Community health equity research & policy最新文献

{"title":"Understanding Barriers and Strategies to Accessing Healthy Food in Urban Agriculture for Community Residents in Predominantly Black Communities.","authors":"Saria Lofton, Akilah Martin, Marjorie Kersten, Nanyombi Lubimbi, Helene Vilme, Forgive Avorgbedor, Angela Odoms-Young","doi":"10.1177/2752535X231214844","DOIUrl":"10.1177/2752535X231214844","url":null,"abstract":"<p><strong>Background: </strong>Some residents in predominantly Black communities face significant challenges in accessing healthy food. However, urban agriculture is a growing sector that aims to increase overall food production, access to affordable and nutritious produce, and potentially improve community food security.</p><p><strong>Purpose: </strong>This study aimed to provide insight into barriers and strategies that urban agriculture growers and advocates identified for accessing urban agriculture markets in their communities.</p><p><strong>Research design and study sample: </strong>We interviewed and conducted focus groups with 17 urban growers and local food advocates that work in predominantly Black communities in Chicago.</p><p><strong>Data collection and/or analysis: </strong>Understanding the complexities of access to healthy food can be challenging; therefore, we used the concept of access - accessibility, availability, affordability, accommodation, and acceptability - to better understand these barriers.</p><p><strong>Results: </strong>Key barriers were the lack of accessibility to traditional food retailers, high availability of processed foods, and cultural acceptability of urban-produced foods.</p><p><strong>Conclusion: </strong>Building urban agriculture networks to support growers, connect with consumers, and emphasize political engagement can help to diversify and grow urban agriculture.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"291-303"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72212184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending Kingdon's Multiple Streams Policy Framework Through an Analysis of How Community Health Workers in India Are Driving Policy Changes.","authors":"Sanjana Santosh, Sumit Kane","doi":"10.1177/2752535X231222654","DOIUrl":"10.1177/2752535X231222654","url":null,"abstract":"<p><p>In this paper we develop and provide a novel account of the process through which the Accredited Social Health Activists (ASHAs), a cadre of seemingly powerless community health workers in India, are navigating a complex policy process to incrementally achieve their goals. ASHAs have been demanding better working conditions, better compensation, and regularisation as public service employees through protests and strikes and have managed to gain concessions from both the Central and various State governments. We observed two important aspects that emerged: (a) ASHAs achieved incremental increases in their wages despite being the lowest in the health system hierarchy, and, (b) major gains were made during the 2 years of the pandemic. We examine and analyse ASHAs' engagement and strategies used, both overt and covert, sometimes with the government, and the role of other actors in determining these policy outcomes. We do so by drawing on academic literature and news media reports; we trace the changes in ASHAs' wages by tying together key events, 'windows of opportunity', and actions of 'policy entrepreneurs' involved in the process.In doing so, we further develop and propose an extension to Kingdon's multiple streams policy framework through the addition of a 'narrative stream'.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"245-260"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813424","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":"An Ethics of Justice in Elderly Care: Ageism and the Covid-19 Pandemic.","authors":"Christopher Ryan Maboloc, Anesito Cutillas","doi":"10.1177/2752535X231219017","DOIUrl":"10.1177/2752535X231219017","url":null,"abstract":"<p><strong>Background: </strong>The study looks into the condition of elderly Covid-19 patients regarding the kind of attention they received during the pandemic given the scarcity of medical resouces in the countries mentioned in this investigation. In this case, we apply the bioethical principle of justice on the age-based criteria in determining which patient must receive treatment The argument is that the same is a form of discimination against the elderly.</p><p><strong>Purpose: </strong>The purpose of this study is to emphasize that the age-based criteria in deciding whether to treat elderly Covid-19 patients or not is violative of the bioethical principle of justice since it discriminates against them.</p><p><strong>Method: </strong>This study uses the interpretive method. The authors analyzed the literature and the arguments pertaining to the issue of ageism at the height of the Covid-19 Pandemic. We mentioned the countries where the issue of prioritization was a big concern. The qualitative analysis in this paper is meant to respond to such medical dilemma.</p><p><strong>Analysis: </strong>In our analysis, we determined that when age is used as a criterion, it violates the bioethical principle of justice. The principle is meant to ensure that physicians are fair in dealing with patients. Using age in deciding whether a life is worth saving or not is a prejudice against old people who require care and attention.</p><p><strong>Discussion: </strong>Medical doctors must treat patients equally and without bias. The challenge, however, is that due to the unprecedented nature of the pandemic, a triage is put in place to be able to manage the overwhelming influx of Covid-19 patients. Some age-based medical treatment criteria that recommend age-based cutoffs for specific treatments are morally untenable. This is because the same is bereft of any acceptable justification that warrants the judgment that the elderly must have less priority when medical resources are scarce.</p><p><strong>Conclusion: </strong>In conclusion, doctors must not discriminate patients on the basis of age. All lives are equal in moral worth. We argue that governments must promulgate non-discriminatory policies when it comes to medical treatment during a global public health emergency.