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This paper examines the challenges posed by the COVID-19 pandemic on the existing health inequalities disproportionately affecting vulnerable populations. It explores the impact of COVID-19 pandemic response measures to "curb the spread" on informal sector workers in Ghana. In Ghana, like many other developing countries, the informal sector was impacted by a higher risk of exposure to the COVID-19 infection and the slew of pandemic response measures, for example, lockdowns and stay-at-home orders, as well as guidelines around social distancing implemented by their governments. Given the high level of precarity that undergirds work in the informal sector and the intersectional forces that contribute to and maintain their marginality—class, race, ethnicity, gender, religion, and geographic location—this paper creates a space for dialogue about the unintended consequences of pandemic response measures on the livelihood security of informal sector workers. [ABSTRACT FROM AUTHOR]

This paper discusses three cultural narratives that threaten the health of people with intellectual/developmental disabilities (IDD) and which have become more evident during the COVID-19 pandemic. These meta-narratives are the medical model of health/disability; the population health approach to health inequalities; and policies premised on the assumption of the importance of national economic growth as an incentive for reducing health inequalities. Evidence exists that health research is more likely to become policy if it fits within a medical model and addresses national economic growth. These two criteria are particularly problematic for people who have IDD. The paper also proposes a research model to facilitate the inclusion of IDD related issues in future policy regarding health inequalities. [ABSTRACT FROM AUTHOR]

Aims: Socio-economic inequalities originate from several channels, one of which is family origins, with clear effects on people's health. This paper aims to evaluate the role played by social mobility in determining health inequalities, relying on Blau and Duncan's status attainment model and focusing specifically on two moments of social reproduction of inequalities: one inter-generational, based on the transmission of resources from the family of origin, the other intra-generational, related to the capitalisation of economic resources to maximise well-being. Methods: Multi-group models of structural equations were used to examine the direct and indirect effects of parental cultural background, education and economic conditions of respondents on self-perceived health in 28 countries, relying on the European Social Survey (N =38,879). Results: Overall, the results confirmed the presence of an inter-generational transmission of social and health status. Different models of transmission of health inequalities emerged among the countries considered. Countries characterised by a social democratic welfare regime showed higher social mobility and fewer health inequalities, although in correspondence with a prominent role of economic factors in determining health conditions. On the other hand, in countries where social mobility is lower, health inequalities are more pronounced, yet driven by factors others than economics, such as socio-cultural origins. Conclusions: The presence of a higher economic-health gradient in social democratic countries – notwithstanding their egalitarian and universal welfare policies – provides support for the existence of a Nordic paradox in relation to health inequalities. [ABSTRACT FROM AUTHOR]

Autistic people face more social barriers to, and experience greater anxiety around, intimate relationships than the general population in our majority neurotypical society, leading to increased loneliness and social isolation. National health and social care policies and publications should recognise these inequalities and guide service systems in reducing them. In this paper, we employ a document analysis design to analyse a cross-section of English national health and social care publications to investigate how autistic adults' intimate lives are represented and prioritised in these publications. Most publications do not adequately and proportionally recognise or prioritise autistic people's intimate lives. They focus on the risks associated with sex and relationships and overlook autism-specific intimacy needs. They prioritise participation in the workforce while renouncing government responsibility for supporting intimate relationships which can reduce loneliness and alienation. We offer recommendations to ensure that health and social care publication processes better recognise intimate lives. [ABSTRACT FROM AUTHOR]

Aims: Historically, health research in the Arctic has focused on documenting ill-health using a narrow set of deficit-oriented epidemiologic indicators (i.e., prevalence of disease and mortality rates). While useful, this type of research does not adequately capture the breadth and complexities of community health and well-being, and fails to highlight solutions. A community's context, strengths, and continued expressions of well-being need to guide inquiries, inform processes, and contextualize recommendations. In this paper, we present a conceptual framework developed to address the aforementioned concerns and inform community-led health and social research in the Arctic. Methods: The proposed framework is informed by our collective collaborations with circumpolar communities, and syntheses of individual and group research undertaken throughout the Circumpolar North. Our framework encourages investigation into the contextual factors that promote circumpolar communities to thrive. Results: Our framework centers on the visual imagery of an iceberg. There is a need to dive deeper than superficial indicators of health to examine individual, family, social, cultural, historical, linguistic, and environmental contexts that support communities in the Circumpolar North to thrive. A participatory community-based approach in conjunction with ongoing epidemiologic research is necessary in order to effectively support health and wellness. Conclusions: The iceberg framework is a way to conceptualize circumpolar health research and encourage investigators to both monitor epidemiologic indicators and also dive below the surface using participatory methodology to investigate contextual factors that support thriving communities. [ABSTRACT FROM AUTHOR]

Reducing social inequalities in health has been an important aim in the development of the Nordic welfare states. This Commentary presents the development of Norwegian policies in this area from 1987 to 2021. Social inequalities entered the political agenda in Norway in the 1980s, but were mostly defined as a problem for selected marginalised groups. The World Health Organization project led by Michael Marmot was an inspiration for Norwegian policy-makers and the concept of the social gradient was introduced. From 2005, levelling the social gradient in health became a central strategy in Norwegian policy-making and culminated in the Public Health Act 2012. This Act focuses on the structural determinants of health and the municipalities have a central role in its implementation. However, the municipalities are mostly responsible for services providing downstream measures and have little control over social determinants such as tax or labour market policies. The Public Health Act is important because it institutionalises social inequalities as a policy field within public health. Not only the municipalities, but all administrative levels have to contribute to meet the aim of reducing the social gradient. [ABSTRACT FROM AUTHOR]

