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Sample records for address social determinants

  1. Addressing the social determinants of children's health: a cliff analogy.

    PubMed

    Jones, Camara Phyllis; Jones, Clara Yvonne; Perry, Geraldine S; Barclay, Gillian; Jones, Camille Arnel

    2009-01-01

    This paper presents a "Cliff Analogy" illustrating three dimensions of health intervention to help people who are falling off of the cliff of good health: providing health services, addressing the social determinants of health, and addressing the social determinants of equity. In the terms of the analogy, health services include an ambulance at the bottom of the cliff, a net or trampoline halfway down, and a fence at the top of the cliff. Addressing the social determinants of health involves the deliberate movement of the population away from the edge of the cliff. Addressing the social determinants of equity acknowledges that the cliff is three-dimensional and involves interventions on the structures, policies, practices, norms, and values that differentially distribute resources and risks along the cliff face. The authors affirm that we need to address both the social determinants of health, including poverty, and the social determinants of equity, including racism, if we are to improve health outcomes and eliminate health disparities.

  2. Making the invisible visible: are health social workers addressing the social determinants of health?

    PubMed

    Craig, Shelley L; Bejan, Raluca; Muskat, Barbara

    2013-01-01

    This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n = 54) employed at major hospitals across Toronto had many years of practice in health care (M = 11 years; SD = 10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.

  3. The first federal budget under Prime Minister Justin Trudeau: Addressing social determinants of health?

    PubMed

    Ruckert, Arne; Labonté, Ronald

    2016-01-01

    A challenging budget environment during the Harper years has meant that crucial investments in the social determinants of health (SDHs) have increasingly been neglected. The tabling of what is widely considered a more progressive budget with expansionary fiscal elements under the new Prime Minister, Justin Trudeau, raises the question as to what extent this budget invests in policy areas that are crucial for achieving a more equitable distribution in the social determinants of health, as promised in the Liberal party platform. In this commentary, we argue that the first Liberal budget represents a step in the right direction, but that this first step needs to be followed up with a sustained commitment to address the pervasive (and unfair) social inequalities that are the root cause of persistent health inequities in Canada. We conclude that the first Trudeau budget, while moving in the right direction, does not fully embody the sustained policy changes needed to effectively address SDHs, including a more expansive role for the federal government in the redistribution of income and wealth. PMID:27526222

  4. Addressing social determinants of health inequities through settings: a rapid review.

    PubMed

    Newman, Lareen; Baum, Fran; Javanparast, Sara; O'Rourke, Kerryn; Carlon, Leanne

    2015-09-01

    Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health equity. This article uses the World Health Organisation's (1998) (WHO Health Promotion Glossary. WHO Collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, NSW) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature. A rapid literature review was undertaken in the period June-August 2014, combining a systematically conducted search of two major databases with targeted searches. The review focused on identifying what works in settings approaches to address the social determinants of health inequities, using Fair Foundations: the VicHealth framework for health equity. This depicts the social determinants of health inequities as three layers of influence, and entry points for action to promote health equity. The evidence review identified work in 12 settings (cities; communities and neighbourhoods; educational; healthcare; online; faith-based; sports; workplaces; prisons; and nightlife, green and temporary settings), and work at the socioeconomic, political and cultural context layer of the Fair Foundations framework (governance, legislation, regulation and policy). It located a relatively small amount of evidence that settings themselves are being changed in ways which address the social determinants of health inequities. Rather, many initiatives focus on individual behaviour change within settings. There is considerable potential for health promotion professionals to focus settings work more upstream and so replace or integrate individual approaches with those addressing daily living conditions and higher level structures, and a significant need for programmes to be evaluated for differential equity impacts and published to provide a more solid evidence base. PMID:26420808

  5. Addressing social determinants of health inequities: what can the state and civil society do?

    PubMed

    Blas, Erik; Gilson, Lucy; Kelly, Michael P; Labonté, Ronald; Lapitan, Jostacio; Muntaner, Carles; Ostlin, Piroska; Popay, Jennie; Sadana, Ritu; Sen, Gita; Schrecker, Ted; Vaghri, Ziba

    2008-11-01

    In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provider or guarantor of human rights and essential services; (2) as facilitator of policy frameworks that provide the basis for equitable health improvement; and (3) as gatherer and monitor of data about their populations in ways that generate health information about mortality and morbidity and data about health equity. We use examples from the knowledge networks to illustrate some of the options governments have in fulfilling this role. Civil society takes many forms: here, we have used examples of community groups and social movements. Governments and civil society can have important positive roles in addressing health inequity if political will exists.

  6. Addressing social determinants of health inequities: what can the state and civil society do?

    PubMed

    Blas, Erik; Gilson, Lucy; Kelly, Michael P; Labonté, Ronald; Lapitan, Jostacio; Muntaner, Carles; Ostlin, Piroska; Popay, Jennie; Sadana, Ritu; Sen, Gita; Schrecker, Ted; Vaghri, Ziba

    2008-11-01

    In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provider or guarantor of human rights and essential services; (2) as facilitator of policy frameworks that provide the basis for equitable health improvement; and (3) as gatherer and monitor of data about their populations in ways that generate health information about mortality and morbidity and data about health equity. We use examples from the knowledge networks to illustrate some of the options governments have in fulfilling this role. Civil society takes many forms: here, we have used examples of community groups and social movements. Governments and civil society can have important positive roles in addressing health inequity if political will exists. PMID:18994667

  7. Addressing Social Issues.

    ERIC Educational Resources Information Center

    Schoebel, Susan

    1991-01-01

    Maintains that advertising can help people become more aware of social responsibilities. Describes a successful nationwide newspaper advertising competition for college students in which ads address social issues such as literacy, drugs, teen suicide, and teen pregnancy. Notes how the ads have helped grassroots programs throughout the United…

  8. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

    PubMed

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH. PMID:26928215

  9. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

    PubMed Central

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH. PMID:26928215

  10. The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

    PubMed

    Valle, Adolfo Martinez

    2016-01-01

    Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

  11. Narratives and images used by public communication campaigns addressing social determinants of health and health disparities.

    PubMed

    Clarke, Christopher E; Niederdeppe, Jeff; Lundell, Helen C

    2012-12-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation's Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one's home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother's education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. PMID:23330220

  12. Narratives and images used by public communication campaigns addressing social determinants of health and health disparities.

    PubMed

    Clarke, Christopher E; Niederdeppe, Jeff; Lundell, Helen C

    2012-12-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation's Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one's home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother's education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means.

  13. Narratives and Images Used by Public Communication Campaigns Addressing Social Determinants of Health and Health Disparities

    PubMed Central

    Clarke, Christopher E.; Niederdeppe, Jeff; Lundell, Helen C.

    2012-01-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation’s Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one’s home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother’s education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. PMID:23330220

  14. Barriers to addressing the social determinants of health: insights from the Canadian experience.

    PubMed

    Raphael, Dennis; Curry-Stevens, Ann; Bryant, Toba

    2008-12-01

    Despite Canada's reputation as a leader in health promotion and population health, implementation of public policies in support of the social determinants of health has been woefully inadequate. The continuing presence of income, housing, and food insecurity has led to Canada being the subject of a series of rebukes from the United Nations for failing to address child and family poverty, discrimination against women and Aboriginal groups, and most recently the crisis of homelessness and housing insecurity. In this article we consider some of the reasons why this might be the case. These include the epistemological dominance of positivist approaches to the health sciences, the ideology of individualism prevalent in North America, and the increasing influence on public policy of the marketplace. Various models of public policy provide pathways by which these barriers can be surmounted. Considering that the International Commission on the Social Determinants of Health will soon be releasing its findings and recommendations, such an analysis seems especially timely for understanding both the Canadian scene and developments in other nations.

  15. A Framework for Educating Health Professionals to Address the Social Determinants of Health

    ERIC Educational Resources Information Center

    National Academies Press, 2016

    2016-01-01

    The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies,…

  16. Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

    PubMed

    Raphael, Dennis; Brassolotto, Julia; Baldeo, Navindra

    2015-12-01

    Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity. The purpose of this study was to gain insight into the key features responsible for differences in SDH-related activities among local PHUs. We interviewed Medical Officers of Health (MOH) and key staff members from nine local PHUs in Ontario varying in SDH activity as to their understandings of the SDH, public health's role in addressing the SDH, and their units' SDH-related activities. We also reviewed their unit's documents and their organizational structures in relation to acting on the SDH. Three clusters of PHUs are identified based on their SDH-related activities: service-delivery-oriented; intersectoral and community-based; and public policy/public education-focused. The two key factors that differentiate PHUs are specific ideological commitments held by MOHs and staff and the organizational structures established to carry out SDH-related activities. The ideological commitments and the organizational structures of the most active PHUs showed congruence with frameworks adopted by national jurisdictions known for addressing health inequalities. These include a structural analysis of the SDH and a centralized organizational structure that coordinates SDH-related activities.

  17. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH. PMID:25602894

  18. The case for the World Health Organization's Commission on Social Determinants of Health to address gender identity.

    PubMed

    Pega, Frank; Veale, Jaimie F

    2015-03-01

    We analyzed the case of the World Health Organization's Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH.

  19. The case for the World Health Organization's Commission on the Social Determinants of Health to address sexual orientation.

    PubMed

    Logie, Carmen

    2012-07-01

    The World Health Organization's (WHO's) social determinants of health discussion underscores the need for health equity and social justice. Yet sexual orientation was not addressed within the WHO Commission on the Social Determinants of Health final report Closing the Gap in a Generation. This omission of sexual orientation as a social determinant of health stands in stark contrast with a body of evidence that demonstrates that sexual minorities are disproportionately affected by health problems associated with stigma and discrimination, such as mental health disorders. I propose strategies to integrate sexual orientation into the WHO's social determinants of health dialogue. Recognizing sexual orientation as a social determinant of health is an important first step toward health equity for sexual minorities.

  20. Policy approaches to address the social and environmental determinants of health inequity in Asia-pacific.

    PubMed

    Friel, Sharon; Loring, Belinda; Aungkasuvapala, Narongsakdi; Baum, Fran; Blaiklock, Alison; Chiang, Tung-Liang; Cho, Youngtae; Dakulala, Paison; Guo, Yan; Hashimoto, Hideki; Horton, Kellie; Jayasinghe, Saroj; Matheson, Don; Nguyen, Huong Thanh; Otto, Caleb; Rao, Mala; Reid, Paaparangi; Surjadi, Charles

    2012-11-01

    Asia Pacific is home to over 60% of the world's population and the fastest growing economies. Many of the leadership in the Asia Pacific region is becoming increasingly aware that improving the conditions for health would go a long way to sustaining economic prosperity in the region, as well as improving global and local health equity. There is no biological reason why males born in Cambodia can expect to live 23 years less than males born in Japan, or why females born in Tuvalu live 23 years shorter than females in New Zealand or why non-Indigenous Australian males live 12 years longer than Indigenous men. The nature and drivers of health inequities vary greatly among different social, cultural and geo-political contexts and effective solutions must take this into account. This paper utilizes the CSDH global recommendations as a basis for looking at the actions that are taking place to address the structural drivers and conditions of daily living that affect health inequities in the Asia Pacific context. While there are signs of action and hope, substantial challenges remain for health equity in Asia Pacific. The gains that have been made to date are not equally distributed and may be unsustainable as the world encounters new economic, social and environmental challenges. Tackling health inequities is a political imperative that requires leadership, political courage, social action, a sound evidence base and progressive public policy. PMID:23070757

  1. A community health worker intervention to address the social determinants of health through policy change.

    PubMed

    Ingram, Maia; Schachter, Ken A; Sabo, Samantha J; Reinschmidt, Kerstin M; Gomez, Sofia; De Zapien, Jill Guernsey; Carvajal, Scott C

    2014-04-01

    Public policy that seeks to achieve sustainable improvements in the social determinants of health, such as income, education, housing, food security and neighborhood conditions, can create positive and sustainable health effects. This paper describes preliminary results of Acción para la Salud, a public health intervention in which Community health workers (CHWs) from five health agencies engaged their community in the process of making positive systems and environmental changes. Academic-community partners trained Acción CHWs in community advocacy and provided ongoing technical assistance in developing strategic advocacy plans. The CHWs documented community advocacy activities through encounter forms in which they identified problems, formulated solutions, and described systems and policy change efforts. Strategy maps described the steps of the advocacy plans. Findings demonstrate that CHWs worked to initiate discussions about underlying social determinants and environment-related factors that impact health, and identified solutions to improve neighborhood conditions, create community opportunities, and increase access to services. PMID:24363179

  2. Migrant women's perceptions of healthcare during pregnancy and early motherhood: addressing the social determinants of health.

    PubMed

    Almeida, Lígia Moreira; Casanova, Catarina; Caldas, José; Ayres-de-Campos, Diogo; Dias, Sónia

    2014-08-01

    Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

  3. A Road Map to Address the Social Determinants of Health Through Community Collaboration.

    PubMed

    Henize, Adrienne W; Beck, Andrew F; Klein, Melissa D; Adams, Monica; Kahn, Robert S

    2015-10-01

    Economic, environmental, and psychosocial needs are common and wide-ranging among families cared for in primary care settings. Still, pediatric care delivery models are not set up to systematically address these fundamental risks to health. We offer a roadmap to help structure primary care approaches to these needs through the development of comprehensive and effective collaborations between the primary care setting and community partners. We use Maslow's Hierarchy of Needs as a well-recognized conceptual model to organize, prioritize, and determine appropriate interventions that can be adapted to both small and large practices. Specifically, collaborations with community organizations expert in addressing issues commonly encountered in primary care centers can be designed and executed in a phased manner: (1) build the case for action through a family-centered risk assessment, (2) organize and prioritize risks and interventions, (3) develop and sustain interventions, and (4) operationalize interventions in the clinical setting. This phased approach to collaboration also includes shared vision, codeveloped plans for implementation and evaluation, resource alignment, joint reflection and adaptation, and shared decisions regarding next steps. Training, electronic health record integration, refinement by using quality improvement methods, and innovative use of clinical space are important components that may be useful in a variety of clinical settings. Successful examples highlight how clinical-community partnerships can help to systematically address a hierarchy of needs for children and families. Pediatricians and community partners can collaborate to improve the well-being of at-risk children by leveraging their respective strengths and shared vision for healthy families.

  4. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

    PubMed

    Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

    2016-08-01

    The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels.

  5. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

    PubMed

    Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

    2016-08-01

    The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels. PMID:27503966

  6. Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico.

    PubMed

    Page-Reeves, Janet; Kaufman, Will; Bleecker, Molly; Norris, Jeffrey; McCalmont, Kate; Ianakieva, Veneta; Ianakieva, Dessislava; Kaufman, Arthur

    2016-01-01

    Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients. PMID:27170801

  7. Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico.

    PubMed

    Page-Reeves, Janet; Kaufman, Will; Bleecker, Molly; Norris, Jeffrey; McCalmont, Kate; Ianakieva, Veneta; Ianakieva, Dessislava; Kaufman, Arthur

    2016-01-01

    Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients.

  8. Moving Upstream: How Interventions that Address the Social Determinants of Health can Improve Health and Reduce Disparities

    PubMed Central

    Williams, David R.; Costa, Manuela V.; Odunlami, Adebola O.; Mohammed, Selina A.

    2012-01-01

    There is considerable scientific and policy interest in reducing socioeconomic and racial/ethnic disparities in healthcare and health status. Currently, much of the policy focus around reducing health disparities has been geared towards improving access, coverage, quality and the intensity of healthcare. However, health is more a function of lifestyles linked to living and working conditions than of healthcare. Accordingly, effective efforts to improve health and reduce gaps in health need to pay greater attention to addressing the social determinants of health within and outside of the healthcare system. This paper highlights research evidence documenting that tackling the social determinants of health can lead to reductions in health disparities. It focuses both on interventions within the healthcare system that address some of the social determinants of health, as well as, interventions in upstream factors such as housing, neighborhood conditions and increased socioeconomic status that can lead to improvements in health. The studies reviewed highlight the importance of systematic evaluation of social and economic policies that might have health consequences and the need for policy makers, healthcare providers, and leaders across multiple sectors of society to apply currently available knowledge to improve the underlying conditions that impact the health of populations. PMID:18843244

  9. Synthesizing Evidence-Based Strategies and Community-Engaged Research: A Model to Address Social Determinants of Health

    PubMed Central

    Bohan, Kyle David; Trotter, Robert Talbot

    2013-01-01

    Addressing social determinants of health (SDH) requires multileveled intervention designs. Increasingly, organizations and coalitions face pressure to use evidence-based strategies when seeking to address SDH. Evidence-based strategies, however, must be locally relevant and integrated into existing systems to function efficiently. We propose the incorporation of an effective rapid assessment technique, Rapid Assessment, Response, and Evaluation (RARE), with evidence-based strategies, findings, and recommendations embedded in community-engaged research to increase the likelihood of success in addressing SDH. Our RARE project—a partnership among a community health center, a nonprofit funding agency, and academic faculty researchers—resulted in community- and policy-level interventions for the prevention of childhood obesity in a Southwestern U.S. city. PMID:24179282

  10. Addressing Social Determinants of Health at Well Child Care Visits: A Cluster RCT

    PubMed Central

    Toy, Sarah; Tripodis, Yorghos; Silverstein, Michael; Freeman, Elmer

    2015-01-01

    OBJECTIVE: To evaluate the effect of a clinic-based screening and referral system (Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education [WE CARE]) on families’ receipt of community-based resources for unmet basic needs. METHODS: We conducted a cluster randomized controlled trial at 8 urban community health centers, recruiting mothers of healthy infants. In the 4 WE CARE clinics, mothers completed a self-report screening instrument that assessed needs for child care, education, employment, food security, household heat, and housing. Providers made referrals for families; staff provided requisite applications and telephoned referred mothers within 1 month. Families at the 4 control community health centers received the usual care. We analyzed the results with generalized mixed-effect models. RESULTS: Three hundred thirty-six mothers were enrolled in the study (168 per arm). The majority of families had household incomes <$20 000 (57%), and 68% had ≥2 unmet basic needs. More WE CARE mothers received ≥1 referral at the index visit (70% vs 8%; adjusted odds ratio [aOR] = 29.6; 95% confidence interval [CI], 14.7–59.6). At the 12-month visit, more WE CARE mothers had enrolled in a new community resource (39% vs 24%; aOR = 2.1; 95% CI, 1.2–3.7). WE CARE mothers had greater odds of being employed (aOR = 44.4; 95% CI, 9.8–201.4). WE CARE children had greater odds of being in child care (aOR = 6.3; 95% CI, 1.5–26.0). WE CARE families had greater odds of receiving fuel assistance (aOR = 11.9; 95% CI, 1.7–82.9) and lower odds of being in a homeless shelter (aOR = 0.2; 95% CI, 0.1–0.9). CONCLUSIONS: Systematically screening and referring for social determinants during well child care can lead to the receipt of more community resources for families. PMID:25560448

  11. Addressing the social determinants of health through the Alameda County, California, place matters policy initiative.

    PubMed

    Schaff, Katherine; Desautels, Alexandra; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-11-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices.

  12. Addressing the Social Determinants of Health through the Alameda County, California, Place Matters Policy Initiative

    PubMed Central

    Schaff, Katherine; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-01-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices. PMID:24179279

  13. Addressing the Social Determinants of Health of Children and Youth: A Role for SOPHE Members

    ERIC Educational Resources Information Center

    Allensworth, Diane D.

    2011-01-01

    The determinants of youth health disparities include poverty, unequal access to health care, poor environmental conditions, and educational inequities. Poor and minority children have more health problems and less access to health care than their higher socioeconomic status cohorts. Having more health problems leads to more absenteeism in school,…

  14. Addressing the social determinants of inequities in physical activity and sedentary behaviours.

    PubMed

    Ball, Kylie; Carver, Alison; Downing, Katherine; Jackson, Michelle; O'Rourke, Kerryn

    2015-09-01

    Participation in both physical activity and sedentary behaviours follow a social gradient, such that those who are more advantaged are more likely to be regularly physically active, less likely to be sedentary, and less likely to experience the adverse health outcomes associated with inactive lifestyles than their less advantaged peers. The aim of this paper is to provide, in a format that will support policymakers and practitioners, an overview of the current evidence base and highlight promising approaches for promoting physical activity and reducing sedentary behaviours equitably at each level of 'Fair Foundations: The VicHealth framework for health equity'. A rapid review was undertaken in February-April 2014. Electronic databases (Medline, PsychINFO, SportsDISCUS, CINAHL, Scopus, Web of Science, Cochrane Library, Global Health and Embase) were searched using a pre-defined search strategy and grey literature searches of websites of key relevant organizations were undertaken. The majority of included studies focussed on approaches targeting behaviour change at the individual level, with fewer focussing on daily living conditions or broader socioeconomic, political and cultural contexts. While many gaps in the evidence base remain, particularly in relation to reducing sedentary behaviour, promising approaches for promoting physical activity equitably across the three levels of the Fair Foundations framework include: community-wide approaches; support for local and state governments to develop policies and practices; neighbourhood designs (including parks) that are conducive to physical activity; investment in early childhood interventions; school programmes; peer- or group-based programmes; and targeted motivational, cognitive-behavioural, and/or mediated individual-level approaches. PMID:25855784

  15. Public social monitoring reports and their effect on a policy programme aimed at addressing the social determinants of health to improve health equity in New Zealand.

    PubMed

    Pega, Frank; Valentine, Nicole B; Matheson, Don; Rasanathan, Kumanan

    2014-01-01

    The important role that monitoring plays in advancing global health is well established. However, the role of social monitoring as a tool for addressing social determinants of health (SDH) and health equity-focused policies remains under-researched. This paper assesses the extent and ways in which New Zealand's (NZ) Social Reports (SRs) supported a SDH- and health equity-oriented policy programme nationally over the 2000-2008 period by documenting the SRs' history and assessing its impact on policies across sectors in government and civil society. We conducted key-informant interviews with five senior policy-makers and an e-mail survey with 24 government and civil society representatives on SRs' history and policy impact. We identified common themes across these data and classified them accordingly to assess the intensity of the reports' use and their impact on SDH- and health equity-focused policies. Bibliometric analyses of government publications and media items were undertaken to empirically assess SRs' impact on government and civil society. SRs in NZ arose out of the role played by government as the "benevolent social welfare planner" and an understanding of the necessity of economic and social security for "progress". The SRs were linked to establishing a government-wide programme aimed at reducing inequalities. They have been used moderately to highly in central and local government and in civil society, both within and outside the health sector, but have neither entered public treasury and economic development departments nor the commercial sector. The SRs have not reached the more universal status of economic indicators. However, they have had some success at raising awareness of, and have stimulated isolated action on, SDH. The NZ case suggests that national-level social monitoring provides a valuable tool for raising awareness of SDH across government and civil society. A number of strategies could improve social reports' effectiveness in stimulating

  16. Addressing the social determinants of health: a case study from the Mitanin (community health worker) programme in India.

    PubMed

    Nandi, Sulakshana; Schneider, Helen

    2014-09-01

    The Mitanin Programme, a government community health worker (CHW) programme, was started in Chhattisgarh State of India in 2002. The CHWs (Mitanins) have consistently adopted roles that go beyond health programme-specific interventions to embrace community mobilization and action on local priorities. The aim of this research was to document how and why the Mitanins have been able to act on the social determinants of health, describing the catalysts and processes involved and the enabling programmatic and organizational factors. A qualitative comparative case study of successful action by Mitanin was conducted in two 'blocks', purposefully selected as positive exemplars in two districts of Chhattisgarh. One case focused on malnutrition and the other on gender-based violence. Data collection involved 17 in-depth interviews and 10 group interviews with the full range of stakeholders in both blocks, including community members and programme team. Thematic analysis was done using a broad conceptual framework that was further refined. Action on social determinants involved raising awareness on rights, mobilizing women's collectives, revitalizing local political structures and social action targeting both the community and government service providers. Through these processes, the Mitanins developed identities as agents of change and advocates for the community, both with respect to local cultural and gender norms and in ensuring accountability of service providers. The factors underpinning successful action on social determinants were identified as the significance of the original intent and vision of the programme, and how this was carried through into all aspects of programme design, the role of the Mitanins and their identification with village women, ongoing training and support, and the relative autonomy of the programme. Although the results are not narrowly generalizable and do not necessarily represent the situation of the Mitanin Programme as a whole, the

  17. Addressing the social and environmental determinants of urban health equity: evidence for action and a research agenda.

    PubMed

    Friel, Sharon; Akerman, Marco; Hancock, Trevor; Kumaresan, Jacob; Marmot, Michael; Melin, Thomas; Vlahov, David

    2011-10-01

    Urban living is the new reality for the majority of the world's population. Urban change is taking place in a context of other global challenges--economic globalization, climate change, financial crises, energy and food insecurity, old and emerging armed conflicts, as well as the changing patterns of communicable and noncommunicable diseases. These health and social problems, in countries with different levels of infrastructure and health system preparedness, pose significant development challenges in the 21st century. In all countries, rich and poor, the move to urban living has been both good and bad for population health, and has contributed to the unequal distribution of health both within countries (the urban-rural divide) and within cities (the rich-poor divide). In this series of papers, we demonstrate that urban planning and design and urban social conditions can be good or bad for human health and health equity depending on how they are set up. We argue that climate change mitigation and adaptation need to go hand-in-hand with efforts to achieve health equity through action in the social determinants. And we highlight how different forms of governance can shape agendas, policies, and programs in ways that are inclusive and health-promoting or perpetuate social exclusion, inequitable distribution of resources, and the inequities in health associated with that. While today we can describe many of the features of a healthy and sustainable city, and the governance and planning processes needed to achieve these ends, there is still much to learn, especially with respect to tailoring these concepts and applying them in the cities of lower- and middle-income countries. By outlining an integrated research agenda, we aim to assist researchers, policy makers, service providers, and funding bodies/donors to better support, coordinate, and undertake research that is organized around a conceptual framework that positions health, equity, and sustainability as central

  18. Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme

    PubMed Central

    Hofman, Karen; Blomstedt, Yulia; Addei, Sheila; Kalage, Rose; Maredza, Mandy; Sankoh, Osman; Bangha, Martin; Kahn, Kathleen; Becher, Heiko; Haafkens, Joke; Kinsman, John

    2013-01-01

    Background The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. Objective As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries – Ghana, Tanzania, and South Africa – as well as the gaps, barriers, and opportunities for training. Methods SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. Results SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the

  19. Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial

    PubMed Central

    Wall, Martin; Hayes, Richard; Moore, Derek; Petticrew, Mark; Clow, Angela; Schmidt, Elena; Draper, Alizon; Lock, Karen; Lynch, Rebecca; Renton, Adrian

    2009-01-01

    organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration Current Controlled Trials ISRCTN68175121 PMID:19558712

  20. Addressing social resistance in emerging security technologies.

    PubMed

    Mitchener-Nissen, Timothy

    2013-01-01

    In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus. Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

  1. Addressing social resistance in emerging security technologies

    PubMed Central

    Mitchener-Nissen, Timothy

    2013-01-01

    In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus.1 Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

  2. Close to community health providers post 2015: Realising their role in responsive health systems and addressing gendered social determinants of health

    PubMed Central

    2015-01-01

    Universal health coverage is gaining momentum and is likely to form a core part of the post Millennium Development Goal (MDG) agenda and be linked to social determinants of health, including gender; Close to community health providers are arguably key players in meeting the goal of universal health coverage through extending and delivering health services to poor and marginalised groups; Close to community health providers are embedded in communities and may therefore be strategically placed to understand intra household gender and power dynamics and how social determinants shape health and well-being. However, the opportunities to develop critical awareness and to translate this knowledge into health system and multi-sectoral action are poorly understood; Enabling close to community health providers to realise their potential requires health systems support and human resource management at multiple levels.

  3. Using a Health in All Policies Approach to Address Social Determinants of Sexually Transmitted Disease Inequities in the Context of Community Change and Redevelopment

    PubMed Central

    Fuller, Elizabeth; Branscomb, Jane; Cheung, Karen; Reed, Phillip Jackson; Wong, Naima; Henderson, Michael; Williams, Samantha

    2013-01-01

    Objectives We used a Health in All Policies (HiAP) framework to determine what data, policy, and community efficacy opportunities exist for improving sexual health and reducing sexually transmitted diseases (STDs) in an area surrounding an Army base undergoing redevelopment in Atlanta, Georgia. Methods We conducted a literature review, consulted with experts, mapped social determinants in the community, conducted key informant interviews with community leaders to explore policy solutions, used Photovoice with community members to identify neighborhood assets, and shared data with all stakeholder groups to solicit engagement for next steps. Results We identified the following HiAP-relevant determinants of STD inequities in the literature: education, employment, male incarceration, drug and alcohol marketing, and social capital. Quantitative data confirmed challenges in education, employment, and male incarceration in the area. Interviews identified policy opportunities such as educational funding ratios, Community Hire Agreements, code and law enforcement, addiction and mental health resources, lighting for safety, and a nonemergency public safety number. Photovoice participants identified community assets to protect including family-owned businesses, green spaces, gathering places, public transportation resources, historical sites, and architectural elements. Stakeholder feedback provided numerous opportunities for next steps. Conclusions This study contributes to the HiAP literature by providing an innovative mixed-methods design that locates social determinants of STDs within a geographic context, identifies policy solutions from local leaders, highlights community assets through the lens of place attachment, and engages stakeholders in identifying next steps. Findings from this study could inform other redevelopments, community-based studies of STDs, and HiAP efforts. PMID:24179283

  4. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    PubMed Central

    Prasad, Amit Mohan; Chakraborty, Gautam; Yadav, Sajjan Singh; Bhatia, Salima

    2013-01-01

    Background At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR) was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself) and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM) in April 2005. Methods Under the NRHM, Rs. 666 billion (US$12.1 billion) was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’. PMID:23458089

  5. Addressing Breastfeeding Disparities in Social Work

    ERIC Educational Resources Information Center

    Hurst, Carol Grace

    2007-01-01

    This article examines social justice issues affecting breastfeeding in the United States. Public health goals for breastfeeding initiation and duration and barriers to breastfeeding among low-income groups are discussed. Suggestions are made about ways social workers may more assertively support breastfeeding in the context of social work practice.

  6. Social Influences on Interest. Presidential Address

    ERIC Educational Resources Information Center

    Bergin, David A.

    2016-01-01

    Where does enduring individual interest come from? One answer is, through social experience that derives from a need for belongingness. Because of this need, students seek social links that influence the development of individual interest. This may occur through experiences with parents, friends, passionate affinity groups, competition, public…

  7. Addressing therapeutic boundaries in social networking.

    PubMed

    Ginory, Almari; Sabatier, Laura Mayol; Eth, Spencer

    2012-01-01

    Facebook is the leading social networking website, with over 500 million users. Prior studies have shown an increasing number of housestaff accessing the site. While Facebook can be used to foster camaraderie, it can also create difficulties in the doctor-patient relationship, especially when boundaries are crossed. This study explored the prevalence of such boundary crossings and offers recommendations for training. An anonymous voluntary survey regarding Facebook use was distributed to current psychiatry residents through the American Psychiatric Association (APA) listserv. Of the 182 respondents, 95.7% had current Facebook profiles, and 9.7% had received friend requests from patients. In addition, 18.7% admitted to viewing patient profiles on Facebook. There is a substantial utilization of Facebook among psychiatric residents as compared with prior studies. Specific guidance regarding social media websites and the potential for ethical difficulties should be offered to trainees. PMID:22397540

  8. Summary of CDC consultation to address social determinants of health for prevention of disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis. December 9-10, 2008.

    PubMed

    Sharpe, Tanya Telfair; Harrison, Kathleen McDavid; Dean, Hazel D

    2010-01-01

    In December 2008, the Centers for Disease Control and Prevention (CDC) convened a meeting of national public health partners to identify priorities for addressing social determinants of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB). The consultants were divided into four working groups: (1) public health policy, (2) data systems, (3) agency partnerships and prevention capacity building, and (4) prevention research and evaluation. Groups focused on identifying top priorities; describing activities, methods, and metrics to implement priorities; and identifying partnerships and resources required to implement priorities. The meeting resulted in priorities for public health policy, improving data collection methods, enhancing existing and expanding future partnerships, and improving selection criteria and evaluation of evidence-based interventions. CDC is developing a national communications plan to guide and inspire action for keeping social determinants of HIV/AIDS, viral hepatitis, STDs, and TB in the forefront of public health activities.

  9. Corporate social responsibility initiatives addressing social exclusion in Bangladesh.

    PubMed

    Werner, Wendy J

    2009-08-01

    The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships- collectively labelled corporate social responsibility (CSR) initiatives-may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation.

  10. Corporate Social Responsibility Initiatives Addressing Social Exclusion in Bangladesh

    PubMed Central

    2009-01-01

    The private sector is often seen as a driver of exclusionary processes rather than a partner in improving the health and welfare of socially-excluded populations. However, private-sector initiatives and partnerships—collectively labelled corporate social responsibility (CSR) initiatives—may be able to positively impact social status, earning potential, and access to services and resources for socially-excluded populations. This paper presents case studies of CSR projects in Bangladesh that are designed to reduce social exclusion among marginalized populations and explores whether CSR initiatives can increase economic and social capabilities to reduce exclusion. The examples provide snapshots of projects that (a) increase job-skills and employment opportunities for women, disabled women, and rehabilitated drug-users and (b) provide healthcare services to female workers and their communities. The CSR case studies cover a limited number of people but characteristics and practices replicable and scaleable across different industries, countries, and populations are identified. Common success factors from the case studies form the basis for recommendations to design and implement more CSR initiatives targeting socially-excluded groups. The analysis found that CSR has potential for positive and lasting impact on developing countries, especifically on socially-excluded populations. However, there is a need for additional monitoring and critical evaluation. PMID:19761088

  11. Cultural and Social Interpretation of Chinese Addressing Strategies

    ERIC Educational Resources Information Center

    Yin, Yahui

    2010-01-01

    This paper examines the influence of Chinese cultural factors on the addressing terms, together with the history of their use, the social dynamics involved in their use. Through the examination of exact terms, the author demonstrates to the reader, the deeply rooted cultural factors behind it and different ways that these terms can be used,…

  12. 2011 AERA Presidential Address: Designing Resilient Ecologies--Social Design Experiments and a New Social Imagination

    ERIC Educational Resources Information Center

    Gutiérrez, Kris D.

    2016-01-01

    This article is about designing for educational possibilities--designs that in their inception, social organization, and implementation squarely address issues of cultural diversity, social inequality, and robust learning. I discuss an approach to design-based research, social design experiments, that privileges a social scientific inquiry…

  13. Social Determinants of Health: Housing and Income.

    PubMed

    Forchuk, Cheryl; Dickins, Kevin; Corring, Deborah J

    2016-01-01

    Social determinants of health such as housing and income have a large impact on mental health. Community-based initiatives have worked to address access to housing, prevent homelessness and assist people who are homeless with mental health problems. There have been several large research projects to tease out multiple subgroups such as youth and veterans and other individuals experiencing long-term homelessness. The issue of poverty has been addressed by exploring issues related to employment. The use of social enterprises is a promising practice to address issues around poverty, social inclusion and employment. Similarly, the community has worked to move hospital-based employment programs to the community. PMID:26854545

  14. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    PubMed

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. PMID:26225503

  15. Addressing Consent Issues in Donation After Circulatory Determination of Death.

    PubMed

    Overby, Kim J; Weinstein, Michael S; Fiester, Autumn

    2015-01-01

    Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.

  16. Addressing Social Aggression in State Anti-Bullying Policies

    ERIC Educational Resources Information Center

    Temkin, Deborah

    2008-01-01

    Social aggression, or victimization using social exclusion, rumors, and body language, has been overlooked in state anti-bullying policies since the policy surge following the 1999 Columbine Massacres. Social aggression has been associated with social anxiety disorder, depression and suicide, and lowered academic achievement and involvement. An…

  17. The NCSS Presidential Addresses, 1936-1969: Perspectives on the Social Studies.

    ERIC Educational Resources Information Center

    Previte, Mark A., Ed.; Sheehan, James J., Ed.

