International journal of social determinants of health and health services最新文献_第4页

War as A Determinant of Population Health: A Systems Approach to Understand Pathways. 战争作为人口健康的决定因素：理解途径的系统方法。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-07-01 Epub Date: 2026-02-03 DOI: 10.1177/27551938261417282

Santhushya Fernando, Nadeeka Chandraratne, Saroj Jayasinghe

{"title":"War as A Determinant of Population Health: A Systems Approach to Understand Pathways.","authors":"Santhushya Fernando, Nadeeka Chandraratne, Saroj Jayasinghe","doi":"10.1177/27551938261417282","DOIUrl":"10.1177/27551938261417282","url":null,"abstract":"Wars have multiple complex effects on population health. Countries suffer extensively from disruptions to their societies, economies, and environment. Understanding the pathways of disruption helps to adapt and mitigate the catastrophic effects of war. We used a previously published 12-dimensional framework on the health impacts of war to derive pathways of influence under three phases. The first phase, before overt aggression, includes economic sanctions, trade wars, and embargoes, often combined with covert military action and disrupted supply chains, infrastructure, and health services. The second phase of overt aggression has multiple direct and indirect effects on health: (a) morbidity and mortality; (b) population displacements with psychosocial implications; (c) opportunity costs from military expenditures often reversing economic growth and widening inequalities; (d) environmental degradation; (e) air and soil pollution from explosives; (f) destroyed infrastructure include housing, basic amenities, and health infrastructure; (g) destroyed arable land, deforestation, and loss of biodiversity; (h) and contamination of water sources. The third phase occurs during peace negotiations and when peace appears and consists of long-term effects. The latter includes transgenerational impacts on human well-being. Considering the wide health, social, and environmental implications of wars lasting for generations, we reiterate the call for an \"end to all wars.\"","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"298-305"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115084","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

Urban Accessibility or Social Inequality? A Multilevel Spatial Analysis of Built Environments and Type 2 Diabetes in Milan. 城市可达性还是社会不平等？米兰城市建筑环境与2型糖尿病的多层次空间分析

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-07-01 Epub Date: 2025-11-24 DOI: 10.1177/27551938251393607

David Consolazio, Miriam Serini, Ahmed Alsayed, David Benassi, Simone Sarti, Marco Terraneo, Corrado Celata, Andrea Rebecchi, Stefano Capolongo, Antonio Giampiero Russo

{"title":"Urban Accessibility or Social Inequality? A Multilevel Spatial Analysis of Built Environments and Type 2 Diabetes in Milan.","authors":"David Consolazio, Miriam Serini, Ahmed Alsayed, David Benassi, Simone Sarti, Marco Terraneo, Corrado Celata, Andrea Rebecchi, Stefano Capolongo, Antonio Giampiero Russo","doi":"10.1177/27551938251393607","DOIUrl":"10.1177/27551938251393607","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) follows a social gradient; however, access to health-related services and amenities in urban areas may also impact its prevalence. This study investigates the association between characteristics of the built environment and T2DM prevalence in Milan, Italy. Utilising administrative health care data and open access territorial information, we examined the relationship between neighbourhood-level features and T2DM among the Milanese population in 2019. The analysis focused on six domains: food environment, physical activity infrastructure, cultural facilities, neighbourhood disorder, health care accessibility, and public transportation. We employed spatial analysis techniques based on road network buffers to evaluate potential access to health-related resources. Multilevel Poisson regression models, stratified by age group and sex, were applied to explore associations while adjusting for average neighbourhood educational attainment. Several built environment indicators demonstrated significant associations with T2DM; however, these associations lost statistical significance after controlling for area-level education. The influence of the built environment on health outcomes may differ in Milan's unique context compared to those settings where previous research has yielded consistent findings, particularly in the American context, which involves larger metropolises with greater urban heterogeneity and low- and middle-income countries characterised by notable urban/rural differences.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"343-359"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598269","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

