Health Equity最新文献

{"title":"What <i>Health Equity</i> Journal Stands For.","authors":"Monica R McLemore","doi":"10.1089/heq.2025.0031","DOIUrl":"https://doi.org/10.1089/heq.2025.0031","url":null,"abstract":"","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"142-143"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660659","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":"From Vision to Action: National Bleeding Disorders Foundation's Roadmap for Achieving Health Equity, Diversity, and Inclusion.","authors":"Keri L Norris, Marissa Melton, Karina Lopez, Dawn Rotellini, Leonard A Valentino","doi":"10.1089/heq.2024.0146","DOIUrl":"https://doi.org/10.1089/heq.2024.0146","url":null,"abstract":"<p><strong>Background: </strong>The National Bleeding Disorders Foundation (NBDF) consistently hears from lived experience experts about daily challenges preventing them from leading their best life and thriving physically, mentally, and emotionally. Dedicated to enabling people and families impacted by inheritable blood and bleeding disorders (BDs) to thrive, NBDF recognized that the impact of social determinants, disparities, and inequities of health must be addressed explicitly to achieve their mission.</p><p><strong>Methods: </strong>NBDF developed a health equity, diversity, and inclusion strategic direction for the coming decade in the context of collaboration with regional, national, and international partners. Drawing upon limited available data, extensive community consultation, and a thorough landscape scan, NBDF identified specific social determinants of health preventing health equity in the inheritable BDs community.</p><p><strong>Results: </strong>NBDF developed a model detailing the engaging, empowering, and elevating work individual, community, organizational, and institutional stakeholders must undertake to dismantle health equity barriers. Overarching priorities and strategies were established, providing leadership, and support was offered in the form of tools, resources, and expertise.</p><p><strong>Conclusion: </strong>Designed to be tailored to needs and capacities, this approach may be applied by other rare disorder communities to develop and operationalize their own health, equity, diversity, and inclusion strategic direction to advance social justice.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"144-160"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660650","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":"Epidemiological Assessment and Inference in Race-Based Clinical Algorithms: A Narrative Review and Health Policy Analysis Focused on Living Kidney Donation.","authors":"Sienna E Schaeffer, Carolina Gonzalez Bravo, Christopher D Ahlers, Alaina N Elliott-Wherry, Hannah Zadeh, Precious-Junia de-Winton Cummings, Kimberly C Dukes, Nasrien E Ibrahim, DeShauna Jones, Patrick T Zamba, Aloha D Wilks, Martha L Carvour","doi":"10.1089/heq.2024.0170","DOIUrl":"https://doi.org/10.1089/heq.2024.0170","url":null,"abstract":"<p><strong>Background: </strong>Minoritized racial and ethnic groups in the United States face long-standing disparities in a variety of health outcomes, owing to inequitable distribution of social and structural determinants of health along racial and ethnic lines. Although the existence of such disparities has long been a topic of scientific inquiry, there has been a dearth of investigations regarding their underlying mechanisms and potential remedies. This presents a challenge to those creating evidence-based and equity-focused health policy.</p><p><strong>Methods: </strong>We conducted an evidence-based, equity-focused narrative review about living kidney donor eligibility using salient literature about donor eligibility and racial and ethnic disparities in kidney transplantation and donation in the United States. We sought to examine the rigor and reproducibility of the evidence base regarding race- and ethnicity-based living kidney donation policies.</p><p><strong>Results: </strong>Our review identified several threats to scientific validity in the evidence base, including ambiguity in the operationalization of race and ethnicity variables, instances of type III error and racial essentialist biases, and causal inferences made using underpowered or scientifically unsubstantial subgroup analyses. We also identified structural barriers to the interpretation of this evidence to advance health equity, including barriers to the practices of clinical equipoise and shared medical decision-making.</p><p><strong>Conclusions: </strong>Threats to scientific validity and inferential errors in the evidence base about health inequities may forestall progress toward equity. We provide recommendations for addressing such barriers using standards applied in other clinical and research domains.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"161-169"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660641","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}