Aims: We examined the development of research articles published in the Scandinavian Journal of Public Health and its predecessors Acta Socio-Medica Scandinavica and the Scandinavian Journal of Social Medicine from 1969 until 2020 to be able to identify the place of international comparisons of socioeconomic inequalities in health in the journal. Methods: Altogether 3237 research articles were screened to yield 126 comparative research articles. Examining full texts of the comparative articles led to 13 articles reporting comparisons of health inequalities. Results: The first one came out in 1972, but the rest only after the mid-1990s. The most common socioeconomic indicator was education, but also occupational class and income was used. The most common health indicator was self-rated health. The articles compared Nordic countries with each other, but also with non-Nordic countries. Although the number of comparative studies on health inequalities was relatively small, there were examples of well-designed studies using advanced methodology. We examined only published journal articles over the past five decades, not submitted but rejected papers. Conclusions: In the Scandinavian Journal of Public Health and its predecessors, comparisons of health inequalities were few and emerged relatively late, that is, during the past two decades. [ABSTRACT FROM AUTHOR]

Background: In an aging society with increasing old age life expectancy, it has become increasingly important to monitor the health development in the population. This paper combines information on mortality and disability and explores educational inequalities in disability-free life expectancy in the aging population in Sweden, and to what extent these inequalities have increased or decreased over time. Methods: A random sample of the Swedish population aged 77 years and above (n =2895) provided information about disability in the population in the years 2002, 2004, 2011 and 2014. The prevalence of disability was assessed by five items of personal activities of daily living and incorporated in period life tables for the corresponding years, using the Sullivan method. The analyses were stratified by sex and educational attainment. Estimates at ages 77 and 85 years are presented. Results: Disability-free life expectancy at age 77 years increased more than total life expectancy for all except men with lower education. Women with higher education had a 2.7-year increase and women with lower education a 1.6-year increase. The corresponding numbers for men were 2.0 and 0.8 years. The educational gap in disability-free life expectancy increased by 1.2 years at age 77 years for both men and women. Conclusions: While most of the increase in life expectancy was years free from disability, men with lower education had an increase of years with disability. The educational differences prevailed and increased over the period as the gains in disability-free life expectancy were smaller among those with lower education. [ABSTRACT FROM AUTHOR]

Aims: This paper highlights how the novel coronavirus pandemic (COVID-19) has amplified economic instability and health risks for disconnected youth and young adults (YYA). We offer a brief review of governmental policy responses in four OECD countries and how they may impact the disconnect YYA within those countries. Methods: Literature was reviewed utilizing Cochrane Library, ERIC, PsychINFO, PubMed/MEDLINE and Web of Science to outline existing inequities among disconnected YYA and COVID-19 economic and health impacts. Government responses to COVID-19 from four OECD countries were reviewed. Using the social protection model, we highlighted significant policy changes and developments that influence the protection of vulnerable populations and evaluated the potential effect of long-term economic dislocations prompted by the COVID-19 pandemic. Results: Disconnected YYA suffered significant financial and health burdens with no social protection floor in place. Lessons learned prior to and during the pandemic indicate that initiatives aimed at improving health and well-being among vulnerable YYA and their communities must be adequately funded, flexible, and comprehensive. Attempts to connect or reconnect YYA who were disconnected prior to the COVID-19 pandemic will require a re-envisioning of policy. Conclusions: Globally, governments must invest in social safety net programs that focus on supporting those most at-risk. A concentrated focus on job creation, education and training, and paid work experience, investments in early childhood care and education, housing, health and mental health care is necessary to not only offset the pandemic's effects but also support thriving in the future for YYA. [ABSTRACT FROM AUTHOR]

Albert Beckham, who was the first Black school psychologist in the U.S., frequently used intelligence tests with Black children. This usage required clinical decision making to explain the results obtained from psychoeducational assessments. In their discussion of this aspect of Beckham's work, introduce the concept of Culturally Relevant Clinical Judgement. This paper discusses issues related to the continued use of cognitive assessment instruments as it relates to clinical judgment in special education eligibility decision-making in comparison to alternatives such as Response-to-Intervention (RtI). [ABSTRACT FROM AUTHOR]

The critical political economy of health offers different explanations for the social causes of health and the social factors determining the distribution of these causes. However, the relational, post-anthropocentric and monist ontology of the new materialisms overcomes this complexity, while retaining a critical focus. In this perspective, the social, economic and political relations of capitalism act upon bodies and other matter in everyday events, rather than as 'social structures'. Using a conceptual toolkit of 'affect', 'assemblage', 'capacity' and 'micropolitics', the paper asks the question: 'what does capitalism do?' The re-analysis of the social and economic relations of capitalism in terms of a production-assemblage and a market-assemblage reveals not only the workings of capitalist accumulation, but also how previously-unremarked more-than-human affects in these assemblages simultaneously produce uncertainty, waste and inequalities. This micropolitical economy of health is illustrated with examples from recent research, including a critical assessment of health inequalities during the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

The Psychology of Women and Equalities Section (POWES) of the British Psychological Society (BPS) accounts for much of the feminist action in British psychology and beyond. In this qualitative study, we use discursively informed thematic analysis to examine a set of eleven in-depth interviews to explore the everyday experiences of feminists within academic spaces in and around the discipline of psychology in the United Kingdom. Three research questions addressing the boundary between activism and academia; the provision of support; and differing approaches to knowledge production were investigated. Our findings highlight the role of POWES as a feminist community as well as the conceptual importance of notions of home, work, and fun. Moreover, the paper examines the ways traditional conceptions of scientific rigour continue to haunt feminist spaces, as does the invisibility of emotional labour. Overall, our findings indicate that the place of feminist academic communities remains vital to sustain critical thought and action: having an intellectual "home" is pivotal to the survival of feminist psychology as well as feminists in psychology. [ABSTRACT FROM AUTHOR]