From Averages to Heterogeneity: A Plain-Language Guide to MAIHDA in Epidemiology. 从平均到异质性：通俗易懂的MAIHDA流行病学指南。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-07-01 Epub Date: 2026-02-24 DOI: 10.1177/27551938261423042

Juan Merlo, Jay S Kaufman, George Leckie

{"title":"From Averages to Heterogeneity: A Plain-Language Guide to MAIHDA in Epidemiology.","authors":"Juan Merlo, Jay S Kaufman, George Leckie","doi":"10.1177/27551938261423042","DOIUrl":"10.1177/27551938261423042","url":null,"abstract":"Many studies compare health averages between groups such as neighbourhoods or social categories. Averages are simple but can be misleading, since individuals within the same group often differ widely. We present MAIHDA (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy) as a general framework to study how context structures health differences. MAIHDA is not a new statistical model but a way to reorganize standard multilevel analysis to look beyond averages. It integrates three perspectives: (1) Specific Contextual Effects (mean differences between groups), (2) General Contextual Effects (how strongly outcomes cluster within groups, eg the variance partition coefficient), and (3) Discriminatory Accuracy (how well group membership classifies individuals according to the outcome). Interpreting these dimensions together shows to which degree a context shapes outcome and whether interventions should be universal or targeted. Although intersectional studies have recently popularized MAIHDA, the framework predates its intersectional applications. It was first developed within contextual epidemiology to study geographical and institutional settings, and later extended to intersectionality and multicategorical analyses, which added visibility. By shifting attention from averages to heterogeneity and clustering, MAIHDA helps avoid group stigmatization and guides equitable strategies such as proportionate universalism. It offers a practical, theory-agnostic way to understand how contexts structure individual inequalities.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"318-331"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286511","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

Why is Peace More Fundamental Than Health and Well-Being: Internal Displacement, Blockades, and Violations of Medical Neutrality. 为什么和平比健康和福祉更重要：国内流离失所、封锁和违反医疗中立。

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-07-01 Epub Date: 2026-02-06 DOI: 10.1177/27551938261417281

Zaldy C Collado

{"title":"Why is Peace More Fundamental Than Health and Well-Being: Internal Displacement, Blockades, and Violations of Medical Neutrality.","authors":"Zaldy C Collado","doi":"10.1177/27551938261417281","DOIUrl":"10.1177/27551938261417281","url":null,"abstract":"Intense armed conflict in Gaza gives rise to record-breaking humanitarian catastrophe. More than destructions of physical residence, the cost to health and well-being remains pressing concerns among people displaced by war. While the international community provide various forms of assistance, deliveries are challenged as blockades, according to reports, are in effect. Access to aid is reported to have been effectively restricted. Alongside with this are the reports of violations of medical neutrality - the targeting of medical facilities, making access to healthcare, treatment, and medical supplies extremely difficult if not impossible. Drawing on the WHO's framework of social determinants of health in conflict settings, this article situates the Gaza violence as a clear and profound case of how conflict dismantles the structural foundations of health and well-being. While mere peace does not guarantee positive health outcomes, peace inherits a cardinal role when war involves aid restrictions and breaches of medical neutrality. Peace becomes more fundamental to health and well-being under these cases of conflict environment. This is not to argue that peace is alternative to health. Rather, as drawn from the Gazan experience, peace is argued to be the foundation of health, indivisible to it. Peace, therefore, precedes health.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"313-317"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133793","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

Freedom to Trade and Safeguarding the National Health Service (NHS) - Did the UK-Australia Free Trade Agreement Safeguard the NHS? 贸易自由和保障国民保健服务（NHS）——英澳自由贸易协定是否保障了国民保健服务？

IF 2.2

International journal of social determinants of health and health services Pub Date : 2026-07-01 Epub Date: 2026-02-10 DOI: 10.1177/27551938251411268

