Health Equity最新文献

{"title":"\"How Am I Going to Do It?\" Understanding the Challenges of Assuming Care of a Child Born During their Mothers' Incarceration.","authors":"Bethany Kotlar, Kate Dawson, Varshini Odayar, Ellen Mason, Henning Tiemeier","doi":"10.1089/heq.2024.0098","DOIUrl":"10.1089/heq.2024.0098","url":null,"abstract":"<p><strong>Objectives: </strong>Mass incarceration of women systematically targets minoritized groups. Approximately 1,000 births occur from prison annually; and most children must be cared for by someone other than their mother. Little is known about caregiving for infants in the context of maternal incarceration. The purpose of this study was to describe the experiences of caregivers assuming care of newborns of incarcerated mothers to identify challenges and provide policy recommendations.</p><p><strong>Materials and methods: </strong>Data from this study were drawn from qualitative intake interviews with caregivers of children born to incarcerated mothers in Georgia participating in the Birth Beyond Bars Study, an ongoing birth cohort of children exposed prenatally to incarceration in three states. One of the primary research questions for these interviews was how caregivers were coping with assuming care for the infant. All caregivers of children born to incarcerated women from August 2020 to January 2023 (<i>n</i> = 48) were approached for enrollment into the study by staff at a nonprofit providing support to incarcerated pregnant and postpartum women and their families. We used thematic analysis to analyze data from 36 caregivers.</p><p><strong>Results: </strong>Caregivers were primarily older (45% were between 46 and 71), female kin (89%), who were frequently impoverished (30%). Caregivers faced challenges in legally assuming care of the infant, maintaining work, securing childcare, enrolling in social services, and managing their health. They primarily relied on their families for support.</p><p><strong>Discussion: </strong>Caregivers of infants of incarcerated mothers are a vulnerable population requiring enhanced support. Targeted support may ameliorate negative consequences of assuming this role.</p><p><strong>Health equity implications: </strong>To promote health equity, state social service agencies should target and assist caregivers in enrolling in social services. Most importantly, states should pass legislation prioritizing community-based alternatives to incarceration for pregnant and parenting mothers.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"731-737"},"PeriodicalIF":2.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693629","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":"Cardiovascular Outcomes, Health-Promoting Behaviors, and Social Determinants: Structural Racism and the Behavioral Risk Factor Surveillance System.","authors":"Jaclyn K Schwartz, Emily A Kringle, Suzanne Perea Burns, Catherine R Hoyt, Kelly M Harris, Sami Tayeb","doi":"10.1089/heq.2023.0203","DOIUrl":"10.1089/heq.2023.0203","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular disease disproportionately affects historically marginalized populations in the United States. This study explored disparities in cardiovascular health outcomes, social determinants of health, and health-promoting behaviors across racial and ethnic groups.</p><p><strong>Methods: </strong>Using data from the 2019 Behavioral Risk Factor Surveillance System, we conducted a descriptive analysis of cardiovascular conditions and diabetes, social determinants of health, and health-promoting behaviors across eight racial/ethnic categories.</p><p><strong>Results: </strong>Historically marginalized groups had higher rates of cardiovascular conditions and greater barriers to health care access. However, these groups often demonstrated equal or higher rates of engagement in health-promoting behaviors compared with White adults. For example, Black adults had the highest hypertension prevalence (41%) despite having the highest rates of blood pressure management behaviors.</p><p><strong>Discussion: </strong>The persistence of health disparities despite equivalent health-promoting behaviors suggests a significant influence of structural factors like racism. Critical examination using Quantitative Critical Theory revealed potential biases in measurement tools and data categorization that may perpetuate inequities.</p><p><strong>Health equity implications: </strong>Findings underscore the need for equity-focused research approaches that explicitly address structural racism. Future studies should prioritize culturally relevant measures, clinically meaningful outcomes, and active involvement of researchers from marginalized communities to advance cardiovascular health equity.