International journal of social determinants of health and health services最新文献_第2页

Power, Politics, and Policy in the Making of Health Inequities: An Empirical Study of Equity-Oriented Policy Actors in Canada. 权力、政治和政策在卫生不公平的制定：在加拿大公平导向的政策行为者的实证研究。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-07-10 DOI: 10.1177/27551938261467630

Arnel M Borras

{"title":"Power, Politics, and Policy in the Making of Health Inequities: An Empirical Study of Equity-Oriented Policy Actors in Canada.","authors":"Arnel M Borras","doi":"10.1177/27551938261467630","DOIUrl":"10.1177/27551938261467630","url":null,"abstract":"Structural health inequities in Canada remain entrenched-and in some areas have intensified-despite decades of commitments to equity. This study examines how power relations shape the conditions under which health equity policy reform is pursued and constrained. Grounded in critical political economy, the analysis draws on 23 semi-structured interviews with Canadian policy scholars, advocates, union leaders, and health professionals engaged in equity-oriented work. Thematic analysis identified four interrelated dynamics shaping health equity policymaking: institutional arrangements that privilege capital accumulation over redistribution; the institutionalization of corporate power within policymaking; neoliberal governance norms that narrow politically feasible policy responses; and fragmentation within civil society that weakens sustained collective pressure for redistributive change. Together, these dynamics illuminate how power is organized across economic, political, and institutional domains, contributing to persistent health inequities despite formal equity commitments. While participants referenced participation, consultation, and access to decision making, these mechanisms were experienced within policy environments characterized by structural power asymmetries. Rather than attributing inequities to evidence gaps or implementation failures, the analysis situates them as outcomes of political-economic arrangements shaping policy feasibility. Advancing health equity therefore requires confronting structural power relations and strengthening collective capacity for redistributive and democratic change beyond the health sector.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"451-466"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426745","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}

引用次数: 0

Privatized Health Care System in Times of Crisis: South Korea's Health Care System Response to the COVID-19 Pandemic. 危机时期的私有化医疗体系：韩国医疗体系对COVID-19大流行的应对。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-06-18 DOI: 10.1177/27551938261449602

Juyeon Lee, Jungwook Kim, Rora Oh, Rangkyung Ha, Myoung-Hee Kim

{"title":"Privatized Health Care System in Times of Crisis: South Korea's Health Care System Response to the COVID-19 Pandemic.","authors":"Juyeon Lee, Jungwook Kim, Rora Oh, Rangkyung Ha, Myoung-Hee Kim","doi":"10.1177/27551938261449602","DOIUrl":"10.1177/27551938261449602","url":null,"abstract":"The COVID-19 pandemic was a global public health crisis that demanded a \"whole-of-society\" response. In many countries, coordinating efforts across public and private health care sectors proved challenging. Yet South Korea maintained one of the world's lowest excess mortality rates despite having a predominantly privatized health care system, with 90.3% of hospital beds privately owned. This outcome was enabled in part by the government's strategy of disproportionately mobilizing and repurposing public hospitals as dedicated COVID-19 treatment facilities. These hospitals, historically few in number, chronically under-resourced, and marginalized as safety nets for vulnerable populations, became the backbone of Korea's health care system response. This qualitative study examines how this process unfolded and its consequences for public hospitals and marginalized populations they serve, drawing on in-depth interviews with public hospital staff and community activists, complemented by publicly available government reports and administrative data. Our findings reveal that the repurposing of public hospitals was carried out through a highly centralized, top-down process with minimal coordination, inadequate legal safeguards, and no institutional protection. This approach generated short-term gains but ultimately led to reduced patient trust, financial instability, and a staffing exodus that compromised the long-term capacity of the public health sector.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"478-490"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280265","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}

引用次数: 0

Clarifying Structural Interpretation in South Korea's COVID-19 Response: A Brief Note on Common Misreadings. 澄清韩国应对新冠肺炎的结构性解释：对常见误读的简要说明。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-04-20 DOI: 10.1177/27551938261442750