    This collection of the National Council for the Social Studies (NCSS) presidential addresses seeks to provide a valuable window to the history of NCSS and the field of social studies. Following the "Introduction" (James J. Sheehan), addresses appear chronologically: 1936 "Social Sanity through the Social Studies" (R. O. Hughes); 1937 "The Dilemma…

  18. Creating Art Environments That Address Social Justice Issues

    ERIC Educational Resources Information Center

    Tremblay, Gail

    2013-01-01

    In this article, I examine strategies for teaching students to make socially conscious art using a variety of media that emphasizes installation work. I present issues of social justice in the contemporary art world and include concerns of censorship that artists sometimes confront. I offer examples of team taught coordinated studies programs…

  19. Career Psychology in South Africa: Addressing and Redressing Social Justice

    ERIC Educational Resources Information Center

    Watson, Mark

    2010-01-01

    This paper explores the definition of social justice in career psychology and how this might be understood in the South African context. In particular, macro-contextual factors that define social justice issues in South African career psychology are described. The extent to which the discipline of career psychology in South Africa has addressed…

  20. The NCSS Presidential Addresses, 1970-2000: Perspectives on the Social Studies.

    ERIC Educational Resources Information Center

    Previte, Mark A., Ed.; Sheehan, James J., Ed.

    This collection of the National Council for the Social Studies (NCSS) presidential addresses seeks to provide a valuable window to NCSS and the field of social studies from 1970 to 2000. Following "Introduction to the NCSS Presidential Addresses, 1970-2000 (J. J. Sheehan), Volume 2 contains the following addresses: 1970: "Exploring the Meaning of…

  1. [Conceptual differences and praxiological implications concerning social determination or social determinants].

    PubMed

    Morales-Borrero, Carolina; Borde, Elis; Eslava-Castañeda, Juan C; Concha-Sánchez, Sonia C

    2013-01-01

    The differences between the social determination of health approach adopted by the Latin-American Social Medicine and Collective Health movement and the WHO's social determinants of health approach are not merely conceptual but involve ethical and political considerations. Different notions of causality and risk are implied in the aforementioned approaches and shape how concepts regarding health-illness and health inequity are understood and how they may be confronted. This article attempts to clarify the praxiological implications of such approaches and contextualise the approaches' socio-historical construction, address epistemological, methodological and ontological differences and propose some considerations regarding the praxiological implications. PMID:25124346

  2. Imaginative Thinking: Addressing Social Justice Issues through MovieMaker

    ERIC Educational Resources Information Center

    Boske, Christa A.

    2009-01-01

    Purpose: The purpose of this paper is to examine the experiences of aspiring school leaders who utilized artmaking in this case, photography, poetry, music, collage, and short films through Microsoft MovieMaker as a means for addressing injustices within surrounding school communities. The paper aims to explore how aspiring school leaders…

  3. Catholic Social Teaching: Addressing Globalization in Catholic Business Education

    ERIC Educational Resources Information Center

    Ball, James B.; Martinez, Zaida; Toyne, Brian

    2009-01-01

    Although business schools are increasingly aware of the importance of globalization in educating future business leaders, their business programs have addressed globalization from a limited perspective that fails to provide students with a broader understanding of its impact on societies and its moral consequences. The conventional approach to the…

  4. Aspiring School Leaders Addressing Social Justice through Art Making

    ERIC Educational Resources Information Center

    Boske, Christa

    2012-01-01

    There is little in the professional literature about how school leaders or other professionals committed to promoting social justice deal with and manage their emotional responses to the challenges that await them in educational arenas. Even less has been written about how art making can be utilized as a means of developing new understandings and…

  5. Social Entrepreneurship in Religious Congregations’ Efforts to Address Health Needs

    PubMed Central

    Werber, Laura; Mendel, Peter J.; Derose, Kathryn Pitkin

    2013-01-01

    Purpose Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Design Multiple case studies. Setting Los Angeles County, California. Participants Purposive sample of 14 congregations representing diverse races-ethnicities (African American, Latino, and white) and faith traditions (Jewish and various Christian). Method Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n=57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed using a qualitative, code-based approach. Results Congregations’ health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations’ health initiatives, providing a safe, confidential environment and leveraging resources from – and for – faith-based and secular organizations in their community networks. Congregations also served as “incubators” for members to engage in social entrepreneurship. Conclusion Although the small scale of congregations’ health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations’ position in their communities permit them to network in productive ways. PMID:23875986

  6. Developing Social Marketing Capacity to Address Health Issues

    ERIC Educational Resources Information Center

    Whitelaw, S.; Smart, E.; Kopela, J.; Gibson, T.; King, V.

    2011-01-01

    Purpose: Social marketing is increasingly being seen as a potentially effective means of pursuing health education practice generally and within various specific areas such as mental health and wellbeing and more broadly in tackling health inequalities. This paper aims to report and reflect on the authors' experiences of undertaking a health…

  7. Helping Social Workers Address the Educational Needs of Foster Children

    ERIC Educational Resources Information Center

    Zetlin, A.G.; Weinberg, L.A.; Kimm, C.

    2005-01-01

    Objective:: The main aim was to evaluate the effectiveness of the Education Initiative, an intervention program in one of the largest urban counties in the US seeking to increase the responsiveness of social workers to the educational needs of foster children. Method:: A pre-post test control group design was used. Data from case files and social…

  8. Social Determinants: Taking the Social Context of Asthma Seriously

    PubMed Central

    Williams, David R.; Sternthal, Michelle; Wright, Rosalind J.

    2012-01-01

    While asthma has emerged as a major contributor to disease and disability in American children, the burden of this disease is unevenly distributed within the population. This paper provides a brief overview of social status variables that predict variation in asthma risks and social exposures such as stress and violence that are emerging as important risk factors. However, the central focus of the paper is on the distal social variables that have given rise to unhealthy residential environments in which the risk factors for asthma and other diseases are clustered. Effective initiatives for the prevention and treatment of childhood asthma need to address these non-medical determinants of the prevalence of asthma. PMID:19221161

  9. Social Determinants and Their Unequal Distribution: Clarifying Policy Understandings

    PubMed Central

    Graham, Hilary

    2004-01-01

    Public health policy in older industrialized societies is being reconfigured to improve population health and to address inequalities in the social distribution of health. The concept of social determinants is central to these policies, with tackling the social influences on health seen as a way to reduce health inequalities. But the social factors promoting and undermining the health of individuals and populations should not be confused with the social processes underlying their unequal distribution. This distinction is important because, despite better health and improvement in health determinants, social disparities persist. The article argues that more emphasis on social inequalities is required for a determinants-oriented approach to be able to inform policies to address health inequalities. PMID:15016245

  10. Use of Social Software to Address Literacy and Identity Issues in Second Language Learning

    ERIC Educational Resources Information Center

    Hutchinson, Jill

    2009-01-01

    The emerging trend of social software technology can address many different second language (L2) learner needs through authentic social interaction and a variety of scaffolding processes. Social software connects education with real-life learning and interests, and engages and motivates students. It can facilitate learning environments that are…

  11. Social determinants of food choice.

    PubMed

    Shepherd, R

    1999-11-01

    Food choice is influenced by a large number of factors, including social and cultural factors. One method for trying to understand the impact of these factors is through the study of attitudes. Research is described which utilizes social psychological attitude models of attitude-behaviour relationships, in particular the Theory of Planned Behaviour. This approach has shown good prediction of behaviour, but there are a number of possible extensions to this basic model which might improve its utility. One such extension is the inclusion of measures of moral concern, which have been found to be important both for the choice of genetically-modified foods and also for foods to be eaten by others. It has been found to be difficult to effect dietary change, and there are a number of insights from social psychology which might address this difficulty. One is the phenomenon of optimistic bias, where individuals believe themselves to be at less risk from various hazards than the average person. This effect has been demonstrated for nutritional risks, and this might lead individuals to take less note of health education messages. Another concern is that individuals do not always have clear-cut attitudes, but rather can be ambivalent about food and about healthy eating. It is important, therefore, to have measures for this ambivalence, and an understanding of how it might impact on behaviour.

  12. Social determinants of food choice.

    PubMed

    Shepherd, R

    1999-11-01

    Food choice is influenced by a large number of factors, including social and cultural factors. One method for trying to understand the impact of these factors is through the study of attitudes. Research is described which utilizes social psychological attitude models of attitude-behaviour relationships, in particular the Theory of Planned Behaviour. This approach has shown good prediction of behaviour, but there are a number of possible extensions to this basic model which might improve its utility. One such extension is the inclusion of measures of moral concern, which have been found to be important both for the choice of genetically-modified foods and also for foods to be eaten by others. It has been found to be difficult to effect dietary change, and there are a number of insights from social psychology which might address this difficulty. One is the phenomenon of optimistic bias, where individuals believe themselves to be at less risk from various hazards than the average person. This effect has been demonstrated for nutritional risks, and this might lead individuals to take less note of health education messages. Another concern is that individuals do not always have clear-cut attitudes, but rather can be ambivalent about food and about healthy eating. It is important, therefore, to have measures for this ambivalence, and an understanding of how it might impact on behaviour. PMID:10817147

  13. Medical Student Volunteerism Addresses Patients' Social Needs: A Novel Approach to Patient-Centered Care

    PubMed Central

    Onyekere, Chinwe; Ross, Sandra; Namba, Alexa; Ross, Justin C.; Mann, Barry D.

    2016-01-01

    Background: Healthcare providers must be equipped to recognize and address patients' psychosocial needs to improve overall health outcomes. To give future healthcare providers the tools and training necessary to identify and address psychosocial issues, Lankenau Medical Center in partnership with the Philadelphia College of Osteopathic Medicine designed the Medical Student Advocate (MSA) program. Methods: The MSA program places volunteer second-year osteopathic medical students in care coordination teams at Lankenau Medical Associates, a primary care practice serving a diverse patient population in the Philadelphia, PA, region. As active members of the team, MSAs are referred high-risk patients who have resource needs such as food, employment, child care, and transportation. MSAs work collaboratively with patients and the multidisciplinary team to address patients' nonmedical needs. Results: From August 2013 to August 2015, 31 osteopathic medical students volunteered for the MSA program and served 369 patients with 720 identified needs. Faculty and participating medical students report that the MSA program provided an enhanced understanding of the holistic nature of patient care and a comprehensive view of patient needs. Conclusion: The MSA program provides students with a unique educational opportunity that encompasses early exposure to patient interaction, social determinants of health, population health, and interdisciplinary collaboration. Students develop skills to help them build patient relationships, understand the psychosocial factors shaping health outcomes, and engage with other healthcare professionals. This work in the preclinical years provides students with the knowledge to help them perform more effectively in the changing healthcare environment. PMID:27046404

  14. How to Address the Volitional Dimension of the Engineer's Social Responsibility

    ERIC Educational Resources Information Center

    Heikkero, T.

    2008-01-01

    In this paper I argue that volitional aspects, i.e. ethos, attitude, pathos, will, underlying emotion, in engineering action need to be addressed when teaching social responsibility within the engineering curriculum. After presenting reasons for this claim, I look at two different, but not mutually exclusive, approaches to address volitional…

  15. Addressing the Academic and Social Needs of Young Male Students through School-Based Mentoring

    ERIC Educational Resources Information Center

    Alston, Curtis E.

    2013-01-01

    This study addressed the problem within the U.S. public school system to sustainably meet the academic and social needs of its African American male students. The administrative team of the elementary school in this study desired an evaluation of a school-based male mentoring program that was designed to address these needs. The program, Gentlemen…

  16. Language Socialization and Interculturality: Address Terms in Intergenerational Talk in Chinese Diasporic Families

    ERIC Educational Resources Information Center

    Hua, Zhu

    2010-01-01

    This paper aims to contribute to the current debate on "interculturality" (IC) by investigating the process of language socialization whereby different generations of diasporic families negotiate, construct, and renew their sociocultural values and identities through interaction. Focusing on the use of address terms and "talk about social,…

  17. Interventions Addressing the Social Determinants of Teenage Pregnancy

    ERIC Educational Resources Information Center

    Fletcher, Adam; Harden, Angela; Brunton, Ginny; Oakley, Ann; Bonell, Chris

    2008-01-01

    Purpose: The limited evidence of effectiveness of existing teenage pregnancy strategies which focus on sex education, together with growing evidence that factors such as poor school ethos, disaffection, truancy, poor employment prospects and low expectations are associated with teenage pregnancy, has increased interest in interventions which…

  18. Which Social Elements Are Visible in Virtual Groups? Addressing the Categorization of Social Expressions

    ERIC Educational Resources Information Center

    Perez-Mateo, M.; Guitert, M.

    2012-01-01

    Learning is a social process. That is why it is extremely important to understand how students interact socially in online courses and how it affects the learning process. However, social aspects, understood as those expressions or comments that go beyond strictly academic interaction, i.e. the need to carry out group work, are not clearly…

  19. Addressing vaccine hesitancy: The potential value of commercial and social marketing principles and practices.

    PubMed

    Nowak, Glen J; Gellin, Bruce G; MacDonald, Noni E; Butler, Robb

    2015-08-14

    Many countries and communities are dealing with groups and growing numbers of individuals who are delaying or refusing recommended vaccinations for themselves or their children. This has created a need for immunization programs to find approaches and strategies to address vaccine hesitancy. An important source of useful approaches and strategies is found in the frameworks, practices, and principles used by commercial and social marketers, many of which have been used by immunization programs. This review examines how social and commercial marketing principles and practices can be used to help address vaccine hesitancy. It provides an introduction to key marketing and social marketing concepts, identifies some of the major challenges to applying commercial and social marketing approaches to immunization programs, illustrates how immunization advocates and programs can use marketing and social marketing approaches to address vaccine hesitancy, and identifies some of the lessons that commercial and non-immunization sectors have learned that may have relevance for immunization. While the use of commercial and social marketing practices and principles does not guarantee success, the evidence, lessons learned, and applications to date indicate that they have considerable value in fostering vaccine acceptance.

  20. Addressing vaccine hesitancy: The potential value of commercial and social marketing principles and practices.

    PubMed

    Nowak, Glen J; Gellin, Bruce G; MacDonald, Noni E; Butler, Robb

    2015-08-14

    Many countries and communities are dealing with groups and growing numbers of individuals who are delaying or refusing recommended vaccinations for themselves or their children. This has created a need for immunization programs to find approaches and strategies to address vaccine hesitancy. An important source of useful approaches and strategies is found in the frameworks, practices, and principles used by commercial and social marketers, many of which have been used by immunization programs. This review examines how social and commercial marketing principles and practices can be used to help address vaccine hesitancy. It provides an introduction to key marketing and social marketing concepts, identifies some of the major challenges to applying commercial and social marketing approaches to immunization programs, illustrates how immunization advocates and programs can use marketing and social marketing approaches to address vaccine hesitancy, and identifies some of the lessons that commercial and non-immunization sectors have learned that may have relevance for immunization. While the use of commercial and social marketing practices and principles does not guarantee success, the evidence, lessons learned, and applications to date indicate that they have considerable value in fostering vaccine acceptance. PMID:25900132

  1. An Approach for Addressing the Multiple Testing Problem in Social Policy Impact Evaluations

    ERIC Educational Resources Information Center

    Schochet, Peter Z.

    2009-01-01

    In social policy evaluations, the multiple testing problem occurs due to the many hypothesis tests that are typically conducted across multiple outcomes and subgroups, which can lead to spurious impact findings. This article discusses a framework for addressing this problem that balances Types I and II errors. The framework involves specifying…

  2. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health

    PubMed Central

    Collins, Patricia A.; Resendes, Sarah J.; Dunn, James R.

    2014-01-01

    Background: Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. Methods: We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. Results: Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. Conclusions: Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation. PMID:25410693

  3. Teaching and addressing health disparities through the family medicine social and community context of care project.

    PubMed

    White, Jordan; Heney, Jessica; Esquibel, Angela Y; Dimock, Camia; Goldman, Roberta; Anthony, David

    2014-09-01

    By training future physicians to care for patients with backgrounds different from their own, medical schools can help reduce health disparities. To address the need for education in this area, the leaders of the Family Medicine Clerkship at the Warren Alpert Medical School of Brown University developed the Social and Community Context of Care project, required of all medical students rotating through this clerkship. Students develop a hypothetical intervention addressing a health issue seen at their preceptor site, and are assessed on their grasp of the social and contextual issues affecting that health issue in their particular community. Some interventions are actualized in later clerkships or independent study projects; one example, a health class for pregnant and parenting teens at Central Falls High School, is described here. If made a routine part of medical education, projects such as these may help medical students address the health disparities they will encounter in future practice.

  4. Social determinants of health: a view on theory and measurement.

    PubMed

    De Maio, Fernando; Mazzeo, John; Ritchie, Dannie

    2013-07-01

    The theory and measurement of the social determinants of health featured in a three-part seminar series on Social Determinants of Health, Law and Policy held at the Taubman Center for Public Policy, Brown University in February 2012. The seminar series represents a broader commitment to engage the public, health providers, researchers, and policy makers in dialogue for the purposes of identifying and addressing social determinants of health at community and state levels. This article summarizes and expands upon the first part of the series by defining social determinants of health and exploring methodological debates over their measurement, with a focus on income inequality, racism and discrimination, housing security, and food security. The authors of this article and the members of the seminar series represent the kind of interdisciplinary and applied work necessary for addressing the five key areas of social determinants of health identified in Healthy People 2020: economic stability, education, social and community context, health and health care, and neighborhood and environment.

  5. Social determinants of health: a view on theory and measurement.

    PubMed

    De Maio, Fernando; Mazzeo, John; Ritchie, Dannie

    2013-07-01

    The theory and measurement of the social determinants of health featured in a three-part seminar series on Social Determinants of Health, Law and Policy held at the Taubman Center for Public Policy, Brown University in February 2012. The seminar series represents a broader commitment to engage the public, health providers, researchers, and policy makers in dialogue for the purposes of identifying and addressing social determinants of health at community and state levels. This article summarizes and expands upon the first part of the series by defining social determinants of health and exploring methodological debates over their measurement, with a focus on income inequality, racism and discrimination, housing security, and food security. The authors of this article and the members of the seminar series represent the kind of interdisciplinary and applied work necessary for addressing the five key areas of social determinants of health identified in Healthy People 2020: economic stability, education, social and community context, health and health care, and neighborhood and environment. PMID:23819135

  6. Social determinants of mental health.

    PubMed

    Allen, Jessica; Balfour, Reuben; Bell, Ruth; Marmot, Michael

    2014-08-01

    A person's mental health and many common mental disorders are shaped by various social, economic, and physical environments operating at different stages of life. Risk factors for many common mental disorders are heavily associated with social inequalities, whereby the greater the inequality the higher the inequality in risk. The poor and disadvantaged suffer disproportionately, but those in the middle of the social gradient are also affected. It is of major importance that action is taken to improve the conditions of everyday life, beginning before birth and progressing into early childhood, older childhood and adolescence, during family building and working ages, and through to older age. Action throughout these life stages would provide opportunities for both improving population mental health, and for reducing risk of those mental disorders that are associated with social inequalities. As mental disorders are fundamentally linked to a number of other physical health conditions, these actions would also reduce inequalities in physical health and improve health overall. Action needs to be universal: across the whole of society and proportionate to need. Policy-making at all levels of governance and across sectors can make a positive difference. PMID:25137105

  7. Social determinants of mental health.

    PubMed

    Allen, Jessica; Balfour, Reuben; Bell, Ruth; Marmot, Michael

    2014-08-01

    A person's mental health and many common mental disorders are shaped by various social, economic, and physical environments operating at different stages of life. Risk factors for many common mental disorders are heavily associated with social inequalities, whereby the greater the inequality the higher the inequality in risk. The poor and disadvantaged suffer disproportionately, but those in the middle of the social gradient are also affected. It is of major importance that action is taken to improve the conditions of everyday life, beginning before birth and progressing into early childhood, older childhood and adolescence, during family building and working ages, and through to older age. Action throughout these life stages would provide opportunities for both improving population mental health, and for reducing risk of those mental disorders that are associated with social inequalities. As mental disorders are fundamentally linked to a number of other physical health conditions, these actions would also reduce inequalities in physical health and improve health overall. Action needs to be universal: across the whole of society and proportionate to need. Policy-making at all levels of governance and across sectors can make a positive difference.

  8. Feeling addressed! The role of body orientation and co-speech gesture in social communication.

    PubMed

    Nagels, Arne; Kircher, Tilo; Steines, Miriam; Straube, Benjamin

    2015-05-01

    During face-to-face communication, body orientation and coverbal gestures influence how information is conveyed. The neural pathways underpinning the comprehension of such nonverbal social cues in everyday interaction are to some part still unknown. During fMRI data acquisition, 37 participants were presented with video clips showing an actor speaking short sentences. The actor produced speech-associated iconic gestures (IC) or no gestures (NG) while he was visible either from an egocentric (ego) or from an allocentric (allo) position. Participants were asked to indicate via button press whether they felt addressed or not. We found a significant interaction of body orientation and gesture in addressment evaluations, indicating that participants evaluated IC-ego conditions as most addressing. The anterior cingulate cortex (ACC) and left fusiform gyrus were stronger activated for egocentric versus allocentric actor position in gesture context. Activation increase in the ACC for IC-ego>IC-allo further correlated positively with increased addressment ratings in the egocentric gesture condition. Gesture-related activation increase in the supplementary motor area, left inferior frontal gyrus and right insula correlated positively with gesture-related increase of addressment evaluations in the egocentric context. Results indicate that gesture use and body-orientation contribute to the feeling of being addressed and together influence neural processing in brain regions involved in motor simulation, empathy and mentalizing. PMID:25640962

  9. Feeling addressed! The role of body orientation and co-speech gesture in social communication.

    PubMed

    Nagels, Arne; Kircher, Tilo; Steines, Miriam; Straube, Benjamin

    2015-05-01

    During face-to-face communication, body orientation and coverbal gestures influence how information is conveyed. The neural pathways underpinning the comprehension of such nonverbal social cues in everyday interaction are to some part still unknown. During fMRI data acquisition, 37 participants were presented with video clips showing an actor speaking short sentences. The actor produced speech-associated iconic gestures (IC) or no gestures (NG) while he was visible either from an egocentric (ego) or from an allocentric (allo) position. Participants were asked to indicate via button press whether they felt addressed or not. We found a significant interaction of body orientation and gesture in addressment evaluations, indicating that participants evaluated IC-ego conditions as most addressing. The anterior cingulate cortex (ACC) and left fusiform gyrus were stronger activated for egocentric versus allocentric actor position in gesture context. Activation increase in the ACC for IC-ego>IC-allo further correlated positively with increased addressment ratings in the egocentric gesture condition. Gesture-related activation increase in the supplementary motor area, left inferior frontal gyrus and right insula correlated positively with gesture-related increase of addressment evaluations in the egocentric context. Results indicate that gesture use and body-orientation contribute to the feeling of being addressed and together influence neural processing in brain regions involved in motor simulation, empathy and mentalizing.

  10. Developmental and Social Determinants of Religious Social Categorization

    ERIC Educational Resources Information Center

    van der Straten Waillet, Nastasya; Roskam, Isabelle

    2012-01-01

    The purpose of this study was to assess developmental and social determinants of the age at which children become aware that the social environment can be marked by categorization into religious groups and that those groups are associated with different religious beliefs. The results show that middle childhood is a critical period for this…

  11. Immigration as a social determinant of health.

    PubMed

    Castañeda, Heide; Holmes, Seth M; Madrigal, Daniel S; Young, Maria-Elena DeTrinidad; Beyeler, Naomi; Quesada, James

    2015-03-18

    Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena-social determinants of health and immigration-has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon.

  12. Recognizing, Determining, and Addressing Entrepreneurial Innovations by Superintendents of Emerging or Established Educational Service Agencies

    ERIC Educational Resources Information Center

    Arfstrom, Kari M.

    2009-01-01

    This dissertation describes how entrepreneurial superintendents of educational service agencies (ESAs) recognize, determine and address common and distinct innovative characteristics within emerging or established regional educational environments. Because internal and external factors assist in recognizing innovative practices, this study…

  13. The social determinants of health: key to global tuberculosis control.

    PubMed

    Rasanathan, K; Sivasankara Kurup, A; Jaramillo, E; Lönnroth, K

    2011-06-01

    Improved tuberculosis (TB) diagnosis and treatment through the DOTS and Stop TB strategies have saved millions of lives; however, their impact on TB incidence has been disappointing and the scale of the epidemic remains overwhelming. To reduce the incidence of TB, the drivers of the epidemic and social determinants of TB need to be addressed. These include co-morbidities and substance use and, moreover, the social and economic conditions that determine both the course of the TB epidemic and exposure to these risk factors. Doing so builds on the history of TB prevention and treatment during the public health revolution that resulted in a dramatic reduction in incidence in many countries. Addressing the social determinants is also imperative to address pervasive inequities in the incidence, mortality and morbidity of TB between different population groups, including in the performance of health systems in delivering diagnostic and treatment interventions, and in the financial consequences of people seeking care. Action on the social determinants can be categorised in terms of health-sector interventions, intersectoral policies impacting across society, and measurement and research to better understand inequities and links between TB and other factors. TB programmes cannot carry out these actions alone; however, they can make important contributions in the delivery of interventions and in advocating and negotiating for intersectoral efforts. The considerable progress seen in the clinical care of TB needs to be sustained; however, the attainment of TB targets, including elimination by 2050, will require expansion of the lens of TB control efforts beyond 'business as usual' to address the social determinants of the disease.

  14. Political Activities of Social Workers: Addressing Perceived Barriers to Political Participation

    ERIC Educational Resources Information Center

    Rocha, Cynthia; Poe, Bethanie; Thomas, Veliska

    2010-01-01

    This article reviews the literature on political participation of social workers and the variables that promote or impede political advocacy. Early research in the 1980s and 1990s most often reported education, feelings of efficacy, having a macro-type job, and being a member of a national association as factors that determine greater political…

  15. The social class determinants of income inequality and social cohesion.

    PubMed

    Muntaner, C; Lynch, J; Oates, G L

    1999-01-01

    The authors argue that Wilkinson's model omits important variables (social class) that make it vulnerable to biases due to model mis-specification. Furthermore, the culture of inequality hypothesis unnecessarily "psychopathologizes" the relatively deprived while omitting social determinants of disease related to production (environmental and occupational hazards) and the capacity of the relatively deprived for collective action. In addition, the hypothesis that being "disrespected" is a fundamental determinant of violence has already been refuted. Shying away from social mechanisms such as exploitation, workplace domination, or classist ideology might avoid conflict but reduce the income inequality model to a set of useful, but simple and wanting associations. Using a nonrecursive structural equation model that tests for reciprocal effects, the authors show that working-class position is negatively associated with social cohesion but positively associated with union membership. Thus, current indicators of social cohesion use middle-class standards for collective action that working-class communities are unlikely to meet. An erroneous characterization of working-class communities as noncohesive could be used to justify paternalistic or punitive social policies. These criticisms should not detract from an acknowledgment of Wilkinson's investigations as a leading empirical contribution to reviving social epidemiology at the end of the century.

  16. The corporate impact of addressing social issues: a financial case study of a project in Peru.

    PubMed

    Dabbs, Alan; Bateson, Matthew

    2002-05-01

    Large, multinational resource development projects can affect many aspects, including social, economic and ecological realities, in the regions where they operate. Social and environmental issues that are usually ignored in such projects are increasingly affecting the financial future of multinational corporations in negative ways. In this article, we advance the argument that corporations can successfully manage these issues and that if they choose to view these management efforts as an investment rather than an expense, they may well acquire a competitive advantage over companies that do not. We describe as a case study the Camisea natural gas and condensates development project in Peru, operated by Shell Prospecting and Development Peru (SPDP). Camisea is one of the first projects anywhere in the world to conduct a detailed analysis of key industry-related social issues and the processes, required investment and financial impact of managing them. The Camisea example supports the argument that addressing social and environmental concerns makes financial sense. In present value terms, the benefit of managing these concerns was expected to surpass the cost investment by approximately US$50 million. PMID:12125747

  17. Using social marketing to address barriers and motivators to agricultural safety and health best practices.

    PubMed

    Yoder, Aaron M; Murphy, Dennis J

    2012-01-01

    Social marketing is an intervention development strategy that pays considerable attention to barriers to and motivators for behavioral change or adoption of recommended behaviors. Barriers are obstacles that prevent individuals from changing or adopting behaviors and are often referred to as the "cons" or "costs" of doing something. Motivators, on the other hand, are factors that encourage individuals to change or adopt behaviors and are often referred to as the "pros," "benefits," or "influencing factors" of doing something. Importantly, social marketing does not target education or knowledge change as an end point; rather, it targets behavior change. Studies across several types of desired behaviors (e.g., smoking cessation, weight control, more exercise, sunscreen use, radon testing) using the Stages of Change model have found systematic relationships between stages of change and pros and cons of changing behavior. A review of literature identifies numerous research and intervention studies that directly reference social marketing in agricultural safety and health, studies that identify reasons why parents allow their children to be exposed to hazardous situations on the farm, and reasons why youth engage in risky behaviors, but only two studies were found that show evidence of systematically researching specific behavioral change motivating factors. The authors offer several suggestions to help address issues relating to social marketing and agricultural safety and health.

  18. The corporate impact of addressing social issues: a financial case study of a project in Peru.

    PubMed

    Dabbs, Alan; Bateson, Matthew

    2002-05-01

    Large, multinational resource development projects can affect many aspects, including social, economic and ecological realities, in the regions where they operate. Social and environmental issues that are usually ignored in such projects are increasingly affecting the financial future of multinational corporations in negative ways. In this article, we advance the argument that corporations can successfully manage these issues and that if they choose to view these management efforts as an investment rather than an expense, they may well acquire a competitive advantage over companies that do not. We describe as a case study the Camisea natural gas and condensates development project in Peru, operated by Shell Prospecting and Development Peru (SPDP). Camisea is one of the first projects anywhere in the world to conduct a detailed analysis of key industry-related social issues and the processes, required investment and financial impact of managing them. The Camisea example supports the argument that addressing social and environmental concerns makes financial sense. In present value terms, the benefit of managing these concerns was expected to surpass the cost investment by approximately US$50 million.

  19. Rural system addresses social, economic needs. Cooperation, education, and advocacy revitalize a region's healthcare delivery.

    PubMed

    Rheinecker, P

    1992-01-01

    In recent years leaders at Presentation Health System (PHS), Sioux Falls, SD, have expanded their mission to help strengthen local communities economically and socially. PHS now offers support to rural leaders in business, politics, and healthcare through its Center for Rural Health and Economic Development. In addition, educational outreach coordinators have created programs that address the needs of the entire rural community. To establish an effective network of services in the region, two of the system's tertiary care hospitals are collaborating to provide emergency helicopter service. These larger facilities also extend outreach services to rural hospitals and clinics. PHS assists rural hospitals in grant writing and in adapting to changing government reimbursement rules. In addition, the healthcare system coordinates a group purchasing program and a debt collection agency. An important voice for its region's healthcare needs, PHS has worked with the state of South Dakota to address problems and concerns about emergency medical services. The system also publishes Report, a quarterly newsletter that keeps rural residents abreast of healthcare issues affecting them. Two years ago, PHS's Center for Rural Health and Economic Development sponsored its first Invitational Rural Health Leadership Conference. These annual conferences bring together leaders to examine ways to improve rural healthcare delivery by strengthening the social and economic fabric of rural communities. PMID:10119539

  20. Understanding and effectively addressing breast cancer in African American women: Unpacking the social context.

    PubMed

    Williams, David R; Mohammed, Selina A; Shields, Alexandra E

    2016-07-15

    Black women have a higher incidence of breast cancer before the age of 40 years, more severe disease at all ages, and an elevated mortality risk in comparison with white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse and to the complex ways in which socioeconomic status and racism shape exposure to psychosocial, physical, chemical, and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which black women live is also needed to maximize the opportunities to prevent breast cancer in this underserved group. Cancer 2016;122:2138-49. © 2016 American Cancer Society.

  1. Understanding and effectively addressing breast cancer in African American women: Unpacking the social context.

    PubMed

    Williams, David R; Mohammed, Selina A; Shields, Alexandra E

    2016-07-15

    Black women have a higher incidence of breast cancer before the age of 40 years, more severe disease at all ages, and an elevated mortality risk in comparison with white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse and to the complex ways in which socioeconomic status and racism shape exposure to psychosocial, physical, chemical, and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which black women live is also needed to maximize the opportunities to prevent breast cancer in this underserved group. Cancer 2016;122:2138-49. © 2016 American Cancer Society. PMID:26930024

  2. Addressing risk factors of cognitive impairment in adults aging with HIV: a social work model.

    PubMed

    Vance, David E; Struzick, Thomas C

    2007-01-01

    With advances in life-extending medications and later- life infections, the number of older adults with HIV is increasing. Unfortunately, the synergistic effects of aging with HIV may place many people at risk of developing cognitive impairments which can disrupt everyday functioning. Fortunately, cognitive reserve may be maintained, or in some cases improved, by taking action to prevent or mitigate such loss. Preventative and treatment strategies that support biopsychosocial aspects of cognition include reducing alcohol and substance use; improving nutrition; diminishing the effects of comorbidities; increasing social contact; reducing depression and stress levels; engaging in cognitively stimulating activities; applying cognitive remediation therapies; and incorporating psychopharmacological interventions. Such strategies can improve the physiological integrity and health of the brain, thus supporting neuroplasticity and increasing cognitive reserve. Social workers are in a favorable position to recognize cognitive decline in clients and recommend or administer solutions to address such problems. A model for social workers advocating for older clients with HIV who have cognitive problems is provided. PMID:17953062

  3. Social Determinants of Racial Disparities in CKD.

    PubMed

    Norton, Jenna M; Moxey-Mims, Marva M; Eggers, Paul W; Narva, Andrew S; Star, Robert A; Kimmel, Paul L; Rodgers, Griffin P

    2016-09-01

    Significant disparities in CKD rates and outcomes exist between black and white Americans. Health disparities are defined as health differences that adversely affect disadvantaged populations, on the basis of one or more health outcomes. CKD is the complex result of genetic and environmental factors, reflecting the balance of nature and nurture. Social determinants of health have an important role as environmental components, especially for black populations, who are disproportionately disadvantaged. Understanding the social determinants of health and appreciating the underlying differences associated with meaningful clinical outcomes may help nephrologists treat all their patients with CKD in an optimal manner. Altering the social determinants of health, although difficult, may embody important policy and research efforts, with the ultimate goal of improving outcomes for patients with kidney diseases, and minimizing the disparities between groups. PMID:27178804

  4. Preparing Early Childhood Educators to Address Young Children's Social-Emotional Development and Challenging Behavior: A Survey of Higher Education Programs in Nine States

    ERIC Educational Resources Information Center

    Hemmeter, Mary Louise; Santos, Rosa Milagros; Ostrosky, Michaelene M.

    2008-01-01

    This article presents results from a survey of faculty members from 2- and 4-year higher education programs in nine states that prepare teachers to work with preschool children. The purpose of the study was to determine how professors address content related to social-emotional development and challenging behaviors, how well prepared they believe…

  5. Highly sensitive covalently functionalized light-addressable potentiometric sensor for determination of biomarker.

    PubMed

    Liang, Jintao; Guan, Mingyuan; Huang, Guoyin; Qiu, Hengming; Chen, Zhengcheng; Li, Guiyin; Huang, Yong

    2016-06-01

    A biomarker is related to the biological status of a living organism and shows great promise for the early prediction of a related disease. Herein we presented a novel structured light-addressable potentiometric sensor (LAPS) for the determination of a model biomarker, human immunoglobulin G (hIgG). In this system, the goat anti-human immunoglobulin G antibody was used as recognition element and covalently immobilized on the surface of light-addressable potentiometric sensor chip to capture human immunoglobulin G. Due to the light addressable capability of light-addressable potentiometric sensor, human immunoglobulin G dissolved in the supporting electrolyte solution can be detected by monitoring the potential shifts of the sensor. In order to produce a stable photocurrent, the laser diode controlled by field-programmable gate array was used as the light emitter to drive the light-addressable potentiometric sensor. A linear correlation between the potential shift response and the concentration of human immunoglobulin G was achieved and the corresponding regression equation was ΔV (V)=0.00714ChIgG (μg/mL)-0.0147 with a correlation coefficient of 0.9968 over a range 0-150 μg/mL. Moreover, the light-addressable potentiometric sensor system also showed acceptable stability and reproducibility. All the results demonstrated that the system was more applicable to detection of disease biomarkers with simple operation, multiple-sample format and might hold great promise in various environmental, food, and clinical applications.

