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Attention on world migration has mostly focused on economic and inter-personal impacts, leaving a large gap in our understanding of how migration can affect migrants’ health. The purpose of this paper is to illustrate how the interdependent experiences of skilled migrants, as they undertake the latter part of their journey of skilled migration and resettle into their adopted homeland, can be conceptualised as a structural determinant of health.

In this qualitative study, semi-structured interviews collected data on skilled migrants’ experiences, including health impacts, related to their migration to Tasmania, Australia. A social determinants of health (SDOH) framework and Bourdieu’s theory of practice were applied to interpret the findings.

In total, 16 skilled migrants, from several nations and occupations, provided wide-ranging accounts of social inclusion and exclusion, and frequently reported experiencing psychological stress. There were also some reports of improved mental health. The migration process shapes life’s chances and choices. Many migrants reported access to important social, economic and cultural resources, however, good health was also impeded by equally significant systemic barriers.

The sample is small and confined to a geographically isolated location, and did not include all types of skilled migrants.

Countries resettling skilled migrants should modify systems to promote rather than inhibit wellbeing, e.g. government and industry partnerships to facilitate employability and enhance access to supportive information about the migration process.

This is the first known study to link Bourdieu’s theory to SDOH relevant to skilled migrants. This approach helped reveal the prominence of structural factors beyond the control of migrants but potentially modifiable by the host country. This study illustrates the importance of examining both positive and negative health outcomes associated with migration, and how these factors relate to theory and policy.

The purpose of this chapter is to offer reflections on conventional theories concerning causes and determinants of diseases. It also intends to examine both theoretical and empirical bases for adopting an Integrated Social-Ecological Systems (ISES) lens as a tool for understanding complexities related to drivers, determinants and causes of diseases.

We assessed the theoretical underpinnings of a range of historical and contemporary lenses for viewing infectious disease drivers and the implications of their use when used to explain both personal (i.e. individual) and population health. We examined these issues within the empirical context of the City of Dhaka (Bangladesh) by adopting an ISES lens. Within this study an emphasis has been placed on illustrating how feedback loops and non-linearity functions in systems have a direct bearing upon various aspects of infectious disease occurrences.

A brief triumph over microbes during the last century stemmed in part from our improved understanding of disease causation which was built using disciplinary-specific, monocausal approaches to the study of disease emergence. Subsequently, empirical inquiries into the multi-factorial aetiology and the ‘web of causation’ of disease emergence have extended frameworks beyond simplistic, individualistic descriptions of disease causation. Nonetheless, much work is yet to be done to understand the roles of complex, intertwined, multi-level, social-ecological factors in affecting disease occurrence. We argue, a transdisciplinary-oriented, ISES lens is needed to explain the complexities of disease occurrence at various and interacting levels. More theoretical and empirical formulations, with evidence derived from various parts of the world, is also required to further the debate.

Our study advances the theoretical as well as empirical basis for considering an integrated human-nature systems approach to explaining disease occurrence at all levels so that factors at the individual, household/neighbourhood, local, regional and global levels are not treated in isolation.

The purpose of this study was to assess the self-perceived need, seeking and use of dental care and its main determinants in Kurdistan province, Iran.

A total of 1,056 adults in Kurdistan province were included in this cross-sectional study. Multistage sampling approach was used to select the samples. Data on sociodemographic characteristics, economic status, self-perceived need, seeking and use of dental care were collected using a self-administrated questionnaire. Multivariate logistic regression model was used to assess factors affecting the use of dental care. In addition, socioeconomic inequality relating to dental care needs and use of dental care were examined using concentration curve and concentration index.

In this study, unmet dental care need was 62.7%. There was a perceived need for dental care among 13.7% (n = 145) of the participants in the past month, with only 39.3% (n = 57) seeking the care. The most important reasons for unmet dental care need were “Could not afford the cost” and “Insurance did not cover the costs.” Multivariate logistic regression showed that supplementary insurance status and household economic status were identified as main determinants affecting dental care-seeking behavior. The result of concentration index revealed that seeking dental care was more concentrated among the rich, whereas the perceived dental care need is more prevalent among the poor.

This study demonstrated that the prevalence of unmet dental care needs is high in the study setting. Also, financial barrier was identified as the main determinant of unmet dental care needs.

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.

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.

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).

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.

The purpose of this paper is to propose an alternative, interdisciplinary teaching of health, health care and medical care based on three pillars: social economics, the social determinants of health (SDH) and ethics. Based on these three pillars, the global financial crisis is presented as the moment of manifestation of the SDH at individual and aggregate levels that require a critical analysis from a broader perspective that is possible with social economics and ethics.

The author designed a writing-intensive course based on four modules about definition of health, health care, medical care and determinants of health; political economy of financing and organization of medical care; policies including reform proposals; and medical ethics and moral philosophies that reflect back on the previous topics, respectively.

