Health Equity最新文献

{"title":"Development and Implementation of Informational Toolkits to Address Inequities in COVID-19 Testing.","authors":"Sunasia Mims, Jessica Rhinehart, Melissa Ryan, Susan Driggers, Travaé Hardaway Griffith, Grace Okoro, Tiffany Osborne, Lori Brand Bateman, Janet M Turan, Raegan H Durant, Barbara Hansen, Gabriela R Oates","doi":"10.1089/heq.2025.0043","DOIUrl":"10.1089/heq.2025.0043","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disproportionately affected African American communities. Informational toolkits have emerged as a strategy to address such inequities. Community-driven approaches to toolkit design may enhance their relevance and impact in underserved communities.</p><p><strong>Methods: </strong>Using a human-centered design approach, we developed COVID-19 testing toolkits tailored to health care, faith-based, and public housing settings in rural and urban communities. A group of community stakeholders representing each setting was recruited to co-create the toolkits. The design process began with an intensive two-day workshop to deliberate on content, format, and dissemination channels, followed by virtual meetings and iterative prototyping cycles that incorporated stakeholder feedback. Given the complexity of implementing such toolkits in health care settings, additional measures were taken to support and assess implementation at the participating health facility sites.</p><p><strong>Results: </strong>The toolkits included core resources, such as training modules, testing guidelines, and maps, and setting-specific content, such as appointment reminders, pulpit announcements, and emergency contact sheets. Materials were provided in both digital and print formats. Onboarding and technical training facilitated implementation in health care settings. Pre/post implementation surveys showed high perceived usefulness and feasibility of the health care toolkits. Implementation patterns favored print resources, with appointment reminders being most utilized. Leadership support enhanced toolkit credibility and adoption. Implementation challenges included COVID-19 fatigue, technology limitations, and leadership transitions.</p><p><strong>Conclusion: </strong>Informational toolkits co-developed with community stakeholders provide a model for translating research into solutions that enhance health equity. Prioritizing community perspectives can improve preparedness for future crises. Successful implementation requires adaptability, multimodal delivery, and sustained leadership buy-in.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"316-325"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Review of Organizational COVID-19 Communications and Guidance for Pregnant and Postpartum People Who Are Incarcerated.","authors":"Ingie Osman, Abaki Beck, Ashley N Watson, Carolyn Sufrin, Rebecca J Shlafer","doi":"10.1089/heq.2024.0235","DOIUrl":"10.1089/heq.2024.0235","url":null,"abstract":"<p><strong>Background: </strong>Each year, thousands of pregnant or postpartum women enter prison and jails across the U.S. During the COVID-19 pandemic, pregnant people who were incarcerated were at increased risk of infection and health complications. Little is known about the role of national public health, medical, and carceral organizations in promoting the health and well-being of pregnant and postpartum people who are incarcerated during the COVID-19 pandemic. The objectives of this study were to assess publicly available COVID-19 communications and guidance from national organizations to better understand guidance for pregnant and postpartum people who were incarcerated during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This study used documentary qualitative analysis to review publicly available COVID-19 guidance and communications from public health agencies and professional organizations. A total of 27 documents were reviewed, coded, and analyzed across eight organizations.</p><p><strong>Results: </strong>In the 338 pages reviewed, \"pregnancy/postpartum\" was coded just 17 times among four organizations. Our review found that mentions of the unique needs of pregnant and postpartum people during the COVID-19 pandemic were mostly absent from organizational guidance.</p><p><strong>Conclusion: </strong>This analysis calls attention to the gaps in the consideration for pregnant and postpartum people who are incarcerated, particularly in the context of the COVID-19 pandemic. We conclude with a series of recommendations to strengthen the care of pregnant and postpartum people who are incarcerated and promote health equity.