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Addressing Health Inequalities: Focus on Social and Cultural Determinants
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Addressing Health Inequalities: Focus on Social and Cultural Determinants

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

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 10680

Special Issue Editor

Dr. Judy Yuen-Man Siu

E-Mail Website
Guest Editor
Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
Interests: the interrelationship between health inequality and social inequality; social experience and health behaviours in infectious disease outbreaks; the illness experience of chronically ill patients and their caregivers; illness-associated stigmas; doctor-patient communication in relation to social structure and gender hierarchy; the interrelationship between people’s perceptions on vaccines and vaccination behavior; perception and the adoption of preventive health behaviours

Special Issue Information

Dear Colleagues,

Health, according to the World Health Organization (http://www.who.int/mediacentre/factsheets/fs323/en/), is a human right. However, in reality, not all people are able to enjoy the same standard of health, and health inequality emerges. How healthy we can be is not just affected by our physical status, but it is determined by our social and cultural surroundings. Our health is determined by various social and cultural factors. The wealthiness of a country and of a government can be decisive in how much health protection we are able to enjoy (for example, the governments of developed countries are able to provide more than basic health protection for their people in terms of vaccines, medications, and a more developed health policy; whereas the governments of developing countries may not be able to have sufficient resources in providing basic vaccines and medications for its people). Even if we are living in a wealthy country, the socio-economic status that we are situating is also decisive in determining how healthy we can be. Locating to a higher socioeconomic status can mean that we are able to enjoy higher income and monetary wealth, so we would be more able to have more resources in enjoying better health. It can also mean that we are able to have a higher education level, so we would be more able to have higher health literacy and better access to health information. It can also mean that we are able to have a better occupation, so we would be more empowered to have more bargaining power when getting sick. In contrast, many past studies have shown that situating at a low socio-economic status can mean a person would have a less positive health outcome, such as suffering from a higher prevalence of obesity and a poorer prognosis in many chronic conditions. In the recent COVID-19 outbreak, those who are of low socioeconomic status are much more disadvantaged than those who are of high socioeconomic status in terms of health and infection risk. Besides, a person’s ethnicity and gender can also determine the extent of health that one can enjoy.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on how these social and cultural determinants can affect human health. Research papers, reviews, and case reports are welcome to this Special Issue.

Dr. Judy Yuen-man Siu
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

  • health inequality
  • health equity
  • social determinant
  • cultural determinant
  • socio-economic status

Published Papers (5 papers)