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"707-719"},"PeriodicalIF":2.6,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693664","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":"The Time for Race-Neutral Pulmonary Function Norms is Now.","authors":"Peter H S Sporn, Cheryl Conner, Min J Joo, Bijal Jain, Sheryl Lowery, Natasha Nichols","doi":"10.1089/heq.2023.0274","DOIUrl":"10.1089/heq.2023.0274","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"683-685"},"PeriodicalIF":2.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693754","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":"Experiences of Discrimination Among Women and Gender Diverse Veterans Using Veterans Health Administration Health Care.","authors":"Jodie G Katon, Samantha K Benson, Vyshnika Sriskantharajah, Lisa S Callegari, Karissa Fenwick, Kristen E Gray, P Adam Kelly, Ashley C Mog","doi":"10.1089/heq.2024.0085","DOIUrl":"10.1089/heq.2024.0085","url":null,"abstract":"<p><strong>Introduction: </strong>Women Veterans are diverse in terms of racial, ethnic, and gender identities and sexual orientation and may experience a variety of forms of discrimination and stigma in health care settings. Our objective was to understand discrimination experienced by women Veterans in the context of Veterans Health Administration (VA) care.</p><p><strong>Methods: </strong>We analyzed data from a series of semistructured telephone interviews with Veterans identified as females in the VA medical record who received VA health care in the past 12 months, purposively sampled by race/ethnicity and age (<i>N</i> = 28). The interview guide elicited experiences with VA health care, including discrimination. Interviews were audio-recorded, transcribed, and analyzed using inductive and deductive content analysis.</p><p><strong>Results: </strong>We identified themes regarding structural discrimination, interpersonal discrimination, and strategies employed in response to discrimination. Veterans described structural discrimination, including challenges with spaces not designed to accommodate disabilities or safety needs and care not sensitive to their gender, trauma histories, or sexual orientation. Interpersonal discrimination included harassment from other Veterans and biased treatment from VA providers and staff based on gender, appearance, and sexual orientation. Gender-based discrimination compounded across additional axes of marginalization including body size and stigma regarding mental illness. Experiences of discrimination undermined Veterans' sense of belonging and trust in VA and created barriers to accessing care. Veterans engaged in various strategies to protect themselves from discrimination and get needed care.</p><p><strong>Discussion: </strong>Quality improvement efforts that address the experience of women Veterans using VA health care must consider multiple forms and sources of discrimination and the intersection of gender-based discrimination with other forms of marginalization.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"692-700"},"PeriodicalIF":2.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693687","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":"Exploring Transfeminine Youth Health Disparities in Thailand: An Online Survey Analysis of Characteristics and Hormonal Use Patterns.","authors":"Nadvadee Aungkawattanapong, Thitaporn Prownpuntu, Chansuda Bongsebandhu-Phubhakdi","doi":"10.1089/heq.2023.0258","DOIUrl":"10.1089/heq.2023.0258","url":null,"abstract":"<p><strong>Background: </strong>Transgender youth in Thailand often encounter limitations when accessing gender services, leading many to use nonprescribed hormones.</p><p><strong>Objectives: </strong>This study aimed to explore 1) the pattern of Gender-Affirming Hormone Treatment (GAHT) use among Thai transfeminine youth, 2) the baseline characteristics of transfeminine youth, and 3) the self-reported happiness score and depression screening.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey among Thai transfeminine youth aged 12 to 25 years. Data were collected using a self-administered questionnaire distributed via social media platforms from September 2021 to October 2022.</p><p><strong>Results: </strong>Of the 256 participants, 226 (88%) reported having used hormones. The average age at which participants first used hormones was 15.5 years (SD 2.5). A majority (94.6%) of those who had used hormones disclosed their gender identity, compared with a lower percentage (60%) in the nonhormone use group. Among those with hormone use experience, only 36.1% reported use that strictly aligned with the recommended regimen, according to the 2017 Endocrine Society Clinical Practice Guideline, which includes an antiandrogen agent (oral cyproterone acetate) and estrogen (either oral estradiol valerate, oral 17 beta-estradiol, or estrogen gel). Furthermore, the average happiness scores and PHQ-A scores showed no significant differences between individuals who have or have not used GAHT.