Search results

This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.

Postneonatal mortality (PNM), which differs from infant and perinatal mortality, has been observed in the past 25 years with respect to the health outcomes of children. While infant and perinatal mortality have been well-evaluated regarding racial differentials, there are no substantial data on PNM in this perspective. The purpose of this study was to assess whether or not social determinants of health adversely affect racial/ethnic PNM differentials in the USA.

A cross-sectional, nonexperimental epidemiologic study design was used to assess race as an exposure function of PNM using Cohort Linked Birth/Infant Death Data (2013). The outcome variable assessed PNM, while the main independent variables were race, social demographic variables (i.e. sex and age) and social determinants of health (i.e. marital status and maternal education). The chi-square statistic was used to assess the independence of variables by race, while the logistic regression model was used to assess the odds of PNM by race and other confounding variables.

During 2013, there were 4,451 children with PNM experience. The cumulative incidence of PNM was 23.6% (n = 2,795) among white infants, 24.3% (n = 1,298) among Black/African-Americans (AA) and 39.5% (n = 88) were American-Indian infants (AI), while 21.3% (n = 270) were multiracial, χ² (3) = 35.7, p < 0.001. Racial differentials in PNM were observed. Relative to White infants, PNM was two times as likely among AI, odds ratio (OR) 2.11 (95% confidence interval [CI] 1.61, 2.78). After controlling for the confounding variables, the burden of PNM persisted among AI, although slightly marginalized, adjusted odds ratio (aOR) 1.70, (99% CI 1.10, 2.65).

In a representative sample of US children, there were racial disparities in PNM infants who are AI compared to their white counterparts, illustrating excess mortality. These findings suggest the need to allocate social and health resources in transforming health equity in this direction.

A growing body of evidence suggests that experiences of discrimination may affect physical and mental health through multiple pathways. This paper aims to characterize the extent of everyday perceived discrimination among Brazilian and Cape Verdean immigrant adults in Portugal, to identify its forms and analyze its association with mental health.

This study draws on data from the EQUALS4COVID19 (Equity in health in times of pandemic) project that implemented a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022.

Women were less likely than men to report no discrimination experiences and more likely to report combined bases of discrimination. While Brazilian women were more likely than Cape Verdean counterparts to report gender and nationality-based discrimination, Cape Verdean women and men were more likely to report experiencing race-based discrimination. Gender (being identified as a woman) and length of stay in Portugal were the main predictors of depression, while resilience and perceived social support were protective factors. Participants with higher levels of resilience showed a significantly diminished association between perceived discrimination and depressive symptoms.

This study highlights the need for further research on the interlocking influences of gender, race, nationality and other structures of power, on health and illness to increase our understanding of what would help meet the specific needs of migrants’ mental health and improve equitable health care.

The findings on the multiple and intersectional discrimination perceived by the Brazilian and Cape Verdean populations in Portugal illustrated the ways mental health can be affected by social structures, such as gender and ethnic hierarchies, and can be used to inform the relevance to design and implement programs on combating individual and institutional discrimination and improving the rights of all people.

This study aims to evaluate the association between ethnic minority membership and their knowledge about their human health rights in Peru.

A secondary analysis of the National Health User Satisfaction Survey 2015–2016 was conducted using an analytical cross-sectional design. Participants who spoke Quechua, Aymara, Awajun, Bora or a language other than Spanish aged 15 year were considered as a racial minority. The question “Do you know that by law you have health rights?” was applied to incorporate knowledge on health rights. Generalized linear models of the Poisson distribution were used to calculate crude prevalence ratio and adjusted prevalence ratio. A total of 3,721 responses were included in the analysis.

The average age was 38.3 year, and 26.6% were males. The prevalence of belonging to an ethnic minority was 7.7%, and 27.6% of the participants did not know about their health rights. An association was found in the adjusted regression analysis between belonging to an ethnic minority and a greater probability of not knowing human health rights.

The value of the works lies in one in four participants who did not know he had health rights by law. Belonging to an ethnic minority was associated with not knowing about having human health rights.

The internet has evolved into an indispensable platform for seeking health information, particularly among transgender individuals. With an abundance of online resources available, extensive research into the credibility and reliability of this information is essential, as concerns about the quality of online resources persist. Transgender individuals are drawn to online health information due to the anonymity it offers, providing them with a sense of freedom from social isolation and the discomfort of experimenting with their transgender identity. However, it is crucial to assess the accuracy and reliability of the transgender health information available on the internet. This article aims to evaluate the quality of online transgender health resources by utilizing ten credibility indicators, along with six indicators to assess the veracity of the content.

A total of 179 online resources were meticulously reviewed after excluding any unnecessary and irrelevant ones, to ensure a comprehensive assessment.

