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As the United States' population grows via migration and immigration, with this rise in diverse identities, there has been increasing concern regarding disparities for undocumented immigrants living in the U.S. with limited access to the health system. Given the various constraints involving communication and social structures that undocumented immigrants face, a culture-centered approach is drawn on to investigating how this group goes about navigating a dominant health system given their restricted access. I explore co-constructed themes that emerged through conversations with undocumented immigrants, (people without papers as I call them in this work) living in the United States to gain an understanding as to the structural and cultural limitations faced by this group. By doing qualitative semi-structured interviews with local participants living in the South Florida region, I describe the various features of a complex U.S. health system that undocumented immigrants (people without papers) deemed as important obstacles that limit their willingness to interact with official medical spaces. This work draws on narratives and accounts to shed light on the intersection of disparities this group has to overcome in order to consider entering a medical space to receive the treatment they might need. The findings of this article highlighted the structural violence that certain subaltern groups, such as people without papers experience due to their limited access to foundational systems in their environment. [ABSTRACT FROM AUTHOR]

Racial and ethnic disparities have been clearly documented in schizophrenia studies, but it is unclear how much research attention they receive among US-based studies published in high-impact journals. The current paper updates Lewine and Caudle's (1999) and Chakraborty and Steinhauer's (2010) works, which quantified how frequently schizophrenia studies included information on race and ethnicity in their analyses. We examined all US-based papers on schizophrenia-spectrum, first-episode psychosis, and clinical high-risk groups, published between 2014 to 2016 in four major psychiatric journals: American Journal of Psychiatry, Journal of the American Medical Association – Psychiatry, Schizophrenia Bulletin, and Schizophrenia Research. Of 474 US-based studies, 62% (n = 295) reported analyses by race or ethnicity as compared to 20% in Lewine and Caudle's (1999) study. The majority of papers (59%) reported sample descriptions, a 42% increase from Lewine and Caudle's (1999) study. Additionally, 47% matched or compared the racial/ethnic composition of primary study groups and 12% adjusted for race (e.g., as a covariate). However, only 9% directly analyzed racial and/or ethnic identity in relation to the primary topic of the paper. While schizophrenia studies report analyses by race and ethnicity more frequently than 20 years ago, there remains a strong need for systematic, nuanced research on this topic. The authors offer recommendations for how to conceptualize and report upon race and ethnicity in schizophrenia research. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dalal convincingly argues that these 'positivist methodologies are unable, even in principle, to capture the intricacies of human exchange' which are fundamental to process-led therapies. Using psychology, psychiatry, and psychotherapy, Dalal shows how "regulatory and legislative capture" have been a consequence of our profession attempting to fit into a model of scientific practice unsuited to a subjective, relational, and process-led undertaking. The study questions whether there is an element of mental health care inequality in community-based psychotherapy provision and concludes that patients who are "better equipped to seek help" are favoured, thereby 'discriminating against patients with severe mental health conditions'. [Extracted from the article]

For Indigenous Peoples the disparities in health status are largely associated with the direct social determinants of invasion and colonisation, marginalisation, intergenerational traumas, and lack of conscious government policy to address these ongoing effects. There is currently limited evidence in the literature on what Cultural Safety practices mean in acute care settings. We aimed to understand the extent and type of evidence in relation to current knowledge and evidence regarding Cultural Safety practices for Indigenous Peoples in acute care settings. This is a scoping review. We searched six databases in consultation with a librarian experienced in health research. A total of 16 papers were included in the scoping review. Four main barriers to Cultural Safety in practice were identified; Among the included studies, only one quality improvement study reported an intervention, which improved culturally safe care. The four barriers identified each have a variable impact on Indigenous Peoples' health outcomes and are dependent upon the circumstances and experiences of both Indigenous Peoples and healthcare professionals. [ABSTRACT FROM AUTHOR]

In contemporary discourse, sexuality is being presented as something fluid, with research persisting in framing sexuality as negotiable to some extent. This way of examining sexuality is problematic because as one discovers how identity changes, a certain terminology, such as 'trend' or 'phase' becomes prominent giving the illusion Lesbian Gay Bisexual Trans + (LGBT+) pupils with Special Educational Needs and Disabilities (SEND) are easily influenced and too immature to form LGBT+ identities because of their SEND. Educators viewing sexuality and gender identity as a phase/trend can result in providing limited support due to the misconception that information about LGBT+ concepts is unimportant for pupils with SEND or that one can simply stop being LGBT+. This paper discusses Special Educational Needs (SEN) teachers' views involving their pupils' ways of exploring their LGBT+ identities and examines how this links to the misconception of their sexuality and gender as a phase/a trend due to their SEND. The paper is framed by intersectionality which allows for a detailed analysis of how identities interact when used as an analytic tool. The paper calls for more nuanced thinking of sexuality and gender in the lives of LGBT+ pupils with SEND, which will help to decrease inequality. [ABSTRACT FROM AUTHOR]

There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]