{"title":"Place-Based Disparities Among Nursing Homes During the COVID-19 Pandemic: A Systematic Literature Review.","authors":"Erica Gigas, Nicholas O'Neel, Lorinda A Coombs, Jamie Conklin, Margaret Chamberlain Wilmoth, Baiming Zou, Patricia Schmidt, Saif Khairat","doi":"10.1089/heq.2024.0091","DOIUrl":"10.1089/heq.2024.0091","url":null,"abstract":"<p><strong>Introduction: </strong>Disasters have disproportionately impacted nursing home (NH) residents. COVID-19 impacted NH more so than the community-dwelling population, but there was much variation in mortality rates among NH residents. These disparities have been studied, but place-based disparities have received less attention. Place-based disparities are differences in health due to physical location, including factors like rurality, local socioeconomic conditions, and the physical environment.</p><p><strong>Methods: </strong>We searched three databases for peer-reviewed studies of place-based factors associated with mortality in U.S. NHs during the COVID-19 pandemic, ending in January 2024. Data were organized using the National Institute on Minority Health and Health Disparities research framework.</p><p><strong>Results: </strong>We identified 27 articles that included individual, interpersonal, community, and societal place-based factors associated with mortality during the pandemic. Differences in mortality were related to local community socioeconomic factors, staff neighborhood socioeconomic factors, urbanity, community viral spread, and state-level factors, including political leaning and social distancing policies. Rurality was associated with lower mortality but was also associated with racial disparities.</p><p><strong>Discussion: </strong>Place-based disparities at the individual, organizational, community, and societal levels were identified. Rurality and local COVID-19 spread were the most commonly studied place-based factors associated with NH deaths during the pandemic. Neighborhood factors may be most impactful through the impact on NH staff. Racial disparities were linked with location, highlighting the effects of historical systemic racism on NHs. Policies to protect NH residents during disasters must be sensitive to local characteristics.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"73-86"},"PeriodicalIF":2.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693782","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":"Moving Beyond Mandatory Modules: Authentic Discussions About Racism and Health Equity at a Large Academic Medical Center.","authors":"Karla Chamorro Garcia, Byron Gonzalez, Julia A Healey, Leah Gordon, Maria Perla Brault, Esteban A Barreto, Carlos G Torres","doi":"10.1089/heq.2024.0129","DOIUrl":"10.1089/heq.2024.0129","url":null,"abstract":"<p><strong>Introduction: </strong>Our institution launched a large-scale virtual training program called \"Stepping Stones\" that uses allegories to provide an increased understanding of concepts, such as interpersonal, internalized, and structural racism. The goal of this project was to implement facilitated discussions with trained leaders and determine the impact of these sessions in improving the experience of the modules and boosting comfort in discussing race and racism.</p><p><strong>Methods: </strong>We developed facilitated discussions as a complimentary intervention for colleagues who participated in the virtual system-wide intervention. Our intention was to create a safe space to foster reflection and collaborative learning on how racism shows up in our work environment. We conducted 22 sessions across Massachusetts General Hospital between December 2021 and February 2023. Each session included between 5 and 30 participants who were asked to complete a survey regarding their experience.</p><p><strong>Results: </strong>We collected post-session surveys from 102 out of 350 participants. Participants found the sessions to be informative and valuable. Over 97% of respondents rated the quality of the discussions as \"Excellent\" or \"Very Good.\" Similarly, 95% of participants felt \"Very\" or \"Somewhat\" comfortable with discussing issues of race and racism in the workplace after the session.</p><p><strong>Discussion: </strong>Participants reported that the facilitated discussions were valuable, enhanced their ability to talk about racism in clinical environments, and provided an opportunity for reflection. Giving the hospital staff a common language and the ability to discuss such challenging topics may contribute to a culture of equity within our hospital.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"65-72"},"PeriodicalIF":2.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693777","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}