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"237-243"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Bridges Toward Common Goals - A Call for Greater Collaboration Between Public Health and Integrative, Complementary and Traditional Health Providers.","authors":"Margaret D Whitley, Michele Maiers, Daniel F Gallego-Pérez, Bernadette Boden-Albala, Ian D Coulter, Patricia M Herman","doi":"10.1177/2752535X231195522","DOIUrl":"10.1177/2752535X231195522","url":null,"abstract":"<p><p>This commentary makes the case for greater collaboration between public health professionals and integrative, complementary and traditional health practitioners (ICTHP). Previous partnerships have been successful, and more such collaborative work is needed to help overcome division, enhance the health workforce, and move all involved toward shared goals. ICTHP providers may be uniquely able to work across ideological differences and engage individuals and communities who are less trusting of public health, including those who are vaccine hesitant. Diverse partnerships can be difficult to maintain, but the application of equitable processes may aid their success. In the face of highly complex public health challenges, partnerships with ICTHP are critical.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"261-263"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10869632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031391","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":"Small Steps Towards an Inclusive Diabetes Prevention Program: How Small Steps for Big Changes is Improving Program Equity and Inclusion.","authors":"Kaela D Cranston, Megan M MacPherson, Jenna Ap Sim, Mary E Jung","doi":"10.1177/2752535X231189932","DOIUrl":"10.1177/2752535X231189932","url":null,"abstract":"<p><p>Social determinants of health, the effects of colonialism, and systemic injustices result in some groups being at disproportionately higher risk for developing type 2 diabetes (T2D). Many T2D prevention programs have not been designed to provide equitable and inclusive care to everyone. This paper presents an example of the steps taken in an evidence-based community T2D prevention program, Small Steps for Big Changes (SSBC), to improve equitable access and inclusivity based on input from a stakeholder advisory group and the ConNECT Framework. To improve reach to those most at risk for T2D, SSBC has changed both eligibility criteria and program delivery. To ensure that all testing is done in an inclusive manner, changes have been made to measurements, and to training for those delivering the program. This paper also provides actionable recommendations for other researchers to incorporate into their own health programs to promote inclusivity and ensure that they reach those most at risk of T2D.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"227-236"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9853672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of street-based COVID-19 vaccination clinics in Phoenix's homeless population.","authors":"Justin Zeien, Jaime Vieira, Jeffery Hanna, Alma Ramirez, Catherine Miller, Jennifer Hartmark-Hill, Cecilia Rosales","doi":"10.1177/2752535X231196415","DOIUrl":"10.1177/2752535X231196415","url":null,"abstract":"<p><p>The novel Coronavirus (COVID-19) is a highly contagious viral illness that has caused the most significant global health crisis in recent human history. Individuals experiencing homelessness represent one of the more vulnerable populations for COVID-19 infection and morbidity. Amongst individuals experiencing homelessness in Phoenix, a student-led interprofessional organization called Street Medicine Phoenix (SMP) sought to both reduce the risk of COVID-19 transmission and morbidity/mortality related to infection. Through collaborations with the Maricopa County Department of Public Health and various community organizations, SMP developed a format for street-based vaccination clinics. SMP deployed these clinics on numerous occasions to the streets directly surrounding the community homeless shelter, allowing SMP to vaccinate individuals directly in their encampments. Through SMP's efforts starting in February 2021, 400 individuals experiencing homelessness have received at least one COVID-19 vaccine. Challenges encountered included low health literacy, lack of established rapport and trust, low vaccine confidence, difficulty verifying patients' vaccination status, difficulty obtaining sufficient information from patients to create a record in the Arizona State Immunization Information System (ASIIS), monitoring patients post-vaccination, transporting vaccine supplies from encampment to encampment, and lack of patient awareness of the mobile vaccine clinic services. Despite challenges, SMP's outreach efforts have demonstrated the feasibility and importance of mobile public health services to reach homeless encampments, particularly mobile vaccination clinics in response to disease outbreaks, and the necessity of strategic partnerships with community agencies to effectively meet the needs of underserved populations.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"265-273"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10459224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Organizational Capacity to Advance Health Equity: Mixed-Methods Approach at a Local Health Department.","authors":"Shipra Singh, Mounika Polavarapu, Katharine Vallerand, Yashika Bhoge, Krista McCarthy Noviski","doi":"10.1177/2752535X231219297","DOIUrl":"10.1177/2752535X231219297","url":null,"abstract":"<p><p>Local health departments (LHDs) play a leading role in eliminating health inequities as they proactively identify and address barriers to optimal health within the community they serve. This study evaluated a Midwestern County LHD's commitment, collaborations, and capacity to advance health equity in their organization. A total of 81 employees completed the online survey (response rate = 51%) and 12 among randomly selected employees completed the qualitative interviews (31.5%). More than 75% of participants reported that all departments had explicit work plans and 50% had a strong capacity to address social determinants of health. Almost 50% of the participants reported strong internal collaboration, but less than 25% indicated that no external partners were involved during the program planning process. Finally, a few participants identified the need for increased diversity in leadership and expressed the importance of quality training and feedback.