Jin-Hwan Kim

{"title":"Clarifying Structural Interpretation in South Korea's COVID-19 Response: A Brief Note on Common Misreadings.","authors":"Jin-Hwan Kim","doi":"10.1177/27551938261442750","DOIUrl":"10.1177/27551938261442750","url":null,"abstract":"This brief note responds to recent critiques of the article, \"The Predestined Failure of the Market Mechanism in Ensuring Health for All in Times of a Pandemic: The Case of the Republic of Korea.\" The critiques primarily stem from interpreting structural arguments through a managerial and episodic lens. First, this response clarifies the theoretical application of state theory (drawing on Wright and Jessop) to distinguish the structural constraints of the state from the behavioral choices of the government, thereby rejecting claims of structural determinism. Second, it reiterates that South Korea's public health measures and medical-care capacity must be understood as inseparable components evolving within a single market-dependent configuration. The analytic focus is on institutional rigidity and path dependency, rather than a post-hoc evaluation of policy choices. Finally, it addresses concerns regarding expenditure estimates, arguing that the high costs incurred during the pandemic reflect the structural burden of purchasing critical-care capacity from a private market. Ultimately, this note underscores the necessity of analyzing public health responses within their broader political economy and institutional contexts.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"495-497"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730778","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}

引用次数: 0

Doctors' Conflict-of-Interest; What it Looks Like and What to do About it. 医生的利益冲突;它看起来像什么，该怎么做。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-03-19 DOI: 10.1177/27551938261431289

Joel Lexchin

引用次数: 0

Analyzing Inclusivity in Disability Policy of India: A Policy Analysis of the Rights of Persons with Disability Act, 2016. 分析印度残疾政策的包容性：对残疾人权利法案的政策分析，2016。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-07-24 DOI: 10.1177/27551938261470644

Amruta Padhye, Megha Tiwari

{"title":"Analyzing Inclusivity in Disability Policy of India: A Policy Analysis of the Rights of Persons with Disability Act, 2016.","authors":"Amruta Padhye, Megha Tiwari","doi":"10.1177/27551938261470644","DOIUrl":"10.1177/27551938261470644","url":null,"abstract":"The Rights of Persons with Disability Act (RPWD), 2016 marked a shift in the approach to disability policy in India. It was designed to ensure protection and inclusion of people with disabilities in the society. Our study attempted to analyse the RPWD, 2016 to examine its provisions. We conducted an in-depth document analysis of the RPWD act of 2016, additional notifications with regards to this act, and the scientific literature on disability. The findings indicated that the act's approach to mental disability and its integration was inadequate. The challenges of disability certification were not addressed sufficiently, and the assessment procedures were elusive in multiple contexts. Additionally, provisions for caregivers and people with disabilities were ambiguous in various areas. Despite the lacunae, the act had certain strengths, including moving away from a stigmatizing medical model to a social model of disability, advocating for nondiscrimination, and policy recognition of the government's role in providing for opportunity and support for people with disabilities and their caregivers, among others. We concluded that while the act is a noteworthy step for protection and inclusion of people with disabilities in the society, it has gaps that require revisions to ensure successful implementation.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"534-541"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581378","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}

引用次数: 0

Australian Community Health and Primary Health Care Policies from 1970s to 2020s: A Policy Analysis of Changing Interpretations. 20世纪70年代至20世纪20年代的澳大利亚社区卫生和初级卫生保健政策：不断变化的解释的政策分析。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-01-16 DOI: 10.1177/27551938251411284

Helen van Eyk, Toby Freeman, Connie Musolino, Denise Fry, Colin McDougall, Tony McBride, Virginia Lewis, Fran Baum