  6. Social Determinants of Racial/Ethnic Health Disparities in Children and Adolescents

    ERIC Educational Resources Information Center

    Price, James H.; McKinney, Molly A.; Braun, Robert E.

    2011-01-01

    Too many racial/ethnic minorities do not reach their full potential for a healthy and rewarding life. This paper addresses the social determinants that impact, either directly or indirectly, child and adolescent health disparities. Understanding the role social determinants play in the life course of health status can help guide educational…

  7. Commentary: what role should physician organizations play in addressing social justice issues?

    PubMed

    Bright, Cedric M

    2012-06-01

    A study by Peek and colleagues in this issue reveals that although racial and ethnic health disparities are recognized as a major national challenge, few physician organizations with both the influence and ability to change practice standards and address disparities appear to be effectively directing their resources to mitigate health disparities. In this commentary, the author examines the history of U.S. health disparities through the lens of social justice. He argues that today, physician organizations have the opportunity to change the paradigm of medicine from being a reactive industry to becoming a proactive industry through collaborations such as the Commission to End Health Disparities, which brings together more than 60 organizations, and the National Medical Association's "We Stand With You" program to improve health and combat disparities. Physician organizations can also address health disparities through advocacy for fair reimbursement policies, funding for pipeline programs to increase the diversity of the workforce, diversity in clinical trials, and other issues. Health disparities present to us in organized medicine a challenge that is cleverly disguised as an immovable object but that is truly a great opportunity for innovation, improvement, and growth. Physician organizations have a unique opportunity to provide avenues of innovation and accomplishment.

  8. The Center on the Social and Emotional Foundations for Early Learning: Addressing Challenging Behavior in Infants and Toddlers

    ERIC Educational Resources Information Center

    Hunter, Amy; Hemmeter, Mary Louise

    2009-01-01

    The Center on the Social and Emotional Foundations for Early Learning (CSEFEL) is a federally funded national resource center designed to support early care and education providers address the social-emotional needs of children birth through age 5 years. Recent research has found that an extraordinarily high number of young children are being…

  9. Precarious employment: understanding an emerging social determinant of health.

    PubMed

    Benach, J; Vives, A; Amable, M; Vanroelen, C; Tarafa, G; Muntaner, C

    2014-01-01

    Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts. PMID:24641559

  10. Addressing the role of medical students using community mobilization and social media in the Ebola response.

    PubMed

    Chapman, Helena J; Animasahun, Victor J; Tade, Adesoji E; Naveed, Asad

    2016-06-01

    Health professions education in the 21st century should incorporate both community mobilization and social media strategies. First, community mobilization facilitates change by educating community members with evidence-based, high-quality and up-to-date health information and empowering their active participation in target health initiatives. Second, advancements in technology and globalization foster the development of innovative communication technologies used as a key tool in the 'roll out' of community health initiatives during epidemics such as Ebola virus disease. In August 2014, medical students of Sierra Leone and Guinea used these dual health promotional strategies in the Kick Ebola Out campaign to educate community members about transmission of the Ebola virus and preventive measures, as well as to reduce perceptions related to stigma or fear of disease transmission. In this report, we describe how medical students, who are trained in basic and clinical sciences, evidence-based practices, and social determinants of health, can serve as human resources for health and facilitate dynamic communication strategies to educate and empower both medical students and community members for local or national health initiatives. PMID:27216169

  11. Social determinants of methadone in pregnancy: violence, social capital, and mental health.

    PubMed

    Alexander, Karen

    2013-10-01

    Mothering and methadone can occur together with the right resources and support. Methadone mothers need to be seen in the context of their social risks and environment. Societal attitudes, social capital, and other contextual variables can be changed through policy. The purpose of this article is to describe the contextual risks experienced by drug abusing mothers in order to direct further research and policy changes that protect their children. Research has focused on biological or genetic determinants, but now social risks and environmental factors are shaping current literature about substance abuse in pregnancy. Significant risk factors, taken from the literature, are detailed, such as intimate partner violence and mental health co-morbidities. Racial differences and the effect of place on pregnant substance abusers are also discussed. Policy recommendations address the barriers substance abusing women face in their journey toward a healthy pregnancy.

  12. Rules of Address in Secondary Schools in Catania: Linguistic Variation and Its Social/Cultural Value.

    ERIC Educational Resources Information Center

    Consoli, Eleonora

    1987-01-01

    Reports on research investigating nonreciprocity of address to female teachers in secondary schools in Catania, Sicily, where male teachers were always addressed with their academic, professional titles (which have great, overt prestige in southern Italy) and women were frequently addressed as "signora" or "signorina" in the vocative form.…

  13. Large system change challenges: addressing complex critical issues in linked physical and social domains

    NASA Astrophysics Data System (ADS)

    Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

    2015-04-01

    Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways

  14. Integrating Education on Addressing Health Disparities into the Graduate Social Work Curriculum

    ERIC Educational Resources Information Center

    Mitchell, Jamie Ann

    2012-01-01

    The purpose of this article is to propose an elective social work course as a means of better preparing social workers entering practice in healthcare to meet the challenges of promoting health and reducing health disparities in minority and underserved communities. Course offerings specifically targeting health or medical social work training…

  15. Action on the social determinants of health: a historical perspective.

    PubMed

    Irwin, A; Scali, E

    2007-01-01

    A renewed concern with social factors has emerged in global public health, spearheaded by the World Health Organization's Commission on Social Determinants of Health. The coming decade may see significant health gains for disadvantaged populations if policies tackle the social roots of health inequities. To improve chances of success, global action on social determinants must draw lessons from history. This article reviews milestones in public health action on social determinants over the past 50 years. The goal is to bring into sharper focus the persistent challenges faced by social determinants agendas, along with distinctive opportunities now emerging. The historical record highlights the vulnerability of health policy approaches incorporating social determinants to resistance from entrenched interests. The Commission on Social Determinants of Health can consolidate political support by building collaborative relationships with policymakers in partner countries. However, this strategy must be complemented by engaging civil society constituencies. Historically, successful action on social determinants has been spurred by organized civil society demand. PMID:19283626

  16. Community participation in a multisectoral intervention to address health determinants in an inner-city community in central Havana.

    PubMed

    Yassi, Annalee; Fernandez, Niurys; Fernandez, Ariadna; Bonet, Mariano; Tate, Robert B; Spiegel, Jerry

    2003-03-01

    It is increasingly acknowledged that the process of community involvement is critical to the successful implementation of community-based health interventions. Between 1995 and 1999, a multisectoral intervention called Plan Cayo Hueso was launched in the inner-city community of Cayo Hueso in Havana, Cuba, to address a variety of health determinants. To provide a better understanding of the political structures and processes involved, the Cuban context is described briefly. The interventions included improvements in housing, municipal infrastructure, and social and cultural activities. A qualitative study, consisting of interviews of key informants as well as community members, was conducted to evaluate the community participatory process. Questions from an extensive household survey pre- and postintervention that had been conducted in Cayo Hueso and a comparison community to assess the effectiveness of the intervention also informed the analysis of community participation, as did three community workshops held to choose indicators for evaluating effectiveness and to discuss findings. It was found that formal leaders led the interventions, providing the institutional driving force behind the plan. However, extensive community involvement occurred as the project took advantage of the existing community-based organizations, which played an active role in mobilizing community members and enhanced linkage systems critical to the project's success. Women played fairly traditional roles in interventions outside their households, but had equivalent roles to men in interventions within their household units. Most impressive about this project was the extent of mobilization to participate and the multidimensional ecosystem approach adopted. Indeed, Plan Cayo Hueso involved a massive mobilization of international, national, and community resources to address the needs of this community. This, as well as the involvement of community residents in the evaluation process, was

  17. Averting the perfect storm: addressing youth substance use risk from social media use.

    PubMed

    Salimian, Parissa K; Chunara, Rumi; Weitzman, Elissa R

    2014-10-01

    Adolescents are developmentally sensitive to pathways that influence alcohol and other drug (AOD) use. In the absence of guidance, their routine engagement with social media may add a further layer of risk. There are several potential mechanisms for social media use to influence AOD risk, including exposure to peer portrayals of AOD use, socially amplified advertising, misinformation, and predatory marketing against a backdrop of lax regulatory systems and privacy controls. Here the authors summarize the influences of the social media world and suggest how pediatricians in everyday practice can alert youth and their parents to these risks to foster conversation, awareness, and harm reduction. PMID:25290130

  18. Translating Research Evidence Into Practice to Reduce Health Disparities: A Social Determinants Approach

    PubMed Central

    Koh, Howard K.; Massin-Short, Sarah B.; Emmons, Karen M.; Geller, Alan C.; Viswanath, K.

    2010-01-01

    Translating research evidence to reduce health disparities has emerged as a global priority. The 2008 World Health Organization Commission on Social Determinants of Health recently urged that gaps in health attributable to political, social, and economic factors should be closed in a generation. Achieving this goal requires a social determinants approach to create public health systems that translate efficacy documented by research into effectiveness in the community. We review the scope, definitions, and framing of health disparities and explore local, national, and global programs that address specific health disparities. Such efforts translate research evidence into real-world settings and harness collaborative social action for broad-scale, sustainable change. PMID:20147686

  19. Racial Socialization of Biracial Youth: Maternal Messages and Approaches to Address Discrimination

    ERIC Educational Resources Information Center

    Rollins, Alethea; Hunter, Andrea G.

    2013-01-01

    We explored how mothers of biracial youth prepare their children to navigate diverse racial ecologies and experiences of racism and discrimination. A qualitative thematic analysis was used to identify racial socialization messages mothers used and emergent racial socialization approaches. Mothers of biracial youth engaged in the full range of…

  20. Education Technologies in Addressing the Problem of Forming the Socially Active Individual

    ERIC Educational Resources Information Center

    Popova, Irina N.

    2016-01-01

    The article is devoted to the analysis of technological support of the educational process in solving the problem of forming the socially active individual. The authors studied the value of the category "social activity" and analyzed educational technologies that have an impact on its formation. The obtained results gave the possibility…

  1. How Is Corporate Social Responsibility Addressed by Biotech Firms? a Case Study Analysis

    ERIC Educational Resources Information Center

    Pérez-Bustamante, Guillermo

    2013-01-01

    This paper explores corporate social responsibility (CSR) in the biotech high-tech sector as a way to achieve competitive advantages. After presenting the importance of science for high-tech firms, the paper focuses on the social and economic role of CSR. Next, the primary reasons for firms' engagement in CSR activities are presented,…

  2. Addressing Dilemmas of Social Justice Mathematics Instruction through Collaboration of Students, Educators, and Researchers

    ERIC Educational Resources Information Center

    Kokka, Kari

    2015-01-01

    Social justice mathematics educators explicitly aim to develop students' sociopolitical consciousness in addition to teaching mathematics content (Gutiérrez 2013; Gutstein 2006). Sociopolitical consciousness refers to Paulo Freire's (1970) concept of "conscientização," or learning to perceive social, political, and economic…

  3. Teaching to Transform? Addressing Race and Racism in the Teaching of Clinical Social Work Practice

    ERIC Educational Resources Information Center

    Varghese, Rani

    2016-01-01

    Faculty members are key stakeholders to support social work students' learning about race and racism in practice and to promote the professional standards established by the field. This qualitative study examines how 15 clinical social work faculty members teaching advanced practice in the Northeast conceptualize and incorporate their…

  4. Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment.

    PubMed

    Perry, Courtney D; Degeneffe, Dennis; Davey, Cynthia; Kollannoor-Samuel, Grace; Reicks, Marla

    2016-05-25

    Women tend to gain weight at midlife (40-60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.

  5. Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment

    PubMed Central

    Perry, Courtney D.; Degeneffe, Dennis; Davey, Cynthia; Kollannoor-Samuel, Grace; Reicks, Marla

    2016-01-01

    Women tend to gain weight at midlife (40–60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change. PMID:27231927

  6. Trade and social determinants of health.

    PubMed

    Blouin, Chantal; Chopra, Mickey; van der Hoeven, Rolph

    2009-02-01

    The effects of trade and trade liberalisation on the social determinants of health are not well known. Here, we outline a conceptual framework of links between trade liberalisation and health outcomes, and review existing evidence for these by focusing on four key factors: income, inequality, economic insecurity, and unhealthy diets. Even though trade liberalisation seems to have positive effects on economic growth, it is not sufficient to boost growth. In several countries, trade reforms have not translated into enhanced economic expansion because complementary policies are needed. Trade liberalisation and openness are associated with greater wage inequality and raised economic insecurity. Trade liberalisation has facilitated availability of highly processed, calorie-rich, nutrient-poor food in developing countries, but further research is needed to better understand the effects of trade on unhealthy diets. Policymakers and health professionals need to be aware that the global economy affects the health of populations and understand how risks associated with trade liberalisation can be mitigated.

  7. Social Determinants, Suboptimal Health Behavior, and Morbidity in Urban Slum Population: An Indian Perspective

    PubMed Central

    Mohan, Palipudi VenkataTrinadaKrishna; Bansal, Rajkumar K.

    2008-01-01

    Improving the health of urban residents, particularly those living in slum areas, requires an integrated approach. Appropriate interventions must be based on a well-grounded understanding of health determinants. Social factors are as important as physical factors in determining health status and suggest alternative interventions. Employment, stress, social exclusion, social support, substance use, nutrition, transport, and conditions during childhood are among the most important social determinants of health status identified by the International Center for Health and Society. This paper uses social determinants of health approach to understand morbidity outcomes for people residing in the slums of Surat City, India. To quantify suboptimal health behavior and identify the determinants of health status for this population survey data on household characteristics, health-seeking behavior, socioeconomic status, food and personal habits, social life, and physical activity has been used. After controlling for socioeconomic and demographic factors, logistic regression analysis reveals that social exclusion, stress, and lack of social support are significantly associated with morbidity. Thus, understanding of social determinants of health by policy makers is important as the health sector has a crucial role in addressing disparities in social determinants. PMID:18404392

  8. Priorities of Low-Income Urban Residents for Interventions to Address the Socio-Economic Determinants of Health

    PubMed Central

    Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

    2013-01-01

    Objectives To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. Methods We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Results Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Conclusions Poor and low-income residents’ priorities may usefully inform allocation of social services that affect health. PMID:21099082

  9. The Ability of Narrative Communication to Address Health-related Social Norms

    PubMed Central

    Moran, Meghan Bridgid; Murphy, Sheila T.; Frank, Lauren; Baezconde-Garbanati, Lourdes

    2013-01-01

    Social norms are an important predictor of health behavior and have been targeted by a variety of health communication campaigns. However, these campaigns often encounter challenges related to the socially specific context in which norms exist: specifically, the extent to which the target population identifies with the reference group presented in the ad and the extent to which the target population believes the campaign's message. We argue that because of its capacity to effect identification among viewers, narrative communication is particularly appropriate for impacting social norms and, consequently, behavioral intention. This manuscript presents the results of a randomized trial testing the effectiveness of two films – one narrative, one non-narrative – in changing perceived social norms and behavioral intention regarding Pap testing to detect cervical cancer. Results of the study indicate that the narrative film was in fact more effective at producing positive changes in perceived norm and intention. PMID:24179677

  10. A Social-Ecological Approach to Promote Self-Determination

    ERIC Educational Resources Information Center

    Walker, Hill M.; Calkins, Carl; Wehmeyer, Michael L.; Walker, Laura; Bacon, Ansley; Palmer, Susan B.; Jesien, George S.; Nygren, Margaret A.; Heller, Tamar; Gotto, George S.; Abery, Brian H.; Johnson, David R.

    2011-01-01

    This article describes a social-ecological approach for promoting and enhancing self-determination among individuals with developmental disabilities. A five-level model is presented, based on the interaction of person and environmental factors, that identifies a series of social mediator variables (i.e., social effectiveness, social capital,…

  11. Health journalism internships: a social marketing strategy to address health disparities.

    PubMed

    Nguyen, Duy H; Shimasaki, Suzuho; Stafford, Helen Shi; Sadler, Georgia Robins

    2010-09-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals. PMID:20186519

  12. Health journalism internships: a social marketing strategy to address health disparities.

    PubMed

    Nguyen, Duy H; Shimasaki, Suzuho; Stafford, Helen Shi; Sadler, Georgia Robins

    2010-09-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals.

  13. Addressing Wife Abuse in Mexican Immigrant Couples: Challenges for Family Social Workers

    ERIC Educational Resources Information Center

    Hancock, Tina

    2006-01-01

    This article addresses wife abuse in undocumented Mexican immigrant couples and suggests an ecosystems treatment approach that takes into consideration the structural forces of oppression and discrimination on abusive behaviors in the home and combines individual, family and community level interventions to help immigrant men stop the abuse.…

  14. Social Justice Leadership and Inclusion: Exploring Challenges in an Urban District Struggling to Address Inequities

    ERIC Educational Resources Information Center

    DeMatthews, David; Mawhinney, Hanne

    2014-01-01

    Research Approach: This cross case study describes the challenges that two principals working in one urban school district addressed while attempting to transform their school cultures to embrace an inclusion model. Analysis of interviews and observations in each school revealed the actions, values, and orientations of the individual leaders and…

  15. Recovering the Role of Reasoning in Moral Education to Address Inequity and Social Justice

    ERIC Educational Resources Information Center

    Nucci, Larry

    2016-01-01

    This article reasserts the centrality of reasoning as the focus for moral education. Attention to moral cognition must be extended to incorporate sociogenetic processes in moral growth. Moral education is not simply growth within the moral domain, but addresses capacities of students to engage in cross-domain coordination. Development beyond…

  16. Addressing Social Injustices, Displacement, and Minority Rights through Cases of Culturally Responsive Evaluation

    ERIC Educational Resources Information Center

    Stokes, Helga; Chaplin, Shane S.; Dessouky, Shimaa; Aklilu, Liya; Hopson, Rodney K.

    2011-01-01

    Evaluation of programs that address the lingering effects of human rights abuses during times of conflict is necessary to improve program sustainability and create a knowledge bank about the effectiveness of strategies. Outcomes, however, are hard to measure. Evaluators have to gain understanding of the roots of a conflict, surrounding events,…

  17. Health in global context; beyond the social determinants of health?

    PubMed Central

    Krumeich, Anja; Meershoek, Agnes

    2014-01-01

    The rise of the social determinants of health (SDH) discourse on the basis of statistical evidence that correlates ill health to SDH and pictures causal pathways in comprehensive theoretical frameworks led to widespread awareness that health and health disparities are the outcome of complex pathways of interconnecting SDH. In this paper we explore whether and how SDH frameworks can be translated to effectively inform particular national health policies. To this end we identified major challenges for this translation followed by reflections on ways to overcome them. Most important challenges affecting adequate translation of these frameworks into concrete policy and intervention are 1) overcoming the inclination to conceptualize SDH as mere barriers to health behavior to be modified by lifestyle interventions by addressing them as structural factors instead; 2) obtaining sufficient in-depth insight in and evidence for the exact nature of the relationship between SDs and health; 3) to adequately translate the general determinants and pathways into explanations for ill health and limited access to health care in local settings; 4) to develop and implement policies and other interventions that are adjusted to those local circumstances. We conclude that to transform generic SDH models into useful policy tools and to prevent them to transform in SDH themselves, in depth understanding of the unique interplay between local, national and global SDH in a local setting, gathered by ethnographic research, is needed to be able to address structural SD in the local setting and decrease health inequity.

  18. African-American Women in the Professoriate: Addressing Social Exclusion and Scholarly Marginalization through Mentoring

    ERIC Educational Resources Information Center

    Lloyd-Jones, Brenda

    2014-01-01

    African-American women and other underrepresented faculty members often report experiences of social exclusion and scholarly marginalization in mainstream institutions of higher education. This lack of inclusion challenges their retention and hinders them from becoming productive members of the professoriate, positioning them at a disadvantage for…

  19. Professional Co-Development Groups: Addressing the Teacher Training Needs of Social Work Teachers

    ERIC Educational Resources Information Center

    Roy, Valérie; Genest Dufault, Sacha; Châteauvert, Joanie

    2014-01-01

    This article reports on a professional development initiative organized by two junior university social work teachers. Along with three experienced colleagues, the two teachers experimented with a professional co-development group. The purpose of this group modality, which has much in common with peer supervision, is to reflect on professional…

  20. From Social Movement Learning to Sociomaterial Movement Learning? Addressing the Possibilities and Limits of New Materialism

    ERIC Educational Resources Information Center

    McGregor, Callum

    2014-01-01

    In recent years academic interest in social movement learning (SML) has flourished. "Studies in the Education of Adults" has arguably emerged as the premier international forum for exploring the links between adult learning and movements for progressive change. In parallel to this subfield, yet largely in isolation from it,…

  1. Annual meeting keynote address: Animal agriculture and emerging social ethics for animals.

    PubMed

    Rollin, B E

    2004-03-01

    Businesses and professions must stay in accord with social ethics, or risk losing their autonomy. A major social ethical issue that has emerged in the past three decades is the treatment of animals in various areas of human use. This point can be illustrated with numerous examples across all areas of animal use. These examples reflect society's moral concern having outgrown the traditional ethic of animal cruelty that began in biblical times and is encoded in the laws of all civilized societies. There are five major reasons for this new social concern, most importantly, the replacement of husbandry-based agriculture with industrial agriculture. This loss of husbandry to industry has threatened the traditional fair contract between humans and animals, and resulted in significant amounts of animal suffering arising on four different fronts. Because such suffering is not occasioned by cruelty, a new ethic for animals was required to express social concerns. Since ethics proceed from preexisting ethics rather than ex nihilo, society has looked to its ethic for humans, appropriately modified, to find moral categories applicable to animals. This concept of legally encoded rights for animals has emerged as a plausible vehicle for reform. The meaning of this ethical movement for animal agriculture is examined. Animal agriculture should explore ways to replace the animal husbandry lost to industrialization.

  2. Addressing Physical Inactivity among Developmentally Disabled Students through Visual Schedules and Social Stories

    ERIC Educational Resources Information Center

    Zimbelman, Merilee; Paschal, Angelia; Hawley, Suzanne R.; Molgaard, Craig A.; St. Romain, Theresa

    2007-01-01

    Introduction: This project tested visual schedules and social stories in a physical education setting in order to increase the physical activity of developmentally disabled students. Method: This cohort study design involved 17 physical education teachers in a training course with an initial survey and 7-month post-survey. The initial survey…

  3. Using Baseball in Social Studies Instruction: Addressing the Five Fundamental Themes of Geography

    ERIC Educational Resources Information Center

    Edgington, William D.; Hyman, William

    2005-01-01

    Many children do not enjoy social studies because they see it as having little, if any, relevance to their lives. That response is attributable primarily to two factors: Dry content and even drier instructional strategies. Teachers know that if material presented to children is not meaningful and relevant to their lives, real learning does not…

  4. Secondary Social Studies Teachers' Time Commitment When Addressing the Common Core State Standards

    ERIC Educational Resources Information Center

    Kenna, Joshua L.; Russell, William Benedict, III

    2015-01-01

    In 2010 the Common Core State Standards (CCSS) were officially released in America for mathematics and English language arts and soon adopted by 45 of the 50 states. However, within the English langue arts domain there were standards intended for secondary social studies teachers under the title, Common Core State Standards for English Language…

  5. Building Hope, Giving Affirmation: Learning Communities That Address Social Justice Issues Bring Equity to the Classroom

    ERIC Educational Resources Information Center

    Hirsh, Stephanie; Hord, Shirley M.

    2010-01-01

    A school that ensures that all students--regardless of race, creed, color, socioeconomic status, gender, or disabilities--have access to and receive the highest-quality education has achieved a key measure of social justice. Since the most significant factor in whether students learn well is quality teaching, and teaching is enhanced through…

  6. Happiness and social determinants across age cohorts in Taiwan.

    PubMed

    Hsu, Hui-Chuan; Chang, Wen-Chiung; Chong, Young-Sook; An, Jeong Shin

    2016-09-01

    The purpose of this study was to examine happiness and social determinants across age cohorts in Taiwan. The data were obtained from the 2011 Taiwan Social Change Survey (aged 18 +, n = 2,199). The social determinants of happiness included socioeconomic status and social connection. Happiness was not different across the age groups. Receiving less family support, less formal support, more social trust and more control over life were significant for the younger group. Being married and having more social participation were significant for the middle-aged. Receiving less family support and having a higher economic status were significant for the older group.

  7. Identifying, Preventing, and Addressing Job Burnout and Vicarious Burnout for Social Work Professionals.

    PubMed

    Wilson, Felicia

    2016-01-01

    Genuineness, concern for others, and empathy are characteristics used to describe the professional social worker. To this end, the social worker tirelessly works on behalf of and in collaboration with the client to move them from stagnant life situations into positive life situations. While the fundamental principles of social work are wonderful, the result for some workers is job burnout and/or vicarious trauma. The concepts of job burnout, its antecedents, and manifestations are thoroughly discussed in this article to provide a holistic overview of this phenomenon. The six antecedents: workload, control, values, fairness, reward, and community are discussed and linked to the manifestations of job burnout. When working with individuals who have been exposed to the depravity of life, the professional can take on the client's vulnerabilities, victimizations, and stress. The common term for this phenomenon is vicarious trauma. Professionals who work with trauma victims can often have issues in their personal and professional life as evidenced by reduced professional efficacy, increased emotional concerns, and physical concerns. The purpose of the author in this article is to provide an overview of job burnout, vicarious trauma, and a discussion about self-care responsibilities.

  8. Leveraging social influence to address overweight and obesity using agent-based models: the role of adolescent social networks.

    PubMed

    Zhang, J; Tong, L; Lamberson, P J; Durazo-Arvizu, R A; Luke, A; Shoham, D A

    2015-01-01

    The prevalence of adolescent overweight and obesity (hereafter, simply "overweight") in the US has increased over the past several decades. Individually-targeted prevention and treatment strategies targeting individuals have been disappointing, leading some to propose leveraging social networks to improve interventions. We hypothesized that social network dynamics (social marginalization; homophily on body mass index, BMI) and the strength of peer influence would increase or decrease the proportion of network member (agents) becoming overweight over a simulated year, and that peer influence would operate differently in social networks with greater overweight. We built an agent-based model (ABM) using results from R-SIENA. ABMs allow for the exploration of potential interventions using simulated agents. Initial model specifications were drawn from Wave 1 of the National Longitudinal Study of Adolescent Health (Add Health). We focused on a single saturation school with complete network and BMI data over two waves (n = 624). The model was validated against empirical observations at Wave 2. We focused on overall overweight prevalence after a simulated year. Five experiments were conducted: (1) changing attractiveness of high-BMI agents; (2) changing homophily on BMI; (3) changing the strength of peer influence; (4) shifting the overall BMI distribution; and (5) targeting dietary interventions to highly connected individuals. Increasing peer influence showed a dramatic decrease in the prevalence of overweight; making peer influence negative (i.e., doing the opposite of friends) increased overweight. However, the effect of peer influence varied based on the underlying distribution of BMI; when BMI was increased overall, stronger peer influence increased proportion of overweight. Other interventions, including targeted dieting, had little impact. Peer influence may be a viable target in overweight interventions, but the distribution of body size in the population needs to

  9. Using hydraulic modeling to address social impacts of small dam removals in southern New Jersey.

    PubMed

    Wyrick, Joshua R; Rischman, Brian A; Burke, Christopher A; McGee, Craig; Williams, Chasity

    2009-07-01

    Small relic mill dams are common in the watersheds of southern New Jersey, dotting the landscape with many small neighborhood lakes. Originally built in the late 1800s, most of these dams have become increasingly unable to handle current design storms due to increased urbanization of the watersheds. Several of these dams have also been classified as "high hazard" by the New Jersey Department of Environmental Protection Dam Safety Division because their failure has the potential for loss of life or extensive property damage. The current private owners are generally unable to afford the high repair costs needed to rehabilitate the dams to current safety standards, and are therefore more inclined to remove them. This research analyses both the physical and social impacts of the removal of two small dams in southern New Jersey, and integrates the two seemingly disparate concepts. Using hydraulic modeling and previous case studies, it is predicted that there will be limited effects to the hydrological and biological characteristics of the stream corridor. A survey distributed to the affected homeowners that live on these lakes shows that the community, however, expects significant impacts to the bio-physical characteristics of the stream corridor, as well financial impacts to their property value and social impacts to their recreational activities. The current study exposes the widening gap between policy makers and landowners, and highlights where complete stakeholder interaction could and should occur.

  10. Addressing Cancer Disparities via Community Network Mobilization and Intersectoral Partnerships: A Social Network Analysis

    PubMed Central

    Ramanadhan, Shoba; Salhi, Carmel; Achille, Erline; Baril, Nashira; D'Entremont, Kerrie; Grullon, Milagro; Judge, Christine; Oppenheimer, Sarah; Reeves, Chrasandra; Savage, Clara; Viswanath, Kasisomayajula

    2012-01-01

    Community mobilization and collaboration among diverse partners are vital components of the effort to reduce and eliminate cancer disparities in the United States. We studied the development and impact of intersectoral connections among the members of the Massachusetts Community Network for Cancer Education, Research, and Training (MassCONECT). As one of the Community Network Program sites funded by the National Cancer Institute, this infrastructure-building initiative utilized principles of Community-based Participatory Research (CBPR) to unite community coalitions, researchers, policymakers, and other important stakeholders to address cancer disparities in three Massachusetts communities: Boston, Lawrence, and Worcester. We conducted a cross-sectional, sociometric network analysis four years after the network was formed. A total of 38 of 55 members participated in the study (69% response rate). Over four years of collaboration, the number of intersectoral connections reported by members (intersectoral out-degree) increased, as did the extent to which such connections were reported reciprocally (intersectoral reciprocity). We assessed relationships between these markers of intersectoral collaboration and three intermediate outcomes in the effort to reduce and eliminate cancer disparities: delivery of community activities, policy engagement, and grants/publications. We found a positive and statistically significant relationship between intersectoral out-degree and community activities and policy engagement (the relationship was borderline significant for grants/publications). We found a positive and statistically significant relationship between intersectoral reciprocity and community activities and grants/publications (the relationship was borderline significant for policy engagement). The study suggests that intersectoral connections may be important drivers of diverse intermediate outcomes in the effort to reduce and eliminate cancer disparities. The findings

  11. The social ecology of resilience: addressing contextual and cultural ambiguity of a nascent construct.

    PubMed

    Ungar, Michael

    2011-01-01

    More than two decades after E. E. Werner and R. S. Smith (1982), N. Garmezy (1983), and M. Rutter (1987) published their research on protective mechanisms and processes that are most likely to foster resilience, ambiguity continues regarding how to define and operationalize positive development under adversity. This article argues that, because resilience occurs even when risk factors are plentiful, greater emphasis needs to be placed on the role social and physical ecologies play in positive developmental outcomes when individuals encounter significant amounts of stress. Four principles are presented as the basis for an ecological interpretation of the resilience construct: decentrality, complexity, atypicality, and cultural relativity. These 4 principles, and the research upon which they are based, inform a definition of resilience that emphasizes the environmental antecedents of positive growth. This framework can guide future theory development, research, and the design of interventions that promote well-being among populations who experience environments that inhibit resilience-promoting processes. PMID:21219271

  12. Social Justice Approach to Road Safety in Kenya: Addressing the Uneven Distribution of Road Traffic Injuries and Deaths across Population Groups

    PubMed Central

    Azetsop, Jacquineau

    2010-01-01

    Road traffic injury and deaths (RTID) are an important public health problem in Kenya, primarily affecting uneducated and disenfranchised people from lower socioeconomic groups. Studies conducted by Kenyan experts from police reports and surveys have shown that pedestrian and driver behaviors are the most important proximal causes of crashes, signifying that the occurrence of crashes results directly from human action. However, behaviors and risk factors do not fully explain the magnitude of RTID neither does it account for socioeconomic gradient in RTID. Instead, a social justice approach to RTID highlights the need for emphasizing distal causal factors. They allow us to understand how social inequities determine risk for RTID. Hence, designing policies that focus on behaviors will simply mask the underlying systemic causes of this growing phenomenon. To eradicate the RTID and address the gradient, a broader policy framework that includes the social dimension of injury, a strong political will to address the underlying causes of RTID and an effective partnership with stakeholders needs to be developed. PMID:20664752

  13. The Social Determinants of Tuberculosis: From Evidence to Action

    PubMed Central

    Boccia, Delia; Evans, Carlton A.; Adato, Michelle; Petticrew, Mark; Porter, John D. H.

    2011-01-01

    Growing consensus indicates that progress in tuberculosis control in the low- and middle-income world will require not only investment in strengthening tuberculosis control programs, diagnostics, and treatment but also action on the social determinants of tuberculosis. However, practical ideas for action are scarcer than is notional support for this idea. We developed a framework based on the recent World Health Organization Commission on Social Determinants of Health and on current understanding of the social determinants of tuberculosis. Interventions from outside the health sector—specifically, in social protection and urban planning—have the potential to strengthen tuberculosis control. PMID:21330583

  14. [The challenge for healthcare systems in the XXI century: how to incorporate the focus of social determinants in healthcare?].

    PubMed

    Cuadrado, Cristóbal

    2015-10-20

    During the 20th century, a series of reflections on the role of biomedicine and social factors in the concept of health and disease processes served as a necessary prelude to the conceptual and empirical development of what later became known as the social determinants of health. In relation to this perspective, the question arises: What is the role of modern health systems from the perspective of the social determinants of health? This article presents an alternative view of the role of health systems from the focus of the social determinants of health, raising its importance and influence on the structural level, while addressing its implications as an intermediary determinant of health inequalities.

  15. Addressing alcohol in the context of elementary education: the social imaginary reconstruction of teachers.

    PubMed

    Felipe, Ingryd Cunha Ventura; Gomes, Antonio Marcos Tosoli

    2010-01-01

    Alcohol consumption is considered a global problem, principally affecting adolescents. In this context, the aims of this study were to identify the pedagogical strategies developed by elementary school teachers in the approach to alcohol with adolescents; To analyze the attitudes, beliefs, values and practices of the elementary school teachers in relation to alcohol; To discuss the repercussions of the attitudes, beliefs, values and practices of the teachers about alcohol in the dialogue with the students and in the implementation of the strategies referred to above. This was a qualitative study performed with 26 teachers of a Rio de Janeiro public school. The data were analyzed through thematic content analysis and grouped into 5 categories. It was concluded that social imaginary and attitudinal construction of the teachers directly interferes with the personal and professional practice and has repercussions in the quotidian life of the students. It was noted that the focus should not just be on the students, but on the relationship of the teachers with their pedagogic strategies.

  16. Health extension in new Mexico: an academic health center and the social determinants of disease.

    PubMed

    Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

    2010-01-01

    The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease.

  17. A community integration approach to social determinants of health in New Mexico.

    PubMed

    McCloskey, Joanne; Tollestrup, Kristine; Sanders, Margaret

    2011-01-01

    Lifestyle and Values Impacting Diabetes Awareness (LA VIDA), a community-based diabetes intervention program targeting Hispanics in southwestern New Mexico, addresses social determinants of health by utilizing promotores and collaborating with community partners and health care providers. Using a mixed-methods approach, a program evaluation documented the promotores' crucial role in providing social support, contributing to social cohesion, and accessing health care, community resources, and LA VIDA's educational and healthy lifestyle activities. Findings suggest that patients with diabetes who participated in the LA VIDA program significantly increased the number of days they checked their feet and took their diabetes medications and significantly lowered their glycated hemoglobin levels.

