agency partnerships. By recognising protective factors like self-efficacy and social support, the GWA moves beyond harm mitigation to promote resilience and flourishing. Its structured, algorithm-based approach informs personalised support plans, transforming service provision and policy. This innovative tool ensures that women's needs are addressed comprehensively and equitably within a broader social context.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"224"},"PeriodicalIF":4.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859089","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 mixed methods analysis of community capacity to address health equity in the rural Southern U.S.","authors":"Michelle C Kegler, April Hermstad, Lauren Bigger, Tina Anderson Smith, Melissa G Line, Arlene Goldson, Alexis J Smith, Regine Haardörfer","doi":"10.1186/s12939-025-02589-x","DOIUrl":"10.1186/s12939-025-02589-x","url":null,"abstract":"<p><strong>Background: </strong>Multisectoral community coalitions have the potential to mobilize change toward health equity. The Two Georgias Initiative supported multisectoral community coalitions with a major goal of building community capacity to address health equity in 11 rural counties in the state of Georgia.</p><p><strong>Methods: </strong>A cross-site, mixed methods evaluation assessed changes in community capacity over the course of the five-year initiative. Coalition member surveys at two points in time, four rounds of key informant interviews, and document review informed various dimensions of community capacity, operationalized as resident participation, leadership development, skills gained, network expansion, resource mobilization, critical reflection, and redistribution of community power.</p><p><strong>Results: </strong>Resident participation (i.e., coalition membership, community assessment, programmatic activities), leadership opportunities (i.e., coalition positions, collecting data, leading implementation, volunteering), skill gains (i.e., understanding health equity and root causes, having difficult conversations about race and class), and strengthened partnerships (i.e., for sharing information, coordinating services, and joint projects) were the most widespread capacity outcomes across the coalitions. Resource mobilization varied by coalition, with significant external funding leveraged by several. As an indicator of critical reflection on health equity, coalitions used quantitative data to identify gaps/inequities, conducted focus groups with members of priority populations, attempted to give everyone a voice, made concerted efforts to reach underserved, disadvantaged and other groups, and took services directly to those in need. Actions to address root causes of inequities within counties were less common as were shifts in community power toward health equity, although several notable examples were shared.</p><p><strong>Conclusions: </strong>Community coalitions are an effective mechanism for strengthening selected dimensions of community capacity for health equity in rural communities. Deeper engagement of those most affected by health inequities and actions toward addressing structural and policy drivers of these inequities may require the active centering of health equity from project inception. Clarity of purpose (i.e., racial/income inequities or rural/urban inequities), technical support for community empowerment, regional networking for policy change, and longer-timeframes may also be beneficial.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"223"},"PeriodicalIF":4.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859087","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":"The effectiveness of gender-based violence prevention among adolescents aged 10 to 19 years in Southeast Asia: a systematic review.","authors":"Hoa Hong Nguyen, Kien G To, Van T H Hoang, Lu Gram, Kathryn M Yount","doi":"10.1186/s12939-025-02514-2","DOIUrl":"10.1186/s12939-025-02514-2","url":null,"abstract":"<p><strong>Background: </strong>Gender-based violence (GBV) is a major public health problem with wide-ranging negative physical and mental health consequences for survivors. The global economic costs of GBV are estimated at US$1.5 trillion. Adolescence is a high-risk period for GBV. The evidence-based GBV prevention programs among adolescents in Southeast Asia are not well understood. This paper synthesizes GBV prevention intervention studies in this region's adolescents aged 10-19 years.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA guidelines. PubMed, Medline, Embase, Web of Science, and PsycINFO were used to search for potential articles published up to September 3, 2024. We screened and identified articles following consistent inclusion and exclusion criteria. We assessed the risk of bias using the ROBINS-I tool for observational and quasi-experimental studies and the RoB 2 tool for randomized controlled trials.</p><p><strong>Results: </strong>Seven of 1689 identified articles were included in the review (four quasi-experimental designs, two pre-test and post-test designs, and one cluster randomized controlled trial). Most studies (6/7) focused on school-based educational programs. The risk of bias in the cluster randomized controlled trial was \"some concern\" level, compared with the moderate to serious level of the non-randomized studies. One pre- and post-test study directly measured GBV behaviour and found that children reported fewer experiences of physical assault (mean difference: 1.1; 95% CI: 0.6, 1.6) and psychological aggression (1.5; 0.8, 2.3) after the intervention. The remaining studies evaluated the knowledge, attitudes, and skills of participants as primary outcomes in sexual violence prevention programs. Three of the five studies that assessed changes in knowledge showed significant improvements. Inconsistent findings were found in association with attitudes and skills of GBV intervention prevention programs.</p><p><strong>Conclusions: </strong>GBV intervention studies among adolescents in Southeast Asia are rare, and evidence of effectiveness is generally weak. Rigorous RCTs that assess program impacts on GBV behaviour, as well as knowledge, attitudes, and skills, are needed. Programs that incorporate classroom activities and online learning with Facebook/Zalo/Instagram assignments and games may show promise for rigorous evaluation in Southeast Asia.