An account of how one Art Therapy training course links information about inequalities with the theory of intersectionality. In trying to understand intersectionality, the course community questions how clients and therapists respond to and experience health inequalities and discrimination. For both, there may be the pain of being 'othered' and the effects of unconscious privilege. Nevertheless, there are examples to be celebrated of how some people manage to use their identity in moving forward. Bizarrely, how identities link to socio-political conditions is not readily acknowledged within therapy professions. The focus of therapy has tended to stay on the inner world. Also, since the end of the second world war, there has been a gradual decoupling of political approaches concerned with social justice and the redistribution of resources and political approaches concerned with identity recognition. When health inequalities and identity issues became sharply visible during the Covid 19 pandemic, the profession responded with adaptations to its educational and therapeutic work. It is possible to see how clients, students, art therapists and colleagues adapt, consult and collaborate. The paper provides descriptions of students' adapted and collaborative practice. The use of culture, art and identity-aware supervision in art therapy are ways of developing our understanding of health inequalities and intersecting identities. The research implications for Art Therapy are that generic knowledge of research about discrimination and glaring health inequalities is a valuable foundation for research in our discipline. This paper discusses how one Art Therapy training course links information about health and social inequalities with ideas about intersecting identities. The course community explores and questions how clients and therapists experience health inequalities and discrimination. There are discussions about the pain of feeling unwanted and the response of people who are not conscious of their inherited privileges simply because they are born into specific societal structures. Whilst recognising that feelings about identity may be painful and a source of shame, the course also considers how it is that some people manage to acknowledge and use self-reflection about their less privileged identities in moving forward. It is strange how the effects of social and health inequalities are rarely acknowledged within psychological disciplines, including art therapy. That seems to be because the focus of therapy has tended to stay on the inner world. Also, since the end of the second world war, there has been a gradual shift in political approaches concerned with social justice and the redistribution of resources and political approaches concerned with identity recognition. When existing health inequalities and identity issues became sharply visible during the Covid 19 pandemic (the Health Foundation, 2020) the profession responded with adaptations that took its educational and therapeutic work online. There is hope because it is increasingly possible to see how clients, students, art therapists and colleagues consult one another and collaborate over adaptations in therapeutic approaches. The paper provides descriptions of some adapted student practices from placements. The use of culture and art, together with supervision in art therapy, are ways of developing our understanding of health inequalities and our intersecting identities. Nevertheless, the pace of social and cultural change can be slow, sometimes moving forward and sometimes backwards. The research implications for the Arts Therapies are that broad knowledge of research about discrimination and glaring health inequalities is valuable in the push for change. Also, research from other disciplines is often the foundation on which the research contribution of the Arts Therapies in this area and others can be built. [ABSTRACT FROM AUTHOR]

School social work is a specialized area of clinical social work practice. Like any aspect of social work, it can be: at its best, used to support and uplift students, families and communities; and at its worst, used to oppress children, youth and their caregivers in both obvious and tacit ways. School social workers need to develop critical consciousness and think critically about their positionality within these institutions, as they have a voice and role in shaping social justice and well-being in schools. This paper reflects upon the notion of decolonization and its meanings within elementary and secondary school contexts, particularly as it relates to students from minoritized groups and cultures. I examine the ways in which school social workers may be drawn into becoming complicit in dominant ideas about academic achievement, behaviors and development, based on my own experiences as a racialized person working in predominantly white spaces. Using the metaphor of a dance, school-based relationships are highlighted as a means to disrupt the systemic structures that are designed to maintain the status quo. [ABSTRACT FROM AUTHOR]

As the social work landscape rapidly changes to more directly address the effects of racism, colonialism and all areas of oppression on individuals, communities and systems, the delivery of responsive clinical social work services is being called to radically transform. This transformation starts with social work education, both in curriculum and in pedagogy, and must include an emphasis on anti-Blackness, starting with raising consciousness and increasing awareness of its prevalence and then deciding how to move beyond awareness. Although clinical social work educators are charged with the task of training emerging social workers to effectively translate theory into practice, missing is guidance on how to do so with an anti-Black, decolonial sensitivity. In 2022, the authors introduced a model – the Trajectory of Awareness (ToA) – to address an aspect of anti-Black racism and in this paper, we return to the ToA model, incorporating decolonial principles. Decoloniality is very much aligned with teaching about anti-Black racism and developing a skill set in teaching about anti-Black racism from a decolonial perspective is essential. [ABSTRACT FROM AUTHOR]

This paper aims to show that the COVID-19 pandemic has amplified existing barriers to healthcare in England for ethnic minority and migrant women. These barriers include those embedded within the institution, stemming from community perceptions and relating to socio-economic factors. Though barriers to accessing healthcare have existed long before the pandemic, more attention must be devoted now because of the inequalities that COVID-19 has laid bare in England for ethnic minority and migrant women. By adopting an intersectional lens, this paper uncovers what has previously been hidden by 'intersectional invisibility', now exacerbated by the COVID-19 pandemic. Whilst the pandemic has seen an increase in focus on inequalities related to race, gender and immigration status, this paper adds to the literature by specifically considering the intersection of race and gender, and immigration status and gender, in the context of inequalities relating to healthcare. We argue that ethnic minority and migrant women experience inequalities in healthcare related to access uniquely because of their intersectional identities and the context of a public health crisis. [ABSTRACT FROM AUTHOR]

By analysing debates between member states of the World Health Organisation (WHO) over health inequities experienced by sexual and gender minorities (SGMs) from 2013 through to 2015 and 2016, this paper interrogates a WHO decision to 'do nothing', and the relationship between this decision and the production of ignorance and non-knowledge. This paper problematises state representatives' discursive practices regarding the lack of evidence on SGM health inequalities, drawing on the sociology of ignorance. Informed by the sociology of nothing, two analytical categories – non-recognition (omissive) and mis-recognition (commissive) of SGM communities – are proposed to critically understand the production of 'no-bodies' and the tolerance of the lack of evidence. The lack of evidence, rather than prompting WHO action, was used as a rationale for intentionally neglecting the health concerns of particular social groups due to their invisibility in health research. Therefore, the paper argues that the lack of evidence in itself is symptomatic of the existence of SGM health inequities, which require the WHO to take action such as formally expressing concerns about and endorsing research on the topic. [ABSTRACT FROM AUTHOR]