The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses and medication use has increased over time around the world, but significant regional differences remain. This paper aims to determine and explain disparities in ADHD prevalence and medication use among school-aged children in two distinct school systems, in Flanders (Belgium) and Québec (Canada). We present detailed descriptive and comparative analyses of data from 35 schools, 114 teachers, and 1046 parents (children) that were collected as part of a comparative international project. The data concern teacher and parent suspicions, teachers' ratings of ADHD-related behaviors in children, teachers' views of medication use, and teachers' beliefs about ADHD. The results show that, compared with Flanders, Québec had significantly more children diagnosed with ADHD and more frequent suspicions of ADHD in children by teachers and parents. We refer to the conceptual, institutional, and interactional levels of medicalization to interpret our findings and conclude that social and cultural readings of children's behaviors differ greatly between regions. Medicalization of children's behaviors is more common in Québec than in Flanders. [ABSTRACT FROM AUTHOR]

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Background: This study explores the lasting mental health impact of the Syria-Turkey earthquakes in 2023 on a population affected by conflict and trauma. It analyzes pre- and post-event mental health and sleep quality differences, identifying predictors of outcomes. Aims: Studying the 2023 Syria-Turkey earthquakes' enduring mental health impact on conflict-affected individuals, this research informs better support and interventions for disaster survivors. Methods: This longitudinal, cross-sectional study examined the enduring mental health impact of the Syria-Turkey earthquakes. The present study involved N = 1,413 Syrian survivors, aged 18 years or older, who actively participated by contributing both pre- and post-earthquake data. A meticulously designed digital questionnaire with established metrics assessed sleep disturbances, depressive symptoms, and anxiety levels. Stratification variables (age, gender, education, marital status) were used for subgroup analysis. Arabic versions of PHQ-9, PSQI, and GAD-2 proved reliable for measuring depression, sleep quality, and anxiety. Results: The majority of participants were female (73.6%) with tertiary education (83.3%). Post-earthquake, a higher percentage reported poor sleep quality (67.7% vs. 59.7%, p <.001) and increased prevalence of MDE (66.1% vs. 56%, p <.001). GAD did not differ significantly. Post-earthquake, women had a higher likelihood of poor sleep quality (OR: 1.58, 95% CI [1.19, 2.10], p <.001) and MDE (OR: 1.55, 95% CI [1.18 to 2.04], p =.003). Predictors varied before and after earthquakes; age and education were significant predictors of poor sleep quality, MDE, and GAD. Conclusion: This study reveals higher rates of poor sleep quality and major depressive episodes among earthquake-affected individuals, especially women. Age, education, and gender contribute to these outcomes. Targeted interventions and comprehensive mental health support are crucial for post-earthquake recovery. [ABSTRACT FROM AUTHOR]

A growing literature over the past 10 years on health and political behavior has established health status as an important source of political inequality. Poor health reduces psychological engagement with politics and discourages political activity. This lowers incentives for governments to respond to the needs of those experiencing ill health and thereby perpetuates health disparities. In this review article, we provide a critical synthesis of the state of knowledge on the links between different aspects of health and political behavior. We also discuss the challenges confronting this research agenda, particularly with respect to measurement, theory, and establishing causality, along with suggestions for advancing the field. With the COVID-19 pandemic casting health disparities into sharp focus, understanding the sources of health biases in the political process, as well as their implications, is an important task that can bring us closer to the ideals of inclusive democracy. [ABSTRACT FROM AUTHOR]

Aims: The COVID-19 pandemic has had a large impact on the financial situation of higher education students, disproportionately affecting students with a low socioeconomic status (SES). This raises the question of whether economic stressors related to COVID-19 have aggravated existing socioeconomic inequalities in mental health. This study examined the relationship between economic stressors and students' depressive symptoms, and the role of students' SES and countries' socioeconomic conditions. Methods: Data from the COVID-19 International Student Well-being Study was used for multilevel analyses, with depressive symptoms as dependent variable. Three indicators measured SES: educational level of the parents, ability to borrow money from their social network, and struggling with financial resources prior to COVID-19. Results: Students with a low SES had more depressive symptoms, and those not able to borrow money and with parents without higher education were more exposed to a deterioration in their financial situation. Both economic stressors (reduction in working hours and a deterioration of their financial situation) were positively related to depressive symptoms. In addition, the positive relationship between a decrease in working hours and depressive symptoms was stronger in countries with a higher unemployment rate. Conclusions: We observed socioeconomic inequalities in students' mental health, which, in part, can be ascribed to a larger exposure to the economic stressors related to COVID-19 among students' with a low SES. The macroeconomic context also played a role, as the impact of a reduction in working hours on depressive symptoms was stronger in countries with poor economic conditions. [ABSTRACT FROM AUTHOR]

This study analyzes stressors experienced by Syrian mothers in Lebanon in 2020 and emphasizes the necessity of addressing their distinct needs. Through in-depth interviews, it identifies stressors linked to living conditions in Lebanon, the economic crisis, health care access, and the impact of the pandemic. The study recommends that social workers should utilize and enhance existing support systems. It also recommends social policies facilitating mobility for Syrians to reunite with their families and livelihood programs enabling families to prioritize their own financial stability. This comprehensive approach has the potential to alleviate the challenges faced by Syrian mothers in Lebanon. [ABSTRACT FROM AUTHOR]

Aim: To outline the organisation and responsibility for health and social care provided to older people in Denmark, Finland and Sweden. Methods: Non-quantifiable data on the care systems were collated from the literature and expert consultations. The responsibilities for primary healthcare, specialised healthcare, prevention and health promotion, rehabilitation, and social care were presented in relation to policy guidance, funding and organisation. Results: In all three countries, the state issues policy and to some extent co-funds the largely decentralised systems; in Denmark and Sweden the regions and municipalities organise the provision of care services – a system that is also about to be implemented in Finland to improve care coordination and make access more equal. Care for older citizens focuses to a large extent on enabling them to live independently in their own homes. Conclusions: Decentralised care systems are challenged by considerable local variations, possibly jeopardising care equity. State-level decision and policy makers need to be aware of these challenges and monitor developments to prevent further health and social care disparities in the ageing population. [ABSTRACT FROM AUTHOR]

