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Social Determinants of Health Disparities and Health Inequities in Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 30 May 2024 | Viewed by 8333

Special Issue Editor


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Guest Editor
Department of Population Health, Hofstra University, Hempstead, NY 11549, USA
Interests: social vulnerability; health disparities; disaster & injury epidemiology

Special Issue Information

Dear Colleagues,

Eliminating health disparities and attaining healthy well-being for all are key objectives of the Healthy People 2030 initiative. A substantial body of empirical work has examined health disparities in populations, but the literature is lacking on the specific contextual determinants of these disparities. While there is a growing appreciation of the role social, cultural, and economic factors play in shaping population health, modest progress has been made in identifying social variables that explain health disparities in specific contexts. For example, few studies have assessed the association between the historical redlining of neighborhoods and health disparities in the United States along the lines of examinations of the health associations of Jim Crow laws.

This Special Issue aims to broaden our understanding of social, cultural, political, and economic factors and their associations with health disparities or inequities in specific contexts. We are particularly interested in original research articles (empirical and theoretical) or systematic reviews that explore the determinants of health disparities or inequities in populations. We will also consider quantitative, qualitative, or mixed methods research that examines the distribution of health disparities or assesses the impacts of policies and interventions on improving disparities. It is imperative that every manuscript considered for publication focuses on social vulnerability, social determinants of health, and/or health inequity.

Dr. Ibraheem M. Karaye
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social vulnerability
  • health disparities
  • social determinants
  • public health
  • health inequity

Published Papers (4 papers)

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Research

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19 pages, 378 KiB  
Article
The Influence of Organizational Aspects of the U.S. Agricultural Industry and Socioeconomic and Political Conditions on Farmworkers’ COVID-19 Workplace Safety
by Fabiola M. Perez-Lua, Alec M. Chan-Golston, Nancy J. Burke and Maria-Elena De Trinidad Young
Int. J. Environ. Res. Public Health 2023, 20(23), 7138; https://doi.org/10.3390/ijerph20237138 - 03 Dec 2023
Viewed by 1968
Abstract
Farmworkers in the U.S. experienced high rates of COVID-19 infection and mortality during the COVID-19 pandemic. Their workplace may have been a significant place of exposure to the novel coronavirus. Using political economy of health theory, this study sought to understand how organizational [...] Read more.
Farmworkers in the U.S. experienced high rates of COVID-19 infection and mortality during the COVID-19 pandemic. Their workplace may have been a significant place of exposure to the novel coronavirus. Using political economy of health theory, this study sought to understand how organizational aspects of the agricultural industry and broader socioeconomic and political conditions shaped farmworkers’ COVID-19 workplace safety during the pandemic. Between July 2020 and April 2021, we conducted and analyzed fourteen in-depth, semi-structured phone interviews with Latinx farmworkers in California. Findings show that regulatory oversight reinforced COVID-19 workplace safety. In the absence of regulatory oversight, the organization of the agricultural industry produced COVID-19 workplace risks for farmworkers; it normalized unsafe working conditions and the worker—rather than employer—responsibility for workplace safety. Under these conditions, farmworkers enacted personal COVID-19 preventative practices but were limited by financial hardships that were exacerbated by the precarious nature of agricultural employment and legal status exclusions from pandemic-related aid. Unsafe workplace conditions negatively impacted workplace camaraderie. Study findings have implications for farmworkers’ individual and collective agency to achieve safe working conditions. Occupational safety interventions must address the organizational aspects that produce workplace health and safety inequities and disempower farmworkers in the workplace. Full article

Review

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27 pages, 541 KiB  
Review
Integrating Social Care into Healthcare: A Review on Applying the Social Determinants of Health in Clinical Settings
by M. Lelinneth B. Novilla, Michael C. Goates, Tyler Leffler, Nathan Kenneth B. Novilla, Chung-Yuan Wu, Alexa Dall and Cole Hansen
Int. J. Environ. Res. Public Health 2023, 20(19), 6873; https://doi.org/10.3390/ijerph20196873 - 02 Oct 2023
Cited by 1 | Viewed by 2384
Abstract
Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings—medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings [...] Read more.
Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings—medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings by exploring the reasons for integration and identifying target patients/conditions, barriers, and recommendations for clinical translation. The foremost reason for integrating SDH in clinical settings was to identify unmet social needs and link patients to community resources, particularly for vulnerable and complex care populations. This was mainly carried out through SDH screening during patient intake to collect individual-level SDH data within the context of chronic medical, mental health, or behavioral conditions. Challenges and opportunities for integration occurred at the educational, practice, and administrative/institutional levels. Gaps remain in incorporating SDH in patient workflows and EHRs for making clinical decisions and predicting health outcomes. Current strategies are largely directed at moderating individual-level social needs versus addressing community-level root causes of health inequities. Obtaining policy, funding, administrative and staff support for integration, applying a systems approach through interprofessional/intersectoral partnerships, and delivering SDH-centered medical school curricula and training are vital in helping individuals and communities achieve their best possible health. Full article