Current speech-language pathology (SLP) services in Cambodia are limited in scope, service accessibility and integration into government systems. However, momentum is growing to develop an internationally recognised profession. This paper examines the depth and breadth of SLP support available to people with communication and/or swallowing difficulties in relation the Sustainable Development Goals (SDGs). Qualitative interview data collected from service facilities (n = 13) and speech therapy practitioners (n = 27) were mapped and analysed for accessibility and scope of SLP services. Data revealed a workforce density of 0.16:100 000. Disparity in service accessibility was identified between provincial and urban locations, adult and paediatric populations and range of practice areas. The findings demonstrate the importance of partnerships (SDG 17) among government departments, non-government organisations and private sector entities to establish a sustainable and culturally responsive SLP profession in Cambodia. Although there is no Cambodian university training program, there is a growing momentum and local commitment to establishing a workforce to support Cambodians with communication and/or swallowing difficulties. This commentary paper focuses on good health and well-being (SDG 3), decent work and economic growth (SDG 8), reduced inequalities (SDG 10), and also addresses no poverty (SDG 1), quality education (SDG 4) and partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

Income inequality had been one of the important manifestations of social inequality, which can affect the health level by affecting savings, health care and living standards. Existing researches about the relationship between income inequality and health ignored the comprehensive characteristic of health concept, and did not consider the intrinsic relationship between health and income inequality. This paper attempts to re-shed light on the relationship. Firstly, this paper constructs a new health level evaluation system from three aspects: health basis, health environment and behavior, and health security. By means of the combination evaluation method, the health levels can be obtained. Then, considering the interaction between health and income inequality, a simultaneous equation group model is constructed to empirically test the relationship between income inequality and health levels in China. The results reveal that health level is negatively correlated with income inequality. Reducing income inequality plays an important role in improving health levels in China. [ABSTRACT FROM AUTHOR]

Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the "duty to report" from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator and researcher perspectives on and questions about the assumed value of ROR in PMR. Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR. Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR. Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. [ABSTRACT FROM AUTHOR]

The stark racial health disparities associated with the COVID-19 pandemic coupled with the apparent rise of white supremacy in the United States (U.S.) supports the necessity of anti-racist social work education and practice. Anti-racist practice is particularly salient given the significant numbers of Black, Indigenous, People of Color (BIPOC) served by social workers across the country. This paper highlights ways in which racism continues to permeate the country and the implications for social work practice and education, and how assessment of anti-racist practice has historically and continues to be absent in social work education. After reviewing the coming changes to the Council on Social Work Education's (CSWE) Educational and Policy Accreditation Standards (EPAS) associated with centering anti-racism in social work education, the paper then offers a rationale for utilizing simulation in student assessment of anti-racist practice behaviors. In order to ensure that social work students are meeting the mandate associated with practicing through an anti-racist lens and are ready to effectively collaborate with BIPOC communities, social work students must be adequately assessed while engaged in their educational training. [ABSTRACT FROM AUTHOR]

There are significant disparities in mental health care between First Nations and non-Indigenous people in settler-colonial nations. This paper, authored by a crosscultural and interdisciplinary team, argues that settler-colonial legislation, the tools and technologies of architecture, and the clinical practice of psychiatry are all implicated. Taking inspiration from Tanganekald, Meintangk-Bunganditj legal scholar Irene Watson, who yearns for freedom to roam across Country and connect with the land of her ancestors, we propose tactics for 'roaming' from the conventions of architecture and psychiatry to decolonize our practices. These include yarning, walking Country, and representing these itinerant practices through wandering lines. The outcomes are processes for developing new therapeutic places and practices for mental health care. [ABSTRACT FROM AUTHOR]

Transgender and gender non-conforming individuals have historically experienced discrimination accessing reproductive rights. This transcends into the ways in which the current systems of healthcare are structured to continue perpetuating the marginalization of this population of gender diverse persons, specifically as it relates to reproductive care. Throughout this paper, we will utilize a reproductive justice framework to explore ways in which transgender patients experience discrimination in unique ways through micro- and macroaggressions within the healthcare system based on the intersection of the reproductive healthcare services in which they are seeking, paying special attention to pregnancy and postpartum care, and their unique social identity. This paper will conclude with specific recommendations for how medical family therapists can impact healthcare systems by integrating trauma-informed care aligned with a reproductive justice framework. [ABSTRACT FROM AUTHOR]

Several health inequities exist among racial/ethnic minoritized populations (REMPs) who use substances including disparities in use patterns, inequities in health and legal consequences of use, as well as in treatment access and effectiveness. To address these inequities, more research is needed to examine the associated factors and identify areas for improving treatment. Divided into three categories, this special issue includes papers that examine the social and contextual factors that are associated with substance use among REMPs, papers that consider the role of racism and discrimination on substance use, and papers that explore racial/ethnic differences in treatment access and outcomes. Recommendations for advancing health equity in substance use research are also included. [ABSTRACT FROM AUTHOR]