</p><p><strong>Registration: </strong>This systematic review was registered on PROSPERO (CRD42023476059).</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"222"},"PeriodicalIF":4.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845894","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":"Multicultural ethics in crisis: prioritizing ECMO allocation and the role of critical consciousness.","authors":"Yaron Connelly, Royi Barnea, Aviad Tur-Sinai, Orna Tal","doi":"10.1186/s12939-025-02597-x","DOIUrl":"10.1186/s12939-025-02597-x","url":null,"abstract":"<p><strong>Background: </strong>Allocation of lifesaving technologies is a worldwide dilemma and the Covid-19 pandemic unprecedently amplified this scenario; medical teams struggled to fight the disease while demand for ECMO devices for severe patients exceeded the supply. Allocation of scarce technologies embedded socio-ethical perspective beyond clinical consideration, and we faced cultural and personal conflicts during the decision-making process. This study explores the multicultural Israeli healthcare arena, in which Arab and Jewish healthcare professionals treat Arab and Jewish patients equally, with a specific focus on the allocation of lifesaving resources and the role of cultural preferences in shaping these decisions.</p><p><strong>Methods: </strong>A nationwide survey was conducted among healthcare professionals during an advanced managerial academic program. A structured questionnaire was produced and referred to a scenario in which the number of Covid-19 patients who need ECMO treatment exceeded the number of available devices. Participants were asked to set allocation preferences regarding theoretical patients representing different sociodemographic statuses and reasonably justify their choices.</p><p><strong>Results: </strong>226 participants completed the survey. 60% of the Jewish, compared to 40% of the Arab participants declared no one should be prioritized. However, Arab participants showed a significant preference for prioritizing two age groups: the elderly and the youngest. For both Jewish and Arab participants, the main justification for prioritizing young patients was their better survival chances. In contrast, the reasons for favoring the elderly differed significantly between the groups; Arabs emphasized respect for \"wisdom and social dignity,\" while Jews highlighted eligibility based on past insurance payments.</p><p><strong>Conclusions: </strong>Differences in perceptions and a range of values between Jewish and Arab participants were observed. Socio-ethical understanding and implementation of critical consciousness, offers an opportunity to increase 'doing good', assist in peers' support in complex situations and can affect the shaping of the next generation of healthcare managers.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"221"},"PeriodicalIF":4.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834989","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":"Correction: Developing health care provider knowledge, confidence, and cultural sensitivity through resident transgender training: a controlled educational study.","authors":"Kathie Huang, Almira J Yang, Lynnetta Skoretz, Anthony Firek, Dhruv Khurana","doi":"10.1186/s12939-025-02602-3","DOIUrl":"10.1186/s12939-025-02602-3","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"220"},"PeriodicalIF":4.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821329","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 is wealth and documents are the currency: exploring the role of NGOs in facilitating healthcare access for undocumented migrants in the Netherlands - a qualitative study.","authors":"Irsa R M Hanssen, Mara A Yerkes","doi":"10.1186/s12939-025-02594-0","DOIUrl":"10.1186/s12939-025-02594-0","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"219"},"PeriodicalIF":4.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821330","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 equitable is the conduct of public health research? Findings across case studies from India and Australia.","authors":"Devaki Nambiar, Hari Sankar D, Misimi Kakoti","doi":"10.1186/s12939-025-02593-1","DOIUrl":"10.1186/s12939-025-02593-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;There have been many calls globally to intentionally incorporate equity-oriented practices into health research to effectively tackle structural inequalities and prevent the creation of new ones. Several toolkits, guidelines, and training modules have emerged to help research teams integrate equity into research conduct. The adoption of these resources and conversion to practice is varied. Developing a deeper understanding of what these variations are and what drives them may help improve both tools and practice in the global research space. Our aim was to document lessons from diverse ongoing public health research projects on how equity is integrated across research stages, what this entails, and what challenges remain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following an institute-wide appraisal process, we identified five research projects carried out from a networked group of research institutes in India and Australia that offered lessons on addressing equity in the conduct of research. We developed five case studies of these projects using an equity in research heuristic by carrying out 22 in depth interviews and one yarning session (an indigenous knowledge generation and exchange method). We spoke with Principal Investigators, research team members, partner organization members, and community representatives. The interviews covered various aspects, such as the context of the study, team building, study design, and analysis. We asked both about strategies for as well as challenges faced when embedding equity into research processes and phases. We analyzed the transcripts using ATLAS.ti version 23, relying on a deductive coding approach aligned with an existing 8quity heuristic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across stages of a research project, efforts were made to integrate equity considerations in all five of our case studies, whether explicitly