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"305-315"},"PeriodicalIF":2.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Considerations and Recommendations for Humanizing Immigrant Language in Health Equity Data Collection, Reporting, and Measurement.","authors":"Andrea Thoumi, Olurotimi Kukoyi, Kamaria Kaalund, Yazmin Garcia Rico, Rosa M Gonzalez-Guarda, Jay Pearson, Viviana Martinez-Bianchi","doi":"10.1089/heq.2024.0127","DOIUrl":"10.1089/heq.2024.0127","url":null,"abstract":"<p><p>Collecting accurate and consistent sociodemographic data is needed to improve health measurement and public health interventions. Missing or inaccurate data hinders the adequate assessment of the state of access, quality, and coverage in the overall population and communities experiencing social marginalization. Health measurement requires data labels that humanize all populations living, working, and residing across the United States and territories. Humanization is fundamentally grounded in the concepts of human dignity and ethical identity integrity. An often-overlooked form of exclusion in health care is the long-standing use of dehumanizing language, including its use in health measurement and data collection efforts, to refer to immigrant populations. In this perspective, we delineate ethical concerns regarding the use of dehumanizing language when referring to immigrant populations. We provide recommendations for health providers, researchers, and policy makers in improving humanizing language in health equity data collection and reporting through engagement of community experts, use of alternative language, implementation, and monitoring.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"281-289"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclusion of Community-Based Participatory Research in High-Impact Medical Journals.","authors":"Michelle Doughtery, Yesmina Salib, Mylynda Massart, Jaime E Sidani, Jean L Raphael, Felicia Savage Friedman, Jason Beery, Monica Ruiz, Elizabeth Miller, Maya I Ragavan","doi":"10.1089/heq.2024.0151","DOIUrl":"10.1089/heq.2024.0151","url":null,"abstract":"<p><p>Community-based participatory research (CBPR) is essential for addressing health care inequities; however, it is unclear to what extent articles published in high-impact medical journals use CPBR. We reviewed original research articles in nine journals across 4 years to determine how frequently CBPR was used and, for articles using CBPR, details about partnerships. Of 5,624 articles, only 6 (0.1%) used CBPR. Five identified community partners and whether partners were involved in research planning/implementation, one reported that partners were involved in dissemination, and none reported adherence to CBPR principles. Improving integration of CBPR is an urgent priority for funders, institutions, journals, and researchers.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"290-295"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial, Ethnic, and Color-Based Discrimination and Pre-Pregnancy Risk Factors for Preeclampsia Among Nulliparous Patients.","authors":"Alexa I K Campbell, Maria J Small, Sarahn M Wheeler, Jerome J Federspiel","doi":"10.1089/heq.2024.0173","DOIUrl":"10.1089/heq.2024.0173","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity and chronic hypertension are well-known risk factors for maternal morbidity and mortality. Evidence suggests racism contributes to the development of these chronic conditions.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the Nulliparous Pregnancy Outcomes: monitoring mothers-to-be (nuMoM2b) cohort, which recruited nulliparous pregnant participants in the United States in 2010-2013. Using logistic regression, we assessed the relationship between experiences of racial, ethnic, and color-based (REC) discrimination (categorized as high, low, or no REC discrimination) and prevalence of a composite outcome of obesity and/or chronic hypertension.</p><p><strong>Results: </strong>Among 8,554 participants, the composite outcome was unequally distributed by race and ethnicity (<i>p</i> < 0.001), present in 19.9% of non-Hispanic White, 23.1% of Hispanic, and 39.0% of non-Hispanic Black participants. Self-reported REC discrimination was similarly unequally distributed (<i>p</i> < 0.001), with high REC discrimination reported by 17.5% of non-Hispanic Black, 10.6% of Hispanic, and 2.1% of and non-Hispanic White participants. In multivariable analyses, high self-reported REC discrimination was associated with a 1.75 adjusted odds ratio (95% confidence interval: 1.43-2.14) of the composite outcome compared with those reporting no REC discrimination. When stratified by race and ethnicity, the odds ratios for the composite outcome among those reporting high REC discrimination were only statistically significant among the Hispanic subgroup.