Parents with disabilities and their families experience pervasive inequities within the child welfare system. However, existing conceptual frameworks do not adequately explain or address the unique needs and experiences of parents with disabilities and their families involved with the child welfare system. Accordingly, we present a conceptual framework that incorporates empirical findings from existing literature while integrating and expanding extant frameworks and models. The conceptual framework, which is aimed at being a starting point from which to investigate child welfare system inequities experienced by disabled parents, includes interrelated factors measured at the contextual, institutional, and individual levels. The paper discusses areas for further research, challenges for researchers, and implications for reducing child welfare system inequities. Parents with disabilities are more likely to be involved with the child welfare system, have their parental rights terminated, and receive inadequate services and supports from the child welfare system, compared to other parents. This paper offers a conceptual framework that identifies factors that impact the inequities experienced by disabled parents who are involved with the child welfare system. Researchers can use the conceptual framework to study the reasons that parents with disabilities have worse child welfare system outcomes than other parents. Policymakers and child welfare professionals can use the conceptual framework to identify ways to prevent parents with disabilities from being unnecessarily involved with the child welfare system and ensure that parents with disabilities who are involved with the child welfare system are treated fairly. [ABSTRACT FROM AUTHOR]

Black Alaskans face serious barriers to health care. This paper reports on qualitative results of a health needs assessment to understand the health challenges facing Black Alaskans. Utilizing exploratory thematic analysis, the findings indicate that Black Alaskans experience barriers such as high cost of care, underinsurance, lack of information and education, a shortage of BIPOC health providers, stigma, negative perceptions by health-care providers, and racism both in the community and in the health-care system. The paper concludes by discussing emerging health equity initiatives to advance responsive care for Black Alaskans. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has accelerated acceptance of learning from other countries, especially for high-income countries to learn from low- and middle-income countries, a practice known as global learning. COVID-19’s rapid disease transmission underscored how connected the globe is as well as revealed stark health inequities which facilitated looking outside of one’s borders for solutions. The Global Learning for Health Equity (GL4HE) Network, supported by Robert Wood Johnson Foundation, held a 3-part webinar series in December 2021 to understand the current state of global learning and explore how global learning can advance health equity in the post-COVID-19 era. This paper reflects on these cutting-edge discussions about the current state of global learning, drawing upon the highlights, perspectives, and conclusions that emerged from these webinars. The paper also comments on best practices for global learning, including adapting for context, addressing biases, funding considerations, ensuring bidirectional partnerships, community engagement, and adopting a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Public health, conflict/war, Social Determinants of Health (SDHs) and Global Health Diplomacy (GHD) are believed to be strongly interwoven. Afghanistan that is known as the 'Graveyard of the Empire' has been passing through a very critical phase given the prolonged civil war during the last couple of decades, wherein the ongoing current situation further pushed the country towards the collapse of the political and economic systems. Thereby, Afghanistan's healthcare system has been entrapped into the civil war conundrum causing the SDHs to be seriously affected. Conflict in any form, i.e. local, regional, or international, has left black swan impacts on not only the SDHs but also led to health crises given the inaccessibility, unaffordability, and more of lack of the infrastructure, and exodus of trained medical staff and healthcare inequity. In this situation, it is anticipated that GHD could play a significant role in providing equitable healthcare to people at stake. Against this backdrop, the focus of this paper is; how the SDHs have been impacted by the civil conflict and how the public healthcare has been turned into a conundrum; would the GHD resolve the healthcare crisis in the prevailing scenario? [ABSTRACT FROM AUTHOR]

The use of physical restraint is a contentious practice in the acute mental health setting. There are a plethora of guidelines surrounding the safe use of restraint. However, there is a scarcity of literature dedicated specifically from the perspective of the patient. The existing literature suggests that there are serious physical and psychological implications associated with the use of physical restraint for both mental health patients and nurses alike. The debate surrounding this practice has been intensified by the compelling evidence suggesting that the application of restraint is not compatible with the values of recovery in mental health care. To influence clinical practice that governs the use of restraint, it is essential to explore patient experiences of its use. Therefore, this review aims to explore patient experiences of physical restraint in the acute setting. PubMed, CINAHL and PsycINFO were systematically searched using keywords; "physical restraint" and "patient experience" and "acute setting". The search yielded n = 482 papers in total. Following the application of rigorous inclusion and exclusion criteria and data extraction, a total of n = 9 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, three themes were identified: 'the bio-psychosocial impact of restraint on patients', 'the impact of restraint on the therapeutic relationship' and 'patient needs concerning the use of restraint'. Future research opportunities have been identified that will add to the body of evidence in developing appropriate health interventions and supports for this population. [ABSTRACT FROM AUTHOR]

This paper synthesises critique from Māori patients with Bipolar Disorder (BD) and their whānau to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system. A qualitative Kaupapa Māori Research methodology was used. Twenty-four semi-structured interviews were completed with Māori patients with BD and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data. Three key themes identified the impact of structural features of the New Zealand mental health system on health equity for Māori with BD. Themes involved the accessibility, delivery and scope of the current health system, and described how structural features influenced the quality, utility and availability of BD services for Māori patients and whānau. Structural barriers in the existing design, and potential changes to improve the accessibility, delivery and scope of BD services for Māori, were proposed including a redesign of operational, environmental, staffing, and navigation points (information, transition, fatigue) to better meet the needs of Māori with BD. A commitment to equity when implementing structural change is needed, including ongoing evaluation and refinement. This paper provides specific recommendations that should be considered in health service redesign to ensure the New Zealand mental health system meets the needs of Māori patients with BD and their whānau. [ABSTRACT FROM AUTHOR]

