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Diabetes is a chronic and challenging disease and requires personal daily self-management decisions and skills. For that, it is necessary that patients have sufficient information and health literacy to make the right choices and decisions in their self-care. Sequentially, health literacy has great relevance and influence in the daily lives of people with diabetes, since it encompasses the necessary skills to manage disease and health. Health literacy can be a relevant factor to consider when tackling diabetes self-management. Thus, for the prevention and treatment of diabetes, it is essential to promote individual health literacy. The quality of communication and patient-centred communication style seems to be a key aspect for the health literacy.

Researchers have spent considerable time studying how racial-ethnic minorities experience poorer health than whites [Townsend, P., & Davidson, N. (Eds). (1990). Inequalities in health: The black report. England: Penguin Press; Platt, L. (2006). Assessing the impact of illness, caring and ethnicity on social activity. STICERD Research Paper No. CASE108 London England), and how low socioeconomic status (SES) can negatively influence health status (Lynch, J., & Kaplan, G. (2000). Socioeconomic position. In: L. F. Berkman & I. Kawachi (Eds), Social epidemiology (pp. 13–55). New York: Oxford University Press]. This research investigates the relationship between class and race and perceived health status among patients with chronic conditions. More specifically, we apply the concept of social capital to assess whether the quantity of health information seeking behaviors (HISB) via social networks mediates the relationship between race and health status, and between SES and health status. Regression, t-test and ANOVA analyses of 305 surveys completed at a chronic illness management clinic in a Northwest research hospital reveal three important findings: first, that social class affects perceived health status more strongly than race; second, that frequency and amount of HISB do not play a significant role in perceived health status, regardless of race or SES; and third, that an interaction effect between frequency and amount of HISB suggests that the way that patients seek health information, and the quality of that information, may be more useful indicators of the role of social capital in HISB than our study can provide.

River flood exposes the population to multiple attacks from the physical, mental, health risks and its related negative effects. This study focused on the Pahang River and the three worst-hit district population (Pekan, Kuantan and Temerloh). Tools on areas of self-perceived health symptoms, QOL, depression, PTSD and community empowerment were assessed. Semi-guided questionnaires were distributed to a total of 602 victims. Questions on health symptoms were asked to respondents (R) and household members (HM). PTSD screening, i.e., the Trauma Screening Questionnaire, was used. Depression was assessed through the Beck Depression Inventory (BDI). WHOQOL-BREF assessed four domains of QOL, i.e., physical activity, psychological, social relationships and environment. Community empowerment using the Individual Community Related Empowerment tool to assess five domains, i.e., self-efficacy, participation, motivation, intention and critical awareness. Prevalent disease showed that majority suffered from hypertension (11.0%) and diabetes (7.3%). Two main symptoms experienced were cough (R = 47.2%, HM = 43.7%) and flu (R = 42.7%, HM = 40.4). Monthly health expenditure was higher post flood. Purchase of prescription medications rose from MYR24.40 to 31.02. A total of 33 people were suspected to suffer from PTSD. Through BDI assessment, it was estimated that as many as 104 (17.3%) suffered overt (high) depression. The prevalence of QOL domains are as such: low physical activity was highest at 59%, low psychological activity at 53.3%, low social relationships at 43% and low environment at 45.2%. On community empowerment, low empowerment was seen on four domains: self-efficacy at 52%, participation at 55%, motivation at 54.2% and critical awareness at 74.4%. The domain with good intention and willing to participate was at 54%. Results indicate that the community was not adaptable to flood events. This is evident from high amount of experienced symptoms, low QOL (physical and psychological aspects) and empowerment (except intention). Proportion of PTSD and overt (high) depression was however quite low.

Despite the increasing evidence on the effects of the economic crisis and austerity policies on the health of the population, we lack knowledge of how the young population is being affected. High unemployment rates, labour instability, high housing costs and cuts in public policies have placed the young in a vulnerable situation. We explore changes (2006–2017) in the both physical and mental health of young people in Spain using a selection of health indicators. By doing so we draw the reader’s attention to three elements with a close relationship to neoliberalism: the prominence of social determinants of health, the importance of inequalities and the accumulation of multiple sources of disadvantage in certain groups and individuals which ultimately condition the course of their lives; and the use of medicalization as a common and legitimised response to poor mental health.

Despite the biological and clinical advances in oral health, dental disease is still a problem for those of low socioeconomic (SE) status, as well as racial and ethnic minorities. In this study, we use the Andersen Behavioral Model of predisposing, enabling, and need factors to examine the effects of race, ethnicity, and income on dental care utilization. Using the Medical Expenditure Panel Survey (MEPS) household component and dental event data (n=8,685), we tested the hypothesis that longer survival or delay in dental care utilization is associated with both minority and lowered SE statuses. Analyses confirm that minority status, income, and education, are predictive of the delay in dental care utilization. This study lends support to the theorized assumption that there are racial and ethnic differences in the pattern of dental care utilization and that these differences as well as other factors contribute to disparity in dental care utilization.

As summarized in our introductory Chapter 1, the trend toward ever-healthier elderly seems to have been broken (Figures 8 and 9). The share of young and middle-aged Swedish men and women, reporting very good or good health status to the Survey of Living Conditions, started to decline already in the 1980s. As a consequence, as the cohorts are graying, the share of elderly people, reporting very good or good health status, has also begun to decline. Increasing health problems among Swedish oldest old have also been reported from the SWEOLD (SWEdish panel of living conditions of oldest OLD) study (Parker et al., 2004). Similar trends have been reported for the United States and for the entire EU-15. Part of the explanation appears to be the growth at young ages in allergy, asthma, diabetes, other long-standing illness, and health problems associated with obesity. In the time perspective of our simulations, these trends in long-standing health problems might have less impact on the health of the elderly (and their demand for healthcare and old-age care or their life expectancy) than on the health of people in their middle ages but still be important. In this section, we will present some additional information on the development of health status during the last 20 years or so for the Swedish population.

Transport shapes the health of urban populations. It can support healthy behaviours such as participation in regular physical activity and access to community connection. Transport systems can also have major negative impacts on health. For example, through air pollution from fossil fuel-based modes of travel, the risk of injury and death from transport related collisions, and in the way sedentary modes of travelling can contribute to less physically active lifestyles.

This chapter considers the long-term impact of the pandemic on a series of well-researched transport-related health outcomes. It first describes the established connections between transport and health. It then considers the future implications of three potential pandemic-induced shifts: the increased uptake of working from home (WFH); decreased usage of public transport and increased interest in walking and cycling in the local neighbourhood. The impacts of these shifts on the transport-health nexus are then discussed, revealing both positive and negative outcomes. The authors conclude by providing policy recommendations to mitigate possible negative outcomes and strengthen the positive consequences into the future.