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1 – 10 of over 4000
Article
Publication date: 10 August 2021

Fateh Tavangar, Hassan Rafiey, Farhad Nosrati Nejad, Ahmad Ali Noorbala and Gholamreza Ghaedamini Harouni

Social determinants of stressful events (SE) play an important role in justifying the cause of inequality in the experience of SE. The purpose of this study is to investigate the…

Abstract

Purpose

Social determinants of stressful events (SE) play an important role in justifying the cause of inequality in the experience of SE. The purpose of this study is to investigate the determinants that impact on inequality in the experience of SE.

Design/methodology/approach

The statistical population of this study includes all residents of Tehran. The statistical sample was 5,895 people who were selected by multistage cluster method and were proportional to the population size. The research tool is a researcher-made questionnaire designed to measure SE in Tehran, which includes 11 psychological stressors. The Oaxaca–Blinder decomposing method was used to analyze data.

Findings

In a total of 11 psychological SE, in 6 of those events, there was significant inequality in the experience of SE. Concentration Index (CI) of political SE is (CI = −0.27, 95% CI: −0.47, −0.07) and in favor of the rich (pro-rich). Education (OR = 1.60) in poor group and region development in poor and rich (respectively in all of the following) (OR = 0.42–0.73) are the main determinants of inequality in this stressor. CI of neighborhood underdevelopment SE is (CI = −0.47, 95% CI: 0.66, −0.28) and pro-rich. Education (OR = 1.26–1.27) and region development (OR = 1.18–2.24) are the main determinants of inequality in this stressor. CI of livelihood problems SE is (CI = −0.58, 95% CI: 0.68, −0.32) and pro-rich. Education (OR = 1.40) and health status (OR = 1.63) in poor group are the main determinants of inequality in this stressor. CI of future uncertainty SE is (CI = −0.12, 95% CI: 0.34, −0.08) and pro-rich. Gender (OR = 1.22) in poor group and region development (OR = 0.24–0.58) are the main determinants of inequality in this stressor. CI of education problems (CI = 0.19, 95% CI: 0.05, 0.32) and pro-poor. Age (OR = 0.32–0.34) and education (OR = 3.65–3.30) are the main determinants of inequality in this stressor. CI of housing problems is (CI = −0.29, 95% CI: −0.49, −0.08) and pro-rich. Education (OR = 1.31) and region development (OR = 1.64) in poor group are the main determinants of inequality in this stressor.

Research limitations/implications

The first limitation is related to the level of data analysis, and the second limitation is the lack of comprehensive data on social determinants.

Practical implications

Social determinants affecting the formation of inequality in the experience of SE. Some social determinants, such as the level of education and development of the region, play a more prominent role in justifying inequality in the experience of stress between rich and poor groups.

Social implications

Inequality in the experience of SE is a serious threat to mental and social health. One of the ways to reduce the experience of psychological and social stress is to pay attention to social determinants that play a role in the formation of stress.

Originality/value

This original paper was conducted by examining the effect of social determinants on the formation of inequality in the experience of stress, which draws the serious attention of policymakers.

Details

International Journal of Human Rights in Healthcare, vol. 17 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

Content available
Article
Publication date: 1 February 2024

Charlotte V. Farewell, Priyanka Shreedar, Diane Brogden and Jini E. Puma

The early care and education (ECE) workforce plays a pivotal role in shaping early childhood developmental trajectories and simultaneously experiences significant mental health…

Abstract

Purpose

The early care and education (ECE) workforce plays a pivotal role in shaping early childhood developmental trajectories and simultaneously experiences significant mental health disparities. The purpose of this study is to investigate how social determinants of health and external stressors are associated with the mental health of ECE staff, which represent a low-resourced segment of the workforce; how psychological capital (psycap) can mitigate these associations.

Design/methodology/approach

The authors administered an 89-item survey to 332 ECE staff employed in 42 Head Start centers in the USA. The authors ran three hierarchical linear regression models to analyze associations between social determinants of health, external sources of stress, psycap and potential moderation effects and mental health outcomes.