</p><p><strong>Conclusion: </strong>We observed a positive, dose-dependent association between self-reported REC discrimination and our outcome of obesity and/or chronic hypertension. By demonstrating this relationship in an obstetric cohort, we aim to highlight the role of racism over the life course in contributing to chronic health conditions and associated maternal outcomes.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"270-280"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee.","authors":"L Lauren Brown, Almariana J Acuña, Amna Osman, Lloyda B Williamson, Carolyn M Audet, Megan L Wilkins, Jessica M Sales, Samantha V Hill, Jill Foster, April C Pettit, Latrice C Pichon","doi":"10.1089/heq.2023.0251","DOIUrl":"10.1089/heq.2023.0251","url":null,"abstract":"<p><strong>Background: </strong>Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure typologies and sequelae among PWH to inform trauma screening and interventions.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with a convenience sample of 20 PWH with PTSD, receiving services from an urban, Tennessee-based HIV Service Organization. Interview guides were conducted to gain a rich understanding of exposure types from the Life Events Checklist-5 (LEC-5), explore potential social determinants of trauma, and uncover effects of chronic trauma or traumata. Thematic content analysis was used to examine typologies and effects.</p><p><strong>Results: </strong>Exposure typologies appeared as social determinants of trauma, including molestation as the most common followed by racial trauma, community violence, incarceration, addiction, interpersonal violence, poverty cycles, and stigma. Standard PTSD symptoms were reported in addition to emerging effects of complexity, synergism, and resilience. Complex effects spanned socioecological contexts and included sequelae of affective dysregulation, negative self-concept/self-organization, and disturbances in relationships.</p><p><strong>Conclusion: </strong>Many typologies were not well accounted for in the LEC-5, underscoring the potential to miss exposure types and thus treatment indication. Similarly, effects expanded beyond standard PTSD symptoms, suggesting that nuanced treatment needs may also be overlooked. Findings are consistent with literature indicating the need for updated trauma screening and assessment measures to most comprehensively and accurately direct treatment needs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"131-141"},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Equity and <i>BRCA1/2</i> Testing.","authors":"Steven Sorscher","doi":"10.1089/heq.2024.0167","DOIUrl":"10.1089/heq.2024.0167","url":null,"abstract":"<p><p>Although most cancers are sporadic, a significant proportion are related to inherited cancer-causing genes called pathogenic germline variants (PGVs). There are recommended measures for prevention and earlier diagnosis of cancers in patients identified as <i>BRCA1</i> and <i>BRCA2</i> PGV carriers, which are the most common cancer-predisposing PGVs. For example, published guidelines recommend that patients with <i>BRCA1/2</i> PGVs undergo bilateral oophorectomies to prevent ovarian cancer and regular magnetic resonance imaging to screen for breast cancer. Also, those same measures are recommended for family members identified by cascade testing as <i>BRCA1/2</i> carriers. Here, reports of the significant disparities between groups in which patients diagnosed with breast cancer are offered and undergo testing for <i>BRCA1/2</i> PGVs are reviewed. Expanding the current standard of care guidelines for <i>BRCA1/2</i> testing to all patients diagnosed with breast cancer and enacting the Cancer Moonshot 2.0 Initiative measures that should mitigate these disparities are discussed as well.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"127-130"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/heq.2024.80057.revack","DOIUrl":"https://doi.org/10.1089/heq.2024.80057.revack","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"125-126"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Strict Isolation Precautions on Families with a Language Other than English.","authors":"Polina Frolova Gregory, Sanyukta Desai, Corrie E McDaniel, Austin DeChalus, Emily Bowen, Michael Dinh, Jessica Gagen, Dwight Barry, Abena Knight, Matthew Test, Arti D Desai, Mersine A Bryan","doi":"10.1089/heq.2024.0117","DOIUrl":"10.1089/heq.2024.0117","url":null,"abstract":"<p><strong>Introduction: </strong>Children with a language for care other than English (LOE) are at risk for inequitable care. We examined the association of isolation precautions in the care of hospitalized children with LOE through the frequency of professional interpreter use and timing of in-person consultation.