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Research

13 pages, 361 KiB  
Article
Food Insecurity and Blood Pressure in a Multiethnic Population
by Claire Townsend Ing, Brettany Clemens, Hyeong Jun Ahn, Joseph Keawe‘aimoku Kaholokula, Peter S. Hovmand, Todd B. Seto and Rachel Novotny
Int. J. Environ. Res. Public Health 2023, 20(13), 6242; https://doi.org/10.3390/ijerph20136242 - 28 Jun 2023
Cited by 1 | Viewed by 1195
Abstract
Food insecurity is a social determinant of health and is increasingly recognized as a risk factor for hypertension. Native Hawaiians bear a disproportionate burden of hypertension and known risk factors. Despite this, the relative effects of food insecurity and financial instability on blood [...] Read more.
Food insecurity is a social determinant of health and is increasingly recognized as a risk factor for hypertension. Native Hawaiians bear a disproportionate burden of hypertension and known risk factors. Despite this, the relative effects of food insecurity and financial instability on blood pressure have yet to be investigated in this population. This study examines the relative effects of food insecurity and financial instability on blood pressure, controlling for potential confounders in a multiethnic sample. Participants (n = 124) were recruited from a U.S. Department of Agriculture-funded study called the Children’s Healthy Living Center of Excellence. Biometrics (i.e., blood pressure, weight, and height) were measured. Demographics, physical activity, diet, psychosocial variables, food insecurity, and financial instability were assessed via self-report questionnaires. Hierarchical linear regression models were conducted. Model 1, which included sociodemographic variables and known biological risk factors, explained a small but significant amount of variance in systolic blood pressure. Model 2 added physical activity and daily intake of fruit, fiber, and whole grains, significantly improving the model. Model 3 added financial instability and food insecurity, further improving the model (R2 = 0.37, F = 2.67, p = 0.031). Food insecurity, female sex, and BMI were significantly and independently associated with increased systolic blood pressure. These results suggest a direct relationship between food insecurity and systolic blood pressure, which persisted after controlling for physical activity, consumption of fruits, fiber, and whole grains, and BMI. Efforts to reduce food insecurity, particularly among Native Hawaiians, may help reduce hypertension in this high-risk population. Full article
(This article belongs to the Special Issue Addressing Health Inequalities: Focus on Social and Cultural Determinants)
11 pages, 714 KiB  
Article
The Impact of Nurse Health-Coaching Strategies on Cognitive—Behavioral Outcomes in Older Adults
by Kathleen Potempa, Susan Butterworth, Marna Flaherty-Robb, Margaret Calarco, Deanna Marriott, Bidisha Ghosh, Amanda Gabarda, Jordan Windsor, Stacia Potempa, Candia Laughlin, Karen Harden, Patricia Schmidt, Alexis Ellis and Philip Furspan
Int. J. Environ. Res. Public Health 2023, 20(1), 416; https://doi.org/10.3390/ijerph20010416 - 27 Dec 2022
Cited by 1 | Viewed by 2051
Abstract
The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health-coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time [...] Read more.
The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health-coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive–behavioral outcomes: change talk, resiliency, self-efficacy/independent agency, insight and pattern recognition, and building towards sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health-coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20 min audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<USD 20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved change talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive–behavioral indicators associated with health behavior change in both non-SDH and SDH individuals. Full article
(This article belongs to the Special Issue Addressing Health Inequalities: Focus on Social and Cultural Determinants)
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15 pages, 372 KiB  
Article
“What If I Die and No One Notices?” A Qualitative Study Exploring How Living Alone and in Poverty Impacts the Health and Well-Being of Older People in Hong Kong
by Crystal Kwan and Ho Chung Tam
Int. J. Environ. Res. Public Health 2022, 19(23), 15856; https://doi.org/10.3390/ijerph192315856 - 28 Nov 2022
Cited by 1 | Viewed by 2276
Abstract
Despite the growing number of older people who live alone and in poverty, the intersection of these two social risk factors and the impacts on older adults’ health and well-being have not been widely examined. This qualitative study explores the challenges and strengths [...] Read more.