Findings

Individuals experiencing greater finance-related stress reported 0.15 higher scores on the depression scale and 0.20 higher scores on the anxiety scale than those experiencing less finance-related stress (p < 0.05). Individuals experiencing greater work-related stress reported 1.26 more days of poorer mental health in the past month than those experiencing less work-related stress (p < 0.01). After controlling for all sociodemographic variables and sources of stress, psycap was significantly and negatively associated with depressive symptomology (b-weight = −0.02, p < 0.01) and the number of poor mental health days reported in the past month (b-weight = −0.13, p < 0.05). Moderation models suggest that higher levels of psycap may mitigate the association between work-related stress and the number of poor mental health days reported in the past month (b-weight = −0.06, p = 0.02).

Originality/value

The implications of these findings suggest a need for policy change to mitigate social determinants of health and promote pay equity and multi-level interventio ns that target workplace-related stressors and psycap to combat poor mental health of the ECE workforce.

Details

Journal of Public Mental Health, vol. 23 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Book part
Publication date: 15 January 2024

Diana Bogueva and Dora Marinova

Many in Generation Z are concerned about health, nutrition, and lifestyle. They are sensitive to the social determinants of health, represented through concerns about access to…

Abstract

Many in Generation Z are concerned about health, nutrition, and lifestyle. They are sensitive to the social determinants of health, represented through concerns about access to health care, viable and affordable housing, poverty, and unemployment. They are also concerned about food choices, their environmental footprint, and the way food is produced. There is similarly high awareness about the importance of nutrition for health. Despite engaging in physical exercise, Generation Z is also exposed to the risks associated with obesity and sedentary lifestyle.

Details

Gen Z Around the World
Type: Book
ISBN: 978-1-83797-092-6

Keywords

Content available
Article
Publication date: 29 August 2023

Inger Lise Teig, Kristine Bærøe, Andrea Melberg and Benedicte Carlsen

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is…

Abstract

Purpose

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

Design/methodology/approach

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

Findings

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

Research limitations/implications

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

Originality/value

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.

Details

International Journal of Health Governance, vol. 28 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Book part
Publication date: 19 March 2024

Cara A. Chiaraluce and Lloyd Levine

This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare…

Abstract

This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare for vulnerable disabled US communities. The focus on vulnerable populations, including the elderly, chronically ill, young disabled, neurodivergent, and/or medically complex children and the families that care for them, is a useful case to present a compelling argument for the need to take seriously digital inclusion to maximize health, safety, and well-being for growing populations of Americans today. The authors argue that digital inclusion is an increasingly influential social determinant of health and a key dimension of health equity that offers important benefits and potentials, especially for vulnerable patient populations, for whom in-home and family-centered care are necessary parts of health maintenance, prevention, and well-being. The chapter ends with a discussion of ways that the US government can mitigate digital barriers and facilitate equitable access to broadband internet and e-health resources that address the intersections of digital, health, and care inequalities, with significant impacts in all three dimensions.

Details

Technology vs. Government: The Irresistible Force Meets the Immovable Object
Type: Book
ISBN: 978-1-83867-951-4

Keywords

Article
Publication date: 31 August 2023

Helena Á Marujo

This underscores individual and social implications for how mental disorders and mental well-being are constructed, conceived of and treated. Further, this paper aims to examine…

Abstract

Purpose

This underscores individual and social implications for how mental disorders and mental well-being are constructed, conceived of and treated. Further, this paper aims to examine positive psychology’s role in supporting the advancement of a broader systemic and contextual approach to mental health. With that aim, this paper connects data on mental health and well-being with peace studies to describe the systems of value and social ecologies underpinning mental disorders, using public happiness/Felicitas Publica as a possible framework to enhance public mental health while intervening at the local level (Bruni and Zamagni, 2007; Marujo and Neto, 2013, 2014, 2016, 2017, 2021; Marujo et al., 2019).

Design/methodology/approach

Theoretical foundations and data on positive peace and mental well-being are described with the intention to propose a systemic, contextual, relational, communitarian, economic and sociopolitical perspective of well-being that goes beyond individual bodies and/or brains and, instead, views mental disorder and mental health as social currency (Beck, 2020).

Findings

The interventions using dialogic, conversational and community approaches are a possible path to promote peace, mental health and public happiness.

Research limitations/implications

Examining the interplay between the fields of positive psychology, mental health and cultures of peace, this work contributes to the broadening of research and subsequent intervention topics through transdisciplinary approaches while reinforcing the role of systemic and social determinants and complementing the prevalent medical model and intraindividual perspective of mental health and well-being.