In this article, we apply theories of non-citizenship assemblage to conceptualise the dynamic relationship of social determinants of health for international students in Canada who face barriers to accessing COVID-19 vaccines and verifying their vaccination status. Social workers' roles in responding to and reducing these inequities are also discussed with attention to micro practice, meso service integration, and macro public policy advocacy. Through theorising assembled inequities emerging from Canada's COVID-19 vaccination policies, this article offers guidance for future social work research and practice towards promoting justice and equity for transnational populations who are often excluded from domestic social welfare programmes. [ABSTRACT FROM AUTHOR]

Background: This contribution responds to three articles (we refer to all three as 'editorials') concerning something called 'geopsychiatry'. Aims: To evaluate claims made in these editorials for 'geopsychiatry' as a new field of inquiry at the interface between geography and psychiatry. Method: Close critical reading of two editorials in the International Journal of Social Psychiatry – entitled 'Geographical determinants of mental health' and 'Political determinants of mental health' – and one in the International Review of Psychiatry – entitled 'What is geopsychiatry?' Results: While this geopsychiatry initiative is to be applauded, disquiet can be expressed about the almost complete neglect of a pre-existing domain of inquiry – 'mental health geography' or 'the geography of mental health' – that has long been researched by academic geographers and cognate scholars. Key trajectories in this field can be identified and related to the proposed foci for geopsychiatry. Conclusions: The hope is voiced that future developments in geopsychiatry will proceed in dialogue with the literature and practitioners of mental health geography. [ABSTRACT FROM AUTHOR]

Policymakers must ration healthcare. This necessity became salient during the COVID-19 pandemic. Some policymakers took that opportunity to reduce inequality of health outcomes at the expense of overall health gains. There is a literature that seeks to quantify the optimal trade-off between efficiency and equality in health outcomes: economists employ surveys to quantify the public's preferred level of equity/efficiency trade-off. An odd result from these studies is that a non-trivial subsample of respondents choose to "level down" i.e., they choose as though an additional year of life delivers negative utility to society if it accrues to the most privileged. In an experiment of US and UK respondents (n = 495), we compare equity/efficiency trade-offs across an abstract scenario along the lines of that presented in previous surveys versus a COVID-19 scenario, where it is made explicit that healthcare rationing is a real and current necessity occasioned by the pandemic. We find that preference for "levelling down" is reduced in the COVID-19 scenario relative to the abstract scenario. This result implies that, at least in the context of the COVID-19 pandemic, previous results have overestimated the public's willingness to sacrifice overall gains in population health in order to reduce inequality of health outcomes. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorders (BD) are significant debilitating mental problems. Here, we introduced a novel index as a representative of the quality of care delivered to BD patients worldwide. Methods: The Global Burden of Disease (GBD) 2019 study was the primary data source on BD, including prevalence, incidence, and years lived with disability (YLDs). Secondary indices were created and transformed into a single component that accounted for most of the variation, using the Principal Component Analysis (PCA) method. This component, reported on a scale of 0 to 100, was presented as the quality of care index (QCI). The QCI was estimated in different age groups and areas within a 30-year time frame. Gender disparity ratio (GDR), as the female-to-male ratio of the QCI, was reported. Results: The Global QCI slightly increased from 50.4 in 1990 to 53.1 in 2019. The GDR value was 0.95 in 2019. The high-middle SDI quintile had the highest QCI estimate of 63.0, and the lowest QCI value of 36.9 was regarding the low SDI quintile. Western-Pacific Region and South-East Asia had the highest and lowest QCI among WHO regions, with estimates of 70.7 and 31.2, respectively. The age group of 20 to 24 years old patients reported the lowest QCI estimate of 30.2, and the highest QCI of 59.8 was regarding 40 to 44 years old patients. Conclusion: The QCI in BD had only a subtle increase from 1990 to 2019 and is in need of further improvement. Inequalities between different regions and age groups are considerable and require proper attention. [ABSTRACT FROM AUTHOR]

Aims: Japan is known as a country with low self-rated health despite high life expectancy. We compared socioeconomic inequalities in self-rated health in Japan with those in 32 European countries and the US using nationally representative samples. Methods: We analysed individual data from the Comprehensive Survey of Living Conditions (Japan), the European Union Statistics on Income and Living Conditions, and the Behavioral Risk Factor Surveillance System (US) in 2016. We used ordered logistic regression models with four ordinal categories of self-rated health as an outcome, and educational level or occupational class as independent variables, controlling for age. Results: In Japan, about half the population perceived their health as 'fair', which was much higher than in Europe (≈20–40%). The odds ratios of lower self-rated health among less educated men compared with more educated were 1.72 (95% confidence interval (CI) 1.61–1.85) in Japan, and ranged from 1.67 to 4.74 in Europe (pooled; 2.10 (95% CI 2.01–2.20)), and 6.65 (95% CI 6.22–7.12) in the US. The odds ratios of lower self-rated health among less educated women were 1.79 (95% CI 1.65–1.95) in Japan, and ranged from 1.89 to 5.30 in Europe (pooled; 2.43 (95% CI 2.33–2.54)), and 8.82 (95% CI 8.29–9.38) in the US. Socioeconomic inequalities were large when self-rated health was low for European countries, but Japan and the US did not follow the pattern. Conclusions: Japan has similar socioeconomic gradient patterns to European countries for self-rated health, and our findings revealed smaller socioeconomic inequalities in self-rated health in Japan compared with those in western countries. [ABSTRACT FROM AUTHOR]

Maternal health in the United States is an area of immediate concern. The compounded disadvantages and unique global positions of refugee women highlight the need for research that explores the experiences of refugee women during pregnancy and childbirth. The present study examines how contextual factors shape pregnancy and childbirth experiences for Syrian, Afghan, Congolese, and Karen women living in Clarkston, Georgia, US. Qualitative data were collected via focus groups facilitated by community interpreters. We used a reproductive justice framework to center women's desires, needs, and experiences, and to highlight the importance of structural factors in the findings and analysis of this study. Using codebook thematic analysis, three themes were developed: (1) isolation and alienated knowledge, (2) gendered disparities and structural inequities, and (3) community support and precarity. The findings reflect both the diversity and constancy of women's experiences and highlight how the context of the US impacts women's ability to exercise agency during pregnancy and childbirth. Systemic change is needed to improve women's access to tools that increase their capacity to exercise agency both during pregnancy and childbirth, and beyond. [ABSTRACT FROM AUTHOR]