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"305-314"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Landscape of Health Technology for Equity Deserving Groups in Rural Communities: A Systematic Review.","authors":"Lindsay Burton, Fathi Milad, Robert Janke, Kathy L Rush","doi":"10.1177/2752535X241252208","DOIUrl":"10.1177/2752535X241252208","url":null,"abstract":"<p><strong>Background: </strong>Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes.</p><p><strong>Purpose: </strong>The purpose of this systematic review was to examine the patient, healthcare, and economic outcomes of health technology applications with rural living equity-deserving groups.</p><p><strong>Research design: </strong>The databases searched included Medline and Embase. Articles were assessed for bias using the McGill mixed methods appraisal tool.</p><p><strong>Analysis: </strong>Data were synthesized narratively using a convergent integrated approach for qualitative and quantitative findings.</p><p><strong>Results: </strong>This evidence synthesis includes papers (<i>n</i> = 21) that reported on health technologies targeting rural equity-deserving groups. Overall, patient outcomes - knowledge, self-efficacy, weight loss, and clinical indicators - improved. Healthcare access improved with greater convenience, flexibility, time and travel savings, though travel was still occasionally necessary. All studies reported satisfaction with health technologies. Technology challenges reported related to connectivity and infrastructure issues influencing appointment quality and modality options. While some studies reported additional costs, overall, studies indicated cost savings for patients.</p><p><strong>Conclusions: </strong>There is a paucity of research on health technologies targeting rural equity-deserving groups, and the available research has primarily focused on women. While current evidence was primarily of high quality, research is needed inclusive of equity-deserving groups and interventions co-designed with users that integrate culturally sensitive approaches. Review registered with Prospero ID = CRD42021285994.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"315-335"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878071","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":"Violence Against Lesbian, Gay, and Bisexual Older Adults: Findings From the Brazilian Health System.","authors":"Daniel Canavese, Maurício Polidoro, Sávio Marcelino Gomes, Ariadne Ribeiro Ferreira","doi":"10.1177/2752535X251327537","DOIUrl":"https://doi.org/10.1177/2752535X251327537","url":null,"abstract":"<p><p>The primary objective of this research was to describe the prevalence of violence against older adults according to sexual orientation as documented in the Notifiable Diseases Information System (SINAN) in Brazil. SINAN is a national database that compiles violence-related notifications reported by healthcare services. This ecological study analyzed aggregated data at the population level, focusing on violence notifications involving individuals aged 50 and above from 2017 to 2021. The data underwent descriptive and bivariate statistical analyses, adhering to a significance level of 5%. The completeness percentage of the sexual orientation variable ranged from 70% to 72%. Our analysis detected noteworthy disparities in the distribution of violence notifications based on sexual orientation. Specifically, lesbians had the highest incidence rates of physical violence compared to heterosexual and bisexual women. In a broader context, women demonstrated a higher susceptibility to psychological violence, with bisexual women experiencing a notably elevated prevalence (41.67%). Reports of physical and psychological violence differed based on contextual variables, such as race, education level, and geographic region. We hereby conclude that the disparities found in violence notifications underscore a troubling situation faced by older adults within the LGB community, with a particular emphasis on the challenges encountered by bisexual individuals. Improving cultural competence in health systems is essential to enhancing data collection and understanding the complexities of violence against this population.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251327537"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Engaged Health Communication Strategies During the COVID 19 Pandemic: Experiences From Southern Andean Peru.","authors":"Jeannie Samuel, Carmen J Yon, Ariel Frisancho, Luz Estrada, Milagro Lourdes Valdez Jaén, Domingo P Paucar Pari, Daniel Rojas","doi":"10.1177/2752535X251323637","DOIUrl":"https://doi.org/10.1177/2752535X251323637","url":null,"abstract":"<p><p>This study examines the work of a collective of community-based Indigenous health rights activists in southern Peru who, at the height of the pandemic, designed, recorded, and disseminated seven Quechua language and culturally tailored Public Service Announcements for radio broadcast to provide information about COVID-19 vaccines. The activists took initiative amid a dysfunctional vaccine roll-out, when vaccination rates in their region were among the lowest in the country, and when mortality rates from COVID-19 were very high. The experiences of the activist collective, including their participatory, community-based approach and their connections with health workers, demonstrate the importance of pre-existing, strong, respectful relationships between communities and health systems in times of public health crisis. This is not an easy task given that relationships between communities and Peru's government-run health system are complex and shaped by dynamics of power, including colonial legacies and contemporary injustices. This case critically reflects on the notion of resilience and provides insights into the enduring struggles by Indigenous activists to decolonize and strengthen the public health system by pushing for forms of community participation based on substantive partnerships with community-based actors that genuinely integrate their knowledge and expertise.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251323637"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}