The findings suggest that among the chosen resources, none of them meet all the criteria for maintaining high standards of accuracy and reliability in health information. In other words, none of these sources completely adhere to the established measures for ensuring that the information they provide is trustworthy and of high quality in the context of health.

The study provides valuable insights into the online realm of transgender health information, revealing both the strengths and weaknesses of the existing resources. By pinpointing areas that need enhancement and showcasing commendable practices, this research strives to promote a more knowledgeable and supportive online environment for individuals in search of transgender health information.

Food insecurity is a major public health concern, especially for refugee families. Despite the growing population of refugee families in the USA and the harmful effects on youth’s health and well-being, there are limited qualitative studies exploring food insecurity among US refugee adolescents. The use of community-based participatory research and photovoice can highlight the strength of gathering and sharing underrepresented and disadvantaged group experiences. The purpose of this study was to understand adolescent refugee's food insecurity perspectives and experiences, with a nutrition and food access focus. Three main themes and nine subthemes emerged around the role that food security plays in a healthy, thriving community. The main themes included food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community. Implications regarding how to apply these results with community and school-based food programs are discussed.

This study followed a phenomenological research approach to understand the experiences of refugee youth and what constitutes healthy food access in a community. Data analysis was conducted using Braun and Clarke’s (2006) thematic analysis to ensure that data saturation was met (Guest et al., 2006).

The thematic analysis of the photovoice methodological approach revealed three main themes and nine subthemes around the role that food security plays in a healthy and thriving community. These themes are as follows: food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community.

Funding resources limited the duration of meeting in which we could meet and discuss the photo’s students were taking. Second, consistent with phenomenological studies, the sample size was small. However, common sample size for studies using a phenomenological approach ranged from 5 to 25 (Creswell et al., 2007), which is in alignment with this study. Next, while participants did receive training in the SHOWeD method, the photography training was limited to only one hour. Despite the limited training, participants felt they had sufficient knowledge and skills to take the necessary pictures.

This study provides important policy implications for school-based food programs, such as food pantries and free or reduced school meals, and how it plays an important role in refugee youth’s well-being and education. Based on feedback from the study participants, many school-based food programs were considered not available or easily accessible, and that youth and their families were often unaware of programs available to them. This study revealed the important role schools can play in ensuring food security among refugee youth and their families as well as for refugee youth to reach their full potential equitably.

This study used a creative research approach that integrates photovoice as a means to elevate the voices of a marginalized populations. This approach has been identified as one of the most culturally appropriate method when working with refugee children and youth (Pieloch et al., 2016). Second, the study included having multiple meetings, that recruited from previously established partnerships. This form of community building and activism elevates participants voices (Catalani and Minkler, 2009). Finally, this study used a cycle of photography and discussion and held a final public photo exhibition for both the participant’s community and its influential leaders (Catalani and Minkler, 2009; Evans-Agnew and Rosemberg, 2016). The results of this study have important policy implications for schools and communities.

Since March 2020, the global COVID-19 pandemic has disproportionately impacted refugees by compounding preexisting and systemic health, social and economic inequities. In Canada, approximately 50,000 Syrian refugees arrived between 2015 and 2020 and were in the process of rebuilding their lives when the pandemic started. This study aims to explore the impact of the COVID-19 pandemic for Syrian refugees in Canada and identify supports needed.

Drawing on frameworks for refugee psychosocial adaptation and social integration and a qualitative descriptive design, the study used thematic analysis to examine semi-structured interviews with 10 Syrians.

Findings indicated four themes that provide a snapshot of impacts relatively early in the pandemic: facing ongoing development, inequity and insecurity during integration; disruption of settlement, integration and adaptation due to the pandemic; ongoing adaptation and resilience during integration in Canada; and ongoing needs and solutions for integration and adaptation.

This study builds upon growing research concerning Syrian refugees and psychosocial adaptation, particularly during the pandemic. The findings highlight the impacts of the pandemic on a population already facing inequities in a resettlement country. While the findings emphasize the resilience of the Syrian refugee community, the study also demonstrates the need for ongoing supports and justice-oriented action to fulfill resettlement commitments, especially in the face of additional stressors like the COVID-19 pandemic. Implications for policy, practice and future research are discussed.

This study aims to discuss the possible consequences of food crises caused by unsustainable food production and distribution, as well as how the rapid depletion of food resources may affect human life, destinations and the food tourism industry.

To address the lack of research examining the impact of sustainability issues and food crises on food tourism, this study conducted a critical review of the literature and reports related to agriculture, food production and sustainability.