Social and cultural poetics take us beyond language to an embodied sensibility. To explore the relevance of social poetics in medical training, this article uses as an exemplar an innovative program in geriatrics in a residency program in primary care. The program began with a series of meetings in which medical residents consulted community elders invited for their advice and wisdom on healthcare dilemmas as Senior Faculty, effectively becoming co-teachers and co-learners with one another. Through iterative reflection, residents, faculty and community elders all reported feeling struck by the unexpected responses and were often guided and called to action by them to ask new questions, to shift their stance, or offer greater accompaniment and care. These experiences illuminated what might otherwise have passed by unnoticed, particularly in regards to human suffering. The reflecting process made visible what mattered to each actor, shifting from negative assumptions and attitudes about older adults to a positive engagement with them, co-creating new possibilities for participants to articulate their lived experience of illness and healing. These are creative and moral acts, honoring the voices of those seldom invited to speak, resonating with them, acknowledging what matters to each participant, while taking into account wider issues of disparity and social justice. [ABSTRACT FROM AUTHOR]

This study discusses the disparity in numbers between Japanese children and their Brazilian immigrant peers concerning placement in Japanese special education classes. In-depth interviews were conducted with 21 stakeholders including Japanese nationals and Brazilian immigrants to see if there were any ways to explain the larger numbers of immigrant children assigned to such classes. Five main factors affecting the stakeholders emerged: Linguistic and Cultural Related Misunderstandings of Information, Limitations Concerning Counseling and Educational Planning, Requests for Improving the Support System for Non-Japanese Students, Importance of a Second Opinion, and Cultural and Linguistic Effects when Evaluating Non-Japanese Students. The study provides policy recommendations aimed at improving the support system for immigrant communities who face a variety of stresses living in an unfamiliar culture. [ABSTRACT FROM AUTHOR]

In some countries, including the United Kingdom, young mothers' pregnant and postnatal bodies remain an area of concern for policy and practice, with interventions developed to support improved health behaviours including diet and physical activity. This article explores what young women themselves think and feel about eating and moving during and after pregnancy. Semi-structured interviews with 11 young mothers were conducted within two voluntary organisations. Data were analysed using thematic analysis with the theoretical lens of embodiment, which provided an understanding of how young women's eating and moving habits related to how they felt about their bodies in the world. Four themes situated in different experiences of being and having a body were identified: pregnant body, emotional body, social body and surveilled body. Stress and low mood impacted eating habits as young women responded to complex circumstances and perceived judgement about their lives. Food choices were influenced by financial constraints and shaped by the spaces and places in which young women lived. Whilst young women were busy moving in their day-to-day lives, they rarely had the resources to take part in other physical activity. Holistic approaches that focus on how women feel about their lives and bodies and ask them where they need support are required from professionals. Interventions that address the structural influences on poor diet and inequalities in physical activity participation are necessary to underpin this. Approaches that over-focus on the achievement of individual health behaviours may fail to improve long-term health and risk reinforcing young women's disadvantage. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to compare the self-rated health status of the Roma and of the general population by gender and educational level in six Central and Eastern European countries. Methods: We analysed the United Nations Development Program Regional Roma Survey and EUROSTAT's European Union Statistics on Income and Living Conditions surveys from 2011 for Bulgaria, Croatia, Czechia, Hungary, Romania and Slovakia. Using logistic regression, predicted probabilities of good or very good self-rated health were estimated for the Roma (n =11,401), Roma neighbours (n =5857) and the general population (n =101,579) stratified by gender, and adjusted by age, country and educational level. Results: There was a distinctive social gradient in self-rated health between the groups among both men and women, and a gap between primary versus secondary or tertiary education among all three groups, but Roma (men) and their neighbours with secondary or higher education had significantly worse predicted self-rated health compared to the general population with similar qualifications. Conclusions: These results strongly suggest that ethnicity and gender should be considered as fundamental causes that explain structural health inequalities. Consequently, future research and policy initiatives to reduce health inequities should acknowledge the impact of ethnic minorities and how these fundamental causes extend the general population's social gradient in health. Study designs enabling direct comparisons between ethnic groups and the general population should be applied. More and better data about ethnic minorities are needed to document and monitor existing health inequalities. [ABSTRACT FROM AUTHOR]

The various feminisms create a complex and sometimes contradictory picture. Within social work and social care, there has been a mixed reception. However, it is maintained that a gendered analysis in a profession where women remain in the majority remains highly relevant. In particular, the continuing and increasing pay gap and the relatively low numbers of women in senior positions are used as markers. Similarly, comparisons between 'choice' feminism and current practices are appraised. It is argued that critical deconstructive analyses drawn from postmodern feminism remain significant in both naming and addressing pervasive gender inequalities in national and international arenas. [ABSTRACT FROM AUTHOR]

Black-oriented magazines have been a staple of Black communities for decades. Essence magazine, in particular, places a strong emphasis on targeting and empowering the Black woman. Essence often covers health issues in their publications alongside other popular issues being discussed in Black communities. Given the prevalence of health articles in Essence, I conducted a content analysis to assess how the magazine discusses the relationships between health, power, and race. The findings suggest that Essence magazine leverages its cultural and popular position to engage in discussions about health issues with its readers in culturally relevant ways that engage and empower Black women. At the same time, given Essence's global platform, the magazine walks a tightrope between being an 'easy-read' popular magazine and an outlet that discusses pressing health-related issues. [ABSTRACT FROM AUTHOR]