</p><p><strong>Conclusion: </strong>Thai transfeminine youth have started using GAHT during adolescence. However, many of them use it in ways that deviate from the recommended standard of gender care. The findings underscore the urgent need to enhance medical access, education, and supervision for gender health care among transfeminine youth.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"676-682"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693690","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 Disparities in Incidence of Diaper Dermatitis and Implications for Diaper Inequities.","authors":"Jennifer Randles, Justin van Zerber, Kristian Browning, Balaraman Rajan, Benito Delgado-Olson","doi":"10.1089/heq.2024.0083","DOIUrl":"10.1089/heq.2024.0083","url":null,"abstract":"<p><strong>Objectives: </strong>To examine if the likelihood of infants and toddlers requiring medical care for diaper dermatitis, a condition linked to infrequent diaper changes and possible diaper need, is different across racial/ethnic groups.</p><p><strong>Materials/methods: </strong>This is a population-based retrospective study. We collected data via public records requests from the California Department of Health Care Access and Information to determine the number of patients aged 0 to 3 years diagnosed with diaper dermatitis from 2010 to 2021 in emergency departments (EDs) and hospitals. We used two sample t-tests to compare the incidences of ED visits and in-patient hospitalization during the 11-year time period to identify differences across racial/ethnic groups.</p><p><strong>Results: </strong>From 2010 to 2021, there were 184,097 total diagnoses of diaper dermatitis, 53,678 of which received in-patient treatment. The annual mean was 15,341 and ranged between 9,407 and 17,425. The prevalence (per 1,000 children aged 0-5 of the respective race) was highest for the Black population averaging 9.56 (range: 5.79 to 11.37). The prevalence was 5.93 (3.75 to 7) for the White population, 2.49 (1.78 to 3.14) for Asian/Pacific Islanders, and 6.67 (4.25 to 7.52) for the Hispanic population. We find that Black children were disproportionately diagnosed with diaper dermatitis in California hospitals and EDs (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Racial disparities in medical conditions that can result from lack of sufficient diapers point to diaper need as a social determinant of health deserving of greater public attention and policy redress.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"686-691"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693683","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 Conceptual Model to Achieve Health Equity in APOL-1 Clinical Studies.","authors":"Raven A Hardy Richard, Rebecca Hayes, Robert Flemming, Cesia Portillo, Richardae Araojo, Christine Lee","doi":"10.1089/heq.2024.0109","DOIUrl":"10.1089/heq.2024.0109","url":null,"abstract":"<p><p>The socioecological model (SEM) conceptualizes health broadly and focuses on multiple factors that might affect health. This article takes a novel approach to leverage an SEM framework to identify challenges and sustainable opportunities to advance diversity for clinical study participation in apolipoprotein L1 (APOL-1)-mediated kidney disease. We describe four levels of an APOL-1 SEM-intrapersonal, interpersonal, community, and structures/systems-for improved diverse APOL-1 clinical study enrollment and engagement. This SEM can serve as a model for improving clinical study diversity and equity to help improve the generalizability of clinical study results in other disease conditions that disproportionally impact racial and ethnic minority populations.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"701-706"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693612","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":"Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa.","authors":"Jennifer M C Sukalski, Natoshia M Askelson, Julie C Reynolds, Peter C Damiano, Wei Shi, Xian Jin Xie, Susan C McKernan","doi":"10.1089/heq.2023.0227","DOIUrl":"10.1089/heq.2023.0227","url":null,"abstract":"<p><strong>Purpose: </strong>Perceived social status (PSS), a measure of social status, reflects cumulative lifetime effects of an individual's relative social status based on resources and lived experiences. PSS is hypothesized to better capture social status compared to traditional measures of socioeconomic status (SES) (i.e., education, occupation, and income). Although recognized as a predictor of health-related morbidity and mortality, limited research has explored PSS and oral health. This study investigated PSS as a predictor of self-reported oral health among low-income adults.