Other

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14 pages, 337 KiB  
Brief Report
Racial and Ethnic Disparities in Alcohol-Attributed Deaths in the United States, 1999–2020
by Ibraheem M. Karaye, Nasim Maleki and Ismaeel Yunusa
Int. J. Environ. Res. Public Health 2023, 20(8), 5587; https://doi.org/10.3390/ijerph20085587 - 20 Apr 2023
Cited by 2 | Viewed by 1902
Abstract
The disparities in alcohol-attributed death rates among different racial and ethnic groups in the United States (US) have received limited research attention. Our study aimed to examine the burden and trends in alcohol-attributed mortality rates in the US by race and ethnicity from [...] Read more.
The disparities in alcohol-attributed death rates among different racial and ethnic groups in the United States (US) have received limited research attention. Our study aimed to examine the burden and trends in alcohol-attributed mortality rates in the US by race and ethnicity from 1999 to 2020. We used national mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and employed the ICD-10 coding system to identify alcohol-related deaths. Disparity rate ratios were calculated using the Taylor series, and Joinpoint regression was used to analyze temporal trends and calculate annual and average annual percentage changes (APCs and AAPCs, respectively) in mortality rates. Between 1999 and 2020, 605,948 individuals died from alcohol-related causes in the US. The highest age-adjusted mortality rate (AAMR) was observed among American Indian/Alaska Natives, who were 3.6 times more likely to die from alcohol-related causes than Non-Hispanic Whites (95% CI: 3.57, 3.67). An examination of trends revealed that recent rates have leveled among American Indians/Alaska Natives (APC = 17.9; 95% CI: −0.3, 39.3) while increasing among Non-Hispanic Whites (APC = 14.3; 95% CI: 9.1, 19.9), Non-Hispanic Blacks (APC = 17.0; 95% CI: 7.3, 27.5), Asians/Pacific Islanders (APC = 9.5; 95% CI: 3.6, 15.6), and Hispanics (APC = 12.6; 95% CI: 1.3, 25.1). However, when the data were disaggregated by age, sex, census region, and cause, varying trends were observed. This study underscores the disparities in alcohol-related deaths among different racial and ethnic groups in the US, with American Indian/Alaska Natives experiencing the highest burden. Although the rates have plateaued among this group, they have been increasing among all other subgroups. To address these disparities and promote equitable alcohol-related health outcomes for all populations, further research is necessary to gain a better understanding of the underlying factors and develop culturally sensitive interventions. Full article
10 pages, 1811 KiB  
Brief Report
Investigating the Spatial Relationship between Social Vulnerability and Healthcare Facility Distribution in Nassau County, New York
by Alea Jones, Ijeoma Nnadi, Kelly Centeno, Giselle Molina, Rida Nasir, Gina G. Granger, Nicholas R. Mercado, Andrea A. Ault-Brutus, Martine Hackett and Ibraheem M. Karaye
Int. J. Environ. Res. Public Health 2023, 20(5), 4353; https://doi.org/10.3390/ijerph20054353 - 28 Feb 2023
Viewed by 1420
Abstract
Health is a fundamental human right, yet healthcare facilities are not distributed equitably across all communities. This study aims to investigate the distribution of healthcare facilities in Nassau County, New York, and examine whether the distribution is equitable across different social vulnerability levels. [...] Read more.
Health is a fundamental human right, yet healthcare facilities are not distributed equitably across all communities. This study aims to investigate the distribution of healthcare facilities in Nassau County, New York, and examine whether the distribution is equitable across different social vulnerability levels. An optimized hotspot analysis was conducted on a dataset of 1695 healthcare facilities—dental, dialysis, ophthalmic, and urgent care—in Nassau County, and social vulnerability was measured using the FPIS codes. The study found that healthcare facilities were disproportionately distributed in the county, with a higher concentration in areas of low social vulnerability compared to areas of high social vulnerability. The majority of healthcare facilities were found to be clustered in two ZIP codes—11020 and 11030—that rank among the top ten wealthiest in the county. The results of this study suggest that socially vulnerable residents in Nassau County are at a disadvantage when it comes to attaining equitable access to healthcare facilities. The distribution pattern highlights the need for interventions to improve access to care for marginalized communities and to address the underlying determinants of healthcare facility segregation in the county. Full article
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