While the COVID-19 pandemic's effect on the health of low-income urban communities in the global South has not been insignificant, the results of state responses carried out without full consideration of poverty consequences have been very serious. Vaccination, which supports both health and economic recovery, is one way people can reduce the risk of further exclusion. This field note, drawing on surveys from informal settlements in Harare, Kampala, Lilongwe and Mumbai between August and November 2021 by national affiliates of Slum Dwellers International (SDI), provides a snapshot of how global vaccine inequalities have played out across these cities. We find that access to local vaccine programmes is influenced by both global supply and existing local-level inequities; that a low or unreliable supply, among other factors, limits political will to invest in reaching already underserved communities; and that local context and the heterogeneity of communities are key to understanding low vaccine uptake. [ABSTRACT FROM AUTHOR]

Aims: The major causes of social inequalities in health are found outside of healthcare. However, healthcare can also play a role in maintaining, reducing, or reinforcing inequality. We present and discuss results from a panel study of doctors' views on whether and how socioeconomic factors should play a role in clinical decision making. Methods: The panel comprised a representative sample of Norwegian doctors, established in 1994. For the current study, the doctors received postal questionnaires in 2008, 2012 and 2016. Data were analysed using descriptive statistics, correlation analysis, factor analysis and mixed models for repeated measurements. Results: The sample sizes were 1072 (65%), 1279 (71%) and 1605 (73%), respectively. The doctors were increasingly positive towards considering socioeconomic factors, and reported giving more time and advice and asking for less pay to compensate for unfavorable socioeconomic factors. General practitioners were more likely to consider socioeconomic factors and changed their practice accordingly compared to other clinicians. The percentage of doctors who agreed that different amounts of resources should be used to obtain similar health effects was high and increased over time. Conclusions: Increasingly more doctors are willing to consider patients' socioeconomic factors in clinical care. This could be contrary to professional ethics, in which only medical need should count. However, it depends on how 'need' is interpreted. As treatment outcomes partly depend on non–medical factors, socioeconomic factors should be considered because they influence patients' ability to benefit from medical care. Equality requires mitigating factors with negative impacts on health outcomes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has shed light on abundant racial and ethnic health disparities in many countries around the world. In Sweden, statistics on COVID-19 mortality and morbidity from both the first and the second wave of the pandemic show that foreign-born individuals have been disproportionately affected, compared to Swedish-born individuals. However, as demonstrated in this article, key stakeholders including politicians, public authorities, mainstream media, and medical researchers do not draw on the same explanatory framework when conceptualizing the health disparity. Probing the different discourses that were articulated through oral and written accounts during the first wave, the article identifies three different frameworks of how ethnic health disparities in relation to COVID-19 were understood in Sweden: the socioeconomic framework, the culturalist framework and the biological framework. We discuss the importance of our findings for health policy and argue for continued interrogation of epidemiological knowledge production from a critical vantage point in order to successfully combat health inequalities. [ABSTRACT FROM AUTHOR]

Using a static microsimulation model based on a link between survey and administrative data, this article investigates the effects of the pandemic on income distribution in Italy in 2020. The analysis focuses on both individuals and households by simulating through nowcasting techniques changes in labour income and in equivalized income, respectively. For both units of observations, we compare changes before and after social policy interventions, that is, automatic stabilizers and benefits introduced by the government to address the effects of the COVID-19 emergency. We find that the pandemic has led to a relatively greater drop in labour income for those lying in the poorest quantiles, which, however, benefited more from the income support benefits. As a result, compared with the 'No-COVID scenario', income poverty and inequality indices grow considerably when these benefits are not considered, whereas the poverty increase greatly narrows and inequality slightly decreases once social policy interventions are taken into account. This evidence signals the crucial role played by cash social transfers to contrast with the most serious economic consequences of the pandemic. [ABSTRACT FROM AUTHOR]

The need to visualise the complexity of the determinants of population health and their interactions inspired the development of the rainbow model. In this commentary we chronicle how variations of this model have emerged, including the initial models of Haglund and Svanström (1982), Dahlgren and Whitehead (1991), and the Östgöta model (2014), and we illustrate how these models have been influential in both public health and beyond. All these models have strong Nordic connections and are thus an important Nordic contribution to public health. Further, these models have underpinned and facilitated other examples of Nordic leadership in public health, including practical efforts to address health inequalities and design new health policy approaches. Apart from documenting the emergence of rainbow models and their wide range of contemporary uses, we examine a range of criticisms levelled at these models – including limitations in methodological development and in scope. We propose the time is ripe for an updated generic determinants of health model, one that elucidates and preserves the core value in older models, while recognising the developments that have occurred over the past decades in our understanding of the determinants of health. We conclude with an example of a generic model that fulfills the general purposes of a determinants of health model while maintaining the necessary scope for further adjustments to be made in the future, as well as adjustments to location or context-specific purposes, in education, research, health promotion and beyond. [ABSTRACT FROM AUTHOR]

The persistence of health inequalities means that many public health professionals face an ongoing task to develop and update policies to tackle them. However, although the inequalities might be unchanged, the political priorities in the many policy areas involved are changing and the ambition to reduce the health divide is constantly facing strong forces pushing in the opposite direction. Recent proposals to re-think health inequalities need to be treated with caution because they are disconnected from what is needed for policy-making in this area. From our experience of 35 years in developing strategies to tackle health inequalities, we still see many entry points with space for local and national improvements, but it is crucial to ask the right questions. The aim of this Commentary is to present a new framework of eight questions that might provide a helpful structure for the necessary dialogue between researchers and policy-makers. Even if answers are not yet available for all of them, we believe that discussing them for a specific population in a specific political context will be fruitful to inform policy on the ground. [ABSTRACT FROM AUTHOR]