Despite the growing number of older people who live alone and in poverty, the intersection of these two social risk factors and the impacts on older adults’ health and well-being have not been widely examined. This qualitative study explores the challenges and strengths of 47 older people who live alone and in poverty in Hong Kong. Thematic analysis was used to identify eight themes related to challenges: (i) social isolation and loneliness, (ii) self-esteem and self-efficacy, (iii) declining mobility, health and activity levels, (iv) high medical expenses, (v) age discrimination and long wait times for medical health services, (vi) age discrimination, retirement, and wanting part-time employment, (vii) not enough gender-specific social participation activities, and (viii) housing insecurity. Four themes related to strengths were identified: (i) An “I have enough” mindset, (ii) strong formal social support, (iii) contributing to the community and others, and (v) “Most of us like to be alone.” Successfully addressing poverty in old age and tackling the challenges associated with living alone will require focusing on and activating not only external and systemic resources but also the intrinsic capacities and strengths of older adults themselves. Five discussion points are raised addressing the implications for future gerontological research and practice. Full article
(This article belongs to the Special Issue Addressing Health Inequalities: Focus on Social and Cultural Determinants)
11 pages, 512 KiB  
Article
Prevalence of Fast Food Intake among a Multi-Ethnic Population of Young Men and Its Connection with Sociodemographic Determinants and Obesity
by Jozaa Z. AlTamimi, Naseem M. Alshwaiyat, Hana Alkhalidy, Nora A. AlFaris, Nora M. AlKehayez, Malak A. Alsemari and Reham I. Alagal
Int. J. Environ. Res. Public Health 2022, 19(22), 14933; https://doi.org/10.3390/ijerph192214933 - 13 Nov 2022
Cited by 4 | Viewed by 2432
Abstract
Fast food is commonly consumed by young adults. Eating fast food is connected with the risk of obesity and other related diseases. The present study examines the prevalence of fast food intake in a diverse sample of young men. This cross-sectional study included [...] Read more.
Fast food is commonly consumed by young adults. Eating fast food is connected with the risk of obesity and other related diseases. The present study examines the prevalence of fast food intake in a diverse sample of young men. This cross-sectional study included 3600 young men (20–35 years) who resided in Riyadh, KSA. The frequency of fast food intake was assessed using a valid and reliable questionnaire. Weekly and daily intake of fast food were the two outcome variables adopted to assess the intake frequency. Weight and height were measured. Fast food was eaten by 88.8% and 50.1% of participants weekly and daily, respectively. Fast food intake was predicted by the nationality of participants. The highest prevalence of weekly fast food intake (99.7%) was observed among Saudi, Egyptian, and Indian participants, while the lowest rate was observed among Sudanese participants (48.6%). The highest and lowest rates of daily intake were seen among Filipino (83.4%) and Bangladeshi (6.3%) participants. Obesity was another predictor of fast food intake. Obese participants had a significantly higher odds ratio of weekly (OR = 2.89, p = 0.006) and daily (OR = 1.39, p = 0.021) fast food intake than non-overweight/non-obese participants. In conclusion, fast food is frequently consumed by young men in KSA. Our findings link the likelihood of fast food intake to sociodemographic determinants and obesity. Full article
(This article belongs to the Special Issue Addressing Health Inequalities: Focus on Social and Cultural Determinants)
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27 pages, 540 KiB  
Article
The Role of Social and Cultural Values in Pandemic Control in a Chinese Community: An Ethnographic Study on the Construction and Stigmatization of “Others” in Severe Acute Respiratory Syndrome (SARS) and COVID-19 in Hong Kong
by Judy Yuen-man Siu
Int. J. Environ. Res. Public Health 2022, 19(20), 13517; https://doi.org/10.3390/ijerph192013517 - 19 Oct 2022
Cited by 1 | Viewed by 2052
Abstract
Background: Studies have widely reported that social and cultural values serve as constraints in controlling the spread of an epidemic. However, I argue that a social and cultural value system is a double-edged sword and can motivate people’s preventive health behaviors. Few studies [...] Read more.
Background: Studies have widely reported that social and cultural values serve as constraints in controlling the spread of an epidemic. However, I argue that a social and cultural value system is a double-edged sword and can motivate people’s preventive health behaviors. Few studies have examined the positive role of social and cultural values in promoting epidemic control. Methods: Using the severe acute respiratory syndrome outbreak in 2003 and the COVID-19 pandemic that began in 2020 in Hong Kong as examples, the present study performed participant observation in Hong Kong from January to June 2003 and from January 2020 to May 2022; in-depth individual semi-structured interviews were conducted with 70 participants between February 2021 and March 2022. Results: Social and cultural values serve as informal social control mechanisms in manipulating people’s adoption of preventive health behaviors that can assist in epidemic control. Specifically, the construction and stigmatization of the “others” groups and the traditional cultural values based on the capitalist ideology were noted to facilitate control measures against the two outbreaks in Hong Kong. Conclusion: These two outbreaks reinforced the embedded social and cultural values of the capitalist ideology of Hong Kong, which increased the vulnerability of disadvantaged social groups to stigmatization. Full article
(This article belongs to the Special Issue Addressing Health Inequalities: Focus on Social and Cultural Determinants)
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