{"title":"Australian Community Health and Primary Health Care Policies from 1970s to 2020s: A Policy Analysis of Changing Interpretations.","authors":"Helen van Eyk, Toby Freeman, Connie Musolino, Denise Fry, Colin McDougall, Tony McBride, Virginia Lewis, Fran Baum","doi":"10.1177/27551938251411284","DOIUrl":"10.1177/27551938251411284","url":null,"abstract":"Community health and primary health care (PHC) concepts are contested globally. We analysed 122 Australian federal and state government policy documents relating to women's, Aboriginal community controlled, generalist and workers' community health services from the 1970s to 2022 using institutional theory to understand how ideas and interests had shaped community health and PHC in Australia. We found an initial flourishing of diverse ideas was contested and constrained over time to reflect a more biomedical, general practice-centric approach to PHC. This was influenced by federal government decisions to prioritise general practice, and state governments' emphasis on reducing hospital costs. This reflects the power of established institutions and biomedical framings that have constrained debate over what is possible and what practices can be considered. From the content of the policies we reviewed, community health ideas and a comprehensive vision of PHC have persisted in Aboriginal community controlled health services, in women's health policy, and in Victorian community health services. Since pursuing comprehensive PHC remains a vital global goal to improve population health and health equity, our examination of policy history can shed light on how ideas and interests have shaped community health and PHC, and how future policies could be strengthened.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"566-579"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992134","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}

引用次数: 0

Aging in Exile: Predictors of Health Accessibility Among Middle-Aged and Older Afghan Refugees in Pakistan. 流亡中的老龄化：巴基斯坦中老年阿富汗难民健康可及性的预测因素。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-10-01 Epub Date: 2026-04-21 DOI: 10.1177/27551938261442743

Tanzeela Jamil, Zhongliang Zhou, Shaoqing Gong

{"title":"Aging in Exile: Predictors of Health Accessibility Among Middle-Aged and Older Afghan Refugees in Pakistan.","authors":"Tanzeela Jamil, Zhongliang Zhou, Shaoqing Gong","doi":"10.1177/27551938261442743","DOIUrl":"10.1177/27551938261442743","url":null,"abstract":"The global refugee crisis has exacerbated health disparities, particularly among middle-aged and older refugees, yet limited research exists on this vulnerable group, especially in low-income countries. This study investigates the predictors of health accessibility among middle-aged and older Afghan refugees in Pakistan in light of the social determinants of health, operationalized across four dimensions: health spending, health provider facilities, health information, and health communication. Using microdata from the 2022 Health Access and Utilization Survey (n = 423) at the household level, the study employed descriptive statistics, chi-square test, and logistic regression to examine the association between sociodemographic factors and health accessibility. The findings revealed discrepancies in gender distribution, literacy levels, and language proficiency. Education was found to be a significant predictor of health providers and health information, while reading ability was negatively associated with health providers and communication, suggesting that basic literacy may not necessarily translate into functional health literacy. The findings underscore the need for inclusive and targeted health policies that extend beyond service provision and address both structural and communication barriers faced by aging refugees. Policy makers and humanitarian organizations should prioritize context-specific, culturally sensitive interventions to promote healthy aging outcomes among vulnerable refugees in Pakistan.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"521-533"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730774","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}

引用次数: 0

Progressive Politics' Impact on Sexual Minority Suicidality and Substance use: A Retrospective Study Using Linked Administrative Data in Ontario. 进步政治对性少数群体自杀和物质使用的影响：使用安大略省相关行政数据的回顾性研究。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-09-21 DOI: 10.1177/27551938261477924

Chungah Kim, Xiaoyang Xia, Natalie Claramunt, Antony Chum

{"title":"Progressive Politics' Impact on Sexual Minority Suicidality and Substance use: A Retrospective Study Using Linked Administrative Data in Ontario.","authors":"Chungah Kim, Xiaoyang Xia, Natalie Claramunt, Antony Chum","doi":"10.1177/27551938261477924","DOIUrl":"https://doi.org/10.1177/27551938261477924","url":null,"abstract":"Despite steady progress towards sexual minority rights since the 1990s, the global political landscape has seen a rapid increase in anti-lesbian, gay, and bisexual (LGB) policies and sentiments. The resurgence in intolerance towards sexual minorities raises questions about the relationship between living in socially progressive areas and sexual minority health. Our study investigated the relationship between living in socially progressive areas and LGB health. Using linked health administrative data (2009-2017), we created a cohort for Ontario residents aged 18 and older identifying as lesbian/gay or bisexual. The study found that a 1% increase in votes for the socially progressive party was independently associated with 1.5% and 6.2% decreases in the odds of suicide-related behaviour and substance use events, respectively, in the gender-combined model. Men saw an 18.8% decrease in the odds of substance use events with no significant change in suicide-related behaviour. In women, a 1% increase in socially progressive votes was associated with 3.5% and 0.9% reductions in suicide-related behaviour and substance use odds, respectively. Taken together with the recent rise of far-right ideologies that are antithetical to lesbian, gay, bisexual, transgender, queer, plus other (LGBTQ+) rights, these findings suggest the potential for serious health consequences for sexual minorities and highlight the importance of policies that safeguard LGBTQ + rights and well-being.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"27551938261477924"},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013398","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}