Background: There is documented social inequality in cancer. The health-care system may contribute to health equity by targeting interventions to potentially vulnerable patients who may be at risk of not receiving optimal treatment and care. Aim: This study aimed to develop and pilot test a tool to identify patients who may need additional support. Method: The study took place in a department of palliative medicine and in a team for head and neck cancer within an oncology department. The tool to identify potentially vulnerable patients was developed based on literature reviews and interviews with patients and health-care personnel. It was pilot tested in a six-month period, with subsequent interviews with health-care personnel. Results: In total, 212 consecutive patients referred to the departments were systematically screened with the tool by health-care personnel. Of these, 74 (35%) patients were considered potentially vulnerable. The most frequently reported sign of vulnerability was 'few supportive relations' (47% of the vulnerable patients). Most health-care personnel found it relevant to focus systematically on these patients. However, some were concerned that using the tool could prove to be stigmatising and were critical of attributing the vulnerability to the individual. Conclusions: Most patients were considered in need of additional support because they lacked a social network or had difficulties communicating with health-care personnel. Applying a tool to identify potentially vulnerable patients was feasible and increased attention to this group of patients. However, the screening procedure was also questioned. [ABSTRACT FROM AUTHOR]

There are significant inequalities in health by socio-economic status, race/ethnicity, gender, neighbourhood deprivation and other axes of social inequality. Reducing these health inequalities and improving health equity is arguably the 'holy grail' of public health. This article engages with this quest by presenting and analysing historical examples of when sizeable population-level reductions in health inequalities have been achieved. Five global examples are presented ranging from the 1950s to the 2000s: the Nordic social democratic welfare states from the 1950s to the 1970s; the Civil Rights Acts and War on Poverty in 1960s USA; democratisation in Brazil in the 1980s; German reunification in the 1990s; and the English health inequalities strategy in the 2000s. Welfare state expansion, improved health care access, and enhanced political incorporation are identified as three commonly held 'levellers' whereby health inequalities can be reduced – at scale. The article concludes by arguing that 'levelling up' population health through reducing health inequalities requires the long-term enactment of macro-level policies that aggressively target the social determinants of health. [ABSTRACT FROM AUTHOR]

Over the last few decades, there has been an increase in the number of large federally funded transdisciplinary programs and initiatives. Scholars have identified a need to develop frameworks, methodologies, and tools to evaluate the effectiveness of these large collaborative initiatives, providing precise ways to understand and assess the operations, community and academic partner collaboration, scientific and community research dissemination, and cost-effectiveness. Unfortunately, there has been limited research on methodologies and frameworks that can be used to evaluate large initiatives. This study presents a framework for evaluating the Flint Center for Health Equity Solutions (FCHES), a National Institute of Minority Health and Health Disparities (NIMHD)-funded Transdisciplinary Collaborative Center (TCC) for health disparities research. This report presents a summary of the FCHES evaluation framework and evaluation questions as well as findings from the Year-2 evaluation of the Center and lessons learned. [ABSTRACT FROM AUTHOR]

Foetal Alcohol Spectrum Disorder (FASD) has emerged as a significant public health issue, in Canada and elsewhere. Health experts increasingly acknowledge that the disproportionate impact of FASD on indigenous people is driven by social and historical contexts, especially in settler colonial states like Canada. However, they generally frame FASD as preventable through abstinence and the effects of FASD as manageable through provision of appropriate medical and legal protection to affected offspring. Drawing from Marxist, anticolonial and anti-imperial theories and applying a Critical Discourse Analysis approach, we identify the (re) production of colonial and capitalist dominance in the expert literature. We show that dominant narratives depoliticize FASD by conceptualizing settler colonialism as a past event, ignoring ongoing, contemporary forms of settler colonial dispossession and resituating FASD within an expert language that locates solutions to FASD within affected individuals and communities. In so doing, these narratives legitimize, and contribute to perpetuating, existing disease inequities, prevent the formulation of policies that address the very real and as yet unmet needs of FASD affected individuals, families and communities and erase from the public discourse discussions about changes that could truly address FASD inequities at their root. We conclude by elaborating on the implication of these narratives for policy, practice and equity, in Canada and other settler colonial states. [ABSTRACT FROM AUTHOR]

Aim: We aimed to understand the interplay between retirement pathways and healthcare use in the postponed and structurally changing context of retirement. Methods: Based on Swedish register data on income and healthcare use, we applied combined sequence and cluster analysis to identify typical pathways into retirement and analysed their relation to healthcare use developments. Results: We detected five distinct pathways into retirement. Level of healthcare use was significantly higher for the pathway via disability pensions. We saw an overall increase in healthcare use across the retirement process that was related to age rather than to the different pathways. Conclusions: Level of healthcare use at the beginning of the retirement process may be related to selection into different pathways of retirement. We did not find clear evidence across several healthcare measures that different pathways lead to different developments in healthcare use. [ABSTRACT FROM AUTHOR]

Objectives: To explore the perspectives of general practitioners (GPs) on the identification and management of people, including those from ethnic minority groups, with Heart Failure with Preserved Ejection Fraction (HFpEF). Methods: Qualitative study. Semi-structured, face-to-face or telephone interviews and focus groups were conducted with 35 GPs in England, which were audio-recorded and transcribed verbatim. Framework analysis was used to manage and interpret data. Results: Themes presented reflect four inter-related challenges: GPs' 1) lack of understanding HFpEF, impacting on 2) difficulties in communicating the diagnosis, leading to 3) uncertainty in managing people with HFpEF, further hindered by (4) discontinuity across the primary/secondary interface. All were considered more challenging by GPs when managing people from different cultures and languages. Discussion: HFpEF is not well understood by GPs, leading to diagnostic difficulty, management uncertainty and potential inequity in care offered. People with HFpEF are seen as complex, with multiple long-term conditions and requiring personalised care. Challenges in their management occur across the healthcare system. This study has identified learning needs for GPs around identification and on-going support for people with HFpEF in primary care. It will contribute to the development of more flexible and patient-centred pathways across the primary/secondary care interface. [ABSTRACT FROM AUTHOR]

