Health Equity最新文献

{"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}

{"title":"\"Created Anew\": Notes on Black Queer Intersectional Joy.","authors":"Marie-Fatima Hyacinthe, Elle Lett","doi":"10.1089/heq.2023.0132","DOIUrl":"10.1089/heq.2023.0132","url":null,"abstract":"<p><p>While a focus on intersectional oppression elucidates important structural influences on health, it also obfuscates elements of how oppressed communities view themselves and their experiences. Black queer intersectional joy is one such element, and exploring this concept provides different openings for researchers to build solidarity with and produce relevant research alongside communities facing class oppression, heterosexism, racism, and cissexism. This article provides examples of Black queer intersectional joy, as well as potential problems and opportunities for engaging this concept.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"60-64"},"PeriodicalIF":2.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693755","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":"Qualitative Study of Health Care Professional Perspectives on Recruiting Minority Patients in Cancer Trials.","authors":"Katharine A Price, Rahma Warsame, Elhadji A Toure, Molly O'Shea, Yong-Hun Kim, Sara A Ellingson, Joselle M Cook, Gladys B Asiedu","doi":"10.1089/heq.2024.0184","DOIUrl":"10.1089/heq.2024.0184","url":null,"abstract":"<p><strong>Background: </strong>Underrepresented minority (URM) patients enroll in cancer clinical trials at low rates. We studied the perspectives of health care professionals to better understand the challenges and potential facilitators of recruiting URM patients into clinical trials.</p><p><strong>Methods: </strong>A purposeful sampling approach was utilized to recruit health care professionals and clinical research staff who recruited and cared for URM patients in a therapeutic cancer clinical trial at any Mayo Clinic site, from July 2018 through October 2021.Data were gathered using a semistructured qualitative interviews. Participants were interviewed about the challenges of recruiting URM patients into cancer clinical trials and possible strategies for improving URM patient enrollment. Data were analyzed using a thematic analysis.</p><p><strong>Results: </strong>Of the key themes that emerged from participant interviews (<i>n</i> = 28), perceived barriers to recruiting URM patients into clinical trials included lack of workforce diversity, underutilization of patient navigators, ineffective community outreach and patient recruitment, restricted access to diverse patient populations, and restrictive clinical trial eligibility criteria. Other barriers reported were lack of insurance and access to care and transportation, low socioeconomic status, and mistrust of health care and research. Strategies suggested for improving the recruitment of URM patients into clinical trials included: diversifying and adding research staff, increasing and improving community outreach and advocacy, partnering with clinics closer to patients, increasing monetary and logistical support for patient participation, creating opportunities that build and enhance trust, and systematically examining and modifying clinical trial eligibility criteria.</p><p><strong>Conclusions: </strong>Our findings reveal barriers that have limited URM patient inclusion in cancer clinical trials and highlight strategies to overcoming these barriers.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"53-59"},"PeriodicalIF":2.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693821","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":"COVID-19 Vaccine Rollout Strategies in Utah from Local Health Departments' Perspectives: A Qualitative Analysis of Focus Group Discussions.","authors":"Khanh N C Duong, Sajesh K Veettil, Richard E Nelson, Barbara E Jones, Andrew T Pavia, Danielle T Nguyen, Makoto M Jones, Matthew H Samore, Susan L Zickmund, Patrick Galyean, Nathorn Chaiyakunapruk","doi":"10.1089/heq.2024.0067","DOIUrl":"10.1089/heq.2024.0067","url":null,"abstract":"<p><strong>Introduction: </strong>Local health departments (LHDs) play an essential role in providing COVID-19 vaccines to underserved populations in Utah. This study aimed to understand barriers to COVID-19 vaccine uptake for these populations and challenges faced by LHDs from LHDs' perspectives. In addition, we explored LHDs' experience with implementing COVID-19 mobile vaccine clinics (MVCs) in Utah.</p><p><strong>Materials and methods: </strong>We conducted virtual focus group discussions (FGDs) from October 28 to November 1, 2022, with health officers from Utah's Department of Health and Human Services (DHHS) and LHDs. We recruited participants via email, transcribed recordings verbatim, and analyzed data using inductive content analysis.</p><p><strong>Results: </strong>Eight participants, one from the Utah DHHS and seven from Utah's LHDs (mostly executive directors or managers), participated in two FGDs. Barriers to vaccine uptake among underserved communities included structural, behavioral, and informational barriers. LHDs faced two main challenges to increasing vaccination rate: limited resources and the lack of established partnerships with trusted communities/organizations/leaders. Strategies implemented to increase vaccine uptake included multiple channels for vaccine access and information provision, and building multiple partnerships. Key lessons learned were the importance of partnerships with trusted community/organization leaders and building core staff for vaccine uptake. Regarding MVCs, they were effective in reaching underserved populations, however, their impact was unclear in rural areas.</p><p><strong>Conclusion: </strong>Building trust through partnerships with trusted community/organization leaders was crucial for increasing vaccine uptake in underserved populations and promoting health equity. The impact of MVCs on underserved populations in different settings remains unclear, further research is needed.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"31-40"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733701","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":"Weight-Based Health Care Discrimination and Cervical Cancer Screening Among Black Sexual and Gender Minoritized Assigned Female at Birth Adults in the United States.","authors":"Simran Singh, Neil Mehta, Madeline Noh, Keosha Bond, Megan Threats, John W Jackson, Nkiru Nnawulezi, Marquisele Mercedes, Madina Agénor","doi":"10.1089/heq.2024.0158","DOIUrl":"10.1089/heq.2024.0158","url":null,"abstract":"<p><strong>Introduction: </strong>Black sexual and gender minoritized (SGM) people assigned female at birth (AFAB) face notable barriers to cervical cancer screening, including racism, heterosexism, and cisgenderism. Although weight-based discrimination is prevalent in the United States and may compound other forms of discrimination, no study has examined the association between weight-based discrimination in health care settings and Pap test use among Black SGM AFAB.