Alison McCallum, Meri Koivusalo, Silke Trommer

{"title":"Freedom to Trade and Safeguarding the National Health Service (NHS) - Did the UK-Australia Free Trade Agreement Safeguard the NHS?","authors":"Alison McCallum, Meri Koivusalo, Silke Trommer","doi":"10.1177/27551938251411268","DOIUrl":"10.1177/27551938251411268","url":null,"abstract":"The United Kingdom (UK) government has claimed that the National Health Service (NHS) was safeguarded throughout the negotiations of the Free Trade Agreement (FTA) with Australia. This article examines if this was achieved. We used public documents on the UK-Australia FTA, including impact assessments, public consultations, and the text of the negotiated agreement. Analytically, we drew on process tracing to assess whether and how the NHS was (i) included in impact statements and assessments, (ii) excluded from the agreement, and (iii) addressed in key chapters, focusing on (a) to what extent NHS safeguarding differs from that of other comparable public policy prerogatives, such as audiovisual services covering national broadcasting, (b) health-related limitations set by Australia, and (c) using the legal obligations of World Trade Organisation (WTO) membership as the null option. Our analysis shows that the NHS was not fully excluded from the trade agreement on the ground of the negotiated agreement compared with the null option of WTO provisions, including for services and public health protection. This would have been possible, but in several chapters was not considered. There was no overarching exclusion and the NHS gained less comprehensive exclusion in comparison to audiovisual services and, in some chapters, to the health-related restrictions set by Australia.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"415-425"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159529","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

Bidi and the Burden of Tobacco Labor: Human Rights and Health Injustices among Women and Children in South Asia. 比迪和烟草劳动负担：南亚妇女和儿童的人权和健康不公正。

IF 2.6

International journal of social determinants of health and health services Pub Date : 2026-06-16 DOI: 10.1177/27551938261458721

Mariyam Abbas, Theodore A Walls, Nathan DeSalvo, Joyce London, Sofia Dopman

引用次数: 0

Poverty Effect on Stunting Among Children Under Two in Kalimantan Region, Indonesia: A Secondary Study. 贫困对印尼加里曼丹地区两岁以下儿童发育迟缓的影响：一项二级研究。

IF 2.6

International journal of social determinants of health and health services Pub Date : 2026-06-03 DOI: 10.1177/27551938261451634

Ratna Dwi Wulandari, Agung Dwi Laksono, Esti Nugraheny, Astridya Paramita, Nailul Izza, Hastin Dyah Kusumawardani

{"title":"Poverty Effect on Stunting Among Children Under Two in Kalimantan Region, Indonesia: A Secondary Study.","authors":"Ratna Dwi Wulandari, Agung Dwi Laksono, Esti Nugraheny, Astridya Paramita, Nailul Izza, Hastin Dyah Kusumawardani","doi":"10.1177/27551938261451634","DOIUrl":"https://doi.org/10.1177/27551938261451634","url":null,"abstract":"Stunting in children in Kalimantan, Indonesia, a resource-rich region commonly seen as economically advantaged but with large social and economic inequities across provinces and districts, is examined in this secondary analysis. Many Kalimantan communities lack access to education, steady jobs, health services, and adequate nutrition, perpetuating childhood undernutrition despite the region's natural abundance and prosperity. We carefully examined 6038 children, using stature as the outcome and income as the exposure. Province, domicile, maternal age, marital status, education, occupation, children's age, gender, and early breastfeeding initiation were included as controls. Our binary logistic regression analysis matched earlier findings. The poorest people were 2.150 times more likely to be stunted (95% CI 2.096-2.205). A lower level increased the risk of stunting by 1.540 times (95% CI 1.504-1.577). The middle class was 1.397 times more likely to be stunted than the wealthy (95% CI 1.365-1.429). Richer people had 0.949 times the risk of stunting (95% CI 0.928-0.970). These findings show that economic growth and regional development in Kalimantan have not led to equitable nutritional outcomes for young children, highlighting the need for targeted, poverty-sensitive nutrition policies, improved social protection for underserved households, and context-specific interventions to address structural inequalities in early-life health.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"27551938261451634"},"PeriodicalIF":2.6,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152386","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

Transitional Justice and Health, Happiness, and Solidarity: An Analysis of the 2020 National Survey in Taiwan. 转型正义与健康、幸福与团结：台湾2020年全国调查分析。