The course attracts students from different disciplines who found it realistic and comprehensive so that it can be related easily to other disciplines owing to its interdisciplinary design. It also helps students to improve their writing skills.

The course is taught only in US context and is still open to further development.

The theoretical pillars of the course can be adopted and experimented with in different contexts (e.g. wars, plagues, immigration, etc.) and inform the participants about the subject matters from a broader perspective.

This paper provides a successful and novel teaching experience of health and medical care by putting social economics, SDH and ethics together.

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.

The right to health for all people means that everyone should have access to the needed healthcare services without suffering from severe financial hardship. The purpose of this paper is to investigate the prevalence as well as the effective factors on facing catastrophic health expenditures (CHE) among gastrointestinal cancer patients and families in Kurdistan province in west of Iran after the implementation of Health Transformation Plan (HTP).

A cross-sectional study was carried out on 189 households with gastrointestinal cancer patients in Kurdistan province in 2018. Data were collected using World Health Survey questionnaire. A method developed by World Health Organization with the threshold of 40 percent household’s capacity to pay was used in order to measure the proportion of households facing CHE. Also, logistic regression was applied for identifying the effective factors on household’s exposure to CHE. Data were analyzed using STATA version 13.

Almost 73 percent (72.7 percent) of the households (n=117) faced the CHE. Not having supplementary health insurance (adjusted odds ratio (AOR): 3.8; 95% confidence interval: 1.3–10.8 (and having low socio-economic status (AOR: 7.1; 95% CI: 1.8–28.1) were the significant factors affecting the households’ exposure to CHE. In total, 57 and 1 percent of the studied households reported that having a gastrointestinal cancer patient at home had a significant effect on refraining from using health services by other family members.

The proportion of the studied households facing CHE was very high. This may indicate the weakness of health system as well as health insurance or the weakness of HTP in financial protection of fragile population.

This paper discusses the role played by social determinants of health in the incidence and management of type 2 diabetes mellitus (diabetes) among vulnerable populations. This issue is especially important in light of recent data from Statistics Canada indicating that mortality rates from diabetes have been increasing among Canadians since the mid‐1980s, with increases being especially great among those living in low‐income communities. Diabetes therefore appears – like cardiovascular disease – to be an affliction more common among the poor and excluded. It also appears to be especially likely to afflict poor women. Yet we know little about how these social determinants of health influence diabetes incidence and management. What evidence is available is provided and the case is made that the crisis in diabetes requires new ways of thinking about this disease, its causes, and its management.

The purpose of this study is to characterize the social and cultural context of the social construction of mental health (MH) by members of Romani communities in Ukraine.

The research collected qualitative data to gain a better understanding of how Romani communities in Ukraine view the social and cultural factors influencing mental health. This paper analyzes data from focus groups in Romani communities in Ukraine (from six different oblasts) from February to March 2020. A total of 49 persons 19–75 years of age participated in the research, including 17 men and 32 women.

This study identifies four clusters of perceived social determinants of Romani mental health, these being employment, financial difficulties, level of education and discrimination. The findings indicate specific cultural characteristics of the Romani community that are seen as helping to support mental health. Family values, mutually supporting and referring to other members of the community are seen as especially important. Such social cohesion is believed to have a positive effect on the mental health of members of the Romani community. This paper discusses the implications of the study and suggests possible avenues for future data-driven policymaking in the area of mental health that take account of the culturally-specific meanings of mental health for these communities.

Given the significant gaps, shortages and, in some cases, complete lack of data on Romani ethnic and cross-cultural psychology, research is urgently needed to fill this gap. Lack of understandings of how Romani construct mental health can lead to badly-matched, misplaced or ineffective actions and distrust. This paper aims to support better understandings of Romani among MH service providers and enhancing the mutual engagement of Romani and MH services, supporting the broader agenda of social inclusion of Romani people.

Patient engagement has been a focus of patient-centered care in recent years, encouraging health care organizations to increase efforts to facilitate a patient's ability to participate in health care. At the same time, a growing body of research has examined the impact that social determinants of health (SDOH) have on patient health outcomes. Additionally, health care equity is increasingly becoming a focus of many organizations as they work to ensure that all patients receive equitable care. These three domains – patient engagement, SDOH, and health care equity – can intersect in the implementation of social needs screenings among health care organizations. We present a case study on a two-phase social needs screening implementation project and describe how this process focuses on equity. As health care organizations seek to increase patient engagement, address SDOH, and improve health equity, we highlight the need to move away from a siloed approach and view these efforts as interrelated. By approaching efforts to address these challenges and barriers as the duty of all those involved in the patient care process, there may be larger strides made toward equitable health care.