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional online survey among Black SGM AFAB adults aged 18-45 years (<i>N</i> = 135) and used multivariable logistic modeling to analyze the association between weight-based health care discrimination and Pap test use, adjusting for demographic, socioeconomic, and health care factors.</p><p><strong>Results: </strong>Approximately one quarter (27.5%; <i>n</i> = 33) of respondents eligible for a Pap test had ever experienced weight-based health care discrimination. Moreover, 63.3% (<i>n</i> = 76) and 45% (<i>n</i> = 54) of respondents had ever received a Pap test in their lifetime and in the last 3 years, respectively. Respondents who had experienced weight-based health care discrimination had significantly lower adjusted odds of having ever received a Pap test in their lifetime (odds ratio [OR] = 0.10; 95% confidence interval [CI]: 0.02-0.40) and in the last 3 years (OR = 0.07; CI: 0.01-0.31) compared with those who had never experienced such discrimination.</p><p><strong>Discussion: </strong>Additional research is needed to elucidate the unique experiences of specific subgroups of Black SGM people and to inform policies, norms, and practices that mitigate the occurrence and effects of weight-based health care discrimination among Black SGM people in the context of cervical cancer screening and other health services.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"22-30"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733702","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":"Effectiveness of Hospital-Community Partnerships in Preventive Health Care Interventions: An Exploration of Racial and Ethnic Disparities in Impact.","authors":"Ohbet Cheon, No Young You","doi":"10.1089/heq.2023.0259","DOIUrl":"10.1089/heq.2023.0259","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital-community partnerships have been increasingly emphasized to improve population health in recent decades. This study investigates the effectiveness of hospital-community partnerships in preventive health care interventions, addressing potential racial and ethnic disparities in impact.</p><p><strong>Methods: </strong>We measured overall hospital-community partnerships with nine community organizations at the county level using the American Hospital Association annual survey. Preventive health care interventions were also measured by preventable hospitalization rates, mammography screening rates, and flu vaccination rates across racial and ethnic groups using County Health Ranking National data. We estimated pooled ordinary least squared models with year-fixed effect and robust cluster standard errors at the state level. We also used generalized least squares models to examine the impact across racial and ethnic groups, including controls for county characteristics.</p><p><strong>Results: </strong>Among 3785 counties across 50 states in the United States in the pooled data, the findings indicated that hospital-community partnerships were effective in increasing mammography screening and flu vaccination rates in general. However, upon closer examination of the impact across racial and ethnic groups, hospital-community partnerships were not significantly associated with any of the interventions in the Black and Hispanic population, while they were effective in the White population.</p><p><strong>Discussion: </strong>Hospital-community partnerships can be effective in increasing uptake rates for mammography screening and flu vaccination rates, but their impact is unevenly distributed among racial and ethnic minorities.</p><p><strong>Health equity implications: </strong>The findings emphasize the need to design targeted hospital-community partnerships for racial and ethnic minorities to mitigate health disparities in preventive health care interventions.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"8-17"},"PeriodicalIF":2.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693741","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":"\"We Have to Move Quickly to Cement This Willingness for Change\": News Narratives About Declarations of Racism as a Public Health Crisis, 2019-2021.","authors":"Hina Mahmood, Pamela Mejia, Katherine Schaff, Catherine Labiran, Xavier Morales, Lori Dorfman","doi":"10.1089/heq.2023.0276","DOIUrl":"10.1089/heq.2023.0276","url":null,"abstract":"<p><strong>Objective: </strong>To understand how declarations of racism as a public health crisis were portrayed in the news from 2019 to 2021.</p><p><strong>Methods: </strong>We assessed a national sample of articles (<i>n</i> = 127) to see how declarations of racism as a public health crisis were characterized in the news.</p><p><strong>Results: </strong>Coverage skyrocketed in June 2020 with 800 articles in that month alone, many of which mentioned systemic or structural racism (43% of articles). Government speakers were quoted in 90% of articles while community voices only appeared in 24% of articles.</p><p><strong>Discussion: </strong>Narratives that center the causes of structural and systemic racism can help inform the public about the health harms of racism and can also report on solutions to achieve health and racial equity that could influence policymakers and the public.</p><p><strong>Health equity implications: </strong>Those proposing new declarations should make concerted efforts to ensure that these declarations generate news coverage, without relying on acts of violence against Black, Indigenous, and People of Color (BIPOC) communities. Public health practitioners, advocates, and officials should center communities most impacted and help them in creating a system that addresses racial and health inequities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693758","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 Age of the Soft-Girl Era: How Public Health Scholars May Seize Opportunity of Innovatively Promoting Reproductive Health and Nutritional Health Among Black Women of Color.","authors":"Vanessa Nicholson-Robinson","doi":"10.1089/heq.2024.0063","DOIUrl":"10.1089/heq.2024.0063","url":null,"abstract":"<p><p>In the current soft-girl era, a soft lifestyle promotes living with ease, comfort, healing, and joy. As health equity programs evolve, they should provide safe spaces for participants' experiences, desires, and motivations for wellness living. Contributions of the soft-girl era movement challenge the notions for historically marginalized women to thrive in their health rather than merely surviving through it. If public health fields are to expand, including the fields of Black maternal health and Black food justice, Black participation is critical. The movement offers researchers to acknowledge participant voice, thereby gaining their trust, interest, and on-going participation in health programs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"18-21"},"PeriodicalIF":2.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693834","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}