IF 2.6

International journal of social determinants of health and health services Pub Date : 2026-04-21 DOI: 10.1177/27551938261442799

Ming-Jui Yeh, Ching Kuan, Hsuan-Wei Lee

{"title":"Transitional Justice and Health, Happiness, and Solidarity: An Analysis of the 2020 National Survey in Taiwan.","authors":"Ming-Jui Yeh, Ching Kuan, Hsuan-Wei Lee","doi":"10.1177/27551938261442799","DOIUrl":"https://doi.org/10.1177/27551938261442799","url":null,"abstract":"Political violence caused by war, armed conflicts, or state violence against its own people is a major determinant of health. Transitional justice is both a value and a set of practices aimed at preventing the recurrence of state political violence. This study proposes a revised conceptual framework that establishes the relationship between people's attitudes toward transitional justice practices and their physical health, happiness, and sense of solidarity in self-defense amid geopolitical tensions. The study uses Taiwan as an illustrative case of transitional justice in a post-authoritarian democracy with historical state political violence and under threats of external political violence. The analysis is based on data from a cross-sectional, nationally representative survey conducted in 2020, with a final sample size of 1048 participants. The study found positive associations between different dimensions of attitudes toward transitional justice and respondents' well-being and willingness to defend themselves. The findings suggest that recognition of the state's unjust political violence and reconciliation among social members may be related to people's well-being. Furthermore, transitional justice should be seen not only as a domestic issue but also as one with significant geopolitical implications.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"27551938261442799"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730815","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

Power, Precariousness, and Health Equity: The Contested Terrain of Population Health. 权力、不稳定性和健康公平：人口健康的争议领域。

IF 2.6

International journal of social determinants of health and health services Pub Date : 2026-04-01 Epub Date: 2026-03-09 DOI: 10.1177/27551938261421775

Carles Muntaner, Joan Benach

引用次数: 0

Social Health Insurance Programs and Preventive Care Utilization Among Chinese Older Adults: Results From the Chinese Longitudinal Healthy Longevity Survey. 中国老年人社会健康保险计划与预防保健利用：来自中国纵向健康寿命调查的结果。

IF 2.6

International journal of social determinants of health and health services Pub Date : 2026-04-01 Epub Date: 2025-08-11 DOI: 10.1177/27551938251365076

Cai Xu, Mack Shelley, Yen-Han Lee

{"title":"Social Health Insurance Programs and Preventive Care Utilization Among Chinese Older Adults: Results From the Chinese Longitudinal Healthy Longevity Survey.","authors":"Cai Xu, Mack Shelley, Yen-Han Lee","doi":"10.1177/27551938251365076","DOIUrl":"10.1177/27551938251365076","url":null,"abstract":"China has aimed to establish a universal health care system through a comprehensive health reform since 2009. However, knowledge about the association between basic social insurances and preventive care utilization (PCU) among Chinese older adults, especially as primary coverage, remains limited. This study investigates these associations using data from the 2018 Chinese Longitudinal Healthy Longevity Survey. We analyzed 9,952 older adults with major medical coverage from urban employee/resident insurance (UE/URBMI), cooperative medical programs (New Rural Cooperative Medical System; NCMS), or self-payment (SP). Propensity score matching (PSM) enhanced comparability between UE/URBMI or NCMS and a control group with SP coverage. Subsequent logistic regression examined associations between major medical expense coverage and PCU for older adults with NCMS + SP (n = 6,580) and UE/URBMI + SP (n = 5,248) groups, respectively. NCMS participants had higher odds of reporting PCU compared to SP users (odds ratio: 1.57, 95% CI: 1.40-1.75, P < .001). Conversely, no significant association was observed in the UE/URBMI + SP group (odds ratio: 1.08, 95% CI: 0.93-1.24, P > .05). This study highlights diverse associations between health insurance types and PCU among older adults. Empirical results suggest sustained government-led health insurance reform may need to continue progressing to strengthen financial incentives for PCU within the social insurance framework.","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"203-216"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818437","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