  18. Social Determinants of Health, the Chronic Care Model, and Systemic Lupus Erythematosus

    PubMed Central

    Williams, Edith M.; Ortiz, Kasim; Browne, Teri

    2014-01-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory rheumatic disease that disproportionately affects African Americans and other minorities in the USA. Public health attention to SLE has been predominantly epidemiological. To better understand the effects of this cumulative disadvantage and ultimately improve the delivery of care, specifically in the context of SLE, we propose that more research attention to the social determinants of SLE is warranted and more transdisciplinary approaches are necessary to appropriately address identified social determinants of SLE. Further, we suggest drawing from the chronic care model (CCM) for an understanding of how community-level factors may exacerbate disparities explored within social determinant frameworks or facilitate better delivery of care for SLE patients. Grounded in social determinants of health (SDH) frameworks and the CCM, this paper presents issues relative to accessibility to suggest that more transdisciplinary research focused on the role of place could improve care for SLE patients, particularly the most vulnerable patients. It is our hope that this paper will serve as a springboard for future studies to more effectively connect social determinants of health with the chronic care model and thus more comprehensively address adverse health trajectories in SLE and other chronic conditions. PMID:26464854

  19. Multiple determinants, common vulnerabilities, and creative responses: addressing the AIDS pandemic in diverse populations globally.

    PubMed

    Mayer, Kenneth H; Pape, Jean W; Wilson, Phill; Diallo, Dazon D; Saavedra, Jorge; Mimiaga, Matthew J; Koenig, Serena; Farmer, Paul

    2012-08-01

    The AIDS epidemic has been fueled by global inequities. Ranging from sexual inequality and underdevelopment to homophobia impeding health care access for men who have sex with men, imbalanced resource allocations, and social biases have potentiated the spread of the epidemic. However, recognition of culturally specific aspects of each microepidemic has yielded development of community-based organizations, which have resulted in locally effective responses to AIDS. This effective approach to HIV prevention, care, and treatment is illustrated through examples of community-based responses in Haiti, the United States, Africa, and other impoverished settings.

  20. Widening the Aim of Health Promotion to Include the Most Disadvantaged: Vulnerable Adolescents and the Social Determinants of Health

    ERIC Educational Resources Information Center

    Mohajer, Nicole; Earnest, Jaya

    2010-01-01

    Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health…

  1. The impact of social determinants on cardiovascular disease

    PubMed Central

    Kreatsoulas, Catherine; Anand, Sonia S

    2010-01-01

    Cardiovascular disease is the leading cause of death among high-income countries and is projected to be the leading cause of death worldwide by 2030. Much of the current research efforts have been aimed toward the identification, modification and treatment of individual-level risk factors. Despite significant advancements, gross inequalities continue to persist over space and time. Although increasing at different rates worldwide, the magnitude of increase in the prevalence of various cardiovascular risk factors has shifted research efforts to study the causes of the risk factors (ie, the ‘causes of the causes’), which include the social determinants of health. The social determinants of health reflect the impact of the social environment on health among people sharing a particular community. Imbalances in the social determinants of health have been attributed to the inequities in health observed between and within countries. The present article reviews the role of the social determinants of health on a global level, describing the epidemiological transition and the persistent trend known as the ‘inverse social gradient’. The impact of social determinants in Canada will also be examined, including data from ethnic and Aboriginal communities. Possible solutions and future directions to reduce the impact of social factors on cardiovascular health are proposed. PMID:20847985

  2. Oral health of foreign domestic workers: exploring the social determinants.

    PubMed

    Gao, Xiaoli; Chan, Chi Wai; Mak, Siu Lun; Ng, Zevon; Kwong, Wai Hang; Kot, Ching Ching Shirley

    2014-10-01

    Foreign domestic helpers constitute a significant proportion of migrant workers worldwide. This population subgroup provides an opportunity for understanding social determinants of oral health in immigrant community. A random sample of 122 Indonesian domestic helpers in Hong Kong completed a questionnaire on their demographic background, social characteristics (competency in local languages, immigration history, living condition, social connections, and leisure activities) and oral health behaviours (knowledge, attitudes, practice and self-efficacy). Their tooth status and periodontal health were assessed. Participants tended to start flossing after settling in Hong Kong. Favourable oral health knowledge was found in more acculturated participants, as indicated by proficiency in local languages and immigration history. Engagement in social and/or religious activities and decent living condition provided by employers were associated with favourable oral health behaviours and/or better oral health. Social determinants explained 13.2 % of variance in caries severity. Our findings support the significant impact of social circumstances on oral health of domestic workers.

  3. Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan? Gender, class and social exclusion

    PubMed Central

    2012-01-01

    Background Pakistan is one of the six countries estimated to contribute to over half of all maternal deaths worldwide. To address its high maternal mortality rate, in particular the inequities in access to maternal health care services, the government of Pakistan created a new cadre of community-based midwives (CMW). A key expectation is that the CMWs will improve access to skilled antenatal and intra-partum care for the poor and disadvantaged women. A critical gap in our knowledge is whether this cadre of workers, operating in the private health care context, will meet the expectation to provide care to the poorest and most marginalized women. There is an inherent paradox between the notions of fee-for-service and increasing access to health care for the poorest who, by definition, are unable to pay. Methods/Design Data will be collected in three interlinked modules. Module 1 will consist of a population-based survey in the catchment areas of the CMW’s in districts Jhelum and Layyah in Punjab. Proportions of socially excluded women who are served by CMWs and their satisfaction levels with their maternity care provider will be assessed. Module 2 will explore, using an institutional ethnographic approach, the challenges (organizational, social, financial) that CMWs face in providing care to the poor and socially marginalized women. Module 3 will identify the social, financial, geographical and other barriers to uncover the hidden forces and power relations that shape the choices and opportunities of poor and marginalized women in accessing CMW services. An extensive knowledge dissemination plan will facilitate uptake of research findings to inform positive developments in maternal health policy, service design and care delivery in Pakistan. Discussion The findings of this study will enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems, including community midwifery care. One key

  4. Religious social capital: Its measurement and utility in the study of the social determinants of health

    PubMed Central

    Maselko, Joanna; Hughes, Cayce; Cheney, Rose

    2014-01-01

    As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health. PMID:21802182

  5. Religious social capital: its measurement and utility in the study of the social determinants of health.

    PubMed

    Maselko, Joanna; Hughes, Cayce; Cheney, Rose

    2011-09-01

    As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health.

  6. Determinism versus Creativity: Which Way for Social Work?

    ERIC Educational Resources Information Center

    Peile, Colin

    1993-01-01

    Contends that dominant cosmology within social work is determinism. Argues for creative cosmology that can synthesize deterministic and random processes. Sees this development made possible by reconceptualization of relative nature of time. Discussion is grounded in relation to small example of social work practice, and implications of creative…

  7. Coalition formation to address structural determinants of methamphetamine use in Thailand.

    PubMed

    Willard, Nancy; Srirojn, Bangorn; Thomson, Nicholas; Aramrattana, Apinun; Sherman, Susan; Galai, Noya; Celentano, David D; Ellen, Jonathan M

    2015-09-01

    Despite two recent government-sponsored 'wars on drugs', methamphetamine use continues to be a pervasive problem in Thailand. Out of concern for reported human rights abuses, there has been a call from the international community to take a different approach from the government's 'zero tolerance'. This paper describes the adaptation of the Connect to Protect® coalition formation process from urban U.S. cities to three districts in northern Thailand's Chiang Mai province, aimed to reduce methamphetamine use by altering the risk environment. Project materials, including manuals and materials (e.g. key actor maps and research staff memos), were reviewed to describe partnering procedures and selection criteria. Potential community partners were identified from various government and community sectors with a focus on including representatives from health, police, district and sub-district government officials. Of the 64 potential partners approached, 59 agreed to join one of three district-level coalitions. Partner makeup included 25% from the health sector, 22% who were sub-district government officials and 10% were representatives from the police sector. Key partners necessary for endorsement of and commitment to the coalition work included district-level governors, police chiefs and hospital directors for each district. Initial coalition strategic planning has resulted in policies and programs to address school retention, youth development initiatives and establishment of a new drug treatment and rehabilitation clinic in addition to other developing interventions. Similarities in building coalitions, such as the need to strategically develop buy-in with key constituencies, as well as differences of whom and how partners were identified are explored. PMID:24493782

  8. Coalition formation to address structural determinants of methamphetamine use in Thailand

    PubMed Central

    Willard, Nancy; Srirojn, Bangorn; Thomson, Nicholas; Aramrattana, Apinun; Sherman, Susan; Galai, Noya; Celentano, David D.; Ellen, Jonathan M.

    2015-01-01

    Despite two recent government-sponsored ‘wars on drugs’, methamphetamine use continues to be a pervasive problem in Thailand. Out of concern for reported human rights abuses, there has been a call from the international community to take a different approach from the government's ‘zero tolerance’. This paper describes the adaptation of the Connect to Protect® coalition formation process from urban U.S. cities to three districts in northern Thailand's Chiang Mai province, aimed to reduce methamphetamine use by altering the risk environment. Project materials, including manuals and materials (e.g. key actor maps and research staff memos), were reviewed to describe partnering procedures and selection criteria. Potential community partners were identified from various government and community sectors with a focus on including representatives from health, police, district and sub-district government officials. Of the 64 potential partners approached, 59 agreed to join one of three district-level coalitions. Partner makeup included 25% from the health sector, 22% who were sub-district government officials and 10% were representatives from the police sector. Key partners necessary for endorsement of and commitment to the coalition work included district-level governors, police chiefs and hospital directors for each district. Initial coalition strategic planning has resulted in policies and programs to address school retention, youth development initiatives and establishment of a new drug treatment and rehabilitation clinic in addition to other developing interventions. Similarities in building coalitions, such as the need to strategically develop buy-in with key constituencies, as well as differences of whom and how partners were identified are explored. PMID:24493782

  9. Social environment determines degree of chemical signalling.

    PubMed

    Steiger, Sandra; Haberer, Wolf; Müller, Josef K

    2011-12-23

    Few studies have attempted to distinguish between cues and signals in the context of chemical communication. A number of chemical substances have been shown to vary with physiological state, such as stage of oestrus cycle, fertility, dominance status or nutritional condition, but little is known about whether this variation is incidental or adaptive. Here, we provide evidence of a substance whose emission varies with breeding state, but is not merely an incidental by-product of physiological state, but rather, an evolved signal. Breeding females of the facultative biparental burying beetle, Nicrophorus vespilloides, release methyl geranate, a substance that helps males to identify breeding status and to distinguish between their female partners and non-breeding intruders. We demonstrate that females respond flexibly to their social environment and emit high amounts of methyl geranate only in the presence of a male partner, i.e. a receiver. In contrast, cuticular hydrocarbons, which also have been shown to change with breeding status, are not modulated and do not differ between single and paired breeding females. Receiver-dependent chemical signalling is expected to evolve when costs are involved in the production or transmission of the signal; such signal modulation might be more common than previously thought.

  10. Are there social determinants of health and disease?

    PubMed

    Thisted, Ronald A

    2003-01-01

    The concept of a determinant is tied to the idea of a mechanism for action. Ideas from epidemiology, particularly the epidemiologic triad of agent, host, and environment, can help to make sense of factors that affect the absence of disease or that interfere with a mechanism that alters health. However, assembling convincing evidence for the existence of social determinants of health is a challenge, in part because of the difficulties of bridging the social and biological realms. While social contexts are measured using aggregates of individuals, disease and dysfunction occur at the individual level, leading to difficult problems of ecological inference. Although social factors have been shown to be associated with differences in mortality from specific causes, these factors account for only a small portion of the mortality from any individual cause. This suggests that the pathways through which social factors influence health are affected by their interactions with other factors. PMID:14563075

  11. Korean Early Childhood Educators' Perceptions of Importance and Implementation of Strategies to Address Young Children's Social-Emotional Competence

    ERIC Educational Resources Information Center

    Heo, Kay H.; Cheatham, Gregory A.; Hemmeter, Mary Louise; Noh, Jina

    2014-01-01

    In South Korea, there has been a rapid increase in challenging behaviors and other social-emotional difficulties at the early childhood level. Korean early childhood educators' perspectives and strategies to address young children's social-emotional competencies and challenging behaviors were investigated. Overall, results suggest that…

  12. Addressing Social Issues in the Classroom and Beyond: The Pedagogical Efforts of Pioneers in the Field. Research in Curriculum and Instruction

    ERIC Educational Resources Information Center

    Totten, Samuel, Ed.; Pedersen, Jon, Ed.

    2007-01-01

    Addressing Social Issues in the Classroom and Beyond: The Pedagogical Efforts of Pioneers in the Field is comprised of essays that delineate the genesis and evolution of the thought and work of pioneers in the field of social issues and education. The authors (many of whom, themselves, are noted professors of education and who have done…

  13. Widening the aim of health promotion to include the most disadvantaged: vulnerable adolescents and the social determinants of health.

    PubMed

    Mohajer, Nicole; Earnest, Jaya

    2010-06-01

    Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health promotion. Drawing on a review of literature on health promotion for marginalized and out-of-school adolescents, this paper highlights some urgent areas of focus for researchers and policy makers addressing adolescent health. Social determinants of health affecting marginalized adolescents identified by the review were education, gender, identity, homelessness, poverty, family structure, culture, religion and perceived racism, yet there is little solid evidence as to how to best address these factors. More systematic research, evaluation and global debate about long-term solutions to chronic poverty, lack of education and social marginalization are needed to break the cycle of ill health among vulnerable adolescents.

  14. What determines social capital in a social-ecological system? Insights from a network perspective.

    PubMed

    Barnes-Mauthe, Michele; Gray, Steven Allen; Arita, Shawn; Lynham, John; Leung, PingSun

    2015-02-01

    Social capital is an important resource that can be mobilized for purposive action or competitive gain. The distribution of social capital in social-ecological systems can determine who is more productive at extracting ecological resources and who emerges as influential in guiding their management, thereby empowering some while disempowering others. Despite its importance, the factors that contribute to variation in social capital among individuals have not been widely studied. We adopt a network perspective to examine what determines social capital among individuals in social-ecological systems. We begin by identifying network measures of social capital relevant for individuals in this context, and review existing evidence concerning their determinants. Using a complete social network dataset from Hawaii's longline fishery, we employ social network analysis and other statistical methods to empirically estimate these measures and determine the extent to which individual stakeholder attributes explain variation within them. We find that ethnicity is the strongest predictor of social capital. Measures of human capital (i.e., education, experience), years living in the community, and information-sharing attitudes are also important. Surprisingly, we find that when controlling for other factors, industry leaders and formal fishery representatives are generally not well connected. Our results offer new quantitative insights on the relationship between stakeholder diversity, social networks, and social capital in a coupled social-ecological system, which can aid in identifying barriers and opportunities for action to overcome resource management problems. Our results also have implications for achieving resource governance that is not only ecologically and economically sustainable, but also equitable.

  15. What Determines Social Capital in a Social-Ecological System? Insights from a Network Perspective

    NASA Astrophysics Data System (ADS)

    Barnes-Mauthe, Michele; Gray, Steven Allen; Arita, Shawn; Lynham, John; Leung, PingSun

    2015-02-01

    Social capital is an important resource that can be mobilized for purposive action or competitive gain. The distribution of social capital in social-ecological systems can determine who is more productive at extracting ecological resources and who emerges as influential in guiding their management, thereby empowering some while disempowering others. Despite its importance, the factors that contribute to variation in social capital among individuals have not been widely studied. We adopt a network perspective to examine what determines social capital among individuals in social-ecological systems. We begin by identifying network measures of social capital relevant for individuals in this context, and review existing evidence concerning their determinants. Using a complete social network dataset from Hawaii's longline fishery, we employ social network analysis and other statistical methods to empirically estimate these measures and determine the extent to which individual stakeholder attributes explain variation within them. We find that ethnicity is the strongest predictor of social capital. Measures of human capital (i.e., education, experience), years living in the community, and information-sharing attitudes are also important. Surprisingly, we find that when controlling for other factors, industry leaders and formal fishery representatives are generally not well connected. Our results offer new quantitative insights on the relationship between stakeholder diversity, social networks, and social capital in a coupled social-ecological system, which can aid in identifying barriers and opportunities for action to overcome resource management problems. Our results also have implications for achieving resource governance that is not only ecologically and economically sustainable, but also equitable.

  16. Social Determinants of Depression: Social Cohesion, Negative Life Events, and Depression Among People Living with HIV/Aids in Nigeria, West Africa

    PubMed Central

    Shittu, Rasaki O.; Issa, Baba A.; Olanrewaju, Ganiyu T.; Mahmoud, Abdulraheem O.; Odeigah, Louis O.; Sule, Abdullateef G.

    2014-01-01

    Background: People Living with HIV/AIDS (PLWHA) continue to face persistent and deep rooted social barriers. Incidentally, studies in social determinants of depression are very limited, necessitating this study, which examined social determinants of depression and the impact of these determinants on depression. Methods: This was a hospital based, cross sectional descriptive study of three hundred adult HIV/AIDS patients, attending the HIV clinic of Kwara State Specialist Hospital, Sobi, Ilorin, Nigeria. Depressive symptoms were measured by the PHQ-9 rating scale. Three variables of social determinants of depression: socio-economic status (years of school and self-reported economic status of family), social cohesion, and negative life events were examined. Results: The self-reported economic status of the family varied from good 35(11.7%), average 162(54%), and poor among 103(34.3%) of the respondents. Social cohesion was low in 199(66.3%), fair in 65(21.7%) and high among 36(12%) of the respondents. There was significant association between social cohesion, negative life events, and depression. Conclusion and Global Health Implications: Income was the most significant socio-economic determinant. Majority had very low social cohesion and more negative life events, while those with below average years of schooling were more depressed. These are statistically significant. Social determinants of depression should be given a lot of emphasis, when addressing the issue of depression, if we are to meaningfully tackle this increasing scourge in our society.

  17. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies.

  18. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    PubMed

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-01

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. PMID:25458716

  19. An exploration of social determinants of health amongst internally displaced persons in northern Uganda.

    PubMed

    Roberts, Bayard; Odong, Vicky Norah; Browne, John; Ocaka, Kaducu Felix; Geissler, Wenzel; Sondorp, Egbert

    2009-12-15

    Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally displaced persons (IDPs) who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006.The findings indicated a number of key social determinants. Experiencing traumatic events could cause "over thinking" which in turn could lead to "madness" and physical ailments. Respondents also attributed "over thinking" to the spirit (cen) of a killed person returning to disturb its killer. Other social determinants included overcrowding which affected physical health and contributed to an emotional sense of loss of freedom; and poverty and loss of land which affected physical health from lack of food and income, and mental health because of worry and uncertainty. Respondents also commented on how the conflict and displacement and led to changes in social and cultural norms such as increased "adultery", "defilement", and "thieving". Response strategies included a combination of biopsychosocial health services, traditional practices, religion, family and friends, and isolating.This study supports work exploring the political, environmental, economic, and socio-cultural determinants of health of IDPs

  20. An exploration of social determinants of health amongst internally displaced persons in northern Uganda

    PubMed Central

    2009-01-01

    Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally displaced persons (IDPs) who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006. The findings indicated a number of key social determinants. Experiencing traumatic events could cause "over thinking" which in turn could lead to "madness" and physical ailments. Respondents also attributed "over thinking" to the spirit (cen) of a killed person returning to disturb its killer. Other social determinants included overcrowding which affected physical health and contributed to an emotional sense of loss of freedom; and poverty and loss of land which affected physical health from lack of food and income, and mental health because of worry and uncertainty. Respondents also commented on how the conflict and displacement and led to changes in social and cultural norms such as increased "adultery", "defilement", and "thieving". Response strategies included a combination of biopsychosocial health services, traditional practices, religion, family and friends, and isolating. This study supports work exploring the political, environmental, economic, and socio-cultural determinants of health of IDPs

  1. Assessing the social and physical determinants of circumpolar population health

    PubMed Central

    Driscoll, David L.; Dotterrer, Bruce; Brown, Richard A.

    2013-01-01

    Introduction Systematic reviews of the social and physical determinants of health provide metrics for evaluation of programs to mitigate health disparities. Previous meta-analyses of the population health literature have identified several proximate social and physical determinants of population health in the circumpolar north including addiction, environmental exposures, diet/nutrition and global climate change. Proximate health determinants are most amenable to early detection and modification or mitigation through disease prevention or health promotion interventions. Design There is a need for research to replicate these findings based on the latest science. This presentation describes a study applying Dahlgren and Whitehead's (1991) socio-ecological model of health determinants to identify the proximate social and physical determinants of health in the circumpolar north. Methods The study consisted of a systematic review of recent studies that link determinants of health with the leading causes of mortality and morbidity in Alaska. Our search strategy employed a keyword search using the Circumpolar Health Bibliographic Database (CHBD) and 4 databases within the Web of Knowledge (WoK) data gateway. Keywords included various terms for the arctic, all relevant nations and territories within the region, as well as leading health outcomes. Results Studies meeting the following inclusion criteria were reviewed: original research within a circumpolar population, published in English during 2011, and involving a rigorous demonstration of a link between a social determinant and selected health outcomes. Conclusions Study conclusions includes a list of determinants identified, their associated outcomes and the study designs implemented to assess that association. PMID:23986893

  2. Social determinants of alcohol and marijuana effects: a systematic theory.

    PubMed

    Orcutt, J D

    1975-01-01

    Based on the sociological perspective on recreational drug effects, three social determinants are propositionally related to the normal effects of alcohol and marijuana. Effects vary across drugs, users, and situations along an experimental-behavioral dimension termed "effect-orientation." The content of normative expectations toward effects and the interactional characteristics of drug-using situations are conceptualized as direct determinants of effect-orientations. The relative clarity of normative expectations indirectly influences effect-orientations through its relationship to the other two social determinants. The theory stresses the importance of comparative research on the normal uses of alcohol and marijuana.

  3. IPCC and other assessments as vehicles for integrating natural and social science research to address human dimensions of climate change

    NASA Astrophysics Data System (ADS)

    Field, C. B.

    2012-12-01

    IPCC and other assessments address both natural and social science aspects of climate change, but this approach has historically involved relatively little integration across the two sets of disciplines. In a framing that is only slightly oversimplified, past relationships were mostly sequential. From a physical climate perspective, human behavior was a boundary condition setting the trajectory of atmospheric forcing. And from an impacts perspective, changes in the physical climate set the stage upon which humans experienced impacts and made decisions about adaptation and mitigation. Integrated assessment models have been the main locus of research on questions about bi-directional coupling, where the trajectory of the physical climate influences GHG balance related to the need for agricultural land as well as GHG emissions from other activities. In the IPCC AR4 (2007), feedbacks from the natural carbon cycle to climate were a focus, but with little discussion of the potentially important feedbacks from climate-carbon interactions in the human domain. Detailed research and modeling in this area are still in the relatively early stages. For the future, IPCC and other assessments potentially provide a vehicle for new insights about the interaction of natural and social science dimensions of climate change. Several aspects could be interesting. Some of these relate to the decisions that modulate GHG emissions. For example, how does scientific understanding of climate change influence people's interest in mitigation and adaptation? How does it influence their willingness to pay? How are these modulated by regional and global geopolitics? Other potentially interesting aspects relate to interactions between mitigation and adaptation. For example, how does local experience of climate change alter the balance of focus on adaptation and mitigation? Still others relate to the nature of impacts and the role of sustainable development. With an aggress sustainable development

  4. Social attributions from faces: determinants, consequences, accuracy, and functional significance.

    PubMed

    Todorov, Alexander; Olivola, Christopher Y; Dotsch, Ron; Mende-Siedlecki, Peter

    2015-01-01

    Since the early twentieth century, psychologists have known that there is consensus in attributing social and personality characteristics from facial appearance. Recent studies have shown that surprisingly little time and effort are needed to arrive at this consensus. Here we review recent research on social attributions from faces. Section I outlines data-driven methods capable of identifying the perceptual basis of consensus in social attributions from faces (e.g., What makes a face look threatening?). Section II describes nonperceptual determinants of social attributions (e.g., person knowledge and incidental associations). Section III discusses evidence that attributions from faces predict important social outcomes in diverse domains (e.g., investment decisions and leader selection). In Section IV, we argue that the diagnostic validity of these attributions has been greatly overstated in the literature. In the final section, we offer an account of the functional significance of these attributions.

  5. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV.

    PubMed

    Caiola, Courtney; Docherty, Sharron L; Relf, Michael; Barroso, Julie

    2014-01-01

    Heightened awareness of the social determinants of health by health scientists and clinicians has failed to translate into significant progress in the amelioration of those social determinants contributing to health inequities. The purpose of this article is to broaden the discussion about conceptual approaches nurse scientists can use to address health and health inequities. We will apply an intersectional approach to the study of the social determinants of health for African American mothers living with human immunodeficiency virus and through this explore the utility of an intersectional approach to generate knowledge in nursing.

  6. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV.

    PubMed

    Caiola, Courtney; Docherty, Sharron L; Relf, Michael; Barroso, Julie

    2014-01-01

    Heightened awareness of the social determinants of health by health scientists and clinicians has failed to translate into significant progress in the amelioration of those social determinants contributing to health inequities. The purpose of this article is to broaden the discussion about conceptual approaches nurse scientists can use to address health and health inequities. We will apply an intersectional approach to the study of the social determinants of health for African American mothers living with human immunodeficiency virus and through this explore the utility of an intersectional approach to generate knowledge in nursing. PMID:25365282

  7. Effects of workplace, family and cultural influences on low back pain: what opportunities exist to address social factors in general consultations?

    PubMed

    Shaw, William S; Campbell, Paul; Nelson, Candace C; Main, Chris J; Linton, Steven J

    2013-10-01

    Social factors are widely acknowledged in behavioural models of pain and pain management, but incorporating these factors into general medical consultations for low back pain (LBP) can be challenging. While there is no compelling evidence that social factors contribute to LBP onset, these factors have been shown to influence functional limitation and disability, especially the effects of organisational support in the workplace, spousal support, family conflict and social disadvantage. A number of barriers exist to address such social factors in routine medical encounters for LBP, but there is emerging evidence that improving social and organisational support may be an effective strategy to reduce the negative lifestyle consequences of LBP. For clinicians to address these factors in LBP treatment requires a clearer psychosocial framework in assessment and screening, more individualised problem-solving efforts, more patient-centred interventions involving family, peers and workplace supports and a less biomechanical and diagnostic approach.

  8. Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

    PubMed

    Chung, Esther K; Siegel, Benjamin S; Garg, Arvin; Conroy, Kathleen; Gross, Rachel S; Long, Dayna A; Lewis, Gena; Osman, Cynthia J; Jo Messito, Mary; Wade, Roy; Shonna Yin, H; Cox, Joanne; Fierman, Arthur H

    2016-05-01

    Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources. PMID:27101890

  9. Addressing inequities in healthy eating.

    PubMed

    Friel, Sharon; Hattersley, Libby; Ford, Laura; O'Rourke, Kerryn

    2015-09-01

    What, when, where and how much people eat is influenced by a complex mix of factors at societal, community and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social and cultural pathways that cause social stratification and influence the quality of conditions in which people live their lives. These factors are the social determinants of inequities in healthy eating. This paper provides an overview of the current evidence base for addressing these determinants and for the promotion of equity in healthy eating. PMID:26420812

  10. Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3)

    PubMed Central

    Labonté, Ronald; Schrecker, Ted

    2007-01-01

    This article is the third in a three-part review of research on globalization and the social determinants of health (SDH). In the first article of the series, we identified and defended an economically oriented definition of globalization and addressed a number of important conceptual and metholodogical issues. In the second article, we identified and described seven key clusters of pathways relevant to globalization's influence on SDH. This discussion provided the basis for the premise from which we begin this article: interventions to reduce health inequities by way of SDH are inextricably linked with social protection, economic management and development strategy. Reflecting this insight, and against the background of the Millennium Development Goals (MDGs), we focus on the asymmetrical distribution of gains, losses and power that is characteristic of globalization in its current form and identify a number of areas for innovation on the part of the international community: making more resources available for health systems, as part of the more general task of expanding and improving development assistance; expanding debt relief and taking poverty reduction more seriously; reforming the international trade regime; considering the implications of health as a human right; and protecting the policy space available to national governments to address social determinants of health, notably with respect to the hypermobility of financial capital. We conclude by suggesting that responses to globalization's effects on social determinants of health can be classified with reference to two contrasting visions of the future, reflecting quite distinct values. PMID:17578570

  11. Globalization and social determinants of health: Promoting health equity in global governance (part 3 of 3).

    PubMed

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    This article is the third in a three-part review of research on globalization and the social determinants of health (SDH). In the first article of the series, we identified and defended an economically oriented definition of globalization and addressed a number of important conceptual and metholodogical issues. In the second article, we identified and described seven key clusters of pathways relevant to globalization's influence on SDH. This discussion provided the basis for the premise from which we begin this article: interventions to reduce health inequities by way of SDH are inextricably linked with social protection, economic management and development strategy. Reflecting this insight, and against the background of the Millennium Development Goals (MDGs), we focus on the asymmetrical distribution of gains, losses and power that is characteristic of globalization in its current form and identify a number of areas for innovation on the part of the international community: making more resources available for health systems, as part of the more general task of expanding and improving development assistance; expanding debt relief and taking poverty reduction more seriously; reforming the international trade regime; considering the implications of health as a human right; and protecting the policy space available to national governments to address social determinants of health, notably with respect to the hypermobility of financial capital. We conclude by suggesting that responses to globalization's effects on social determinants of health can be classified with reference to two contrasting visions of the future, reflecting quite distinct values.

  12. Addressing the Photometric Calibration Challenge: Explicit Determination of the Instrumental Response and Atmospheric Response Functions, and Tying it All Together.

    NASA Astrophysics Data System (ADS)

    Stubbs, C. W.; Tonry, J. L.

    2016-05-01

    Photometric calibration is currently the dominant source of systematic uncertainty in exploiting type Ia supernovae to determine the nature of the dark energy. We review our ongoing program to address this calibration challenge by performing measurements of both the instrumental response function and the optical transmission function of the atmosphere. A key aspect of this approach is to complement standard star observations by using NIST-calibrated photodiodes as a metrology foundation for optical flux measurements. We present our first attempt to assess photometric consistency between synthetic photometry and observations, by comparing predictions based on a NIST-diode-based determination of the PanSTARRS-1 instrumental response and empirical atmospheric transmission measurements, with fluxes we obtained from observing spectrophotometric standards.

  13. Conducting Community Research in Rural China –Addressing the Methodological Challenges of Recruiting Participants in Rapidly Changing Social Environments

    PubMed Central

    Dai, Jing; Chiu, Helen F.K.; Hou, Zai-Jin; Caine, Eric D.

    2012-01-01

    Background The paper addressed a unique challenge for public health and community research in rural China, i.e., the very large percentage of young adults that comprises a highly mobile working population that has been an essential component of the country’s economic transformation. Fluid local demographic patterns potentially have a substantial impact on sample representativeness and data validity. Methods This report is based upon a cross sectional survey with face-to-face interviews of residents aged 16–34 years in rural communities of Mianyang, Sichuan Province, China. Two waves of fieldwork and other strategies were adopted in response to recruitment challenges. Results 1654 of 3008 potential participants took part in the study; this constituted 98% of those individuals approached and 55% of the persons enumerated in the local household registration system (hukou). Analyses revealed substantial differences among those who were interviewed during September and October 2005, versus those seen during the Chinese Lunar New Year of 2006 when many migrant workers and students returned to their homes. Both groups together differed from those who were unavailable during either recruiting episode. Discussion and Conclusions We discuss potential responses to associated methodological challenges, including, (1) permanent hukou mismatches; (2) temporary hukou mismatches; (3) difficulties faced by potential participants to fully understand the purpose of research, the informed consent process, and specific research questions; and (4) appreciation of the importance of local social networks, as they pertain in particular to rural China. These findings underscore that there may be a need to make “on-the-ground” adjustments to varying local conditions to maximize sample representativeness and data validity. PMID:22662022

  14. Social Determinants of Educational Outcomes in Indigenous Learners

    ERIC Educational Resources Information Center

    Chandler, Michael J.

    2010-01-01

    For the better part of two decades, the author and his research colleagues have been engaged in a broad program of research aimed at identifying certain of the "social determinants of health and wellbeing" common to Canadian First Nation, Metis, and Inuit youth. The present account samples from these ongoing research efforts by recapping two sets…

  15. "Healthy People": A 2020 Vision for the Social Determinants Approach

    ERIC Educational Resources Information Center

    Koh, Howard K.; Piotrowski, Julie J.; Kumanyika, Shiriki; Fielding, Jonathan E.

    2011-01-01

    For the past three decades, the "Healthy People" initiative has represented an ambitious yet achievable health promotion and disease prevention agenda for the nation. The recently released fourth version--"Healthy People 2020"--builds on the foundations of prior iterations while newly embracing and elevating a comprehensive "social determinants"…

  16. Self-Determination and the Social Education of Native Americans.

    ERIC Educational Resources Information Center

    Senese, Guy B.

    This book is a critical analysis of the concept of self-determination as it has been developed in the federal government's American Indian social and educational policies since the 1950s. Analyses focus on the links between Indian educational policy and economic development concerns and on the ways in which the idealistic language of…

  17. Why Police Kill Black Males with Impunity: Applying Public Health Critical Race Praxis (PHCRP) to Address the Determinants of Policing Behaviors and "Justifiable" Homicides in the USA.

    PubMed

    Gilbert, Keon L; Ray, Rashawn

    2016-04-01

    Widespread awareness of the recent deaths of several black males at the hands of police has revealed an unaddressed public health challenge-determining the root causes of excessive use of force by police applied to black males that may result in "justifiable homicides." The criminalization of black males has a long history in the USA, which has resulted in an increase in policing behaviors by legal authorities and created inequitable life chances for black males. Currently, the discipline of public health has not applied an intersectional approach that investigates the intersection of race and gender to understanding police behaviors that lead to "justifiable homicides" for black males. This article applies the core tenets and processes of Public Health Critical Race Praxis (PHCRP) to develop a framework that can improve research and interventions to address the disparities observed in recent trend analyses of "justifiable homicides." Accordingly, we use PHCRP to offer an alternative framework on the social, legal, and health implications of violence-related incidents. We aim to move the literature in this area forward to help scholars, policymakers, and activists build the capacity of communities to address the excessive use of force by police to reduce mortality rates from "justifiable homicides." PMID:26661386

  18. Why Police Kill Black Males with Impunity: Applying Public Health Critical Race Praxis (PHCRP) to Address the Determinants of Policing Behaviors and "Justifiable" Homicides in the USA.

    PubMed

    Gilbert, Keon L; Ray, Rashawn

    2016-04-01

    Widespread awareness of the recent deaths of several black males at the hands of police has revealed an unaddressed public health challenge-determining the root causes of excessive use of force by police applied to black males that may result in "justifiable homicides." The criminalization of black males has a long history in the USA, which has resulted in an increase in policing behaviors by legal authorities and created inequitable life chances for black males. Currently, the discipline of public health has not applied an intersectional approach that investigates the intersection of race and gender to understanding police behaviors that lead to "justifiable homicides" for black males. This article applies the core tenets and processes of Public Health Critical Race Praxis (PHCRP) to develop a framework that can improve research and interventions to address the disparities observed in recent trend analyses of "justifiable homicides." Accordingly, we use PHCRP to offer an alternative framework on the social, legal, and health implications of violence-related incidents. We aim to move the literature in this area forward to help scholars, policymakers, and activists build the capacity of communities to address the excessive use of force by police to reduce mortality rates from "justifiable homicides."

  19. 'Health equity through action on the social determinants of health': taking up the challenge in nursing.

    PubMed

    Reutter, Linda; Kushner, Kaysi Eastlick

    2010-09-01

    Reducing health inequities is a priority issue in Canada and worldwide. In this paper, we argue that nursing has a clear mandate to ensure access to health and health-care by providing sensitive empowering care to those experiencing inequities and working to change underlying social conditions that result in and perpetuate health inequities. We identify key dimensions of the concept of health (in)equities and identify recommendations to reduce inequities advanced in key global and Canadian documents. Using these documents as context, we advocate a 'critical caring approach' that will assist nurses to understand the social, political, economic and historical context of health inequities and to tackle these inequities through policy advocacy. Numerous societal barriers as well as constraints within the nursing profession must be acknowledged and addressed. We offer recommendations related to nursing practice, education and research to move forward the agenda of reducing health inequities through action on the social determinants of health. PMID:20712665

  20. Social determinants of workers' health in Central America.

    PubMed

    Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

    2011-01-01

    This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region. PMID:21905391

  1. [Social determinants and risk of acute viral hepatitis].