</p><p><strong>Methods: </strong>Retrospective cohort study of children in a strict isolation unit (SIU) between 2/2020 and 12/2021. Negative binomial regression was used to assess both differences in interpretation rates between SIU and non-SIU, and within 72-h/in-person consultation rates within the SIU between English-speaking and LOE encounters.</p><p><strong>Results: </strong>We identified 487 encounters in the SIU; 126 (26%) involved patients with LOE. The median interpretations per day were 4.5 (Interquartile Range [IQR]: 2.0-6.7). Among patients with LOE, there was an observed difference in median interpretations per day in the SIU (3.9, IQR: 1.7-6.4) versus encounters in non-SIU acute care units (5.0, IQR: 1.2-8.2). However, this difference was not statistically significant (Incidence Rate Ratio [IRR]: 0.89; 95% confidence interval [CI]: 0.70-1.13). Sub-specialty consultations were requested for 410 (84%) encounters within the SIU; 282 (69%) were completed in person within 72 h. A small difference between the percentage of completed consultations for encounters with LOE (<i>n</i> = 61, 64%) and English-speaking patients' encounters (<i>n</i> = 221, 70%) was noted, which again was not statistically significant (IRR: 0.93; 95% CI: 0.71-1.21).</p><p><strong>Conclusion: </strong>Despite the increased barriers of strict isolation, we exceeded institutional standards for interpretations per day and had similar rates of interpretation for encounters with LOE admitted to medical units regardless of isolation status.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"100-105"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Rapid Qualitative Analysis to Support Collaborative Synergy Within a Community Coalition for Health Equity in Detroit.","authors":"Hayley S Thompson, Ten-Niah Kinney, Carrie Leach, Alexandra Sass, Ariel Washington, Rhonda Dailey, Elizabeth Towner, Alyssa Beavers, Rodlescia Sneed, Karen Solomon Edwards, Ijeoma Nnodim Opara, Arthur Hampton, Zachary Cichon, Afsana Rinky, Joneigh Khaldun","doi":"10.1089/heq.2024.0160","DOIUrl":"10.1089/heq.2024.0160","url":null,"abstract":"<p><strong>Introduction: </strong>A community coalition is an effective strategy for addressing complex health challenges. A citywide coalition of community and academic experts was formed to address Detroit's persistent health disparities. To foster collaborative synergy, we explored hyperlocal perspectives on health equity by applying rapid qualitative analysis (RQA) as a time-efficient and rigorous approach.</p><p><strong>Methods: </strong>Twenty coalition members completed a key informant interview addressing five key areas: health equity meanings, Detroit's most pressing health problems, social ecological domains that influence health equity and outcomes, and strategies to achieve health equity. We used RQA to interpret interview data.</p><p><strong>Results: </strong>Participants were majority female, Black/African American, and over 60 years old. Participants defined health equity as equal access to opportunities for a healthy life and emphasized the importance of individual choice in pursuing those opportunities. As an indication of their awareness of social determinants of health, participants articulated connections between various social ecological factors and health outcomes.</p><p><strong>Discussion: </strong>This study highlights participants' recognition of both systemic factors and personal agency in achieving health equity, indicating their nuanced understanding of the complex interplay between social structures and individual health, which is crucial for community-driven multilevel health interventions. Furthermore, by fostering better communication and alignment, RQA is an efficient and effective method to enhance coalition synergy.</p><p><strong>Health equity implications: </strong>By facilitating a shared understanding of health equity and its determinants, RQA can help coalitions ensure inclusion and integration of diverse perspectives in intervention planning and delivery, particularly in urban settings facing similar challenges.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"87-99"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}