Global conflicts, climate change and supply disruptions result in the reduction of food availability and quality. The high price of food and energy in such circumstances will further exacerbate poverty and delay destination development, which will negatively impact food tourism's economic sustainability. Furthermore, local businesses will be limited in their ability to offer a variety of culinary experiences, which will negatively impact the overall experience of food tourism. In this context, there is a pressing need to investigate the experiential aspects of food tourism as well as today's challenges relating to food crises at multiple levels, sustainable approaches, food quality and food services.

The United Nations, FAO, WHO, UNICEF and other regional and international organizations refer to unsustainable practices and food crises on a variety of levels. Several sectors, including the food tourism industry, are predicted to be negatively affected by the current situation. However, governments have not adopted an emergency code to address this issue, except in some regions experiencing extreme inflation and food shortages. Besides promoting sustainable practices, responding to global crises and enhancing culinary and cultural tourism experiences, food crisis management and sustainability efforts can have a significant impact on future research, practical applications and societal outcomes.

As one of the first studies conducted in this field, this study examines the effects of declines in food production and issues in the supply chain on the food tourism industry.

本文讨论了不可持续的粮食生产和分配造成的粮食危机的可能后果, 以及粮食资源的快速枯竭如何影响人类生活、目的地和食品旅游业。

为了解决缺乏研究可持续性问题和粮食危机对食品旅游的影响问题, 本研究对与农业、粮食生产和可持续性相关的文献和报告进行了批判性回顾。

全球冲突、气候变化和供应中断导致粮食供应和质量下降。在这种情况下, 粮食和能源的高昂价格将进一步加剧贫困, 阻碍目的地的发展, 这将对食品旅游的经济可持续性产生负面影响。此外, 当地企业提供各种烹饪体验的能力将受到限制, 这将对美食旅游的整体体验产生负面影响。在此背景下, 迫切需要了解食品旅游的体验, 以及当今在多个层面上与粮食危机、可持续方法、食品质量和食品服务相关的挑战。

联合国、粮农组织、世界卫生组织、儿童基金会和其他区域和国际组织在各种层面上提到了不可持续的做法和粮食危机。包括食品旅游业在内的几个部门预计将受到当前形势的负面影响。然而, 除了一些经历极端通货膨胀和粮食短缺的地区外, 各国政府还没有通过紧急代码来解决这个问题。除了推广可持续实践、应对全球危机、增强烹饪和文化旅游体验外, 粮食危机管理和可持续发展工作还可以对未来的研究、实际应用和社会成果产生重大影响。

作为该领域最早进行的研究之一, 本研究考察了食品产量下降和供应链问题对食品旅游业的影响。

Este artículo analiza las posibles consecuencias de las crisis alimentarias provocadas por la producción y distribución insostenibles de alimentos, así como el modo en que el rápido agotamiento de los recursos alimentarios puede afectar a la vida humana, a los destinos y a la industria del turismo gastronómico.

Para abordar la falta de investigaciones que examinen el impacto de las cuestiones de sostenibilidad y las crisis alimentarias en el turismo gastronómico, este estudio realizó una revisión crítica de la literatura y los informes relacionados con la agricultura, la producción de alimentos y la sostenibilidad.

Los conflictos mundiales, el cambio climático y las interrupciones en el suministro provocan la reducción de la disponibilidad y la calidad de los alimentos. El elevado precio de los alimentos y la energía en tales circunstancias agravará aún más la pobreza y retrasará el desarrollo de los destinos, lo que repercutirá negativamente en la sostenibilidad económica del turismo gastronómico. Además, los negocios locales verán limitada su capacidad de ofrecer una variedad de experiencias culinarias, lo que repercutirá negativamente en la experiencia global del turismo gastronómico. En este contexto, existe una necesidad acuciante de investigar los aspectos experienciales del turismo gastronómico, así como los retos actuales relacionados con las crisis alimentarias a múltiples niveles, los enfoques sostenibles, la calidad de los alimentos y los servicios alimentarios.

Las Naciones Unidas, la FAO, la OMS, UNICEF y otras organizaciones regionales e internacionales se refieren a las prácticas insostenibles y a las crisis alimentarias en diversos niveles. Se prevé que varios sectores, entre ellos la industria del turismo alimentario, se verán afectados negativamente por la situación actual. Sin embargo, los gobiernos no han adoptado un código de emergencia para abordar esta cuestión, excepto en algunas regiones que experimentan una inflación extrema y escasez de alimentos. Además de promover prácticas sostenibles, responder a las crisis mundiales y mejorar las experiencias turísticas culinarias y culturales, la gestión de las crisis alimentarias y los esfuerzos de sostenibilidad pueden tener un impacto significativo en la investigación futura, las aplicaciones prácticas y los resultados sociales.

Como uno de los primeros estudios realizados en este campo, este estudio examina los efectos de la disminución de la producción de alimentos y los problemas de la cadena de suministro en la industria del turismo gastronómico.