    PubMed

    Malvasio, P; Russo, R; Zotti, C; Vigna, I; Ruggenini Moiraghi, A

    1998-01-01

    The authors examined the relationship between viral hepatitis risk and social determinants in Piedmont region population surveyed by SEIEVA (sistema epidemiologico integrato dell'epatite virale acuta). The education and the working position showed different correlation with incidence rates of different types of viral hepatitis A, B, non-A non-B. The hepatitis A risk is proportional to education and the probability of hepatitis B and non-A non-B is higher in low social classes. This situation is only apparently a balanced risk: the clinical seriousness and the strong probability of complications of hepatitis B and non-A non-B make the risks deeply unequal.

  2. Efforts to Bridge the Gap between Research and Practice in Social Work: Precedents and Prospects: Keynote Address at the Bridging the Gap Symposium

    ERIC Educational Resources Information Center

    Rubin, Allen

    2015-01-01

    This keynote address discusses previous and ongoing efforts to reduce the persistent gap between research and practice in social work and offers recommendations for further bridging that gap. Key among those recommendations is the need to conduct descriptive outcome studies of efforts to adapt research-supported interventions in everyday practice…

  3. Acceptance of Disability: Determinants of Overcoming Social Frustration

    PubMed Central

    Morozova, Elena Valeryevna; Shmeleva, Svetlana Vasilyevna; Sorokoumova, Elena Aleksandrovna; Nikishina, Vera Borisovna; Abdalina, Larisa Vasilyevna

    2015-01-01

    The article is devoted to the subjective reaction of patients at different stages of disabling disease, in the context of the formation of a specific cognitive-emotional and motivational model of “internal picture of disability”, depending on the severity of social frustration as the most important deconditioning factor. We wanted to identify psychological determinant of the specificity of adaptive activity of the patient to the situation disabling disease, depending on the level of increase social frustration. Nature of adaptation to the disabling disease depending on the level of increase social frustration expressed by: 1) decrease in self-esteem of patient self-efficacy with an increase in subjective experience of disability; 2) the growing tension of personal protective mechanisms; 3) reductions coping competence, which, depending on the rise of frustration, becomes effective instead of the rational-intelligent, more maladaptive emotional. PMID:25948469

  4. Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances

    PubMed Central

    Short, Susan E.; Mollborn, Stefanie

    2015-01-01

    Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied “social determinants” approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity. PMID:26213711

  5. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    PubMed Central

    2012-01-01

    Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face

  6. Social determinants of Black-White disparities in breast cancer mortality: a review.

    PubMed

    Gerend, Mary A; Pai, Manacy

    2008-11-01

    Despite the recent decline in breast cancer mortality, African American women continue to die from breast cancer at higher rates than do White women. Beyond the fact that breast cancer tends to be a more biologically aggressive disease in African American than in White women, this disparity in breast cancer mortality also reflects social barriers that disproportionately affect African American women. These barriers hinder cancer prevention and control efforts and modify the biological expression of disease. The present review focuses on delineating social, economic, and cultural factors that are potentially responsible for Black-White disparities in breast cancer mortality. This review was guided by the social determinants of health disparities model, a model that identifies barriers associated with poverty, culture, and social injustice as major causes of health disparities. These barriers, in concert with genetic, biological, and environmental factors, can promote differential outcomes for African American and White women along the entire breast cancer continuum, from screening and early detection to treatment and survival. Barriers related to poverty include lack of a primary care physician, inadequate health insurance, and poor access to health care. Barriers related to culture include perceived invulnerability, folk beliefs, and a general mistrust of the health care system. Barriers related to social injustice include racial profiling and discrimination. Many of these barriers are potentially modifiable. Thus, in addition to biomedical advancements, future efforts to reduce disparities in breast cancer mortality should address social barriers that perpetuate disparities among African American and White women in the United States. PMID:18990731

  7. Social determinants of Black-White disparities in breast cancer mortality: a review.

    PubMed

    Gerend, Mary A; Pai, Manacy

    2008-11-01

    Despite the recent decline in breast cancer mortality, African American women continue to die from breast cancer at higher rates than do White women. Beyond the fact that breast cancer tends to be a more biologically aggressive disease in African American than in White women, this disparity in breast cancer mortality also reflects social barriers that disproportionately affect African American women. These barriers hinder cancer prevention and control efforts and modify the biological expression of disease. The present review focuses on delineating social, economic, and cultural factors that are potentially responsible for Black-White disparities in breast cancer mortality. This review was guided by the social determinants of health disparities model, a model that identifies barriers associated with poverty, culture, and social injustice as major causes of health disparities. These barriers, in concert with genetic, biological, and environmental factors, can promote differential outcomes for African American and White women along the entire breast cancer continuum, from screening and early detection to treatment and survival. Barriers related to poverty include lack of a primary care physician, inadequate health insurance, and poor access to health care. Barriers related to culture include perceived invulnerability, folk beliefs, and a general mistrust of the health care system. Barriers related to social injustice include racial profiling and discrimination. Many of these barriers are potentially modifiable. Thus, in addition to biomedical advancements, future efforts to reduce disparities in breast cancer mortality should address social barriers that perpetuate disparities among African American and White women in the United States.

  8. Sex-specific determinants of fitness in a social mammal.

    PubMed

    Lardy, Sophie; Allainé, Dominique; Bonenfant, Christophe; Cohas, Aurélie

    2015-11-01

    Sociality should evolve when the fitness benefits of group living outweigh the costs. Theoretical models predict an optimal group size maximizing individual fitness. However, beyond the number of individuals present in a group, the characteristics of these individuals, like their sex, are likely to affect the fitness payoffs of group living. Using 20 years of individually based data on a social mammal, the Alpine marmot (Marmota marmota), we tested for the occurrence of an optimal group size and composition, and for sex-specific effects of group characteristics on fitness. Based on lifetime data of 52 males and 39 females, our findings support the existence of an optimal group size maximizing male fitness and an optimal group composition maximizing fitness of males and females. Additionally, although group characteristics (i.e., size, composition and instability) affecting male and female fitness differed, fitness depended strongly on the number of same-sex subordinates within the social group in the two sexes. By comparing multiple measures of social group characteristics and of fitness in both sexes, we highlighted the sex-specific determinants of fitness in the two sexes and revealed the crucial role of intrasexual competition in shaping social group composition.

  9. Sex-specific determinants of fitness in a social mammal.

    PubMed

    Lardy, Sophie; Allainé, Dominique; Bonenfant, Christophe; Cohas, Aurélie

    2015-11-01

    Sociality should evolve when the fitness benefits of group living outweigh the costs. Theoretical models predict an optimal group size maximizing individual fitness. However, beyond the number of individuals present in a group, the characteristics of these individuals, like their sex, are likely to affect the fitness payoffs of group living. Using 20 years of individually based data on a social mammal, the Alpine marmot (Marmota marmota), we tested for the occurrence of an optimal group size and composition, and for sex-specific effects of group characteristics on fitness. Based on lifetime data of 52 males and 39 females, our findings support the existence of an optimal group size maximizing male fitness and an optimal group composition maximizing fitness of males and females. Additionally, although group characteristics (i.e., size, composition and instability) affecting male and female fitness differed, fitness depended strongly on the number of same-sex subordinates within the social group in the two sexes. By comparing multiple measures of social group characteristics and of fitness in both sexes, we highlighted the sex-specific determinants of fitness in the two sexes and revealed the crucial role of intrasexual competition in shaping social group composition. PMID:27070014

  10. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin

    PubMed Central

    Pande, Saket; Keyzer, Michiel A; Arouna, Aminou; Sonneveld, Ben GJS

    2008-01-01

    Background In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions in the Middle Belt will remain moderate. Consequently, the Middle Belt might become a major area for immigration but there may be constraining factors as well, particularly with respect to water availability. As a case study, the paper looks into the capacity of the Middle Belt zone of Benin, known as the Oueme River Basin (ORB), to reduce diarrhea prevalence. In Benin it links to the Millennium Development Goals on child mortality and environmental sustainability that are currently farthest from realization. However, diarrhea prevalence is only in part due to lack of availability of drinking water from a safe source. Social factors such as hygienic practices and poor sanitation are also at play. Furthermore, we consider these factors to possess the properties of a local public good that suffers from under provision and requires collective action, as individual actions to prevent illness are bound to fail as long as others free ride. Methods Combining data from the Demographic Health Survey with various spatial data sets for Benin, we apply mixed effect logit regression to arrive at a spatially explicit assessment of geographical and social determinants of diarrhea prevalence. Starting from an analysis of these factors separately at national level, we identify relevant proxies at household level, estimate a function with geo-referenced independent variables and apply it to evaluate the costs and impacts of improving access to good water in the basin. Results First, the study confirms the well established stylized fact on the causes of diarrhea that a household with access to clean water and with good hygienic practices will, irrespective of other conditions, not suffer

  11. Sociology, Music Education, and Social Change: The Prospect of Addressing Their Relations by Attending to Some Central, Expanded Concepts

    ERIC Educational Resources Information Center

    Johansen, Geir

    2014-01-01

    Studies on sociology and music education are important because they can enlighten how music education relates to social change. By studying how music education changes and is changed by society we enable ourselves to describe how it can contribute to the understanding of social change generally. This may lay the ground for us in contributing to…

  12. Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting.

    PubMed

    Haselow, Nancy J; Stormer, Ame; Pries, Alissa

    2016-05-01

    Despite progress in reducing hunger and malnutrition since the 1990s, many still suffer from undernutrition and food insecurity, particularly women and young children, resulting in preterm birth, low birthweight and stunting, among other conditions. Helen Keller International (HKI) has addressed malnutrition and household food insecurity through implementation of an Enhanced Homestead Food Production (EHFP) programme that increases year-round availability and intake of diverse micronutrient-rich foods and promotes optimal nutrition and hygiene practices among poor households. This paper reviews the evolution and impact of HKI's EHFP programme and identifies core components of the model that address the underlying determinants of stunting. To date, evaluations of EHFP have shown impact on food production, consumption by women and children and household food security. Sale of surplus produce has increased household income, and the use of a transformative gender approach has empowered women. EHFP has also realized nutrition improvements in many project sites. Results from a randomized control trial (RCT) in Baitadi district, Nepal showed a significant improvement in a range of practices known to impact child growth, although no impact on stunting. Additional non-RCT evaluations in Kailali district of Nepal, demonstrated a 10.5% reduction in stunting and in the Chittagong Hill Tracts in Bangladesh, revealed an 18% decrease in stunting. Based on evidence, the EHFP has evolved into an integrated package that includes agriculture, nutrition, water/hygiene/sanitation, linkages to health care, women's empowerment, income generation and advocacy. Closing the stunting gap requires long-term exposure to targeted multi-sectoral solutions and rigorous evaluation to optimize impact. PMID:27187913

  13. Evidence-based evolution of an integrated nutrition-focused agriculture approach to address the underlying determinants of stunting.

    PubMed

    Haselow, Nancy J; Stormer, Ame; Pries, Alissa

    2016-05-01

    Despite progress in reducing hunger and malnutrition since the 1990s, many still suffer from undernutrition and food insecurity, particularly women and young children, resulting in preterm birth, low birthweight and stunting, among other conditions. Helen Keller International (HKI) has addressed malnutrition and household food insecurity through implementation of an Enhanced Homestead Food Production (EHFP) programme that increases year-round availability and intake of diverse micronutrient-rich foods and promotes optimal nutrition and hygiene practices among poor households. This paper reviews the evolution and impact of HKI's EHFP programme and identifies core components of the model that address the underlying determinants of stunting. To date, evaluations of EHFP have shown impact on food production, consumption by women and children and household food security. Sale of surplus produce has increased household income, and the use of a transformative gender approach has empowered women. EHFP has also realized nutrition improvements in many project sites. Results from a randomized control trial (RCT) in Baitadi district, Nepal showed a significant improvement in a range of practices known to impact child growth, although no impact on stunting. Additional non-RCT evaluations in Kailali district of Nepal, demonstrated a 10.5% reduction in stunting and in the Chittagong Hill Tracts in Bangladesh, revealed an 18% decrease in stunting. Based on evidence, the EHFP has evolved into an integrated package that includes agriculture, nutrition, water/hygiene/sanitation, linkages to health care, women's empowerment, income generation and advocacy. Closing the stunting gap requires long-term exposure to targeted multi-sectoral solutions and rigorous evaluation to optimize impact.

  14. Social determinants of health and oral health: An Indian perspective

    PubMed Central

    Mehta, Viral V.; Rajesh, G.; Rao, Ashwini; Shenoy, Ramya; Pai, Mithun

    2015-01-01

    Several conventional approaches have been tried in the past to resolve health inequities in India. However, achieving Universal Health Coverage (UHC) is yet to be fully realized as the benefits have been meager. The recent concept of targeting social determinants of general and oral health in order to achieve health for all has shown positive results in the developed as well as the developing nations. Based on the framework recommended by the Commission on Social Determinants of Health, several policies have been introduced and suitably backed up with the intention of providing health care even to people living in remote sections of the society. This paper intends to highlight the rationale for social determinants approach in Indian context, its application and future recommendations for the same. It is considered as a radical approach, and adequate measures have been implemented by health systems to achieve the desired targets without delay. However, in order to achieve UHC, redistribution of the available resources and converting the “normative” needs into “felt” needs of the people is going to be an uphill task to accomplish. PMID:26500407

  15. A Social Media mHealth Solution to Address the Needs of Dengue Prevention and Management in Sri Lanka

    PubMed Central

    Rathnayake, Vajira Sampath; Lim, Gentatsu; Panchapakesan, Chitra; Foo, Schubert; Wijayamuni, Ruwan; Wimalaratne, Prasad; Fernando, Owen Noel Newton

    2016-01-01

    Background Sri Lanka has witnessed a series of dengue epidemics over the past five years, with the western province, home to the political capital of Colombo, bearing more than half of the dengue burden. Existing dengue monitoring prevention programs are exhausted as public health inspectors (PHIs) cope with increasing workloads and paper-based modes of surveillance and education, characterizing a reactive system unable to cope with the enormity of the problem. On the other hand, the unprecedented proliferation and affordability of mobile phones since 2009 and a supportive political climate have thus far remained unexploited for the use of mobile-based interventions for dengue management. Objective To conduct a needs assessment of PHIs in Colombo with respect to their dengue-related tasks and develop a new mobile-based system to address these needs while strengthening existing systems. Methods One-on-one in-depth interviews were conducted with 29 PHIs to a) gain a nuanced, in-depth understanding of the current state of surveillance practices, b) understand the logistical, technological and social challenges they confront, and c) identify opportunities for mobile-based interventions. Quantitative analysis included simple descriptive statistics while qualitative analysis comprised textual analysis of 209 pages of transcripts (or nearly 600 minutes of conversations) using grounded theory approaches. Results Current paper-based data collection practices for dengue surveillance involved a circuitous, time consuming process that could take between 7-10 days to officially report and record a single case. PHIs confronted challenges in terms of unreliable, standalone GIS devices, delays in registering mosquito breeding sites and lack of engagement from communities while delivering dengue education. These findings, in concert with a high motivation to use mobile-based systems, informed the development of Mo-Buzz, a mobile-based system that integrates three components

  16. 49 CFR Appendix E to Part 26 - Individual Determinations of Social and Economic Disadvantage

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... disadvantage determinations (see 13 CFR 124.103(c) and 124.104). Social Disadvantage I. Socially disadvantaged... 49 Transportation 1 2013-10-01 2013-10-01 false Individual Determinations of Social and Economic... Appendix E to Part 26—Individual Determinations of Social and Economic Disadvantage The following...

  17. 49 CFR Appendix E to Part 26 - Individual Determinations of Social and Economic Disadvantage

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... disadvantage determinations (see 13 CFR 124.103(c) and 124.104). Social Disadvantage I. Socially disadvantaged... 49 Transportation 1 2011-10-01 2011-10-01 false Individual Determinations of Social and Economic... Appendix E to Part 26—Individual Determinations of Social and Economic Disadvantage The following...

  18. Social and Medical Determinants of Cardiometabolic Health: The Big Picture.

    PubMed

    Puckrein, Gary A; Egan, Brent M; Howard, George

    2015-01-01

    Cardiometabolic diseases, including diabetes and heart disease, account for >12 million years of life lost annually among Black adults in the United States. Health disparities are geographically localized, with ~80% of health disparities occurring within ~6000 (16%) of all 38,000 US ZIP codes. Socio-economic status (SES), behavioral and environmental factors (social determinants) account for ~80% of variance in health outcomes and cluster geographically. Neighborhood SES is inversely associated with prevalent diabetes and hypertension, and Blacks are four times more likely than Whites to live in lowest SES neighborhoods. In ZIP code 48235 (Detroit, 97% Black, 16.2% unemployed, income/capita $18,343, 23.6% poverty), 1082 Medicare fee-for service (FFS) beneficiaries received care for type 2 diabetes (T2D) and coronary artery disease (CAD) in 2012. Collectively, these beneficiaries had 1082 inpatient admissions and 839 emergency department visits, mean cost $27,759/beneficiary and mortality 2.7%. Nationally in 2011, 236,222 Black Medicare FFS beneficiaries had 213,715 inpatient admissions, 191,346 emergency department visits, mean cost $25,580/beneficiary and 2.4% mortality. In addition to more prevalent hypertension and T2D, Blacks appear more susceptible to clinical complications of risk factors than Whites, including hypertension as a contributor to stroke. Cardiometabolic health equity in African Americans requires interventions on social determinants to reduce excess risk prevalence of risk factors. Social-medical interventions to promote timely access to, delivery of and adherence with evidence-based medicine are needed to counterbalance greater disease susceptibility. Place-based interventions on social and medical determinants of health could reduce the burden of life lost to cardiometabolic diseases in Blacks. PMID:26673674

  19. Social and Medical Determinants of Cardiometabolic Health: The Big Picture.

    PubMed

    Puckrein, Gary A; Egan, Brent M; Howard, George

    2015-01-01

    Cardiometabolic diseases, including diabetes and heart disease, account for >12 million years of life lost annually among Black adults in the United States. Health disparities are geographically localized, with ~80% of health disparities occurring within ~6000 (16%) of all 38,000 US ZIP codes. Socio-economic status (SES), behavioral and environmental factors (social determinants) account for ~80% of variance in health outcomes and cluster geographically. Neighborhood SES is inversely associated with prevalent diabetes and hypertension, and Blacks are four times more likely than Whites to live in lowest SES neighborhoods. In ZIP code 48235 (Detroit, 97% Black, 16.2% unemployed, income/capita $18,343, 23.6% poverty), 1082 Medicare fee-for service (FFS) beneficiaries received care for type 2 diabetes (T2D) and coronary artery disease (CAD) in 2012. Collectively, these beneficiaries had 1082 inpatient admissions and 839 emergency department visits, mean cost $27,759/beneficiary and mortality 2.7%. Nationally in 2011, 236,222 Black Medicare FFS beneficiaries had 213,715 inpatient admissions, 191,346 emergency department visits, mean cost $25,580/beneficiary and 2.4% mortality. In addition to more prevalent hypertension and T2D, Blacks appear more susceptible to clinical complications of risk factors than Whites, including hypertension as a contributor to stroke. Cardiometabolic health equity in African Americans requires interventions on social determinants to reduce excess risk prevalence of risk factors. Social-medical interventions to promote timely access to, delivery of and adherence with evidence-based medicine are needed to counterbalance greater disease susceptibility. Place-based interventions on social and medical determinants of health could reduce the burden of life lost to cardiometabolic diseases in Blacks.

  20. What constitutes a health-enabling neighborhood? A grounded theory situational analysis addressing the significance of social capital and gender.

    PubMed

    Eriksson, Malin; Emmelin, Maria

    2013-11-01

    Variations in health between neighborhoods are well known and the conceptualization of social capital has contributed to an understanding of how contextual factors influence these differences. Studies show positive health-effects from living in high social capital areas, at least for some population sub-groups. The aim of this qualitative study was to understand what constitutes a 'health-enabling' neighborhood. It follows up results from a social capital survey in northern Sweden indicating that the health effects of living in a high social capital neighborhood is gendered in favor of women. A grounded theory situational analysis of eight focus group discussions--four with men and four with women--illustrated similar and different positions on how neighborhood characteristics influence health. A neighborhood, where people say hi to each other ("hi-factor") and where support between neighbors exist, were factors perceived as positive for health by all, as was a good location, neighborhood greenness and proximity to essential arenas. Women perceived freedom from demands, feeling safe and city life as additional health enabling factors. For men freedom to do what you want, a sense of belonging, and countryside life were important. To have burdensome neighbors, physical disturbances and a densely living environment were perceived as negative for health in both groups while demands for a well styled home and feeling unsafe were perceived as negative for health among women. Neighborhood social capital, together with other elements in the living environment, has fundamental influence on people's perceived health. Our findings do not confirm that social capital is more important for women than for men but that distinctive form of social capital differ in impact. Investing in physical interventions, such as planning for meeting places, constructing attractive green areas, and making neighborhoods walking-friendly, may increase human interactions that is instrumental for

  1. What constitutes a health-enabling neighborhood? A grounded theory situational analysis addressing the significance of social capital and gender.

    PubMed

    Eriksson, Malin; Emmelin, Maria

    2013-11-01

    Variations in health between neighborhoods are well known and the conceptualization of social capital has contributed to an understanding of how contextual factors influence these differences. Studies show positive health-effects from living in high social capital areas, at least for some population sub-groups. The aim of this qualitative study was to understand what constitutes a 'health-enabling' neighborhood. It follows up results from a social capital survey in northern Sweden indicating that the health effects of living in a high social capital neighborhood is gendered in favor of women. A grounded theory situational analysis of eight focus group discussions--four with men and four with women--illustrated similar and different positions on how neighborhood characteristics influence health. A neighborhood, where people say hi to each other ("hi-factor") and where support between neighbors exist, were factors perceived as positive for health by all, as was a good location, neighborhood greenness and proximity to essential arenas. Women perceived freedom from demands, feeling safe and city life as additional health enabling factors. For men freedom to do what you want, a sense of belonging, and countryside life were important. To have burdensome neighbors, physical disturbances and a densely living environment were perceived as negative for health in both groups while demands for a well styled home and feeling unsafe were perceived as negative for health among women. Neighborhood social capital, together with other elements in the living environment, has fundamental influence on people's perceived health. Our findings do not confirm that social capital is more important for women than for men but that distinctive form of social capital differ in impact. Investing in physical interventions, such as planning for meeting places, constructing attractive green areas, and making neighborhoods walking-friendly, may increase human interactions that is instrumental for

  2. Social determinants of health, inequality and social inclusion among people with disabilities1

    PubMed Central

    Fiorati, Regina Celia; Elui, Valeria Meirelles Carril

    2015-01-01

    OBJECTIVE: to analyze the socio-familial and community inclusion and social participation of people with disabilities, as well as their inclusion in occupations in daily life. METHOD: qualitative study with data collected through open interviews concerning the participants' life histories and systematic observation. The sample was composed of ten individuals with acquired or congenital disabilities living in the region covered by a Family Health Center. The social conception of disability was the theoretical framework used. Data were analyzed according to an interpretative reconstructive approach based on Habermas' Theory of Communicative Action. RESULTS: the results show that the socio-familial and community inclusion of the study participants is conditioned to the social determinants of health and present high levels of social inequality expressed by difficult access to PHC and rehabilitation services, work and income, education, culture, transportation and social participation. CONCLUSION: there is a need to develop community-centered care programs in cooperation with PHC services aiming to cope with poverty and improve social inclusion. PMID:26039305

  3. Understanding veterinary students' use of and attitudes toward the social networking site, Facebook, to assist in developing curricula to address online professionalism.

    PubMed

    Coe, Jason B; Weijs, Cynthia A; Muise, Amy; Christofides, Emily; Desmarais, Serge

    2012-01-01

    Social media is an increasingly common form of communication, with Facebook being the preferred social-networking site among post-secondary students. Numerous studies suggest post-secondary students practice high self-disclosure on Facebook. Research evaluating veterinary students' use of social media found a notable proportion of student-posted content deemed inappropriate. Lack of discretion in posting content can have significant repercussions for aspiring veterinary professionals, their college of study, and the veterinary profession they represent. Veterinarians-in-training at three veterinary colleges across Canada were surveyed to explore their use of and attitude toward the social networking site, Facebook. Students were invited to complete an online survey with questions relating to their knowledge of privacy in relation to using Facebook, their views on the acceptability of posting certain types of information, and their level of professional accountability online. Linear regression modeling was used to further examine factors related to veterinary students' disclosure of personal information on Facebook. Need for popularity (p<.01) and awareness of consequences (p<.001) were found to be positively and negatively associated, respectively, with students' personal disclosure of information on Facebook. Understanding veterinary students' use of and attitudes toward social media, such as Facebook, reveals a need, and provides a basis, for developing educational programs to address online professionalism. Educators and administrators at veterinary schools may use this information to assist in developing veterinary curricula that addresses the escalating issue of online professionalism. PMID:22951465

  4. Understanding veterinary students' use of and attitudes toward the social networking site, Facebook, to assist in developing curricula to address online professionalism.

    PubMed

    Coe, Jason B; Weijs, Cynthia A; Muise, Amy; Christofides, Emily; Desmarais, Serge

    2012-01-01

    Social media is an increasingly common form of communication, with Facebook being the preferred social-networking site among post-secondary students. Numerous studies suggest post-secondary students practice high self-disclosure on Facebook. Research evaluating veterinary students' use of social media found a notable proportion of student-posted content deemed inappropriate. Lack of discretion in posting content can have significant repercussions for aspiring veterinary professionals, their college of study, and the veterinary profession they represent. Veterinarians-in-training at three veterinary colleges across Canada were surveyed to explore their use of and attitude toward the social networking site, Facebook. Students were invited to complete an online survey with questions relating to their knowledge of privacy in relation to using Facebook, their views on the acceptability of posting certain types of information, and their level of professional accountability online. Linear regression modeling was used to further examine factors related to veterinary students' disclosure of personal information on Facebook. Need for popularity (p<.01) and awareness of consequences (p<.001) were found to be positively and negatively associated, respectively, with students' personal disclosure of information on Facebook. Understanding veterinary students' use of and attitudes toward social media, such as Facebook, reveals a need, and provides a basis, for developing educational programs to address online professionalism. Educators and administrators at veterinary schools may use this information to assist in developing veterinary curricula that addresses the escalating issue of online professionalism.

  5. [Intersectoriality, social and environmental determinants and health promotion].

    PubMed

    Silva, Kênia Lara; Sena, Roseni Rosângela; Akerman, Marco; Belga, Stephanie Marques Moura; Rodrigues, Andreza Trevenzoli

    2014-11-01

    The study seeks to analyze intersectoriality from the socio-environmental perspective on health promotion. Qualitative research was conducted in six municipalities in Belo Horizonte, Minas Gerais, Brazil. The data were obtained from the mapping of health promotion experiences considered successful by municipal managers, interviews with coordinators, professionals and participants and observations of participants of the practices. The data were subjected to thematic content analysis. Intersectoriality was revealed as a premise for the political definition of the majority of the practices. At the normative program level, the social assistance sector has shown greater potential to develop intersectorial practices and centrality in the implementation grid due to its involvement with the social and environmental determinants. The results indicate that there is a gap between the intention to practice intersectoriality, witnessed by the political decisions in the municipalities, and effective intersectorial action in everyday life. The conclusion reached is that there is potential for intersectorial interventions on the social and environmental determinants in favor of health promotion, but the lack of consistency between what occurs in practice and the political aspects reveal a challenge to be overcome.

  6. Difference in social determinants of health between men in the poor and the wealthy social strata in a Caribbean nation

    PubMed Central

    Bourne, Paul A.; Eldemire-Shearer, Denise

    2010-01-01

    Background: Studies that have examined social determinants of health have made their investigations on the population, but none have reviewed them from the perspective of particular social hierarchies. Aim: The study examined the factors determining the self-reported health of men of different socioeconomic status, by using models derived through econometric analyses. Materials & Methods: The study used a sample of 6,474 respondents: 2,704 from the two poor quintiles and 3,770 from the two wealthy quintiles. The survey used a random stratified probability sampling technique and involved the use of self-administered questionnaires. Multiple logistic regression technique was used to identify variables which are associated with health conditions of men in the two social hierarchies. Results: The findings revealed that the self-reported health of men in the two wealthiest quintiles were substantially influenced by private health insurance coverage (Odds Ratio (OR) = 32.9, 95%CI: 20.64, 52.45) and age of respondents (OR = 1.03, 95%CI: 1.02, 1.04) This was similar for men in the two poorest income quintiles; private health insurance coverage (OR = 16.97, 95%CI: 10.18, 28.27) and age (OR=1.05, 95%CI: 1.03, 1.06). Negative affective psychological conditions, consumption and medical expenditure affected the self-reported health of those in the two wealthiest quintiles, while positive affective, secondary levels of education and living alone influenced those in the two poorest quintiles. Conclusion: This research serves as a foundation for further work relating to the determinants of self-reported health conditions, inequity across socio-economic strata for men, and how patient care should be addressed. PMID:22574302

  7. Integrating the 3Ds—Social Determinants, Health Disparities, and Health-Care Workforce Diversity

    PubMed Central

    Pierre, Geraldine

    2014-01-01

    The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce. PMID:24385659

  8. Addressing the Social and Academic Behavior of a Student with Emotional and Behavioral Disorders in an Alternative Setting

    ERIC Educational Resources Information Center

    Swoszowski, N. C.; Jolivette, K.; Frederick, L. D.

    2013-01-01

    Check-In/Check-Out is a secondary tier positive behavior support program in which an adult mentor is paired with a student to address problem behavior and support appropriate behavior. This case study extended the implementation of the Check-In/Check-Out strategy to a residential facility for students with emotional and behavioral disorders. The…

  9. Globalization, human rights, and the social determinants of health.

    PubMed

    Chapman, Audrey R

    2009-02-01

    Globalization, a process characterized by the growing interdependence of the world's people, impacts health systems and the social determinants of health in ways that are detrimental to health equity. In a world in which there are few countervailing normative and policy approaches to the dominant neoliberal regime underpinning globalization, the human rights paradigm constitutes a widely shared foundation for challenging globalization's effects. The substantive rights enumerated in human rights instruments include the right to the highest attainable level of physical and mental health and others that are relevant to the determinants of health. The rights stipulated in these documents impose extensive legal obligations on states that have ratified these documents and confer health entitlements on their residents. Human rights norms have also inspired civil society efforts to improve access to essential medicines and medical services, particularly for HIV/AIDS. Nevertheless, many factors reduce the potential counterweight human rights might exert, including and specifically the nature of the human rights approach, weak political commitments to promoting and protecting health rights on the part of some states and their lack of institutional and economic resources to do so. Global economic markets and the relative power of global economic institutions are also shrinking national policy space. This article reviews the potential contributions and limitations of human rights to achieving greater equity in shaping the social determinants of health.

  10. Distance Education MBA Students: An Investigation into the Use of an Orientation Course to Address Academic and Social Integration Issues

    ERIC Educational Resources Information Center

    Kanuka, Heather; Jugdev, Kam

    2006-01-01

    Distance education programmes warrant the use of innovative intervention practices to enhance student learning experiences. Academic and social empathy by faculty has been shown to enhance student retention in programmes along with their critical thinking abilities. Using Holmberg's theory of teaching-learning conversations as the guiding…

  11. Social Franchising: A Blockbuster to Address Unmet Need for Family Planning and to Advance Toward the FP2020 Goal.

    PubMed

    2015-06-17

    Social franchising has scaled-up provision of voluntary family planning, especially long-acting reversible contraceptives, across Africa and Asia at a rapid and remarkable pace. The approach should be pursued vigorously, especially in countries with a significant private-sector presence, to advance the FP2020 goal of providing access to modern contraception to 120 million additional clients by 2020.

  12. Impact Evaluation of Reactive Assessment Strategies to Address Social Loafing by Promoting Student Cooperation and Encouraging Mutual Support

    ERIC Educational Resources Information Center

    Arevalillo-Herráez, Miguel

    2014-01-01

    Cooperative work is an effective strategy when team members are kept motivated and collaborate towards the achievement of a common goal. However, social loafing may significantly reduce educational gains. In this article, we analyse whether assessment-based reactive strategies that exploit existing emotional relationships between the team members…

  13. Poststroke Depression: Social Workers' Role in Addressing an Underrecognized Psychological Problem for Couples Who Have Experienced Stroke

    ERIC Educational Resources Information Center

    McCarthy, Michael J.; Powers, Laurie E.; Lyons, Karen S.

    2011-01-01

    Depression is the most common psychological challenge faced by many individuals and families following stroke. Fortunately, poststroke depression is treatable, and even preventable, if social work and other rehabilitation practitioners understand the most common risk factors and become familiar with measures for assessing for depression among…

  14. Social cognitive determinants of dietary behavior change in university employes.

    PubMed

    Doerksen, Shawna E; McAuley, Edward

    2014-01-01

    Many adults have poor dietary habits and few studies have focused on mechanisms underlying these behaviors. This study examined psychosocial determinants of dietary behavior change in university employes across a 5-month period. Participants completed measures of fruit and vegetable consumption (FVC) and low fat food consumption (LFC) and social cognitive constructs. Multiple regression analyses accounted for a unique proportion of variation in dietary change. Outcome expectations significantly predicted FVC and LFC. Self-efficacy significantly predicted LFC. Goals were not associated with dietary behaviors. Further research into implementation strategies may provide insight into how goals work to bring about change.

  15. Social Cognitive Determinants of Dietary Behavior Change in University Employes

    PubMed Central

    Doerksen, Shawna E.; McAuley, Edward

    2014-01-01

    Many adults have poor dietary habits and few studies have focused on mechanisms underlying these behaviors. This study examined psychosocial determinants of dietary behavior change in university employes across a 5-month period. Participants completed measures of fruit and vegetable consumption (FVC) and low fat food consumption (LFC) and social cognitive constructs. Multiple regression analyses accounted for a unique proportion of variation in dietary change. Outcome expectations significantly predicted FVC and LFC. Self-efficacy significantly predicted LFC. Goals were not associated with dietary behaviors. Further research into implementation strategies may provide insight into how goals work to bring about change. PMID:24765620

  16. Beyond inequality: Acknowledging the complexity of social determinants of health.

    PubMed

    Eckersley, Richard

    2015-12-01

    The impact of inequality on health is gaining more attention as public and political concern grows over increasing inequality. The income inequality hypothesis, which holds that inequality is detrimental to overall population health, is especially pertinent. However the emphasis on inequality can be challenged on both empirical and theoretical grounds. Empirically, the evidence is contradictory and contested; theoretically, it is inconsistent with our understanding of human societies as complex systems. Research and discussion, both scientific and political, need to reflect better this complexity, and give greater recognition to other social determinants of health. PMID:26560411

  17. The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

    PubMed Central

    Kim, Daniel; Saada, Adrianna

    2013-01-01

    Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world. PMID:23739649

  18. The social determinants of infant mortality and birth outcomes in Western developed nations: a cross-country systematic review.

    PubMed

    Kim, Daniel; Saada, Adrianna

    2013-06-01

    Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world.

  19. 49 CFR Appendix E to Part 26 - Individual Determinations of Social and Economic Disadvantage

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Appendix E to Part 26—Individual Determinations of Social and Economic Disadvantage The following guidance... disadvantage determinations (see 13 CFR 124.103(c) and 124.104). Social Disadvantage I. Socially disadvantaged... access to institutions of higher education and vocational training, exclusion from social...