equity focused (N = 2) or not (N = 3). All studies attempted to locate research in context. For non-equity focussed studies, this was done even when not desired by donors; it was common across project types to have longstanding engagement in particular communities and topic areas. This in turn shaped the formulation of research questions. Equity focused projects invested in inclusion of community members as research team members, while other forms of diversity were prioritised by other teams. All studies placed emphasis on capacity strengthening-for team members (especially those newly joining and not from the community), community members, and health providers. Governance of studies employed strategies like being embedded/living in communities, ensuring engagement (on weekends and evenings), and informal outreach, even as this was sometimes challenging to operationalise. Equity focused projects were concerned with power and coloniality and made explicit efforts to reflect upon and address this. Analysis across studies was concerned with disaggregated analysis; in equity","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"218"},"PeriodicalIF":4.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804032","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":"Community health workers for mental health care in refugee camps: a scoping review.","authors":"Rasha Istaiteyeh, Wael K Al-Delaimy","doi":"10.1186/s12939-025-02580-6","DOIUrl":"10.1186/s12939-025-02580-6","url":null,"abstract":"<p><strong>Objectives: </strong>In recent years, countries in the Middle East and North Africa (MENA) region have seen a rise in immigration, driven by global conflicts, leading to increased prevalence of physical and mental health issues among refugees. This places significant demands on both refugees and healthcare professionals encountering them in various situations. The analysis considers the social and psychological implications of relying on specialized trainers versus the refugees themselves to determine the most effective and sustainable method for providing mental health support in challenging refugee camp environments.</p><p><strong>Methods: </strong>This article uses a scoping review methodology to compare the impact of two approaches for addressing mental health needs in refugee camps. Drawing upon previous studies, the research investigates the effectiveness and sustainability of recruiting external experts versus empowering refugees as mental health trainers within their communities.</p><p><strong>Results: </strong>The analysis suggests that in refugee camps, empowering refugees as mental health trainers within their communities yields more sustainable and culturally appropriate mental health support compared to recruiting external experts. This approach fosters community resilience and addresses the unique social and psychological needs of refugees in challenging camp environments.</p><p><strong>Conclusion: </strong>Ultimately, this analysis demonstrates the context-specific nature of health interventions in refugee camps. Empowering refugees as mental health trainers emerges as a promising approach to addressing mental health needs sustainably and effectively within these environments.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"217"},"PeriodicalIF":4.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798998","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":"Assessing the impact of physician supply inequality on mortality in China: implications for global health.","authors":"Maomao Cao, Wei Jiang, Run Dong, Yan Chen, Rong Liufu, Li Weng, Bin Du","doi":"10.1186/s12939-025-02586-0","DOIUrl":"10.1186/s12939-025-02586-0","url":null,"abstract":"<p><strong>Background: </strong>Enough supply of physicians plays a vital role in ensuring equitable access to healthcare for residents. This study aims to present a national profile of physician supply and investigate its correlation with all-cause mortality in China.</p><p><strong>Methods: </strong>This epidemiological study utilized population-level administrative data. The estimated annual percentage change (EAPC) was calculated to evaluate temporal trends in physician density. The concentration index (CCI) was used to analyze inequalities in physician supply. A generalized estimating equation model and restricted cubic spline were employed to explore the association between physician supply and mortality.</p><p><strong>Results: </strong>In China, physician density increased significantly from 23.13 per 10,000 population in 2016 to 30.40 per 10,000 population in 2021, which corresponds to a substantial growth of 23.92% with an EAPC of 5.79% (95% CI: 4.89-6.69). Concurrently, age-standardized all-cause mortality has exhibited a declining trend. The CCI for physician supply remained stable at approximately 0.327. Furthermore, a multivariable generalized estimating equation model and restricted cubic spline analysis demonstrated a strong negative correlation between physician supply and all-cause mortality (R² = -0.923, P < 0.001). Compared to regions with high physician density, the risk ratios were 1.17 (95% CI: 1.07-1.29) for regions with low physician density, 1.16 (95% CI: 1.07-1.26) for those with lower middle density, and 1.06 (95% CI: 1.00-1.13) for those with upper middle density.</p><p><strong>Conclusions: </strong>Regional disparities in physician supply continue to exist, with a gradual narrowing gap within regions. Higher physician supply is associated with reduced all-cause mortality, underscoring the critical importance of equitable physician distribution.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"216"},"PeriodicalIF":4.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760033","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":"Policies and guidelines supporting the sustainability of human milk donation to milk banks in Switzerland: a document analysis.","authors":"Christelle Kaech, Tracy Humphrey, Catherine Kilgour, Céline Julie Fischer Fumeaux, Claire de Labrusse","doi":"10.1186/s12939-025-02591-3","DOIUrl":"10.1186/s12939-025-02591-3","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"214"},"PeriodicalIF":4.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760034","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}