引用次数: 0

Gendered Illnesses and Embodied Knowledge: A Phenomenological Body-Mapping Study of Endometriosis. 性别疾病与具身知识：子宫内膜异位症的现象学体图研究。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-09-11 DOI: 10.1177/27551938261473770

Korinne Alcala Bisig, Syeda Sidra Idrees, Karin Hannes

{"title":"Gendered Illnesses and Embodied Knowledge: A Phenomenological Body-Mapping Study of Endometriosis.","authors":"Korinne Alcala Bisig, Syeda Sidra Idrees, Karin Hannes","doi":"10.1177/27551938261473770","DOIUrl":"https://doi.org/10.1177/27551938261473770","url":null,"abstract":"Endometriosis, a chronic health condition primarily associated with women, is not just a physical experience but is an invisible, gendered illness deeply intertwined with societal narratives that often overlook women's embodied knowledge. This research employs body-mapping as a visual, verbal, and symbolic methodology to foreground embodied experiences and explore how social perceptions shape women's lived realities of endometriosis. Through an interpretive phenomenological analysis of six body maps, this research reveals conforming bodies, which internalize societal stigmas, resulting in disconnection from self and others, and resisting bodies, who actively challenge and transform oppressive narratives. The integration of visual, symbolic, and verbal expressions in body-mapping offers a nuanced understanding of how participants with endometriosis navigate the intersection of chronic illness and societal expectations. Our findings highlight the necessity of acknowledging and valuing embodied knowledge, emphasizing the importance of reflecting critically on the social narratives that shape the experiences of gendered illnesses.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"27551938261473770"},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946205","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}

引用次数: 0

Gender Inequalities in Health and Self-Employment During the Covid-19 Pandemic: Insights From a Southern European City. 2019冠状病毒病大流行期间健康和自营职业中的性别不平等：来自南欧一个城市的见解

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-08-30 DOI: 10.1177/27551938261480536

Lucía Artazcoz, Imma Cortès-Franch, Katherine Pérez, Laia Ollé-Espluga

{"title":"Gender Inequalities in Health and Self-Employment During the Covid-19 Pandemic: Insights From a Southern European City.","authors":"Lucía Artazcoz, Imma Cortès-Franch, Katherine Pérez, Laia Ollé-Espluga","doi":"10.1177/27551938261480536","DOIUrl":"https://doi.org/10.1177/27551938261480536","url":null,"abstract":"This study examines gender differences in self-perceived health and psychological distress among self-employed workers and employees in Barcelona, Spain, during the COVID-19 pandemic. This cross-sectional study used data from the 2021 Barcelona Health Survey. We included a subsample of workers aged 25-64 years (892 men and 885 women). Employment status was classified into four categories: permanent employee, temporary employee, self-employed, or employer. Two health outcomes were analysed: self-perceived health and psychological distress. Gender-stratified analyses were performed. Unlike men, female employers were less likely to belong to higher social classes, less likely to live with a partner, and more likely to have children than other employed women. Self-perceived health did not differ by employment status in either sex; however, psychological distress outcomes diverged: male employers reported better psychological status than male employees, whereas female employers had higher odds of poor psychological status than other employed women. These findings suggest that many female employers may be necessity-driven entrepreneurs, particularly affected by the impacts of the pandemic. Although results for female employers should be interpreted with caution due to the small sample size, they are consistent with a structural interpretation linking gendered care responsibilities, labour market segmentation, and health inequalities.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"27551938261480536"},"PeriodicalIF":2.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868264","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}

引用次数: 0