</p><p><strong>Methods: </strong>In spring 2018, a survey was administered to a random sample of low-income adults in the state of Iowa with public dental insurance (<i>N</i> = 18,000). Respondents were asked about PSS, oral health status, and demographics. Multivariable linear regression models examined PSS as a predictor of self-reported oral health and compared the predictive power of PSS and SES indicators.</p><p><strong>Results: </strong>The final adjusted sample size was 2,331. The mean PSS (range 1-10) was 5.3 (standard deviation 2.0). A significant positive association was noted between PSS (<i>ß</i> = 0.16, <i>p</i> < 0.0001) and self-reported oral health status when controlling for demographics. Furthermore, PSS accounted for an additional 3% of variance when controlling for demographic and SES indicators.</p><p><strong>Conclusions: </strong>PSS was associated with self-reported oral health status after adjusting for SES indicators, which reflects the importance of exploring the impact of individuals' perceptions of their social status in addition to objective measures of SES. Results suggest the need for future dental research to explore cumulative effects of lived experiences on current oral health status.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"667-675"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693636","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":"Practical Steps to Advance Health Equity in Research from the UCLA COVID-19 Health Equity Research and Advisory Committee.","authors":"Enrico G Castillo, Alma D Guerrero, Eraka P J Bath, Rochelle A Dicker, Eric Esrailian, Helena Hansen, Nina T Harawa, Breena R Taira, Christina Harris","doi":"10.1089/heq.2024.0088","DOIUrl":"10.1089/heq.2024.0088","url":null,"abstract":"<p><strong>Introduction: </strong>The University of California, Los Angeles COVID-19 Health Equity Research and Advisory Committee was created to identify and fund research to address COVID-19 inequities.</p><p><strong>Methods: </strong>The committee addressed barriers to health equity research and funded $1.5 million of research.</p><p><strong>Results: </strong>These actions facilitated dialogue, shifted research infrastructure, and piloted strategies to enhance health equity impacts through consultation and feedback. We provide an overview of projects funded and highlight one to demonstrate impact.</p><p><strong>Conclusion: </strong>We provide a framework to help institutions implement similar approaches to centering health equity in research.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"654-658"},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693610","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 Patient-Centered Forensic Nursing Model of Care for Victims of Law Enforcement Violence.","authors":"Maija Anderson, Jacqueline Callari-Robinson, Margaret Glembocki, Elizabeth Louden","doi":"10.1089/heq.2023.0270","DOIUrl":"10.1089/heq.2023.0270","url":null,"abstract":"<p><strong>Background: </strong>The manuscript examines the nature, manifestations, and potential causes of law enforcement violence as well the need for a model of care for victims. Specifically, it explores development of a preliminary forensic nursing model of care. The questions posed over the course of development of the model follow (1) What are the challenges to developing a rudimentary forensic nursing model of care for victims of law enforcement violence? (2) What are the tenets to be utilized in developing the model? (3) What additional recommendations are to be considered in refining and expanding the model?</p><p><strong>Key concept: </strong>A review of the literature in forensic nursing found a gap in care for victims of law enforcement violence. To address the gap given the lack of research, a preliminary model of care was developed based on key constructs from the following established models: (1) Theory of Abolition, (2) Critical Race Theory, (3) Levels of Racism, (4) Intersectionality, (5) Social Determinants of Health, (6) Emancipatory Praxis - Theory of Forensic Nursing, (7) Trauma-Informed Model of Care, and (8) Patient-Centered Model of Care.</p><p><strong>Implications for practice: </strong>The preliminary model developed adheres to the International Council of Nurses guidelines, which emphasize the nurse's duty to care without judgment or bias. Protocols established must be followed precisely to mitigate potential conflicts of interest in care of the victim. A practical application algorithm was developed based on care provided to other victims of violence.</p><p><strong>Conclusion: </strong>The model developed was focused on forensic nursing care. There is a need for further refinement involving an interdisciplinary approach. There is also a need for additional research as it relates to forensic nursing's role in caring for victims of law enforcement violence.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"8 1","pages":"619-635"},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693623","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}