In the United States, Black women's use of infertility treatments is relatively low, despite elevated or similar rates of infertility compared with White women. Ethical concerns about infertility treatments have been identified as a potential sociocultural factor contributing to these treatment-seeking disparities. Despite documented differences, the substance of these ethical concerns is unclear. Clarifying the nature of these concerns contributes to our understanding of the social forces that shape the contexts of infertility care. Using an intersectional and comparative analysis of semi-structured interviews with Black or African American and White women enrolled in U.S. graduate programmes, this paper investigates the nature and substance of ethical concerns about medicalized infertility treatments. Three central themes emerged: (i) ethical concerns were not binary; (ii) ethical concerns varied by modality, but not by race, and focussed primarily on infertility treatments involving third parties; and (iii) substantive non-ethical concerns were concentrated among Black women and were driven by discomfort with or preferences against treatments involving third-parties. The paper concludes with a discussion of the implications of these findings for researchers, providers, and policymakers. [ABSTRACT FROM AUTHOR]

Structural competency is a recent framework for understanding and addressing the structural drivers of disease. Latin American Social Medicine and Collective Health is a decades-long movement similarly concerned with the study and transformation of social structures to achieve health equity. In this paper, we put insights from Latin American Social Medicine and Collective Health into conversation with the developing structural competency framework. We focus specifically on insights from Jaime Breilh's new article summarising his theoretical work on medical ethics and rights in this special issue and his new book, Critical Epidemiology and the People's Health. This paper is comprised of three parts. Part 1 provides an introduction to the structural competency framework. Part 2 provides an overview of the Latin American Social Medicine and Collective Health movement, along with a summary of the social determination of health paradigm. Part 3 places insights from these works into conversation with structural competency and considers ways in which Latin American Social Medicine and Collective Health might inform the further development of structural competency, and potentially vice versa. The paper closes by calling for greater attention to Latin American Social Medicine and Collective Health among those committed to health equity within the anglophone world. [ABSTRACT FROM AUTHOR]

While violence against health care workers is being progressively recognised as a serious problem in the healthcare industry, it remains an under-studied area of enquiry in global public health. Anthropologists have long observed that violence toward patients is tied to institutional care practises in multiple ways, including repression, misrecognition and silencing. But research on health care staff's experience of violence is still lacking. This article aims to address this literature gap by providing research on the daily experience of vulnerability to violence that health care providers face during their work. To do so, the paper ethnographically explores the effects and perception of violence against health care workers in an emergency department (ED) in northern Italy, a place with a dramatic escalation of violent incidents. The article illustrates how the ED staff attended to the experience of suffering of potentially violent patients. In so doing, ED professionals shifted the responsibility of violence against them from violent individuals to violent structures shaping health inequities. The paper thus argues that ED professionals display a structural competence perspective when dealing with violence. [ABSTRACT FROM AUTHOR]

Anthropologists have critically examined a range of reforms from education and land to finance and health. Yet the predominant way of looking at reforms has been through a lens focused on neoliberal governance. For example, prior studies of health reforms focus on insurance, financing, and access to care. Yet, seeing reform in this way fails to attend to other types of cultural work at play when calling a policy or law a reform. In this paper, we draw on ethnographic research on health policy reforms in Israel and Bolivia to examine the concept of reform and the work it does within national movements. We argue that while the language of reform often signals change or novelty, reforms also carry forward historical continuities and reifications of the past. By delving into the past and its relationship with ongoing health reforms, we attend to how reforms can reinforce and maintain health inequities in some cases, while creating a national language for new possibilities in others. Reform, as we will discuss in this paper, is not only about political ideology, neoliberal governance, or on-the-ground policy implementation, but centrally it is about representations of aspirations, and about crafting relationships between past, present, and future. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Substantial racial/ethnic disparities exist in adolescent alcohol use and related consequences. Although many protective and risk factors influence adolescent alcohol use across racial/ethnic groups, some determinants of alcohol use are more salient among adolescents of color. Understanding the determinants of alcohol use that are most relevant to adolescents of color is critical to informing the content of culturally sensitive prevention programs. This paper focuses on two categories of determinants of alcohol use that are often targeted in culturally sensitive prevention programs: alcohol-specific behavioral determinants and socio-cultural determinants. The paper also reviews the literature on how socio-cultural determinants influence alcohol use through alcohol-specific determinants among adolescents of color, and concludes by discussing implications for future research, prevention, and social work education. [ABSTRACT FROM AUTHOR]

This paper represents the first study to focus on quantifying racial/ethnic group differences in older adults' involvement with adult protective services (APS). Across 3 independent county programs, the rate of APS reports was about twice as high for Black older adults compared to White older adults. These differences were greater for clients who were older and male but remained similar across allegation type. The percent of reports validated was slightly but consistently lower for Black clients than for White clients, and a lower percentage of Black clients' cases were closed due to investigation or service refusal. Findings for Hispanic clients differed by county, so it was impossible to generalize about their APS experience. Researchers should distinguish racial/ethnic group differences that persist across multiple programs from those that are program-specific. Further studies with larger data sets are needed to guide APS practice and ensure equity for all clients served. [ABSTRACT FROM AUTHOR]

This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care - not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas's philosophy of infinite responsibilities to care, tracking how changes at several temporal scales - the life course, intergenerational re-negotiations - affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women's changing perspectives on sabar primarily in the provocations of everyday life. [ABSTRACT FROM AUTHOR]