  20. 49 CFR Appendix E to Part 26 - Individual Determinations of Social and Economic Disadvantage

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Appendix E to Part 26—Individual Determinations of Social and Economic Disadvantage The following guidance... disadvantage determinations (see 13 CFR 124.103(c) and 124.104). Social Disadvantage I. Socially disadvantaged... access to institutions of higher education and vocational training, exclusion from social...

  1. Addressing Environmental Health Inequalities

    PubMed Central

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), “Addressing Environmental Health Inequalities—Proceedings from the ISEE Conference 2015”, we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  2. Addressing Environmental Health Inequalities.

    PubMed

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), "Addressing Environmental Health Inequalities-Proceedings from the ISEE Conference 2015", we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  3. State of the (net)work address Developing criteria for applying social networking to the work environment.

    PubMed

    Valdez, André Calero; Schaar, Anne Kathrin; Ziefle, Martina

    2012-01-01

    In an increasingly faster paced innovative world, maintaining the ability to innovate in spite of an aging work force will become every company's strongest leverage for success. Tapping the latent knowledge resources and creativity of overlooked employees and persisting crucial information for business conduct are promising results for social networking sites (SNS) in a working context. Usability and usefulness are exponential factors in creating a successful SNS. In order to make a SNS usable for a heterogeneous user group, analyses of user diversity in regard to social media need to be done. Furthermore differences in communication medium and frequency in regard to age, content, hierarchy position, departmental thresholds and company size need to be analyzed. For analysis purposes both qualitative and quantitative research methods were applied. Strong effects of age and communication content were found in survey with 194 participants. PMID:22317248

  4. State of the (net)work address Developing criteria for applying social networking to the work environment.

    PubMed

    Valdez, André Calero; Schaar, Anne Kathrin; Ziefle, Martina

    2012-01-01

    In an increasingly faster paced innovative world, maintaining the ability to innovate in spite of an aging work force will become every company's strongest leverage for success. Tapping the latent knowledge resources and creativity of overlooked employees and persisting crucial information for business conduct are promising results for social networking sites (SNS) in a working context. Usability and usefulness are exponential factors in creating a successful SNS. In order to make a SNS usable for a heterogeneous user group, analyses of user diversity in regard to social media need to be done. Furthermore differences in communication medium and frequency in regard to age, content, hierarchy position, departmental thresholds and company size need to be analyzed. For analysis purposes both qualitative and quantitative research methods were applied. Strong effects of age and communication content were found in survey with 194 participants.

  5. Social determinants of health and health inequities in Nakuru (Kenya)

    PubMed Central

    Muchukuri, Esther; Grenier, Francis R

    2009-01-01

    Background Dramatic inequalities dominate global health today. The rapid urban growth sustained by Kenya in the last decades has created many difficulties that also led to worsening inequalities in health care. The continuous decline in its Human Development Index since the 1990s highlights the hardship that continues to worsen in the country, against the general trend of Sub-Saharan Africa. This paper examines the health status of residents in a major urban centre in Kenya and reviews the effects of selected social determinants on local health. Methods Through field surveys, focus group discussions and a literature review, this study canvasses past and current initiatives and recommends priority actions. Results Areas identified which unevenly affect the health of the most vulnerable segments of the population were: water supply, sanitation, solid waste management, food environments, housing, the organization of health care services and transportation. Conclusion The use of a participatory method proved to be a useful approach that could benefit other urban centres in their analysis of social determinants of health. PMID:19439105

  6. What we mean by social determinants of health.

    PubMed

    Navarro, Vicente

    2009-01-01

    This article analyzes the changes in health conditions and quality of life in the populations of developed and developing countries over the past 30 years, resulting from neoliberal policies developed by many governments and promoted by the World Bank, International Monetary Fund, World Health Organization, and other international agencies. It challenges interpretations by the analysts of "globalization", including the common assumption that states are disappearing. The author shows that what has been happening is not a reduction of state interventions but a change in the nature and character of those interventions, resulting from major changes in class (and race and gender) power relations in each country, with establishment of an alliance between the dominant classes of developed and developing countries-a class alliance responsible for the promotion of its ideology, neoliberalism. This is the cause of the enormous health inequalities in the world today. The article concludes with a critical analysis of the WHO report on social determinants of health, applauding its analysis and many of its recommendations, but faulting it for ignoring the power relations that shape these social determinants. It is not inequalities that kill people, as the report states; it is those who are responsible for these inequalities that kill people. PMID:19771949

  7. Relative Importance of Social Status and Physiological Need in Determining Leadership in a Social Forager

    PubMed Central

    Öst, Markus; Jaatinen, Kim

    2013-01-01

    Group decisions on the timing of mutually exclusive activities pose a dilemma: monopolized decision-making by a single leader compromises the optimal timing of activities by the others, while independent decision-making by all group members undermines group coherence. Theory suggests that initiation of foraging should be determined by physiological demand in social foragers, thereby resolving the dilemma of group coordination. However, empirical support is scant, perhaps because intrinsic qualities predisposing individuals to leadership (social status, experience or personality), or their interactions with satiation level, have seldom been simultaneously considered. Here, we examine which females initiated foraging in eider (Somateria mollissima) brood-rearing coalitions, characterized by female dominance hierarchies and potentially large individual differences in energy requirements due to strenuous breeding effort. Several physiological and social factors, except for female breeding experience and boldness towards predators, explained foraging initiation. Initiators spent a larger proportion of time submerged during foraging bouts, had poorer body condition and smaller structural size, but they were also aggressive and occupied central positions. Initiation probability also declined with female group size as expected given random assignment of initiators. However, the relative importance of physiological predictors of leadership propensity (active foraging time, body condition, structural size) exceeded those of social predictors (aggressiveness, spatial position) by an order of magnitude. These results confirm recent theoretical work suggesting that ‘leading according to need’ is an evolutionary viable strategy regardless of group heterogeneity or underlying dominance structure. PMID:23691258

  8. Relative importance of social status and physiological need in determining leadership in a social forager.

    PubMed

    Öst, Markus; Jaatinen, Kim

    2013-01-01

    Group decisions on the timing of mutually exclusive activities pose a dilemma: monopolized decision-making by a single leader compromises the optimal timing of activities by the others, while independent decision-making by all group members undermines group coherence. Theory suggests that initiation of foraging should be determined by physiological demand in social foragers, thereby resolving the dilemma of group coordination. However, empirical support is scant, perhaps because intrinsic qualities predisposing individuals to leadership (social status, experience or personality), or their interactions with satiation level, have seldom been simultaneously considered. Here, we examine which females initiated foraging in eider (Somateria mollissima) brood-rearing coalitions, characterized by female dominance hierarchies and potentially large individual differences in energy requirements due to strenuous breeding effort. Several physiological and social factors, except for female breeding experience and boldness towards predators, explained foraging initiation. Initiators spent a larger proportion of time submerged during foraging bouts, had poorer body condition and smaller structural size, but they were also aggressive and occupied central positions. Initiation probability also declined with female group size as expected given random assignment of initiators. However, the relative importance of physiological predictors of leadership propensity (active foraging time, body condition, structural size) exceeded those of social predictors (aggressiveness, spatial position) by an order of magnitude. These results confirm recent theoretical work suggesting that 'leading according to need' is an evolutionary viable strategy regardless of group heterogeneity or underlying dominance structure. PMID:23691258

  9. Relative importance of social status and physiological need in determining leadership in a social forager.

    PubMed

    Öst, Markus; Jaatinen, Kim

    2013-01-01

    Group decisions on the timing of mutually exclusive activities pose a dilemma: monopolized decision-making by a single leader compromises the optimal timing of activities by the others, while independent decision-making by all group members undermines group coherence. Theory suggests that initiation of foraging should be determined by physiological demand in social foragers, thereby resolving the dilemma of group coordination. However, empirical support is scant, perhaps because intrinsic qualities predisposing individuals to leadership (social status, experience or personality), or their interactions with satiation level, have seldom been simultaneously considered. Here, we examine which females initiated foraging in eider (Somateria mollissima) brood-rearing coalitions, characterized by female dominance hierarchies and potentially large individual differences in energy requirements due to strenuous breeding effort. Several physiological and social factors, except for female breeding experience and boldness towards predators, explained foraging initiation. Initiators spent a larger proportion of time submerged during foraging bouts, had poorer body condition and smaller structural size, but they were also aggressive and occupied central positions. Initiation probability also declined with female group size as expected given random assignment of initiators. However, the relative importance of physiological predictors of leadership propensity (active foraging time, body condition, structural size) exceeded those of social predictors (aggressiveness, spatial position) by an order of magnitude. These results confirm recent theoretical work suggesting that 'leading according to need' is an evolutionary viable strategy regardless of group heterogeneity or underlying dominance structure.

  10. 49 CFR 26.67 - What rules determine social and economic disadvantage?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false What rules determine social and economic... Standards § 26.67 What rules determine social and economic disadvantage? (a) Presumption of disadvantage. (1... the determination of his or her disadvantage. (4) When an individual's presumption of social...

  11. 49 CFR 26.67 - What rules determine social and economic disadvantage?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What rules determine social and economic... Standards § 26.67 What rules determine social and economic disadvantage? (a) Presumption of disadvantage. (1... the determination of his or her disadvantage. (4) When an individual's presumption of social...

  12. A Research Agenda for Helminth Diseases of Humans: Social Ecology, Environmental Determinants, and Health Systems

    PubMed Central

    Gazzinelli, Andrea; Correa-Oliveira, Rodrigo; Yang, Guo-Jing; Boatin, Boakye A.; Kloos, Helmut

    2012-01-01

    In this paper, the Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), with the mandate to review helminthiases research and identify research priorities and gaps, focuses on the environmental, social, behavioural, and political determinants of human helminth infections and outlines a research and development agenda for the socioeconomic and health systems research required for the development of sustainable control programmes. Using Stockols' social-ecological approach, we describe the role of various social (poverty, policy, stigma, culture, and migration) and environmental determinants (the home environment, water resources development, and climate change) in the perpetuation of helminthic diseases, as well as their impact as contextual factors on health promotion interventions through both the regular and community-based health systems. We examine these interactions in regard to community participation, intersectoral collaboration, gender, and possibilities for upscaling helminthic disease control and elimination programmes within the context of integrated and interdisciplinary approaches. The research agenda summarises major gaps that need to be addressed. PMID:22545168

  13. Using a smokeless tobacco control mass media campaign and other synergistic elements to address social inequalities in India.

    PubMed

    Turk, Tahir; Murukutla, Nandita; Gupta, Shefali; Kaur, Jagdish; Mullin, Sandra; Saradhi, Ranjana; Chaturvedi, Pankaj

    2012-03-01

    The burden of tobacco-related morbidity and mortality in India is substantial, with smokeless tobacco being the predominant form of tobacco use. Use of smokeless tobacco (for example gutkha, paan, khaini, and pan masala) is linked to a host of socioeconomic and cultural factors including gender, regional differences, educational level, and income disparities. Given the scale of the problem, a national social marketing campaign was developed and implemented. The creative approach used testimonials from a surgeon and patients at Tata Memorial Hospital in Mumbai. The communication message approach was designed to reflect the realities of disfiguring, disabling, and fatal cancers caused by smokeless tobacco. Evaluation of the campaign identified significant differences across a range of campaign behavioral predictors by audience segments aware of the campaign versus those who were "campaign unaware". Significant findings were also identified regarding vulnerable groups by gender (female/male) and rural/urban disparities. Findings are discussed in relation to the powerful impact of using graphic, emotive, and testimonial imagery for tobacco control with socially disadvantaged groups. PMID:22350861

  14. Using a smokeless tobacco control mass media campaign and other synergistic elements to address social inequalities in India.

    PubMed

    Turk, Tahir; Murukutla, Nandita; Gupta, Shefali; Kaur, Jagdish; Mullin, Sandra; Saradhi, Ranjana; Chaturvedi, Pankaj

    2012-03-01

    The burden of tobacco-related morbidity and mortality in India is substantial, with smokeless tobacco being the predominant form of tobacco use. Use of smokeless tobacco (for example gutkha, paan, khaini, and pan masala) is linked to a host of socioeconomic and cultural factors including gender, regional differences, educational level, and income disparities. Given the scale of the problem, a national social marketing campaign was developed and implemented. The creative approach used testimonials from a surgeon and patients at Tata Memorial Hospital in Mumbai. The communication message approach was designed to reflect the realities of disfiguring, disabling, and fatal cancers caused by smokeless tobacco. Evaluation of the campaign identified significant differences across a range of campaign behavioral predictors by audience segments aware of the campaign versus those who were "campaign unaware". Significant findings were also identified regarding vulnerable groups by gender (female/male) and rural/urban disparities. Findings are discussed in relation to the powerful impact of using graphic, emotive, and testimonial imagery for tobacco control with socially disadvantaged groups.

  15. Social acceleration and the network effect: a defence of social 'science fiction' and network determinism.

    PubMed

    Hassan, Robert

    2010-06-01

    This essay is a response to Judy Wajcman's essay 'Life in the fast lane? Towards a sociology of technology and time' (2008: 59-77). In that article Wajcman argued that recent developments in the sociology of temporal change had been marked by a tendency in social theory towards a form of 'science fiction'--a sociological theorizing, she maintains, that bears no real relation to actual, empirically provable developments in the field and should therefore be viewed as not contributing to 'a richer analysis of the relationship between technology and time' (2008: 61). This reply argues that as Wajcman suggests in her essay, there is indeed an 'urgent need for increased dialogue to connect social theory with detailed empirical studies' (2008: 59) but that the most fruitful way to proceed would not be through a constraining of 'science fiction' social theorizing but, rather, through its expansion--and more, that 'science fiction' should take the lead in the process. This essay suggests that the connection between social theory and empirical studies would be strengthened by a wider understanding of the function of knowledge and research in the context of what is termed 'true originality' and 'routine originality'. The former is the domain of social theory and the latter resides within traditional sociological disciplines. It is argued that both need each other to advance our understanding of society, especially in the context of the fast-changing processes of technological development. The example of 'technological determinism' is discussed as illustrative of how 'routine originality' can harden into dogma without the application of 'true originality' to continually question (sometimes through ideas that may appear to border on 'science fiction') comfortable assumptions that may have become 'routine' and shorn of their initial 'originality'.

  16. Quality of life of men with AIDS and the model of social determinants of health1

    PubMed Central

    da Cunha, Gilmara Holanda; Fiuza, Maria Luciana Teles; Gir, Elucir; Aquino, Priscila de Souza; Pinheiro, Ana Karina Bezerra; Galvão, Marli Teresinha Gimeniz

    2015-01-01

    OBJECTIVE: to analyze the quality of life (QoL) of men with AIDS from the perspective of the model of social determinants of health (MSDH). METHOD: cross-sectional study conducted in an outpatient infectious diseases clinic from a Brazilian university hospital over the course of one year with a sample of 138 patients. A form based on the MSDH was used to collect sociodemographic data addressing individual, proximal, intermediate determinants and the influence of social networks together with an instrument used to assess the QoL of people with HIV/AIDS. The project was approved by the Institutional Review Board (Protocol No. 040.06.12). RESULTS: according to MSDH, most men with AIDS were between 30 and 49 years old (68.1%), mixed race (59.4%), heterosexual (46.4%), single (64.5%), Catholic (68.8%), had a bachelor's degree (39.2%), had no children (61.6%), and had a formal job (71.0%). The perception of QoL in the physical, level of independence, environment, and spirituality domains was intermediate, while QoL was perceived to be superior in the domains of psychological and social relationship. A perception of lower QoL was presented by homosexual (p=0.037) and married men (p=0.077), and those with income below one times the minimum wage (p=0.042). A perception of greater QoL was presented by those without a religion (p=0.005), living with a partner (p=0.049), and those who had a formal job (p=0.045). CONCLUSION: social determinants influence the QoL of men with AIDS. PMID:26039287

  17. A Minority Report for Social Work? The Predictive Risk Model (PRM) and the Tuituia Assessment Framework in addressing the needs of New Zealand's Vulnerable Children

    PubMed Central

    Oak, Eileen

    2016-01-01

    This article examines the viability of the Risk Predictor Model (RPM) and its counterpart the actuarial risk assessment (ARA) tool in the form of the Tuituia Assessment Framework to address child vulnerability in New Zealand. In doing so, it suggests that these types of risk-assessment tools fail to address issues of contingency and complexity at the heart of the relationship-based nature of social work practice. Such developments have considerable implications for the capacity to enhance critical reflexive practice skills, whilst the introduction of these risk tools is occurring at a time when the reflexive space is being eroded as a result of the increased regulation of practice and supervision. It is further asserted that the primary aim of such instruments is not so much to detect risk, but rather to foster professional conformity with these managerialist risk-management systems so prevalent in contemporary Western societies. PMID:27559223

  18. Re-imagining decision making: addressing a discrete social driver of HIV/AIDS through the lens of complexity science.

    PubMed

    Burman, Christopher J; Moerschell, Linda; Mamabolo, Robert; Aphane, Marota; Delobelle, Peter

    2015-01-01

    This article argues that decision making is a discrete social driver that can be associated with the HIV/AIDS epidemic in the Limpopo province in South Africa. The authors argue that complexity science can inform future research and interventions by presenting two decision making frameworks arising out of complexity science that have the potential to enable young people to better negotiate decision-making contexts whilst simultaneously opening spaces of dialogue that can mitigate the impact of HIV-risk in specific, punctuated contexts. The methodological design was prompted by findings from youth-oriented community engagement projects that include Communication Conversations and Sex & Relationships Education. The proposed methods have the potential to exploit the phenomenon of leadership emergence as a product of decision making at critical moments. This has the potential to promote the growth of home-grown leadership skill sets that make sense to young people and to enable them better manage their own health, thus reducing risk and vulnerability to HIV infection and sexual violence. PMID:25920986

  19. Re-imagining decision making: addressing a discrete social driver of HIV/AIDS through the lens of complexity science.

    PubMed

    Burman, Christopher J; Moerschell, Linda; Mamabolo, Robert; Aphane, Marota; Delobelle, Peter

    2015-01-01

    This article argues that decision making is a discrete social driver that can be associated with the HIV/AIDS epidemic in the Limpopo province in South Africa. The authors argue that complexity science can inform future research and interventions by presenting two decision making frameworks arising out of complexity science that have the potential to enable young people to better negotiate decision-making contexts whilst simultaneously opening spaces of dialogue that can mitigate the impact of HIV-risk in specific, punctuated contexts. The methodological design was prompted by findings from youth-oriented community engagement projects that include Communication Conversations and Sex & Relationships Education. The proposed methods have the potential to exploit the phenomenon of leadership emergence as a product of decision making at critical moments. This has the potential to promote the growth of home-grown leadership skill sets that make sense to young people and to enable them better manage their own health, thus reducing risk and vulnerability to HIV infection and sexual violence.

  20. Socialization and Self- Determination in Different-Age Dyads of Students Who Are Deafblind

    ERIC Educational Resources Information Center

    Bruce, Susan M.; Zatta, Mary C.; Gavin, Mary; Stelzer, Sharon

    2016-01-01

    Introduction: Deafblindness limits access to social cues and social feedback, thus restricting the development of social skills. Many children with CHARGE syndrome, a leading cause of deafblindness, experience challenges with emotional self-regulation and anxiety that may interfere with socialization. Learning about self-determination skills such…

  1. Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud

    PubMed Central

    O’Brien, Matthew J; Garland, Joseph M; Murphy, Katie M; Shuman, Sarah J; Whitaker, Robert C; Larson, Steven C

    2014-01-01

    Purpose Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. Participants and methods We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP), was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where students develop, implement, and evaluate an intervention to address a community-defined need. Results In our quantitative evaluation, students reported high levels of agreement with the HSP meeting stated course goals, including developing an understanding of the social determinants of health and working effectively with peers to implement community-based projects. Qualitative assessments revealed students’ perception of learning more about this topic in the HSP than in their formal medical training and of developing a long-term desire to serve vulnerable communities as a result. Conclusion Our experience with the HSP suggests that partnerships between academic medical centers and community-based organizations can create a feasible, effective, and sustainable platform for teaching medical students about the social determinants of health. Similar medical education programs in the future should seek to achieve a larger scale and to evaluate both students’ educational experiences and community

  2. Preliminary findings exploring the social determinants of Black males' lay health perspectives.

    PubMed

    Mount, David L; Johnson, Darin M; Rego, Maria Isabel; Schofield, Kandyce; Amponsah, Alethea; Graham, Louis F

    2012-01-01

    The unequal discussion of Black males' health is a pressing social problem. This study addressed Black males' lay perspectives regarding their health, illness, and mortality, with attention to the determinants of men's health, prevention, lifestyle, and opportunities for health promotion using an exploratory/qualitative research methodology. Participants were 68 Black males aged 15 to 68 years, with an average age of 44 years (SD = 14.5). The narratives represented a complex interplay of biopsychosocial factors, ranging from intrapersonal attitudes, interpersonal experiences to discussions about community and public policy injustices. Five prominent themes emerged: (a) lack of chronic disease awareness, (b) fatalism, (c) fear and anxiety of academic-medical settings, (d) hyperactive masculinity fatigue, and (e) the gay-straight divide. The term Tired Black Male Health syndrome was coined in the forum. Implications of these findings are discussed in the context of culturally relevant strategies for improving Black male community health engagement. PMID:22105065

  3. The Environmental Protection Agency's Watershed-based Approach: where social and natural sciences meet to address today's water resource challenges

    NASA Astrophysics Data System (ADS)

    Biddle, J. C.

    2010-12-01

    A growing number of governmental organizations at the local, state, and federal level collaborate with nongovernmental organizations and individuals to solve watershed scale problems (Imperial and Koontz, 2007). Such a shift in policy approach from hierarchical regulation to bottom-up collaboration is largely a result of regulator’s recognition of the interdependence of natural and socio-economic systems on a watershed scale (Steelman and Carmin, 2002. Agencies throughout the federal government increasingly favored new governing institutions that encourage cooperation between local actors with conflicting interests, divergent geographic bases, and overlapping administrative jurisdictions to resolve continuing disputes over resource management (Bardach 1998). This favoritism of collaborative over command-and-control approaches for managing nonpoint source pollution led to the development of watershed partnerships and the watershed-based approach (Lubell et al., 2002). This study aims to further collaborative governance scholarship and aid decision-makers in identifying the critical elements of collaborative governance resulting in environmental improvements. To date, this relationship has not been empirically determined, in spite of the fact that collaborative governance is used routinely by the U.S. Environmental Protection Agency in resolving issues related to watershed management and other applications. This gap in the research is largely due to the lack of longitudinal data. In order to determine whether changes have occurred, environmental data must be collected over relatively long time periods (Koontz and Thomas, 2006; Sabatier, et al., 2005). However, collecting these data is often cost prohibitive. Monitoring water quality is expensive and requires technical expertise, and is often the first line item cut in environmental management budgets. This research is interdisciplinary, looking at the physical, chemical, and biological parameters for 44 waterbodies

  4. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3)

    PubMed Central

    Labonté, Ronald; Schrecker, Ted

    2007-01-01

    Globalization is a key context for the study of social determinants of health (SDH): broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace. PMID:17578569

  5. Globalization and social determinants of health: The role of the global marketplace (part 2 of 3).

    PubMed

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    Globalization is a key context for the study of social determinants of health (SDH): broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

  6. Equity and the social determinants of health in European cities.

    PubMed

    Ritsatakis, Anna

    2013-10-01

    Equity in health has been the underlying value of the World Health Organization's (WHO) Health for All policy for 30 years. This article examines how cities have translated this principle into action. Using information designed to help evaluate phase IV (2003-2008) of the WHO European Healthy Cities Network (WHO-EHCN) plus documentation from city programs and websites, an attempt is made to assess how far the concept of equity in health is understood, the political will to tackle the issue, and types of action taken. Results show that although cities continue to focus considerable support on vulnerable groups, rather than the full social gradient, most are now making the necessary shift towards more upstream policies to tackle determinants of health such as poverty, unemployment, education, housing, and the environment, without neglecting access to care. Although local level data reflecting inequalities in health is improving, there is still a long way to go in some cities. The Healthy Cities Project is becoming an integral part of structures for long-term planning and intersectoral action for health in cities, and Health Impact Assessment is gradually being developed. Participation in the WHO-EHCN appears to allow new members to leap-frog ahead established cities. However, this evaluation also exposes barriers to effective local policies and processes to reduce health inequalities. Armed with locally generated evidence of critical success factors, the WHO-EHCN has embarked on a more rigorous and determined effort to achieve the prerequisites for equity in health. More attention will be given to evaluating the effectiveness of action taken and to dealing not only with the most vulnerable but a greater part of the gradient in socioeconomic health inequalities.

  7. Addressing Concerns.

    ERIC Educational Resources Information Center

    Cronin, Greg; Helmig, Mary; Kaplan, Bill; Kosch, Sharon

    2002-01-01

    Four camp directors discuss how the September 11 tragedy and current world events will affect their camps. They describe how they are addressing safety concerns, working with parents, cooperating with outside agencies, hiring and screening international staff, and revising emergency plans. Camps must continue to offer community and support to…

  8. Social Determinants of Health for Native Hawaiian Children and Adolescents

    PubMed Central

    Alameda, Christian K

    2011-01-01

    Introduction Traditional Hawaiian thought places children in a position of prominence in the family. Yet in Hawai‘i, Native Hawaiian children and adolescents face significant inequity in health outcomes. From prenatal alcohol and tobacco use, late or no prenatal care, macrosomia as well as low birth rates, to exclusive breastfeeding rates at 6 months, and high rates of infant mortality, Native Hawaiians face inequities in pre and early childhood indicators. During childhood and adolescence, Native Hawaiians experience high rates of obesity, and physical, mental and sexual abuse. This review examines the determinants behind the health inequities encountered by Native Hawaiian children and adolescents, and contextualizes those inequities s in a human rights-based approach to health. Methods A literature review was conducted for relevant research on Native Hawaiian and other indigenous children and adolescents. Existing data sources were also reviewed for relevant Native Hawaiian data. Results There is a significant dearth of data on the determinants of health for Native Hawaiian children and adolescents. Some prenatal data is available from the Prenatal Risk Assessment Monitoring System, while selected youth data is available from the Youth Behavioral Risk Factor system. Available data show significant inequities for Native Hawaiian children and adolescents, compared to other groups in Hawai‘i. Based on comparisons with other indigenous and marginalized peoples, the etiology of these disparities may be a lack of health equity, deriving from multigenerational trauma and discrimination as well as poverty and inequities of housing, education, environment, healthcare access, and social capital. Conclusions The significant barriers facing Native Hawaiian children and adolescents achieving their full potential constitute a challenge to the fulfillment of the human right to health. Future research needs to more fully articulate the linkage between the health status of

  9. Caste-, work-, and descent-based discrimination as a determinant of health in social epidemiology.

    PubMed

    Patil, Rajan R

    2014-01-01

    Social epidemiology explores health in the context of broad social determinants of health, where the boundary lines between health and politics appear increasingly blurred. Social determinants of health such as caste, discrimination, and social exclusion are inherently political in nature, hence it becomes imperative to look at health through a broader perspective of political philosophy, ideology, and caste that imposes enormous obstacles to a person's full attainment of civil, political, economic, social, and cultural rights. Caste is descent based and hereditary in nature. It is a characteristic determined by one's birth into a particular caste, irrespective of the faith practiced by the individual. Caste denotes a system of rigid social stratification into ranked groups defined by descent and occupation. Under various caste systems throughout the world, caste divisions also dominate in housing, marriage, and general social interaction divisions that are reinforced through the practice and threat of social ostracism, economic boycotts, and even physical violence-all of which undermine health equality.

  10. Social Harmony in Hong Kong: Level, Determinants and Policy Implications

    ERIC Educational Resources Information Center

    Ho, Simon S. M.; Chan, Raymond S. Y.

    2009-01-01

    This study aims at ascertaining how Hong Kong people perceive Hong Kong as a harmonious society. It also identifies the elements that are most conducive to social harmony in Hong Kong, so that the government could take reference when formulating new policies. 1,062 adults residents were asked to rate their perceived level of social harmony and…

  11. Social Determinants of Health: Implications for Environmental Health Promotion

    ERIC Educational Resources Information Center

    Schulz, Amy; Northridge, Mary E.

    2004-01-01

    In this article, the authors draw on the disciplines of sociology and environmental and social epidemiology to further understanding of mechanisms through which social factors contribute to disparate environmental exposures and health inequalities. They propose a conceptual framework for environmental health promotion that considers dynamic social…

  12. SOME SOCIAL DETERMINANTS OF VERBAL BEHAVIOR. WORKING PAPER NUMBER 4.

    ERIC Educational Resources Information Center

    BLOM, JAN-PETTER; GUMPERZ, JOHN J.

    IN RECENT DISCUSSIONS OF THE PROBLEM OF LANGUAGE AND SOCIETY, BERNSTEIN (1961, 1964) EXPLORES THE HYPOTHESIS THAT SOCIAL RELATIONSHIPS ACT AS INTERVENING VARIABLES BETWEEN LINGUISTIC STRUCTURES AND THEIR REALIZATION IN SPEECH. HIS FORMULATION SUGGESTS THAT THE ANTHROPOLOGISTS' ANALYSIS OF SOCIAL CONSTRAINTS GOVERNING INTERPERSONAL RELATIONSHIPS…

  13. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

    Though President Barack Obama has rarely made healthcare references in his State of the Union addresses, health policy experts are hoping he changes that strategy this year. "The question is: Will he say anything? You would hope that he would, given that that was the major issue he started his presidency with," says Dr. James Weinstein, left, of the Dartmouth-Hitchcock health system. PMID:23487896

  14. Report Summary--Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015.

    PubMed

    Stankiewicz, A; Herel, M; DesMeules, M

    2015-09-01

    In 2012, Canada and other United Nations (UN) Member States endorsed the "Rio Political Declaration on Social Determinants of Health" (Rio Declaration), a non-binding pledge which calls on World Health Organization (WHO) Member States to improve/influence the working and living conditions that affect health and well-being. The Rio Declaration sets out actions to address health inequities in five themes: to adopt better governance for health and development; to promote participation in policy making and implementation; to further reorient the health sector towards reducing health inequities; to strengthen global governance and collaboration; and to monitor and increase accountability. In 2013, following the endorsement of the Rio Declaration, the Government of Canada released a report to begin to document Canadian actions related to its five themes. Building on this first report, and in anticipation of WHO reporting on Member State implementation of the Rio Declaration at the May 2015 World Health Assembly, the Government of Canada developed the report, Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015, which showcases Canada's recent actions since 2013 contributing to the advancement of the five Rio Declaration themes. The report provides a current picture of the diverse spectrum of activities undertaken across levels of government and sectors to advance health equity and address social determinants of health in Canada, and intends to stimulate global and domestic exchange and uptake of promising practices to advance health equity.

  15. Prenatal maternal programming determines testosterone response during social challenge.

    PubMed

    Kemme, Kristina; Kaiser, Sylvia; Sachser, Norbert

    2007-03-01

    The present study investigated in domestic guinea pigs whether the effects of prenatal social stress are pathological consequences of adverse social conditions; or whether mothers adjust their offspring to the environment they experience during pregnancy. As a prenatal stressor social instability was used: we studied male guinea pig offspring whose mothers lived in a stable social environment (SE-sons) or in an unstable social environment (UE-sons) during pregnancy. Eight experimental groups were established, consisting of one SE-son, one UE-son and five females, respectively. All experimental groups remained in a stable group composition for the whole investigation time. We hypothesized that if mothers prenatally adapt their offspring, in a stable social environment SE-sons will be dominant, display agonistic and courtship behavior more frequently, have higher body weights, be less stressed and have higher testosterone concentrations than UE-sons. Our results show no significant differences between SE- and UE-sons concerning behavior, body weight or plasma-cortisol concentrations. Hence no evidence exists that an unstable social environment during pregnancy has pathological consequences for the male offsprings' phenotype. However, SE-sons had significantly higher plasma testosterone concentrations than UE-sons in phases when females were receptive. A higher reactivity of the hypothalamic-pituitary-gonadal axis might enable SE-males to adjust testosterone levels to the present social situation: they are significantly elevated in decisive phases of female receptivity, but remain on a lower level before and after reproductive challenge. Thus, mothers who experienced social stability during pregnancy provide their sons prenatally with a promising reproductive strategy in competitive situations later in life.

  16. [Role of the UNASUR national institutes of health in generating evidence on the social determinants of health].

    PubMed

    Rosenberg, Félix; Tobar, Sebastián; Buss, Paulo

    2015-08-01

    The present article analyzes the role of the Union of South American Nations (UNASUR) national institutes of health since their creation at the beginning of the 20th century up until the present time. It postulates that the national institutes of health are in a position to play a strategic role in generating knowledge and evidence to facilitate decision-making through monitoring and research on the social determinants of health and health inequities. To explore this hypothesis, the national institutes of health are analyzed in the context of the current global scenario, which is generating increased social inequalities, thus leading in turn to serious inequities in health conditions. The article proposes a new model of health promotion, disease prevention, and health care, where necessary, as well as policies and intersectoral actions that address these social determinants. In this new stage, the UNASUR national institutes of health should play a significant strategic role in identifying and analyzing correlations between patterns of production and consumption, social divisions that exist in the territory, conditions of development, and the health of their populations. These national institutes of health are members of the UNASUR Network of National Institutes of Health (RINS-UNASUR). The literature on their creation, drawn from the Network's websites and the proceedings of its meetings and seminars, is reviewed. Given that the current globalized development model is generating enormous social inequalities, by definition, the proposed hypothesis is that the national institutes of health should assume a much broader role in addressing the consequent inequities in the health of the population, complementing their traditional activities with this new strategic role. Without a major reduction in the existing social inequalities and economic inequities, it will be impossible to make significant improvements in health in a democratic manner. PMID:26581056

  17. Weighing social and economic determinants related to inequalities in mortality.

    PubMed

    Pasarín, M Isabel; Borrell, Carme; Brugal, M Teresa; Díaz-Quijano, Estela

    2004-09-01

    It is well known that there are social inequalities in health. Following the ecological approach, unemployment has been one of the most used indicators to study social inequalities. The aim of the present study was to investigate the relationships between indicators of extreme poverty and social unrest, along with unemployment, and mortality in Barcelona, during the years 1989 to 1993. A cross-sectional ecological study was carried out using Primary Health Care Areas (PHCAs) as the unit of analysis. The study population consisted of residents in Barcelona City. The indicators studied as dependent variables were the age-standardized mortality rates of the following causes of death: total mortality; lung cancer; bronchitis, emphysema, and asthma; cirrhosis; cerebrovascular disease; ischemic heart disease; breast cancer; traffic accidents; acquired immunodeficiency syndrome (AIDS); and drug overdose. Independent variables were male unemployment rate of the primary health care areas and indicators of extreme poverty and social conflict. A descriptive analysis, a bivariate analysis using Spearman correlation coefficients, and a multivariate analysis fitting Poisson regression models were carried out. For the main results, one group of causes of death was associated only with unemployment: bronchitis, emphysema and asthma, cerebrovascular disease, and ischemic heart disease (both men and women); lung cancer (only among men); total mortality and cirrhosis (only among women). Among men, another group of causes of death was associated with extreme poverty and/or social unrest, as well as unemployment: total mortality, cirrhosis, and drug overdose. AIDS in men was only associated with extreme poverty and social unrest. We concluded that we see different types of relationships between deprivation and mortality. Unemployment has been related to mortality because of pathologies with socially accepted risk factors (tobacco and alcohol). Causes of death with risk factors not

  18. Lifestyle determinants for social activity levels among the Japanese elderly.

    PubMed

    Aoki, R; Ohno, Y; Tamakoshi, A; Kawakami, N; Nagai, M; Hashimoto, S; Ikari, A; Shimizu, H; Sakata, K; Kawamura, T; Wakai, K; Senda, M

    1996-01-01

    We conducted a self-administered questionnaire survey to a total of 5239 elderly persons in four areas in Japan in 1993, which inquired about past lifestyles and present social activities. Based on the survey data, we first developed social activity measures, and then examined associations of the present total social activity measure with past lifestyles and physical conditions. The lifestyles significantly associated with high social activity after 65 years of age were 'high educational attainment'; having been 'healthy', 'plump', 'physically active' and 'having had hobbies' at about 50 years of age; and having 'frequent intake of many kinds of foods' during 30-50 years of age. Intake during 30-50 years of age of Japanese-style foods (rice, soybean paste soup, bean curd, pickles), noodles, beans, plant roots and potatoes was not significantly linked with the social activity levels at old age in either males or females. The same was true for smoking and drinking habits at about 50 years of age. Our findings essentially suggest the importance of a positive attitude at middle age to maintain and promote health status and improve lifestyles in order to attain high social activity at old age.