Practical implications

Adopting positive psychology to address mental health through public happiness concepts and interventions opens opportunities to respond to the ebb and flow of social challenges and life-giving opportunities. Therefore, the paper intends to articulate actor-related, relational, structural and cultural dimensions while moving away from discrete technocratic and individual models and pays attention to the way their implementations are aligned with both individual and social needs.

Social implications

The work offers an inclusive, equalitarian, politically sensitive approach to positive mental health and positive psychology, bringing forward a structural transformation and human rights-based approach perspective while rethinking the type of social and political solutions to mental health issues.

Originality/value

Creating a critically constructive debate vis-à-vis the fluidity and complexity of the social world, the paper examines mental health and positive psychology simultaneously from a “hardware” (institutions, infrastructures, services, systems, etc.) and a “software” (i.e. individuals and community/societal relations).

Details

Mental Health and Social Inclusion, vol. 27 no. 4
Type: Research Article
ISSN: 2042-8308

Keywords

Open Access
Article
Publication date: 13 February 2023

Maria Goddard

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were…

1429

Abstract

Purpose

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.

Design/methodology/approach

The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.

Findings

The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.

Originality/value

This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 21 November 2023

Marzieh Ghasemi, Akram Karimi-Shahanjarini, Maryam Afshari and Leili Tapak

Understanding the factors that influence individuals’ adherence to social distancing is critical to effective policymaking in respiratory pandemics such as COVID-19. This study…

Abstract

Purpose

Understanding the factors that influence individuals’ adherence to social distancing is critical to effective policymaking in respiratory pandemics such as COVID-19. This study aims to explore the role of social factors in relation to social distancing measures.

Design/methodology/approach

Stratified convenience sampling was used in this survey research, involving 450 adults residing in both rural and urban areas of Aligodarz County, Lorestan, Iran.

Findings

The findings showed that approximately 14% of participants did not adhere to any of the assessed social distancing behaviors, while only around 30% adhered to all four assessed behaviors. On average, participants reported having 5.13 (SD = 3.60) close physical contact within the 24 h prior to completing the questionnaire. Bridging social capital and gender emerged as the most frequently observed predictors across the assessed social distancing measures. Additionally, age, employment status and residential setting were identified as influential factors for some of the evaluated measures.

Originality/value

This study contributes to the field by highlighting that the likelihood of non-adherence to social distancing measures tends to increase among male participants, those aged above 60, employed individuals, urban residents and those with a higher level of bridging social capital.

Details

Global Knowledge, Memory and Communication, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2514-9342

Keywords

Book part
Publication date: 7 February 2024

Anne M. Hewitt

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…

Abstract

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Article
Publication date: 1 January 2024

Fatemeh Kokabisaghi

Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the…

Abstract

Purpose

Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the situation of the right and its determinants is necessary. This paper aims to analyze Iran’s conduct in realizing its population’s right to health.

Design/methodology/approach

A qualitative case study design involving a structured review of relevant laws, policy documents, reports and academic literature was undertaken. The data were collected from electronic databases and the official Web pages of the United Nations (UN) and Iran’s Government and analyzed by a framework suggested by the UN.

Findings

Iran’s law and policies intend to combat health inequalities and to provide an adequate standard of living for everyone, particularly disadvantaged groups and individuals. However, not all laws and policies protecting disadvantaged groups are adequately implemented. There are disparities in health status and access to health care among different socio-economic groups. International economic sanctions and government policies decreased people’s ability to access the necessities of life including health care. Moreover, social determinants of health, such as cultural beliefs regarding women’s rights have not been addressed sufficiently in the country’s laws.

Research limitations/implications

This study includes a broad range of subjects and provides an overview of the health-care system of Iran. However, more detail is needed to describe every aspect of the right to health. It was not feasible to address them all in this paper and needs more research. In addition, as with the majority of qualitative studies, the design of the current study is subject to limitations. Firstly, the research quality of narrative reviews is dependent on the researcher’ skills and more easily can be influenced by his/her personal biases. Second, the rigor is more difficult to maintain, assess and demonstrate. Nevertheless, narrative studies often complement quantitative studies and are informative.

Originality/value

To fulfill the right to health, Iran should improve affordability and quality of care and the situation of the determinants of health. The gaps in people’s access to health care need to be identified, and all necessary means and scarce resources be allocated to remove access barriers and to improve the situation of disadvantaged people. The adoption of relatively low-cost targeted programs, the proper management of resources and the prevention of unnecessary costs are suggested.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

1 – 10 of over 4000