Our experiences of temporality are defined and shaped by our experiential reality. For Māori, our experiences of time have been marginalised by hegemonic western-centric temporal understandings that are privileged and embedded into structures and institutions. Modelling is a commonly-used tool for estimating the benefits of interventions to inform decision-making. In addition to taking little account of health equity, western-centric modelling methods generally omit Indigenous time concepts. This paper presents findings from a qualitative literature review of Māori temporal ontologies and considers implications for modelling within the context of addressing hauora Māori aspirations. Of the total of 5,677 potential records identified, 78 texts were included in the knowledge synthesis. We identified six overlapping themes: Tohu; Hurihanga; Te Taiao; Whakapapa; Pūtahi; and, Mana Motuhake. In contrast with colonial time (understood as flowing uniformly in one direction throughout the universe), Māori temporal concepts were interconnected, interdependent and complex, with multi-layered and multi-faceted dimensions. If modelling approaches are to have utility for hauora Māori, we need to be open to interrogating and critiquing how colonial time shapes statistical assumptions and assigns value to a broader range of epidemiological methods commonplace in health and disability research, including the reification of colonial time in modelling methods.Glossary of Māori words: āmua: hereafter; āmuri: hereafter; anamata: hereafter; ātea: be clear, free from obstruction; hau ora: healthy, well; hurihanga: changing, turning, cycle; kaitiaki: guardian; kaupapa Māori: Māori agenda, Māori principles, Māori ideology; a philosophical doctrine, incorporating the knowledge, skills, attitudes, and values of Māori society; koru: spiral motif; onamata: ancient times; mana: spiritual power; mana motuhake: authority and capacity to be autonomous; Māori: name for Indigenous peoples of New Zealand; mua: former; muri: after; pākehā: foreign; Papatūānuku: Earth Mother; pūtahi: meeting place, intersection; takiwā: period of time, space; te ao Māori: the Māori world; te reo Māori: the Māori language; te taiao: the natural world, environment; tohu: sign, symbol; tūpuna: ancestors; wā: period of time, interval; wānanga: to meet, discuss, deliberate, consider; whakairo: carving; whakapapa: ancestry, familial relationships; whaikōrero: oratory; whakataukī: to utter a proverb; whānau: to be born, extended family, family group [ABSTRACT FROM AUTHOR]

The Indian Prime Minister, Narendra Modi, while addressing the United Nations General Assembly on 26 September 2020, stated that India had introduced legal reforms to accord rights to transgender citizens. Even though there is not much material basis to these rights, transgender communities have been protesting against the state and at times negotiating with it to get laws that are more in alignment with their rights. In the wake of serialised deaths and precarity intensified by the Covid-19 pandemic, transgender communities also stage other negotiations in the everyday with activists, transnationally funded NGOs and academics researching their communities, encounters that are not as spectacular as the protests against the state, but that which ensures their daily sustenance. This paper investigates how they inhabit these systemically violent institutions. Deploying ethnographic field notes from eastern India, this paper argues that they inhabit them subjunctively, which is not about refusing engagement with what is oppressive but about the ceaseless conjuring of improvisatory and contingent gestures that are marked by hope as well as uncertainty. The simultaneity of protests, rage, hopelessness, hope, negotiations, supplications and scepticism allow them to not only endure the violence of institutions but also to rupture them and imagine them otherwise. [ABSTRACT FROM AUTHOR]

Based on a multi-phase study conducted on the World Health Organization’s (WHO) age-friendly cities program, healthy-cities program, and global sustainable-cities initiatives, this paper assesses how older adults – particularly those living with chronic health conditions and disabilities – discuss mobility challenges in qualitative research. Initial results indicate that demobilizing levels of travel cost and travel risk are implied, with older adults refraining from direct discussion. Reflective analysis is performed on marginalized older adults’ conceptual associations, ideologies, and response to social norms, to identify sources of pressure which may lead to downplaying or self-censorship on transport disadvantage. Results highlight that inequalities may arise from both the built environment and how research trainees communicate in research. Despite literature which suggests severe impacts of transport disadvantage, older adults may face difficulties in voicing their needs when research trainees adhere to the following social norms. First, physical access and feasibility may be minimized as mere matters of convenience to the able-bodied individual; second, overcoming transportation barriers may be seen as based on one’s effort – as opposed to the disabling effects of the built environment; third, health and fitness in general may be also associated with one’s effort, and increasingly also to one’s commitment to environmental-sustainability; fourth, older adults may feel pressure to align perspectives with more privileged stakeholders, or with the general public; fifth, money and income may be delegitimized as apt research topics, regardless of how inability to overcome travel costs may impact daily-wellbeing. Implications for educating future gerontology-research trainees conclude the study. [ABSTRACT FROM AUTHOR]

Globally, traumatic brain injury (TBI) has been recognised as a serious health issue not only because of the immediate impacts at the time the injury occurs but even more so due to the longstanding impacts. Even though TBI is a globally recognised condition, the research is disproportionately focused on its incidence in, and immediate and long-term effects on men. A growing body of research suggests that generally, women who experience family violence are at high risk of TBI and suffer its impacts in ways that reflect gendered differences in the patterns and frequency of violence. In Australia, the social and physical costs of TBI are multiplied for Indigenous women, whose experience of disability and access to healthcare lies at the intersection of gender and race in the historical context of settler colonialism. The present study addresses the need for research into the sociodemographic inequalities that affect access to culturally appropriate hospital care, timely response systems, and flexible, safe and engaged social services. This paper draws on data from interviews and focus groups with Indigenous women, hospital staff and community-based service providers and suggests potential pathways for further research in settler-colonial settings elsewhere in the world. [ABSTRACT FROM AUTHOR]