  19. Social biases determine spatiotemporal sparseness of ciliate mating heuristics.

    PubMed

    Clark, Kevin B

    2012-01-01

    Ciliates become highly social, even displaying animal-like qualities, in the joint presence of aroused conspecifics and nonself mating pheromones. Pheromone detection putatively helps trigger instinctual and learned courtship and dominance displays from which social judgments are made about the availability, compatibility, and fitness representativeness or likelihood of prospective mates and rivals. In earlier studies, I demonstrated the heterotrich Spirostomum ambiguum improves mating competence by effecting preconjugal strategies and inferences in mock social trials via behavioral heuristics built from Hebbian-like associative learning. Heuristics embody serial patterns of socially relevant action that evolve into ordered, topologically invariant computational networks supporting intra- and intermate selection. S. ambiguum employs heuristics to acquire, store, plan, compare, modify, select, and execute sets of mating propaganda. One major adaptive constraint over formation and use of heuristics involves a ciliate's initial subjective bias, responsiveness, or preparedness, as defined by Stevens' Law of subjective stimulus intensity, for perceiving the meaningfulness of mechanical pressures accompanying cell-cell contacts and additional perimating events. This bias controls durations and valences of nonassociative learning, search rates for appropriate mating strategies, potential net reproductive payoffs, levels of social honesty and deception, successful error diagnosis and correction of mating signals, use of insight or analysis to solve mating dilemmas, bioenergetics expenditures, and governance of mating decisions by classical or quantum statistical mechanics. I now report this same social bias also differentially affects the spatiotemporal sparseness, as measured with metric entropy, of ciliate heuristics. Sparseness plays an important role in neural systems through optimizing the specificity, efficiency, and capacity of memory representations. The present

  20. Social biases determine spatiotemporal sparseness of ciliate mating heuristics.

    PubMed

    Clark, Kevin B

    2012-01-01

    Ciliates become highly social, even displaying animal-like qualities, in the joint presence of aroused conspecifics and nonself mating pheromones. Pheromone detection putatively helps trigger instinctual and learned courtship and dominance displays from which social judgments are made about the availability, compatibility, and fitness representativeness or likelihood of prospective mates and rivals. In earlier studies, I demonstrated the heterotrich Spirostomum ambiguum improves mating competence by effecting preconjugal strategies and inferences in mock social trials via behavioral heuristics built from Hebbian-like associative learning. Heuristics embody serial patterns of socially relevant action that evolve into ordered, topologically invariant computational networks supporting intra- and intermate selection. S. ambiguum employs heuristics to acquire, store, plan, compare, modify, select, and execute sets of mating propaganda. One major adaptive constraint over formation and use of heuristics involves a ciliate's initial subjective bias, responsiveness, or preparedness, as defined by Stevens' Law of subjective stimulus intensity, for perceiving the meaningfulness of mechanical pressures accompanying cell-cell contacts and additional perimating events. This bias controls durations and valences of nonassociative learning, search rates for appropriate mating strategies, potential net reproductive payoffs, levels of social honesty and deception, successful error diagnosis and correction of mating signals, use of insight or analysis to solve mating dilemmas, bioenergetics expenditures, and governance of mating decisions by classical or quantum statistical mechanics. I now report this same social bias also differentially affects the spatiotemporal sparseness, as measured with metric entropy, of ciliate heuristics. Sparseness plays an important role in neural systems through optimizing the specificity, efficiency, and capacity of memory representations. The present

  1. Convocation address.

    PubMed

    Gore, M S

    1997-07-01

    In India, data from the decennial censuses have been the catalyst that has led researchers to identify social policy needs and craft programs to lower overall mortality rates, infant mortality rates, and fertility rates. A new demographic phenomenon that is being exposed by the data is the increase in life expectancy that will see large numbers of individuals surviving 15-20 years beyond age 60. This increased life expectancy will lead to an increased old age dependency ratio and will require reexamination of the issue of resources to meet the needs of the elderly. These needs are social and psychological as well as physical. Research is needed to predict the initial consequences of population aging within different states. International comparisons within the Asian region will also foster identification of effective policies. Research is also needed to identify whether longevity is tied to higher educational and socioeconomic status in order to improve life expectancy among low-income groups. Another aspect that requires consideration is that most elderly women will likely survive their husbands. This means that they will be available to care for their husbands but will have to depend upon their children to care for them. The possible demographic diversity in the experience of aging among various states and classes and between the genders may be of special interest to researchers. PMID:12293130

  2. Presidential address.

    PubMed

    Shunglu, V K

    1994-07-01

    Rapid and substantial population growth in India is hampering development. Family welfare programs in the country during the last four years have not met population reduction goals. The decentralization of political and administrative power in relevant programs, however, will help the country attain its goal of replacement fertility. To that end, the 73rd and 74th amendments to the constitution have recently been enacted to help decentralize power to people at the village, intermediate, and district levels. The participation of the people is essential for success. State ministers of health must begin assigning management of the rural health care systems to the Panchayats. Population policy has changed so that family planning is now provided within the broader context of maternal and child health care, emphasizing voluntarism and informed choice among contraceptive methods and popular participation. The speaker laments the decline of male participation in family planning and calls for high priority to be given to developing fertility regulation methods for men as well as identifying factors which prohibit male participation. The country's unbalanced female to male sex ratio and interstate and inter-district variations in social parameters which have a bearing upon population growth rates also merit attention. Investing in human resources is crucial to the success of population programs. Financing has therefore increased for poverty alleviation programs and other social sector programs.

  3. The Role of Sport as a Social Status Determinant for Children: Thirty Years Later

    ERIC Educational Resources Information Center

    Chase, Melissa A.; Machida, Moe

    2011-01-01

    The purpose of this study was to examine the role of sport as a social status determinant among racially diverse children. Participants were 1,233 fourth- to seventh-grade children. Results indicated there were gender, grade, and racial differences for the selection of social status determinants. Boys placed more importance than girls on being…

  4. Determinants of MSK health and disability--social determinants of inequities in MSK health.

    PubMed

    Guillemin, Francis; Carruthers, Erin; Li, Linda C

    2014-06-01

    Even in most egalitarian societies, disparities in care exist to the disadvantage of some people with chronic musculoskeletal (MSK) disorders and related disability. These situations translate into inequality in health and health outcomes. The goal of this chapter is to review concepts and determinants associated with health inequity, and the effect of interventions to minimize their impact. Health inequities are avoidable, unnecessary, unfair and unjust. Inequities can occur across the health care continuum, from primary and secondary prevention to diagnosis and treatment. There are many ways to define and identify inequities, according for instance to ethical, philosophical, epidemiological, sociological, economic, or public health points of view. These complementary views can be applied to set a framework of analysis, identify determinants and suggest targets of action against inequity. Most determinants of inequity in MSK disorders are similar to those in the general population and other chronic diseases. People may be exposed to inequity as a result of policies and rules set by the health care system, individuals' demographic characteristics (e.g., education level), or some behavior of health professionals and of patients. Osteoarthritis (OA) represents a typical chronic MSK condition. The PROGRESS-Plus framework is useful for identifying the important role that place of residence, race and ethnicity, occupation, gender, education, socioeconomic status, social capital and networks, age, disability and sexual orientation may have in creating or maintaining inequities in this disease. In rheumatoid arthritis (RA), a consideration of international data led to the conclusion that not all RA patients who needed biologic therapy had access to it. The disparity in care was due partly to policies of a country and a health care system, or economic conditions. We conclude this chapter by discussing examples of interventions designed for reducing health inequity. PMID

  5. Mental Retardation: Determining Eligibility for Social Security Benefits.

    ERIC Educational Resources Information Center

    Reschly, Daniel J., Ed.; Myers, Tracy G., Ed.; Hartel, Christine R., Ed.

    The Social Security Administration (SSA) provides income support and medical benefits for adults with mental retardation unable to perform substantial gainful activity through the Disability Insurance (DI) program and the Supplemental Security Income (SSI) program. SSI benefits are also provided to families of children and adolescents who evidence…

  6. Inaugural address

    NASA Astrophysics Data System (ADS)

    Joshi, P. S.

    2014-03-01

    From jets to cosmos to cosmic censorship P S Joshi Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, India E-mail: psj@tifr.res.in 1. Introduction At the outset, I should like to acknowledge that part of the title above, which tries to capture the main flavour of this meeting, and has been borrowed from one of the plenary talks at the conference. When we set out to make the programme for the conference, we thought of beginning with observations on the Universe, but then we certainly wanted to go further and address deeper questions, which were at the very foundations of our inquiry, and understanding on the nature and structure of the Universe. I believe, we succeeded to a good extent, and it is all here for you in the form of these Conference Proceedings, which have been aptly titled as 'Vishwa Mimansa', which could be possibly translated as 'Analysis of the Universe'! It is my great pleasure and privilege to welcome you all to the ICGC-2011 meeting at Goa. The International Conference on Gravitation and Cosmology (ICGC) series of meetings are being organized by the Indian Association for General Relativity and Gravitation (IAGRG), and the first such meeting was planned and conducted in Goa in 1987, with subsequent meetings taking place at a duration of about four years at various locations in India. So, it was thought appropriate to return to Goa to celebrate the 25 years of the ICGC meetings. The recollections from that first meeting have been recorded elsewhere here in these Proceedings. The research and teaching on gravitation and cosmology was initiated quite early in India, by V V Narlikar at the Banares Hindu University, and by N R Sen in Kolkata in the 1930s. In course of time, this activity grew and gained momentum, and in early 1969, at the felicitation held for the 60 years of V V Narlikar at a conference in Ahmedabad, P C Vaidya proposed the formation of the IAGRG society, with V V Narlikar being the first President. This

  7. Immigrant and refugee social networks: determinants and consequences of social support among women newcomers to Canada.

    PubMed

    Hynie, Michaela; Crooks, Valorie A; Barragan, Jackeline

    2011-12-01

    Recent immigrants and refugees (newcomers) vary on many dimensions but do share similar challenges. Newcomers must rebuild social networks to obtain needed social support but often face social exclusion because of their race, language, religion, or immigrant status. In addition, most have limited access to personal, social, and community resources. Effects of situational and personal variables on the benefits and limitations associated with the social networks of female newcomers were explored through interviews and focus groups with 87 women from 7 communities. Using thematic analysis, the authors identify 5 sources of informal support across all 7 communities, which were almost exclusively limited to co-ethnic relationships, and the types of support, limitations, and reciprocity within each. Perceived support was strongest from family and close friends and, when support from close relationships was unavailable, from primary care providers. The results suggest that co-ethnic peer support networks may be overwhelmed in newcomer communities because of their limited size and resources.

  8. The Social Determinants of Health in Military Forces of Iran: A Qualitative Study

    PubMed Central

    Bahadori, Mohammadkarim; Sanaeinasab, Hormoz; Ghanei, Mostafa; Mehrabi Tavana, Ali; Ravangard, Ramin; Karamali, Mazyar

    2015-01-01

    Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces' health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces' health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces. PMID:26379716

  9. Opening Address

    NASA Astrophysics Data System (ADS)

    Yamada, T.

    2014-12-01

    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  10. Convocation address.

    PubMed

    Ghatowar, P S

    1993-07-01

    The Union Deputy Minister of Health and Family Welfare in India addressed the 35th convocation of the International Institute for Population Sciences in Bombay in 1993. Officials in developing countries have been concerned about population growth for more than 30 years and have instituted policies to reduce population growth. In the 1960s, population growth in developing countries was around 2.5%, but today it is about 2%. Despite this decline, the world will have 1 billion more individuals by the year 2001. 95% of these new people will be born in developing countries. India's population size is so great that India does not have the time to wait for development to reduce population growth. Population needs to be viewed as an integrated part of overall development, since it is linked to poverty, illiteracy, environmental damage, gender issues, and reproductive health. Despite a large population size, India has made some important advancements in health and family planning. For example, India has reduced population growth (to 2.14% annually between 1981-1991), infant mortality, and its birth rate. It has increased the contraceptive use rate and life expectancy. Its southern states have been more successful at achieving demographic goals than have the northern states. India needs to implement efforts to improve living conditions, to change attitudes and perceptions about small families and contraception, and to promote family planning acceptance earlier among young couples. Improvement of living conditions is especially important in India, since almost 33% of the people live in poverty. India needs to invest in nutrition, health, and education. The mass media and nongovernmental organizations need to create population awareness and demand for family planning services. Improvement in women's status accelerates fertility decline, as has happened in Kerala State. The government needs to facilitate generation of jobs. Community participation is needed for India to achieve

  11. Cross national study of injury and social determinants in adolescents

    PubMed Central

    Pickett, W; Molcho, M; Simpson, K; Janssen, I; Kuntsche, E; Mazur, J; Harel, Y; Boyce, W

    2005-01-01

    Objectives: To compare estimates of the prevalence of injury among adolescents in 35 countries, and to examine the consistency of associations cross nationally between socioeconomic status then drunkenness and the occurrence of adolescent injury. Design: Cross sectional surveys were obtained from national samples of students in 35 countries. Eight countries asked supplemental questions about injury. Setting: Surveys administered in classrooms. Subjects: Consenting students (n = 146 440; average ages 11–15 years) in sampled classrooms. 37 878 students (eight countries) provided supplemental injury data. Exposure measures: Socioeconomic status (material wealth, poverty) and social risk taking (drunkenness). Outcome measures: Specific types and locations of medically treated injury. Results: By country, reports of medically treated injuries ranged from 33% (1060/3173) to 64% (1811/2833) of boys and 23% (740/3172) to 51% (1485/2929) of girls, annually. Sports and recreation were the most common activities associated with injury. High material wealth was positively (OR>1.0; p<0.05) and consistently (6/8 countries) associated with medically treated and sports related injuries. Poverty was positively associated with fighting injuries (6/8 countries). Drunkenness (social risk taking) was positively (p<0.01) and consistently (8/8 countries) associated with medically treated, street, and fighting injuries, but not school and sports related injuries. Conclusion: The high prevalence of adolescent injury confirms its importance as a health problem. Social gradients in risk for adolescent injury were illustrated cross nationally for some but not all types of adolescent injury. These gradients were most evident when the etiologies of specific types of adolescent injury were examined. Prevention initiatives should focus upon the etiologies of specific injury types, as well as risk oriented social contexts. PMID:16081749

  12. [Social participation in health: spaces and actors determining its development].

    PubMed

    Hersch-Martínez, P

    1992-01-01

    This paper deals with an analysis of a rural experience of social participation (SP), defined as the possibility of communities gaining real access to the control of processes affecting health. This analysis evidences the relevance of peasant women in the promotion of SP in health, as well as the need to include health education and organization actions in regional organizational process, strengthened by local policies. The creation of a sanitary mediator to serve as a regulatory agent negotiating with the State is proposed.

  13. Social determinants of health: present status, unanswered questions, and future directions.

    PubMed

    Raphael, Dennis

    2006-01-01

    This article reviews the current status of theory and research concerning the social determinants of health. It provides an overview of current conceptualizations and evidence on the impact of various social determinants of health. The contributions of different disciplines--epidemiology, sociology, political economy, and the human rights perspective--to the field are acknowledged, but profound gaps persist in our understanding of the forces that drive the quality of various social determinants of health and why research is too infrequently translated into action. Many of these gaps in knowledge concern the political, economic, and social forces that make implementation of public policy agendas focused on strengthening the social determinants of health problematic. The author identifies the areas of inquiry needed to help translate knowledge into action.

  14. Leveraging the Social Determinants of Health: What Works?

    PubMed Central

    Taylor, Lauren A.; Tan, Annabel Xulin; Coyle, Caitlin E.; Ndumele, Chima; Rogan, Erika; Canavan, Maureen; Curry, Leslie A.; Bradley, Elizabeth H.

    2016-01-01

    We summarized the recently published, peer-reviewed literature that examined the impact of investments in social services or investments in integrated models of health care and social services on health outcomes and health care spending. Of 39 articles that met criteria for inclusion in the review, 32 (82%) reported some significant positive effects on either health outcomes (N = 20), health care costs (N = 5), or both (N = 7). Of the remaining 7 (18%) studies, 3 had non-significant results, 2 had mixed results, and 2 had negative results in which the interventions were associated with poorer health outcomes. Our analysis of the literature indicates that several interventions in the areas of housing, income support, nutrition support, and care coordination and community outreach have had positive impact in terms of health improvements or health care spending reductions. These interventions may be of interest to health care policymakers and practitioners seeking to leverage social services to improve health or reduce costs. Further testing of models that achieve better outcomes at less cost is needed. PMID:27532336

  15. Compatibility of basic social perceptions determines perceived attractiveness.

    PubMed

    Johnson, Kerri L; Tassinary, Louis G

    2007-03-20

    The human body's shape and motion afford social judgments. The body's shape, specifically the waist-to-hip ratio, has been related to perceived attractiveness. Early reports interpreted this effect to be evidence for adaptation, a theory known generally as the waist-to-hip ratio hypothesis. Many of the predictions derived from this perspective have been empirically disconfirmed, leaving the issue of natural selection unresolved. Knowing the cognitive mechanisms undergirding the relationship between judgments of attractiveness and body cues is essential to understanding its evolution. Here we show that perceived attractiveness covaries with body shape and motion because they cospecify social percepts that are either compatible or incompatible. The body's shape and motion provoke basic social perceptions, biological sex and gender (i.e., masculinity/femininity), respectively. The compatibility of these basic percepts predicts perceived attractiveness. We report evidence for the importance of cue compatibility in five studies that used diverse stimuli (animations, static line-drawings, and dynamic line-drawings). Our results demonstrate how a proximal cognitive mechanism, itself likely the product of selection pressures, helps to reconcile previous contradictory findings. PMID:17360395

  16. Welcome Address

    NASA Astrophysics Data System (ADS)

    Kiku, H.

    2014-12-01

    Ladies and Gentlemen, It is an honor for me to present my welcome address in the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3), as the president of Kanto Gakuin University. Particularly to those from abroad more than 17 countries, I am very grateful for your participation after long long trips from your home to Yokohama. On the behalf of the Kanto Gakuin University, we certainly welcome your visit to our university and stay in Yokohama. First I would like to introduce Kanto Gakuin University briefly. Kanto Gakuin University, which is called KGU, traces its roots back to the Yokohama Baptist Seminary founded in 1884 in Yamate, Yokohama. The seminary's founder was Albert Arnold Bennett, alumnus of Brown University, who came to Japan from the United States to establish a theological seminary for cultivating and training Japanese missionaries. Now KGU is a major member of the Kanto Gakuin School Corporation, which is composed of two kindergartens, two primary schools, two junior high schools, two senior high schools as well as KGU. In this university, we have eight faculties with graduate school including Humanities, Economics, Law, Sciences and Engineering, Architecture and Environmental Design, Human and Environmental Studies, Nursing, and Law School. Over eleven thousands students are currently learning in our university. By the way, my major is the geotechnical engineering, and I belong to the faculty of Sciences and Engineering in my university. Prof. T. Yamada, here, is my colleague in the same faculty. I know that the nuclear physics is one of the most active academic fields in the world. In fact, about half of the participants, namely, more than 50 scientists, come from abroad in this conference. Moreover, I know that the nuclear physics is related to not only the other fundamental physics such as the elementary particle physics and astrophysics but also chemistry, medical sciences, medical cares, and radiation metrology

  17. Conceptual understanding of social capital in a First Nations community: a social determinant of oral health in children

    PubMed Central

    Salehyar, Mohammad H.; Keenan, Louanne; Patterson, Steven; Amin, Maryam

    2015-01-01

    Objectives The purpose of the study was: (a) to better understand the concept of social capital and its potential role in oral health of children in a First Nations community and (b) to identify the strengths and resources in terms of social capital and a health promotion model that the community has at its disposal to address its oral health issues. Methods In this qualitative case study, participants were purposively selected in a First Nations community: Seven individual interviews and two focus groups involving 18 parents/care givers were selected. Putnam's concept of social capital guided all the interviews. The interviews were recorded and transcribed verbatim. Thematic analysis was employed using the NVivo software. Results The community was close-knit and seemed to have strong moral fibre, which encouraged members to help each other. A strong bonding social capital was also found among the members, especially inside the clans (families). A need for improvement in bridging social capital that would help the community to reach external resources was observed. While members of the community were actively involved in religious rituals and cultural ceremonies, more efforts seemed to be required to recruit volunteers for other events or programs. Active engagement of community members in any program requires that members be given a voice as well as some ownership of the process. Mobilizing or building community's social capital can play a role when planning future interventions. Conclusions A better understanding of social capital may enhance the community's investment and efforts by reinforcing healthy oral behaviours and improving access to external resources. With more dynamic collaboration, it may be possible to create more sustainable community-based oral health promotion programs. PMID:25623814

  18. Opening Address

    NASA Astrophysics Data System (ADS)

    Crovini, L.

    1994-01-01

    Ladies and Gentlemen To quote Mr Jean Terrien: "Physics must be one step ahead of metrology". A long-serving Director of the BIPM, he said these words when visiting the IMGC in 1970 as a member of the scientific board of our Institute. At that time it was still an open question whether the IMGC should start research work on the absolute measurement of silicon lattice spacing. Mr Terrien underlined the revolutionary character of x-ray interferometry and, eventually, he caused the balance needle to lean towards the ... right direction. Mr Terrien correctly foresaw that, like Michelson's interferometer of 1880, x-ray interferometry could have a prominent place in today's science and technology. And while, in the first case, after more than a century we can see instruments based on electromagnetic wave interaction within every one's reach in laboratories and, sometimes, in workshops, in the second case, twenty-five years since the first development of an x-ray interferometer we can witness its role in nanometrology. Today and tomorrow we meet to discuss how to go beyond the sixth decimal place in the value of the Avogadro constant. We are aware that the quest for this achievement requires the cooperation of scientists with complementary capabilities. I am sure that the present workshop is a very good opportunity to present and discuss results and to improve and extend existing cooperation. The new adjustment of fundamental constants envisaged by the CODATA Task Group is redoubling scientists' efforts to produce competitive values of NA. The results of the measurements of the silicon lattice spacing in terms of an optical wavelength, which were available for the 1986 adjustment, combined with the determination of silicon molar volume, demonstrate how such an NA determination produces a consistent set of other constants and opens the way to a possible redefinition of the kilogram. We shall see in these two days how far we have progressed along this road. For us at the

  19. Early childhood development and the social determinants of health inequities.

    PubMed

    Moore, Timothy G; McDonald, Myfanwy; Carlon, Leanne; O'Rourke, Kerryn

    2015-09-01

    Children's health and development outcomes follow a social gradient: the further up the socioeconomic spectrum, the better the outcomes. Based upon a review of multiple forms of evidence, and with a specific focus upon Australia, this article investigates the causes of these socially produced inequities, their impact upon health and development during the early years and what works to reduce these inequities. Using VicHealth's Fair Foundations framework, we report upon child health inequity at three different levels: the socioeconomic, political and cultural level; daily living conditions; the individual health-related behaviours. Although intensive interventions may improve the absolute conditions of significantly disadvantaged children and families, interventions that have been shown to effectively reduce the gap between the best and worst off families are rare. Numerous interventions have been shown to improve some aspect of prenatal, postnatal, family, physical and social environments for young children; however, sustainable or direct effects are difficult to achieve. Inequitable access to services has the potential to maintain or increase inequities during the early years, because those families most in need of services are typically least able to access them. Reducing inequities during early childhood requires a multi-level, multi-faceted response that incorporates: approaches to governance and decision-making; policies that improve access to quality services and facilitate secure, stable, flexible workplaces for parents; service systems that reflect the characteristics of proportionate universalism, function collaboratively, and deliver evidence-based programs in inclusive environments; strong, supportive communities; and information and timely assistance for parents so they feel supported and confident.

  20. Language Structure Is Partly Determined by Social Structure

    PubMed Central

    Lupyan, Gary; Dale, Rick

    2010-01-01

    Background Languages differ greatly both in their syntactic and morphological systems and in the social environments in which they exist. We challenge the view that language grammars are unrelated to social environments in which they are learned and used. Methodology/Principal Findings We conducted a statistical analysis of >2,000 languages using a combination of demographic sources and the World Atlas of Language Structures— a database of structural language properties. We found strong relationships between linguistic factors related to morphological complexity, and demographic/socio-historical factors such as the number of language users, geographic spread, and degree of language contact. The analyses suggest that languages spoken by large groups have simpler inflectional morphology than languages spoken by smaller groups as measured on a variety of factors such as case systems and complexity of conjugations. Additionally, languages spoken by large groups are much more likely to use lexical strategies in place of inflectional morphology to encode evidentiality, negation, aspect, and possession. Our findings indicate that just as biological organisms are shaped by ecological niches, language structures appear to adapt to the environment (niche) in which they are being learned and used. As adults learn a language, features that are difficult for them to acquire, are less likely to be passed on to subsequent learners. Languages used for communication in large groups that include adult learners appear to have been subjected to such selection. Conversely, the morphological complexity common to languages used in small groups increases redundancy which may facilitate language learning by infants. Conclusions/Significance We hypothesize that language structures are subjected to different evolutionary pressures in different social environments. Just as biological organisms are shaped by ecological niches, language structures appear to adapt to the environment (niche) in

  1. Social, economic, and political determinants of child health.

    PubMed

    Spencer, Nick

    2003-09-01

    This article presents a brief overview of the effects of social, economic, and political factors on child health. It starts by highlighting child poverty in rich nations, in particular the United Kingdom and the United States, and identifies the economic and political factors underlying this phenomenon. The evidence linking socioeconomic status and child health is briefly reviewed with particular attention to birth weight and child mental health-2 of the most important public health challenges in the 21st century. The implications for pediatricians of high levels of child poverty and the effect that these have on children are discussed.

  2. [Economic and social determinants of mortality in Latin America].

    PubMed

    Behm, H

    1980-01-01

    It is estimated that more than half of the infants born in Latin America are exposed to a mortality rate higher than 120/1000. Social indicators, such as number of hospital beds, protein consumption, literacy level, and type of housing are highly related to life expectancy at birth. More important yet is the relation of mortality with the socioeconomic characteristics of a given country within Latin America. Geographical differences of mortality are the result of national policies especially in regard to urban and rural population. For example, probability of death in Ecuador is 98/1000 in urban areas, and 145/1000 in rural areas; data are similar for other countries. The socioeconomic contradictions of the capitalist system create differences in mortality rates by concentrating in the few cities most of the health services, and by providing better living conditions for the urban population. Mortality, especially infant, is inversely related to income and to educational status and age of the mother. The many indigenous ethnic groups still existing in many Latin American countries have even higher mortality rates than the rest of the population. Respiratory dysfunctions, infectious diseases, malnutrition and accidents are the main causes of infant mortality in all groups of people, but with much higher rates for the working classes, and lower rates for the higher income classes. As a final analysis, not only is it important to use modern medical knowledge and technology to lower mortaltiy rates, but, and above all, it is imperative to modify social and economic structures.

  3. Social and Proximate Determinants of the Frequency of Condom Use Among African, Caribbean, and Other Black People in a Canadian City: Results from the BLACCH Study.

    PubMed

    Baidoobonso, Shamara; Bauer, Greta R; Speechley, Kathy Nixon; Lawson, Erica

    2016-02-01

    African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about condom use in this population. This exploratory community-based research project addresses this gap in knowledge. 125 sexually active ACB people completed a questionnaire covering condom use and social determinants of health. The data were analyzed using ordinal logistic regression and mediation analyses. 20.5 % of sexually active ACB adults used condoms consistently. Male gender, wealth, unstable immigration classes, and unsecure employment statuses were independently associated with more frequent condom use. Proximate determinants mediating these relationships included: not having a cohabiting regular partner, not disliking condoms, and having a history of unwanted sex. The proximate determinants mediated 85.7-97.6 % of the effects of the social determinants. These results link social context and proximate factors with condom use. They can be used to design evidence-informed interventions for ACB people.

  4. 49 CFR Appendix E to Part 26 - Individual Determinations of Social and Economic Disadvantage

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disadvantage determinations (see 13 CFR 124.103(c) and 124.104). Social Disadvantage I. Socially disadvantaged... Disadvantage E Appendix E to Part 26 Transportation Office of the Secretary of Transportation PARTICIPATION BY DISADVANTAGED BUSINESS ENTERPRISES IN DEPARTMENT OF TRANSPORTATION FINANCIAL ASSISTANCE PROGRAMS Pt. 26, App....

  5. Determining the Curricular Conceptions of Elementary School Social Studies. Research Report.

    ERIC Educational Resources Information Center

    Rooze, Gene E.

    The paper discusses the theoretical basis of elementary social studies curriculum. Using a categorization tool developed by Eisner and Vallance, the author examines recent elementary school social studies literature in order to determine the underlying of curriculum philosophies. Five philosophical positions are revealed. The first, academic…

  6. Social Determinants of Influenza Illness and Outbreaks in the United States.

    PubMed

    Cordoba, Evette; Aiello, Allison E

    2016-01-01

    Social determinants-such as education, race/ethnicity, socioeconomic status, access to health care services and vaccination, neighborhood-level stressors, and workplace or school policies-can impact influenza illness and outbreaks in the United States. To reduce transmission and disparities in influenza infection, policies should focus on removing existing vaccination barriers and supporting equitable social policies. PMID:27621346

  7. Social Work and End-of-Life Decisions: Self-Determination and the Common Good.

    ERIC Educational Resources Information Center

    Wesley, Carol A.

    1996-01-01

    Self-determination and the common good must be respected in social work practice and policy regarding end-of-life decisions. This article discusses self-determination in end-of-life decision making, ethical decision making and the NASW Code of Ethics, and professional ethics based on a balanced view of both self-determination and the common good.…

  8. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health

    PubMed Central

    Prochaska, John D.; Nolen, Alexandra B.; Kelley, Hilton; Sexton, Ken; Linder, Stephen H.; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society. PMID:24771993

  9. Social Determinants of Health in Environmental Justice Communities: Examining Cumulative Risk in Terms of Environmental Exposures and Social Determinants of Health.

    PubMed

    Prochaska, John D; Nolen, Alexandra B; Kelley, Hilton; Sexton, Ken; Linder, Stephen H; Sullivan, John

    2014-01-01

    Residents of environmental justice (EJ) communities may bear a disproportionate burden of environmental health risk, and often face additional burdens from social determinants of health. Accounting for cumulative risk should include measures of risk from both environmental sources and social determinants. This study sought to better understand cumulative health risk from both social and environmental sources in a disadvantaged community in Texas. Key outcomes were determining what data are currently available for this assessment, clarifying data needs, identifying data gaps, and considering how those gaps could be filled. Analyses suggested that the traditionally defined EJ community in Port Arthur may have a lower environmental risk from air toxics than the rest of the City of Port Arthur (although the entire city has a higher risk than the average for the state), but may have a larger burden from social determinants of health. However, the results should be interpreted in light of the availability of data, the definitions of community boundaries, and the areal unit utilized. Continued focus on environmental justice communities and the cumulative risks faced by their residents is critical to protecting these residents and, ultimately, moving towards a more equitable distribution and acceptable level of risk throughout society.

  10. Prioritizing the Determinants of Social-health Inequality in Iran: A Multiple Attribute Decision Making Application

    PubMed Central

    Zaboli, Rouhollah; Tourani, Sogand; Seyedin, Seyed Hesam; Oliaie Manesh, Alireza

    2014-01-01

    Background: One of the main challenges of healthcare systems of developing countries is health inequality. Health inequality means inequality in individuals’ ability and proper functioning, resulting in inequality in social status and living conditions, which thwarts social interventions implemented by the government. Objectives: This study aimed to determine and prioritize the social determinants of health inequality in Iran. Materials and Methods: This was a mixed method study with two phases of qualitative and quantitative research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect qualitative data along with a multiple attribute decision making method for the quantitative phase of the research in which the TOPSIS technique was employed for prioritization. The qualitative findings were entered into NVivo for analysis, as were the quantitative data entered into MATLAB software. Results: The results approved the suitability of the conceptual framework of social determinants of health suggested by the WHO (world health organization) for studying social determinants of health inequality; however, this framework general and theoretical rather than a guideline for practice. Thus, in this study, 15 themes and 31 sub-themes were determined as social determinants of social health inequality in Iran. Based on the findings of the quantitative phase of our research, socioeconomic status, living facilities such as housing, and social integrity had the greatest effect on decreasing health inequality. Conclusions: A major part of the inequality in health distribution is avoidable because they are mostly caused by adjustable factors like economic conditions, educational conditions, employment, living facilities, etc. As in the majority of developing countries the living and health conditions are the same as Iran, the

  11. Opening address

    NASA Astrophysics Data System (ADS)

    Castagnoli, C.

    1994-01-01

    Ladies and Gentlemen My cordial thanks to you for participating in our workshop and to all those who have sponsored it. When in 1957 I attended the International Congress on Fundamental Constants held in Turin on the occasion of the first centenary of the death of Amedeo Avogadro, I did not expect that about thirty-five years later a small but representative number of distinguished scientists would meet here again, to discuss how to go beyond the sixth decimal figure of the Avogadro constant. At that time, the uncertainty of the value of this constant was linked to the fourth decimal figure, as reported in the book by DuMond and Cohen. The progress made in the meantime is universally acknowledged to be due to the discovery of x-ray interferometry. We are honoured that one of the two founding fathers, Prof. Ulrich Bonse, is here with us, but we regret that the other, Prof. Michael Hart, is not present. After Bonse and Hart's discovery, the x-ray crystal density method triggered, as in a chain reaction, the investigation of two other quantities related to the Avogadro constant—density and molar mass. Scientists became, so to speak, resonant and since then have directed their efforts, just to mention a few examples, to producing near-perfect silicon spheres and determining their density, to calibrating, with increasing accuracy, mass spectrometers, and to studying the degree of homogeneity of silicon specimens. Obviously, I do not need to explain to you why the Avogadro constant is important. I wish, however, to underline that it is not only because of its position among fundamental constants, as we all know very well its direct links with the fine structure constant, the Boltzmann and Faraday constants, the h/e ratio, but also because when a new value of NA is obtained, the whole structure of the fundamental constants is shaken to a lesser or greater extent. Let me also remind you that the second part of the title of this workshop concerns the silicon

  12. Confidentiality considerations for use of social-spatial data on the social determinants of health: Sexual and reproductive health case study.

    PubMed

    Haley, Danielle F; Matthews, Stephen A; Cooper, Hannah L F; Haardörfer, Regine; Adimora, Adaora A; Wingood, Gina M; Kramer, Michael R

    2016-10-01

    Understanding whether and how the places where people live, work, and play are associated with health behaviors and health is essential to understanding the social determinants of health. However, social-spatial data which link a person and their attributes to a geographic location (e.g., home address) create potential confidentiality risks. Despite the growing body of literature describing approaches to protect individual confidentiality when utilizing social-spatial data, peer-reviewed manuscripts displaying identifiable individual point data or quasi-identifiers (attributes associated with the individual or disease that narrow identification) in maps persist, suggesting that knowledge has not been effectively translated into public health research practices. Using sexual and reproductive health as a case study, we explore the extent to which maps appearing in recent peer-reviewed publications risk participant confidentiality. Our scoping review of sexual and reproductive health literature published and indexed in PubMed between January 1, 2013 and September 1, 2015 identified 45 manuscripts displaying participant data in maps as points or small-population geographic units, spanning 26 journals and representing studies conducted in 20 countries. Notably, 56% (13/23) of publications presenting point data on maps either did not describe approaches used to mask data or masked data inadequately. Furthermore, 18% (4/22) of publications displaying data using small-population geographic units included at least two quasi-identifiers. These findings highlight the need for heightened education for researchers, reviewers, and editorial teams. We aim to provide readers with a primer on key confidentiality considerations when utilizing linked social-spatial data for visualizing results. Given the widespread availability of place-based data and the ease of creating maps, it is critically important to raise awareness on when social-spatial data constitute protected health

  13. Confidentiality considerations for use of social-spatial data on the social determinants of health: Sexual and reproductive health case study.