This article brings together two discrete studies of Indonesian welfare innovations, the conditional cash transfer and the deinstitutionalisation of children, both delivered at the lowest administrative level by social workers. Patterns across the two studies indicated a confounding variable influential in social workers' innovation implementation and administrative decisions. This variable, incentive-based remuneration, was inhibiting implementation and potentially sustaining the social inequalities and rights violations that each innovation proposed to address. Social workers' over-reliance on remuneration incentives has inherent problems. Increases to base-rates of pay and realignment of incentivisation in development are needed to support change. [ABSTRACT FROM AUTHOR]

Increased income inequality, and policies that can limit its further growth, are an important issue for citizens, politicians and the media. Numerous empirical studies have measured political support for redistributive policies by asking whether the government should equalize gaps between rich and poor. They try to discover whether 'redistributive' policies are supported by public opinion and are therefore politically feasible. This research note argues that the standard instrument measures diffuse support for more equality, but gives rather vague hints if this support is transformed into a political mandate for redistributive programmes. With regard to the way in which the political demand for state redistribution to reduce income inequality has been raised so far, methodological critique and innovation is largely lacking. This article therefore tests the validity of the standard item. It argues that the conventional measurement only captures a general 'inclination' towards the idea of equality. However, since the item phrasing is unspecific, other orientations confound the answers, so that ultimately the predictive power in terms of political behaviour is low. The standard item measures egalitarian preferences with inconsistence. This limits its reliability, so that hardly any conclusions can be drawn regarding voting for left parties or support for redistributive programmes. [ABSTRACT FROM AUTHOR]

Recent studies suggest that culturally divergent explanatory models of illness and treatment practices, differing physician–patient goals and expectations, and mistrust and misunderstandings between refugee patients and health care professionals are associated with lower health care utilization and outcomes among refugees in Western host countries. In our experience working as psychiatrists with persons who are refugees, we have found that attention to the processes that define and redefine boundary relationships has important implications for therapeutic care, as well as for training residents and others in culturally-responsive care. This article examines the manner and micro-processes by which boundaries are established, maintained, or altered between medical provider and person who is a refugee as a key pathway in the development of working relationships that are culturally sensitive. We work from an expanded concept of boundaries in psychiatry, viewing boundaries as a way of describing interactions that play important and even critical roles in advancing, impeding, and redefining significant aspects of the therapeutic relationship between practitioner and patient. The quality of the interactions occurring minute by minute within treatment sessions provides the foundation from which relationships are defined, parameters of openness or closure of communication are conveyed, and the power structure is laid out. We offer Martin Buber's formulation of the I–Thou relationship as the philosophical grounding of flexible, culturally sensitive boundary behaviors. At its best, boundaries of mutual engagement that are respectful and cognizant of a patient's individuality and cultural history and values are conveyed to the refugee patient. [ABSTRACT FROM AUTHOR]

White Americans are predicted to soon comprise less than half of the U.S. population. Such demographic changes can affect political attitudes by threatening group status. The present studies built from this literature to examine a process in which information about such demographic shifts can also affect health policy attitudes, in part by increasing death-related thoughts, and that health inequalities may in turn buffer such cognitions. Three experiments (N = 1,651) adopted a causal chain approach to test these ideas. In Study 1, exposure to demographic changes decreased support for equitable health policies. In Study 2, the demographic manipulation increased death-thought accessibility, unless paired with information about worsening health inequalities. In Study 3, contemplation of mortality lessened both support for equitable health policies and resources allocated to health equity. Health inequalities may mitigate existential concerns raised by shifting racial demographics. [ABSTRACT FROM AUTHOR]

Background: Generations of women living in Iraq endured three major regional wars and internal conflicts, which weakened their psychological vulnerability and social role by poverty, displacements, and loss of their beloved ones. The available literature about women's mental health is scarce and does not signify the gender inequality and gender disparity of mental disorders. Method: During 1st August to October 2020, we explored the search engines: Google Scholar, Pub-Med, Medline, and Clarivate using keywords of Iraq, gender inequality, women's mental health, violence, and conflict, mental disorders, gender-based violence, etc. From 1792 research items, 64 articles were scrutinized for this study. We selected the most relevant studies with some available documents excluding data bout Immigrant women outside Iraq and reports from foreign military sources. Finding: Women living in Iraq have struggled for equality and empowerment since the 20th century. For the last four decades, successive wars, economic sanction, gender-based violence, and internal conflicts have affected their development endeavors. The 2003 US-led invasion caused a loss of lives, destruction of infrastructure, and forced displacement for tens of thousands of civilians, including women and children. These atrocities increased women's vulnerability to develop or worsen the existing mental disorders. This review tries to attract world attention to women's situations in Iraq. [ABSTRACT FROM AUTHOR]

Background: Foreign-born people with epilepsy carry two mutually independent risk factors for poor health. While epilepsy increases the need for trust and clear communication, minority status presents additional barriers in communication, causing misconceptions, inadequate treatment and increased suffering. Objectives: This study aimed to explore experiences of communication in the medical encounter from the perspectives of foreign-born people with epilepsy. Methods: A qualitative approach was applied. Twenty semi-structured in-depth interviews were conducted, recorded, transcribed verbatim and analyzed using manifest and latent content analysis. Results: Within the main theme, "Trustful communication in unpredictable terms of life," three subthemes appeared: "Social struggle overshadowing the epilepsy condition"; "Reliable health consultations as a key to feeling safe" and "Addressing 'the real problem' in the medical encounter." A reduced social network due to migration, together with fears related to epilepsy, seems to increase the need for immediate access to health consultations and the need to be listened to. Patients' narratives shed light on multiple social, medical and psychological events that may present reasons for the lack of medical adherence or missed booked appointments. Discussion: A respectful approach, listening and confirming the normalcy of epilepsy events seem fundamental for trustful communication in the context of epilepsy, regardless of a patient's culture or country of origin. [ABSTRACT FROM AUTHOR]