In this paper, as Black scholars, we address ways that interventions designed to promote equity in health can create pathways for coupling decolonization with antiracism by drawing on the intersection of the health of Africans and African Americans. To frame this intersection, we offer the Public Health Critical Race Praxis (PHCRP) and the PEN-3 Cultural Model as antiracism and decolonization tools that can jointly advance research on colonization and racism globally. We argue that racism is a global reality; PHCRP, an antiracism framework, and PEN-3, a decolonizing framework, can guide interventions to promote equity for Africans and African Americans. [ABSTRACT FROM AUTHOR]

AbstractThis paper presents the first study to investigate ethnic differential treatment in public housing through a correspondence test field experiment. The experiment involved sending inquiries from fictitious couples with Swedish or Arabic names to all public housing companies in Sweden. Four outcomes were examined: whether the public housing companies responded to the inquiries, whether they initiated their response with a greeting, whether they had a priority system in place, and whether they provided information about problematic neighborhoods. The findings revealed disparities in the treatment of the couples. The Swedish couple received greetings and information about problematic neighborhoods at a greater rate than the Arab couple. This study contributes to existing literature on ethnic differences in the housing market by providing evidence of differential treatment within the public housing sector. Additionally, it explores the content and quality of public housing companies’ responses, offering valuable insights for policymakers and housing professionals in designing interventions to promote equality and counteract differential treatment. [ABSTRACT FROM AUTHOR]

The implementation of city lockdowns in response to the COVID-19 pandemic exposed some social inequalities in Mexico. The paper evaluates the effects of the closure of the Alameda Central, a public park in the Historic Centre of Mexico City. It examines how its closure affected some vulnerable populations, including homeless people, beggars, street vendors, buskers, and male sex workers, to the extent that they resisted leaving or found ways to return to public space. The research shows how Mexican COVID-19 policies tended to overlook the diversity of populations making use of public space, and their various necessities. [ABSTRACT FROM AUTHOR]

Buyer's clubs were first recognised during the HIV/AIDS pandemic in the 1980s and focussed on knowledge curation and distribution of treatments. In the past decade, there has been a resurgence of buyer's clubs, mostly focussed on hepatitis C treatment and PrEP. This paper aims to increase understanding of buyer's clubs and stimulate discussion on their role in achieving equitable access to medicines. Our proposed definition of a buyer's club is 'a community-led organisation or group which seeks to improve an individual's access to medication through knowledge sharing and/or distribution as its primary goal'. The logistical and relational infrastructures of buyer's clubs have been mapped out. Networks and communities are integral to buyer's clubs by facilitating practical aspects of buyer's clubs and creating a sense of community that serves as a foundation of trust. For a user to receive necessary medical support, doctors play a crucial role, yet, obtaining this support is difficult. Whilst buyer's clubs are estimated to have enabled thousands of people to access medicines, and they run the risk of perpetuating health inequities and injustices. They may have the potential to serve as a health activism tool to stimulate sustainable changes; however, this needs to be explored further. [ABSTRACT FROM AUTHOR]

The second wave feminist dream of smashing the patriarchy remains a task yet to be completed on a complex to do list. Women, particularly able-bodied cis-gendered white women however do enjoy the privilege of living longer than men. But our longer lives take place within patriarchal-capitalist systems where many women's social and cultural rights continue to be compromised. How do we ensure that all women can exercise our right to health and wellbeing? In this paper, the authors examine, critique, review and re-vision the dynamics of power and patriarchy over three distinct time periods – 1999, 2019 and 2039. We look to the past to track progress; we look to the present to see what we have achieved and look to the future for what might be. This conceptual paper is informed by the authors' expert knowledge, a review of the literature and the novel use of speculative ethnography. The authors conclude that patriarchy remains not only a negative determinant of women's health that needs to be smashed, but is also a threat to all people and to planetary health. [ABSTRACT FROM AUTHOR]

It has long been recognised that human health is indelibly shaped by a variety of factors. These include pathogens such as bacteria and viruses, but also broad-ranging social, economic and political forces operating at different spatial scales. In seeking to understand the nature and effects of these forces, two concepts have become particularly influential: the 'social determinants of health' and 'structural violence'. In this paper, we critically examine their origins, tracing their 'prehistory' and little-recognised intersections, based on searches of both concepts in PubMed and Google Scholar, and a critical reading of the range of texts our searches produced. This forms the groundwork from which we examine their similarities and differences, and their potentialities and limitations. We demonstrate that both concepts operate largely as black boxes. Their usage has thus become tied to disciplinary and methodological projects, with attendant implications for their wider usage – especially given the respective statuses of the fields of medical anthropology and social epidemiology in public health. We conclude that structural violence and the social determinants of health have both been influential in research and policy, but have struggled to effect the kinds of political change that their moral commitment to social justice promises and that further dialogue between them is required. [ABSTRACT FROM AUTHOR]

Racism has implicit and explicit manifestations that perpetuate disparities and negatively influence patient-centered health outcomes. Subsequently, a list of action items was provided to assist medical schools in becoming anti-racist institutions. A deep subject matter knowledge, beliefs, and reflections were a driving force for the management of medical schools or faculty members involved in undergraduate and postgraduate medical education to move forward toward inclusion of anti-racism in traditional medical curriculum or adapting existing training modules on diversity, equity, and inclusion. This paper proposes twelve practical and specific tips for implementing and teaching anti-racism in medical education. These twelve tips elaborate on the proposed actions for leaders in undergraduate and postgraduate medical education, valuable for designing future curricula and educational activities. [ABSTRACT FROM AUTHOR]

Black women face differences in treatment based on their gender and racial identity. Therefore, scholarship has increased in understanding gendered racial socialization. This paper explains how parents negotiate their memorable messages about Black womanhood with the messages they want their Black daughters to receive. We used the subreddit/r/Blackparents to answer our research questions. Our findings showed the prevalence of memorable messages regarding hair and representational intersectionality. Additionally, we found how parents use their memorable messages to provide advice for anticipatory socialization. We explore how these results allow us to extend theorizing on memorable messages, and supplement work on gendered racial socialization. Results demonstrate the political power of Black parenthood, as well as showcase the dynamic nature of memorable messages. [ABSTRACT FROM AUTHOR]

Medical mistrust among the public was amplified during the COVID-19 pandemic due to racial and social inequities in infection rates and misinformation in the media. In Boston, two initiatives were launched by the Boston University Clinical Translational Science Institute (BU CTSI), Boston Medical Center (BMC), community health centers (CHCs), and community organizations to establish longitudinal and authentic partnerships with community-research boundary spanners who remained trusted sources of information. Each initiative addressed the immediate need for community-informed and partnered COVID research and provided a structure for longitudinal partnerships. In this paper, we describe the process of envisioning how these two initiatives could move from isolation toward collective impact. We also identify opportunities to improve community-engaged research practices within an academic health system. Our approach provides a structure that other organizations can use to align initiatives and move toward boundary-crossing partnerships which foster health equity. [ABSTRACT FROM AUTHOR]

Comparative empirical evidence for 22 OECD countries shows that country differences in cumulative mortality impacts of SARS-CoV-2 are caused by weaknesses in public health competences, pre-existing variances in structural socio-economic and public health vulnerabilities, and the presence of fiscal constraints. Remarkably, the (fiscally non-constrained) U.S. and the U.K. stand out, as they experience mortality outcomes similar to those of fiscally-constrained countries. High COVID19 mortality in the U.S. and the U.K. is due to pre-existing socio-economic and public health vulnerabilities, created by the following macroeconomic policy errors: (a) a deadly emphasis on fiscal austerity (which diminished public health capacities, damaged public health and deepened inequalities); (b) an obsessive belief in a trade-off between 'efficiency' and 'equity', which is mostly used to justify extreme inequality; (c) a complicit endorsement by mainstream macro of the unchecked power over monetary and fiscal policy-making of global finance and the rentier class; and (d) an unhealthy aversion to raising taxes, which deceives the public about the necessity to raise taxes to counter the excessive liquidity preference of the rentiers and to realign the interests of finance and of the real economy. The paper concludes by outlining a few lessons for a saner macroeconomics. [ABSTRACT FROM AUTHOR]

Given the discrimination, harassment, and lack of adequate healthcare facilities, the transgender community members find it hard to access the COVID-19 vaccination. The COVID-19 pandemic has exacerbated the disparities in access to healthcare for the transgender community. In November 2020, on the topic of 'COVID-19 and Disaster Vulnerability in Pakistan: A Human Rights Based Analysis', a co-published report from the UNDP and Ministry of Human Rights Pakistan, reflected concerns on the challenges of access to healthcare for the transgender community in Pakistan. The report demanded the government to amplify its response to further protect the transgender community. In this paper, I aim at developing a theoretical framework for providing indiscriminate access to the COVID-19 vaccination for the transgender community as a part of right to health by reporting the first-hand knowledge about the challenges of access to vaccination facilities using qualitative research methods. [ABSTRACT FROM AUTHOR]

Little is known about how portrayals of American unity (i.e. "we're all in this together") have been received by essential workers on the front lines of the COVID risk divide, and how the pandemic may have contributed to perceptions of class inequality among lower-income workers. In this paper, we draw upon 192 in-depth interviews with precarious and gig-based workers in New York City. We find that during the height of the first wave of the pandemic, precarious workers often expressed frustration over class-based inequalities and antagonism toward elites. Many respondents expressed significant skepticism toward messages that the pandemic has brought Americans together. Instead, workers identified two distinct, class-based realities in New York: elite Americans are able to socially-distance in "mansions," or on "yachts," while precarious workers struggled to weather the storm in "dinghies." Likewise, workers felt "abandoned" by wealthy owners and managers, who fled the city to socially-distanced homes in beach communities and surrounding suburbs. Our findings suggest that low-wage, high-risk workers articulate complex conceptualizations of inequality and convey grievances toward elites during the pandemic. This study contributes to broader literature on perceived inequality, the rise of noxious work, and the social consequences of COVID-19. [ABSTRACT FROM AUTHOR]

Planetary health equity – the equitable enjoyment of good health and wellbeing in a sustainable ecosystem – is under threat from anthropogenic climate change and economic and social inequities. Driving these major challenges is the global consumptogenic system that encourages excessive production and consumption goods and services that are harming human and planetary health. Growth models lie at the core of the consumptogenic system. This paper examines the sources of economic growth in Australia, the coalitions that sustain this approach politically, and the implications of these dynamics for planetary health equity. Australia's consumption-led growth model is underpinned by a combination of rising house prices and a permissive credit regime. This growth model is supported by a dominant growth coalition of producer interests, elements of organised labour, and property owners. The growth coalition has been able to successfully generate growth model policy convergence between the mainstream political parties. In turn this growth model, and associated growth coalition, has undermined the pursuit of planetary health equity in Australia by incentivising and driving excessive consumption, greenhouse gas emissions, and economic inequality. [ABSTRACT FROM AUTHOR]