    PubMed

    Haley, Danielle F; Matthews, Stephen A; Cooper, Hannah L F; Haardörfer, Regine; Adimora, Adaora A; Wingood, Gina M; Kramer, Michael R

    2016-10-01

    Understanding whether and how the places where people live, work, and play are associated with health behaviors and health is essential to understanding the social determinants of health. However, social-spatial data which link a person and their attributes to a geographic location (e.g., home address) create potential confidentiality risks. Despite the growing body of literature describing approaches to protect individual confidentiality when utilizing social-spatial data, peer-reviewed manuscripts displaying identifiable individual point data or quasi-identifiers (attributes associated with the individual or disease that narrow identification) in maps persist, suggesting that knowledge has not been effectively translated into public health research practices. Using sexual and reproductive health as a case study, we explore the extent to which maps appearing in recent peer-reviewed publications risk participant confidentiality. Our scoping review of sexual and reproductive health literature published and indexed in PubMed between January 1, 2013 and September 1, 2015 identified 45 manuscripts displaying participant data in maps as points or small-population geographic units, spanning 26 journals and representing studies conducted in 20 countries. Notably, 56% (13/23) of publications presenting point data on maps either did not describe approaches used to mask data or masked data inadequately. Furthermore, 18% (4/22) of publications displaying data using small-population geographic units included at least two quasi-identifiers. These findings highlight the need for heightened education for researchers, reviewers, and editorial teams. We aim to provide readers with a primer on key confidentiality considerations when utilizing linked social-spatial data for visualizing results. Given the widespread availability of place-based data and the ease of creating maps, it is critically important to raise awareness on when social-spatial data constitute protected health

  14. The health of Canada's children. Part III: Public policy and the social determinants of children's health.

    PubMed

    Raphael, Dennis

    2010-03-01

    The health of Canada's children does not compare well with other wealthy industrialized nations. Significant inequalities in health exist among Canadian children, and many of these inequalities are due to variations in Canadian children's life circumstances - the social determinants of health. The present article describes the social determinants of children's health and explains how the quality of these social determinants is shaped, in large part, by public policy decisions. The specific public policies that shape the quality of Canadian children's health are examined, and Canadian approaches in comparison with other wealthy developed nations are described. Policy directions that would improve the quality of the social determinants of children's health are presented and barriers to their implementation are considered.

  15. Social determinants of tuberculosis in Europe: a prospective ecological study.

    PubMed

    Ploubidis, George B; Palmer, Melissa J; Blackmore, Charlotte; Lim, Tek-Ang; Manissero, Davide; Sandgren, Andreas; Semenza, Jan C

    2012-10-01

    Tuberculosis (TB) is considered to be a disease of poverty, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices, and immigration from endemic countries. A prospective country level study, using a comprehensive dataset of TB incidence and prevalence taken from countries within the World Health Organization (WHO) European region, was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) and a nation's wealth, level of egalitarianism, migration rate, health-related lifestyle and social capital with TB incidence and prevalence over a 10-yr period (2000-2009). We found that ∼50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged gross domestic product and TB rates, and a positive prospective association between income inequality and TB. National income levels per capita and income inequality are important predictors for TB incidence and prevalence in the WHO European region. They account for 50% of country-level variation, indicating the importance of a combined absolute and relative socioeconomic disadvantage in the development of TB. These findings also provide a tool for forecasting potential fluctuations in the level of TB epidemics in the WHO European region, with respect to socioeconomic changes.

  16. Individual Preferences and Social Interactions Determine the Aggregation of Woodlice

    PubMed Central

    Devigne, Cédric; Broly, Pierre; Deneubourg, Jean-Louis

    2011-01-01

    Background The aggregation of woodlice in dark and moist places is considered an adaptation to land life and most studies are focused on its functionality or on the behavioural mechanisms related to the individual's response to abiotic factors. Until now, no clear experimental demonstration was available about aggregation resulting from inter-attraction between conspecifics. Methodology/Main Findings We present the dynamics of aggregation, not previously described in detail in literature, as being independent of the experimental conditions: homogeneous and heterogeneous environments with identical or different shelters. Indeed whatever these conditions, the aggregation is very quick. In less than 10 minutes more than 50% of woodlice were aggregated in several small groups in the homogeneous environment or under shelters in the heterogeneous environment. After this fast aggregation, woodlice progressively moved into a single aggregate or under one shelter. Conclusions/Significance Here we show for the first time that aggregation in woodlice implies a strong social component and results from a trade-off between individual preferences and inter-attraction between individuals. Moreover, our results reveal that the response to the heterogeneities affects only the location of the aggregates and not the level of aggregation, and demonstrate the strong inter-attraction between conspecifics which can outweigh individual preferences. This inter-attraction can lead to situations that could seem sub-optimal. PMID:21364761

  17. Caste-, work-, and descent-based discrimination as a determinant of health in social epidemiology.

    PubMed

    Patil, Rajan R

    2014-01-01

    Social epidemiology explores health in the context of broad social determinants of health, where the boundary lines between health and politics appear increasingly blurred. Social determinants of health such as caste, discrimination, and social exclusion are inherently political in nature, hence it becomes imperative to look at health through a broader perspective of political philosophy, ideology, and caste that imposes enormous obstacles to a person's full attainment of civil, political, economic, social, and cultural rights. Caste is descent based and hereditary in nature. It is a characteristic determined by one's birth into a particular caste, irrespective of the faith practiced by the individual. Caste denotes a system of rigid social stratification into ranked groups defined by descent and occupation. Under various caste systems throughout the world, caste divisions also dominate in housing, marriage, and general social interaction divisions that are reinforced through the practice and threat of social ostracism, economic boycotts, and even physical violence-all of which undermine health equality. PMID:24871772

  18. Exploring the Influence of Social Determinants, Social Capital, and Health Expertise on Health and the Rural Church.

    PubMed

    Plunkett, Robyn; Leipert, Beverly; Olson, Joanne

    2016-09-01

    In rural communities, religious places can significantly shape health for individuals, families, and communities. Rural churches are prominent community centers in rural communities and are deeply woven into rural culture. Thus, health influences arising from the rural church likely have health implications for the greater community. This article explores health influences emerging from rural churches using social determinants of health, social capital, and health expertise. Although nurses are important health resources for all populations, their value in rural areas may be exceedingly significant. The contribution of nurses to church-based health capital in rural communities may be quite significant and underestimated, although it remains poorly understood. PMID:26385751

  19. Explaining the role of the social determinants of health on health inequality in South Africa

    PubMed Central

    Ataguba, John Ele-Ojo; Day, Candy; McIntyre, Di

    2015-01-01

    Background Action on the social determinants of health (SDH) is relevant for reducing health inequalities. This is particularly the case for South Africa (SA) with its very high level of income inequality and inequalities in health and health outcomes. This paper provides evidence on the key SDH for reducing health inequalities in the country using a framework initially developed by the World Health Organization. Objective This paper assesses health inequalities in SA and explains the factors (i.e. SDH and other individual level factors) that account for large disparities in health. The relative contribution of different SDH to health inequality is also assessed. Design A cross-sectional design is used. Data come from the third wave of the nationally representative National Income Dynamics Study. A subsample of adults (18 years and older) is used. The main variable of interest is dichotomised good versus bad self-assessed health (SAH). Income-related health inequality is assessed using the standard concentration index (CI). A positive CI means that the rich report better health than the poor. A negative value signifies the opposite. The paper also decomposes the CI to assess its contributing factors. Results Good SAH is significantly concentrated among the rich rather than the poor (CI=0.008; p<0.01). Decomposition of this result shows that social protection and employment (contribution=0.012; p<0.01), knowledge and education (0.005; p<0.01), and housing and infrastructure (−0.003; p<0.01) contribute significantly to the disparities in good SAH in SA. After accounting for these other variables, the contribution of income and poverty is negligible. Conclusions Addressing health inequalities inter alia requires an increased government commitment in terms of budgetary allocations to key sectors (i.e. employment, social protection, education, housing, and other appropriate infrastructure). Attention should also be paid to equity in benefits from government

  20. What does Williams syndrome reveal about the determinants of social behavior?

    PubMed Central

    Järvinen, Anna M.; Bellugi, Ursula

    2013-01-01

    Growing evidence on autonomic nervous system (ANS) function in individuals with Williams syndrome (WS) has begun to highlight aberrancies that may have important implications for the social profile characterized by enhanced social motivation and approach. In parallel, neurobiological investigations have identified alterations in the structure, function, and connectivity of the amygdala, as well as prosocial neuropeptide dysregulation, as some of the key neurogenetic features of WS. A recent social approach/withdrawal hypothesis (Kemp and Guastella, 2011) suggests that autonomic cardiac control may play a key role in regulating the relationship between oxytocin (OT) and social behavior. This article discusses evidence from these critical, new strands of research into social behavior in WS, to consider the extent to which data on WS may provide novel insight into the determinants of social behavior. Future research directions are suggested. PMID:23825455

  1. Social Determinants of HIV-Related Stigma in Faith-Based Organizations

    PubMed Central

    Tate, Allan D.; Gaddist, Bambi; White, Jacob

    2016-01-01

    Objectives. To examine the association between social factors in faith-based settings (including religiosity and proximity to people living with HIV/AIDS) and HIV stigma. Methods. A total of 1747 congregants from primarily African American faith-based organizations of Project FAITH (Fostering AIDS Initiatives That Heal), a South Carolina statewide initiative to address HIV-related stigma, completed a survey. Results. Female gender (P = .001), higher education (P < .001), knowing someone with HIV/AIDS (P = .01), and knowing someone who is gay (P < .001), but not religiosity, were associated with lower levels of stigma and with lower odds of stigmatizing attitudes (P < .05). Conclusions. Opportunities for connection with people living with HIV/AIDS tailored to the social characteristics of faith-based organizations may address HIV stigma in African American communities. PMID:26794158

  2. If you build it will they come? Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men

    PubMed Central

    LeGrand, Sara; Muessig, Kathryn E.; Pike, Emily C.; Baltierra, Nina; Hightow-Weidman, Lisa B.

    2014-01-01

    The rate of HIV infections among young black men who have sex with men (YBMSM) continues to rise at an alarming pace. YBMSM are particularly vulnerable to social isolation and a lack of social support due to experiences with racism and homophobia, which may have implications for sexual risk behaviors. The purpose of this study was to explore perceptions of social isolation and sense of community among YBMSM, the need for and receptivity to social networking features designed to reduce social isolation and build community within an internet and mobile phone-based primary and secondary HIV prevention intervention for YBMSM and to identify strategies to develop these features. Focus groups were conducted with 22 YBMSM ages 20–30 at three sites in North Carolina. Data from the focus groups were thematically analyzed using NVivo. Feelings of social isolation and lack of a sense of community were strongly endorsed by participants with homophobia, lack of opportunities for social engagement, and a focus on sex rather than friendship in interpersonal relationships with other YBMSM cited as contributing factors. Participants were receptive to a social networking intervention designed to reduce social isolation and build community. Recommendations offered by participants to increase acceptability and usability of such features included: availability of information about healthy relationships, the ability to connect with other YBMSM and health care providers, and ensuring the site had ongoing facilitation by the study team as well as monitoring for inappropriate content. The development of a social networking feature of an HIV prevention intervention may present an opportunity to reduce social isolation, build community and reduce risky sexual behaviors among YBMSM. The findings from this study are being used to inform the development of a social networking feature for an existing internet and mobile phone-based primary and secondary HIV prevention intervention for YBMSM

  3. If you build it will they come? Addressing social isolation within a technology-based HIV intervention for young black men who have sex with men.

    PubMed

    LeGrand, Sara; Muessig, Kathryn E; Pike, Emily C; Baltierra, Nina; Hightow-Weidman, Lisa B

    2014-01-01

    The rate of HIV infections among young black men who have sex with men (YBMSM) continues to rise at an alarming pace. YBMSM are particularly vulnerable to social isolation and a lack of social support due to experiences with racism and homophobia, which may have implications for sexual risk behaviors. The purpose of this study was to explore perceptions of social isolation and sense of community among YBMSM, the need for and receptivity to social networking features designed to reduce social isolation and build community within an Internet- and mobile phone-based primary and secondary HIV prevention intervention for YBMSM and to identify strategies to develop these features. Focus groups were conducted with 22 YBMSM aged 20-30 years at three sites in North Carolina. Data from the focus groups were thematically analyzed using NVivo. Feelings of social isolation and lack of a sense of community were strongly endorsed by participants with homophobia, lack of opportunities for social engagement, and a focus on sex rather than friendship in interpersonal relationships with other YBMSM cited as contributing factors. Participants were receptive to a social networking intervention designed to reduce social isolation and build community. Recommendations offered by participants to increase acceptability and usability of such features included: availability of information about healthy relationships, the ability to connect with other YBMSM and health care providers, and ensuring the site had ongoing facilitation by the study team as well as monitoring for inappropriate content. The development of a social networking feature of an HIV prevention intervention may present an opportunity to reduce social isolation, build community, and reduce risky sexual behaviors among YBMSM. The findings from this study are being used to inform the development of a social networking feature for an existing Internet- and mobile phone-based primary and secondary HIV prevention intervention for

  4. Media created violence: a social determinant of mental health.

    PubMed

    Begum, Shamshad; Khowaja, Shaneela Sadruddin; Ali, Gulnar

    2012-12-01

    In today's high technological world, scientific discoveries contribute remarkable development to human life, but it could also have an adverse impact on mankind. Among all these advancements, media is one of the inventions which aims at capturing a countless group of viewers and transmit information via various mediums. Media violence is considered one of the hampering determinants which harms an individual psychologically. The primary goal of a health professional is to work for the maintenance of mental health. Therefore, it is imperative to create an understanding about the impact of media violence on mental health, particularly in the Pakistani context. Violence has become a major public health problem in Pakistan. The main cause of violence seems to be anger and frustration due to poverty, political conflicts, lack of education, and the overall governance approach in the country. Therefore, there is a prime need to think and work on this neglected area like conducting research and increasing public awareness, and to curb media violence. PMID:23866487

  5. Equity and social determinants of health at a city level.

    PubMed

    Ritsatakis, Anna

    2009-11-01

    Equity in health has been the underlying value of the WHO Health for All policy for 30 years, distinguished from equality and difference in a commissioned series of theoretical reports in the early 1990s. This article examines how cities translated this principle into action. Using information designed to help evaluate Phase III (1998-2002) of the WHO European Healthy Cities Network, plus documentation from city programmes and websites, an attempt is made to assess how far stakeholders in cities understood the concept of equity in health, had the political will to tackle the issue and the types of action undertaken. Results show that cities focused mainly on support for vulnerable groups, and a wide range of actions were being implemented, including lifestyle-oriented methods or those to improve access to care. Few cities made the necessary shift towards more upstream policies to tackle determinants of health such as poverty, unemployment and housing. There was little experience of evaluating the impact of interventions to reduce the gaps. This is partly explained by a frequent lack of local level data reflecting inequalities in health. The article concludes that although half the cities in the Network needed stronger action to make equity in health an integral part of long-term planning, innovative experience was available to be shared by its members in Phase IV (2003-2008) of the Network.

  6. A Social-Ecological Analysis of the Self-Determination Literature

    ERIC Educational Resources Information Center

    Shogren, Karrie A.

    2013-01-01

    This paper uses a social-ecological lens to examine self-determination research, attempting to organize what is known (and unknown) about contextual factors that have the potential to impact the development and expression of self-determined behavior in people with disabilities across multiple ecological systems. Identifying and categorizing the…

  7. A Social-Ecological Analysis of the Self-Determination Literature

    ERIC Educational Resources Information Center

    Shogren, Karrie A.

    2013-01-01

    This paper uses a social-ecological lens to examine self-determination research, attempting to organize what is known (and unknown) about contextual factors that have the potential to impact the development and expression of self-determined behavior in individuals with disabilities across multiple ecological systems. Identifying and categorizing…

  8. A National Content Analysis of PhD Program Objectives, Structures, and Curricula: Do Programs Address the Full Range of Social Work's Needs?

    ERIC Educational Resources Information Center

    Drisko, James; Hunnicutt, Christie; Berenson, Laura

    2015-01-01

    The Group for the Advancement of Doctoral Education (GADE) promotes excellence in PhD education in Social Work. GADE's 2013 Quality Guidelines for PhD Programs heavily emphasize preparation for research. Little is known, however, about the details of the contemporary social work PhD program structure and curriculum. Several prior surveys have…

  9. Modeling the determinants of the social impacts of agricultural development projects

    SciTech Connect

    Ahmadvand, Mostafa; Karami, Ezatollah; Iman, Mohammad Taghi

    2011-01-15

    In an attempt to help policy-makers improve the social sustainability of development projects, this study identifies the key determinants of farmers' attitudes relating to the social impacts of the floodwater spreading project (FWSP) on the Gareh-Bygone plain in Iran. In order to analyze the links between the various factors that affect the experience of social impact, a theoretical framework was developed. Stratified random sampling was used to survey 138 farm households from the four villages in the region. One male and one female from each house were interviewed face-to-face using a questionnaire, resulting in a total of 276 interviews. Structural factors were found to be the largest contribution to stakeholders' attitudes relating to the social impacts of the project. Results from a cluster analysis suggested that the level of floodwater information, level of participation, water access, ownership change, and environmental worldview were the most important factors explaining attitude towards social impact of the FWSP.

  10. Does social dominance generate prejudice? Integrating individual and contextual determinants of intergroup cognitions.

    PubMed

    Guimond, Serge; Dambrun, Michaël; Michinov, Nicolas; Duarte, Sandra

    2003-04-01

    Social dominance orientation (SDO) has been proposed as an important variable in the explanation of prejudice. We distinguish between three conceptualizations of SDO: SDO as a personality trait (personality model), SDO as a moderator of the effects of situational variables (Person x Situation model), and SDO as a mediator of the effect of social position on prejudice (group socialization model [GSM]). Four studies (N = 1.657) looking at the relations between social positions, SDO, and prejudice in a natural setting and in a laboratory setting provide strong support for the GSM. In contrast to previous correlational findings, there is evidence of a cause (dominant social position), an effect (prejudice increases), and a mediator (SDO). These results suggest new perspectives on the integration of individual and contextual determinants of prejudice.

  11. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

    PubMed

    Jennings, Viniece; Larson, Lincoln; Yun, Jessica

    2016-02-05

    Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.

  12. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health

    PubMed Central

    Jennings, Viniece; Larson, Lincoln; Yun, Jessica

    2016-01-01

    Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365

  13. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

    PubMed

    Jennings, Viniece; Larson, Lincoln; Yun, Jessica

    2016-02-01

    Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365

  14. Social Determinants of Quality of Elderly Life in a Rural Setting of India

    PubMed Central

    Dongre, Amol R; Deshmukh, Pradeep R

    2012-01-01

    Objective: The aim of this study is to understand the social determinants of quality of elderly life in rural central India and describe their perspectives on various issues related to their quality of life. Materials and Methods: It was a community-based mixed-methods study in which quantitative (survey) method was followed by qualitative (Focus Group Discussion, FGD). The study was done in field practice area of a Rural Health Training Centre. We decided to interview all the elderly (>60 years) in two feasibly selected wards of village Anji by using the “WHO-Quality of Life (WHOQOL)-brief questionnaire.” We used WHOQOL syntax for the calculation of mean values of four domains. Following survey, four FGDs were carried out. Results: The determinants of perceived physical health, amenable for intervention were their currently working status, not being neglected by the family, and involvement in social activities. The determinants for psychological support were health insurance, and their current working status. The determinants for social relations were membership in social group and their present working status. The determinants for perceived environment were membership in social groups and relationship with the family members. In qualitative research, factors such as active life, social activity, spirituality, health care, involvement in decision making, and welfare schemes by the Government were found to contribute to better quality of elderly life. Problems or conflicts in family environment, lack of shelter and financial security, overtapped resources, and gender bias add to negative feelings in old age life. Conclusions: There is a need for intervention at social and family level for elderly friendly environment at home and community level. PMID:23439878

  15. 20 CFR 220.37 - When a child's disability determination is governed by the regulations of the Social Security...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... governed by the regulations of the Social Security Administration. 220.37 Section 220.37 Employees... Disability Determinations Governed by the Regulations of the Social Security Administration § 220.37 When a child's disability determination is governed by the regulations of the Social Security...

  16. 20 CFR 220.37 - When a child's disability determination is governed by the regulations of the Social Security...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... governed by the regulations of the Social Security Administration. 220.37 Section 220.37 Employees... Disability Determinations Governed by the Regulations of the Social Security Administration § 220.37 When a child's disability determination is governed by the regulations of the Social Security...

  17. 20 CFR 220.37 - When a child's disability determination is governed by the regulations of the Social Security...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... governed by the regulations of the Social Security Administration. 220.37 Section 220.37 Employees... Disability Determinations Governed by the Regulations of the Social Security Administration § 220.37 When a child's disability determination is governed by the regulations of the Social Security...

  18. 20 CFR 220.37 - When a child's disability determination is governed by the regulations of the Social Security...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... governed by the regulations of the Social Security Administration. 220.37 Section 220.37 Employees... Disability Determinations Governed by the Regulations of the Social Security Administration § 220.37 When a child's disability determination is governed by the regulations of the Social Security...

  19. The role of social determinants in explaining racial/ethnic disparities in perinatal outcomes.

    PubMed

    Lorch, Scott A; Enlow, Elizabeth

    2016-01-01

    In the United States, there continue to be significant racial/ethnic disparities in preterm birth (PTB) rates, infant mortality, and fetal mortality rates. One potential mediator of these disparities is social determinants of health, including individual socioeconomic factors; community factors such as crime, poverty, housing, and the racial/ethnic makeup of the community; and the physical environment. Previous work has identified statistically significant associations between each of these factors and adverse pregnancy outcomes. However, there are recent studies that provide new, innovative insights into this subject, including adding social determinant data to population-based datasets; exploring multiple constructs in their analysis; and examining environmental factors. The objective of this review will be to examine this recent research on the association of each of these sets of social determinants on racial/ethnic disparities PTB, infant mortality, and fetal mortality to highlight potential areas for targeted intervention to reduce these differences.

  20. A review of family and social determinants of children's eating patterns and diet quality.

    PubMed

    Patrick, Heather; Nicklas, Theresa A

    2005-04-01

    With the growing problem of childhood obesity, recent research has begun to focus on family and social influences on children's eating patterns. Research has demonstrated that children's eating patterns are strongly influenced by characteristics of both the physical and social environment. With regard to the physical environment, children are more likely to eat foods that are available and easily accessible, and they tend to eat greater quantities when larger portions are provided. Additionally, characteristics of the social environment, including various socioeconomic and sociocultural factors such as parents' education, time constraints, and ethnicity influence the types of foods children eat. Mealtime structure is also an important factor related to children's eating patterns. Mealtime structure includes social and physical characteristics of mealtimes including whether families eat together, TV-viewing during meals, and the source of foods (e.g., restaurants, schools). Parents also play a direct role in children's eating patterns through their behaviors, attitudes, and feeding styles. Interventions aimed at improving children's nutrition need to address the variety of social and physical factors that influence children's eating patterns. PMID:15798074

  1. Suicide and alcohol related disorders in the U.S. Arctic: boosting research to address a primary determinant of health disparities

    PubMed Central

    Allen, James; Levintova, Marya; Mohatt, Gerald

    2011-01-01

    Objectives To review the existing epidemiological literature on suicide and alcohol related disorders and their social determinants in the U.S. Arctic, as it relates to U.S. government research and evaluation efforts, and to offer recommendations to boost research capacity in the U.S. Arctic and collaborations across the circumpolar arctic as part of global health initiatives. Study design: Synthetic literature review. Methods Published literature, federal and state reports on suicide and alcohol-related disorders, federal databases on research and program evaluation in the U.S Arctic were reviewed, with a focus on epidemiological trends over the past 50 years. Results Suicide and alcohol-related disorders play a significant role in health disparities t in the U.S. Arctic, with evidence of a disturbing prevalence trend over the past 50 years. Important variations exist in suicide rates across different regions of Alaska with different majority populations of Alaska Native cultural groups, and in selected key instances, within these regions, with immense implications for guiding effective prevention efforts. Consequences of alcohol abuse are severe and particularly significant in their impact upon Alaska Native people. Health related conditions associated with alcohol abuse are among leading causes of mortality. Conclusions Recommendations to boost research capacity in behavioural health in the U.S. Arctic are offered; specifically on strategies and methods of inquiry and analysis, distinctions between populations and communities in rural circumpolar contexts, future epidemiological and implementation research. PMID:22067096

  2. Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part II: lay perspectives

    PubMed Central

    Popay, Jennie; Kowarzik, Ute; Mallinson, Sara; Mackian, Sara; Barker, Jacqui

    2007-01-01

    Objectives This study aimed to describe social problems presented to general practitioners (GPs) in UK inner cities and GPs' responses; describe patients help‐seeking pathways; and consider how these pathways can be improved. Methods The study involved a pilot survey and follow‐up qualitative interviews with patients in two inner city areas in London and Salford in 2001–2. The pilot survey involved five practices in each locality. GPs completed questionnaires on 57 people presenting with social problems. A diversity sample of 12 patients was followed up for interview. Results Study results are presented in two parts. Here (Part II) qualitative research results are reported highlighting four themes: the complex and enduring nature of social problems; the persistence people display seeking help; the fragmented and problematic pathways available; and the roles GPs play as: primary medical adviser; formal gateway to another service; advocates or facilitators to another service; and sources of support and advice during a process of recovery. Commonly, GPs occupied more than one role. Conclusions GPs do help people deal with social problems, but their responses are limited. More integrated pathways to help and advice for social problems are needed. Existing pathways could be more visible and accessible, and new pathways developed through commissioning and extending social prescribing. More partnerships across sectors may create more co‐ordinated provision, but these are notoriously difficult, and other trends such as the focus on lifestyle issues and long‐standing conditions may make it more difficult for people with social needs to access support. PMID:17933955

  3. Learned fear to social out-group members are determined by ethnicity and prior exposure

    PubMed Central

    Golkar, Armita; Björnstjerna, Marie; Olsson, Andreas

    2015-01-01

    Humans, like other animals, have a tendency to preferentially learn and retain some associations more readily than others. In humans, preferential learning was originally demonstrated for certain evolutionary prepared stimuli, such as snakes and angry faces and later extended to human social out-groups based on race (Olsson et al., 2005). To address the generality of this social learning bias, we examined if this learning bias extended to two separate classes of social out-groups represented by neutral Black and Middle-Eastern faces in 38 White (Swedish) participants. We found that other-ethnicity alone was not sufficient to induce an out-group learning bias; it was observed for Black, but not Middle-Eastern, out-group faces. Moreover, an exploratory analysis showed that growing up in an ethnically diverse environment was inversely related to the learning bias toward Middle-Eastern, but not Black, out-groups faces, suggesting that learned fears toward Middle-Eastern faces might be more permeable to environmental factors. Future research should address how both the quantity and quality of inter-group contact modulate out-group learning. PMID:25762953

  4. An interdisciplinary perspective on social and physical determinants of seismic risk

    NASA Astrophysics Data System (ADS)

    Lin, K.-H.; Chang, Y.-C.; Liu, G.-Y.; Chan, C.-H.; Lin, T.-H.; Yeh, C.-H.

    2015-01-01

    While disaster studies researchers usually view risk as a function of hazard, exposure, and vulnerability, few studies have systematically examined the relationships among the various physical and socioeconomic determinants underlying disasters, and fewer have done so through seismic risk analysis. In the context of the 1999 Chi-Chi earthquake in Taiwan, this study constructs five hypothetical models to test different determinants that affect disaster fatality at the village level, namely seismic hazard intensity, population, building fragility, demographics and socioeconomics. The Poisson Regression Model is used to estimate the impact of natural hazards and social factors on fatality. Results indicate that although all of the determinants have an impact on the specific dimension of seismic fatality, some indicators of social inequality, such as gender ratio, dependency ratio, income and its SD, are the driving determinants deteriorating vulnerability to seismic risk. These findings have strong social implications for policy interventions to mitigate such disasters. This study presents an interdisciplinary investigation into social and physical determinants in seismic risk.

  5. Epidemiology of the 21 st century and cyberspace: rethinking power and the social determination of health.

    PubMed

    Breilh, Jaime

    2015-01-01

    The study of epidemiologic processes as a form of socially determined movement requires a renewed understanding of the social order, and thus, an updated understanding of the social relations that move society. Recently, the dominance of big corporations on cyberspace has become visible as a new historical process that conditions the social order and extends the technological subordination of daily life, therefore expanding community massive submission to standard conducts. The new digital technological revolution, about which some frightening prognoses are made for the next decades, could easily imply the advent of an era of radical subsumption of life processes. This will negatively affect not only our general way of living, thinking and planning, but also our deepest daily intimacy. This movement implies radical effects on health which we call cybernetic determination and subsumption. This novel process raises new questions on public health and prevention; but also requires a new reading of reality, a rethinking of human life and health, of its social determination, which implies the need for new new categories and analysis and renewed challenges for critical epidemiology. PMID:26982311

  6. Social and individual determinants of adolescents' acceptance of novel healthy and cool snack products.

    PubMed

    Nørgaard, Maria Kümpel; Sørensen, Bjarne Taulo; Grunert, Klaus G

    2014-12-01

    Four new, healthy snack products, consisting of fruit, vegetables, bread, dip and topping, were tested with 600 Danish adolescents aged 9-16. Participants could view, handle, and test the products in a school setting. Acceptance was measured by overall buying intention, as well as buying intention contingent on specific substitutes and on the social situation. Price consciousness, health consciousness, snack neophobia, peer influence, social activities and word-of-mouth were measured as potential determinants of acceptance of the novel products. An exploratory analysis in TETRAD suggested that the measured constructs form three layers, with overall buying intention as the terminal causal effect, health consciousness, word of mouth, snack neophobia and peer influence as endogenous determinants, and social activities and the contingent buying intentions as mediators. Estimation of the causal relationships was conducted in LISREL. Findings show a predominance of social factors as determinants of novel snack acceptance, whereas health consciousness had only a weak and indirect effect on buying intentions and the effect of snack neophobia was partly mediated by social factors. PMID:25173064

  7. Chronic Neglect and Services Without Borders: A Guiding Model for Social Service Enhancement to Address the Needs of Parents With Intellectual Disabilities

    PubMed Central

    Azar, Sandra; Robinson, Lara; Proctor, Stephon

    2016-01-01

    Child neglect has negative effects throughout the lifespan. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this paper argues for a more fine grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of etiology. Based on this model and what is known about the efficacy of behaviorally-based interventions, implications for enhancements to the social service system to adapt to the needs of parents with intellectual disabilities are presented. The areas covered include improvements to screening and assessment of parents; provision of adapted services; and changes in selection processes and training of staff. Future directions for integrating social information processing elements into interventions are discussed with examples from empirically tested prevention programs. PMID:27617050

  8. Chronic Neglect and Services Without Borders: A Guiding Model for Social Service Enhancement to Address the Needs of Parents With Intellectual Disabilities

    PubMed Central

    Azar, Sandra; Robinson, Lara; Proctor, Stephon

    2016-01-01

    Child neglect has negative effects throughout the lifespan. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this paper argues for a more fine grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of etiology. Based on this model and what is known about the efficacy of behaviorally-based interventions, implications for enhancements to the social service system to adapt to the needs of parents with intellectual disabilities are presented. The areas covered include improvements to screening and assessment of parents; provision of adapted services; and changes in selection processes and training of staff. Future directions for integrating social information processing elements into interventions are discussed with examples from empirically tested prevention programs.

  9. Inclusion in Urban Educational Environments: Addressing Issues of Diversity, Equity, and Social Justice. Issues in the Research, Theory, Policy, and Practice of Urban Education

    ERIC Educational Resources Information Center

    Armstrong, Denise E.; McMahon, Brenda J.

    2006-01-01

    This book is motivated by the authors' experiences in working with students and their families in urban communities. They are particularly concerned about the urgent imperative to address the endemic educational and societal challenges that pervade the lives of urban students, particularly those who live in poverty, are of minority and immigrant…

  10. Association of substance-use behaviours and their social-cognitive determinants in secondary school students.

    PubMed

    Victoir, An; Eertmans, Audrey; Van den Bergh, Omer; Van den Broucke, Stephan

    2007-02-01

    In two samples of Flemish secondary school students, co-occurrence of different types of substance use was observed: smoking was associated with marijuana use in Sample 1 (n = 597) and alcohol consumption in Sample 2 (n = 403). It was investigated whether social-cognitive determinants of these behaviours were also associated. Low to medium correlations were observed. Confirmatory factor analyses showed that a model with general social-cognitive factors (across different substances) did not have adequate fit. Substance use was mainly associated with variables referring to the specific substance under consideration, with the exception of self-efficacy in buying and smoking cigarettes; this factor was linked not only to smoking but also to alcohol and marijuana use. Adolescents who regularly used two substances generally held positions on social-cognitive scales that were more unfavourable than those who only used one substance. In order to change determinants of use, substance-specific cognitions and skills may be important targets.

  11. "Voicing" the social determinants of health on the backside of a horse racetrack.

    PubMed

    Kiesler, Joseph; Vaughn, Lisa M; Kaur, Gupreet

    2013-08-01

    Workers in the horse racing industry often live and work on the backside of the track, traveling from track to track as the racing season dictates. There has been little research on the social determinants of health and living conditions of the workers. We conducted a two-phase project: (1) a cross-sectional survey of backside workers; and (2) a community-based participatory research project with four workers who worked and lived at a local racetrack using Photovoice. Substance abuse, safety concerns, limited access to health care, a high rate of work-related injuries and social isolation were common problems reported by the workers. Six themes were identified: (1) safety and health; (2) coping; (3) life philosophy: fatalism vs. hope; (4) love of horses; (5) working conditions; (6) living conditions; and (7) backside culture. Results are discussed in relation to the social determinants of health.

  12. Dying as a social relationship: a sociological review of debates on the determination of death.

    PubMed

    Kellehear, Allan

    2008-04-01

    The research literature about 'brain death' is largely characterized by biomedical, bioethical and legal writing. This has led to overlooking wider but no less pertinent social, historical and cultural understandings about death. By ignoring the work of other social and clinical colleagues in the study of dying, the literature on the determination of death has become unnecessarily abstract and socially disconnected from parallel concerns about death and dying. This has led, and continues to lead to, incomplete suggestions and narrow discussions about the nature of death as well as an ongoing misunderstanding of general public and health care staff responses to brain death criteria. This paper provides a sociological outline of these problems through a review of the key literature on the determination of death.

  13. The Role of Individual- and Macro-Level Social Determinants on Young Adolescents' Psychosomatic Complaints

    ERIC Educational Resources Information Center

    Ottova, Veronika; Erhart, Michael; Vollebergh, Wilma; Kokonyei, Gyongyi; Morgan, Antony; Gobina, Inese; Jericek, Helena; Cavallo, Franco; Valimaa, Raili; Gaspar de Matos, Margarida; Gaspar, Tania; Schnohr, Christina W.; Ravens-Sieberer, Ulrike

    2012-01-01

    This study examines the social determinants of psychosomatic complaints in young adolescents. Using data from the Health Behaviour in School-aged Children (HBSC) study, psychosomatic complaints are studied in 98,773 adolescents (11- and 13-year-olds; 48% 11-year-olds, 52% 13-year-olds; 52% females, 48% males) from 34 European countries.…

  14. Social Cohesion as Determined by the Levels and Types of Involvement.

    ERIC Educational Resources Information Center

    Grubb, Henry Jefferson

    1987-01-01

    Asserts that all behavior is result of individual-group interaction, determined by attachment to and identification with various groups to which one belongs. Presents this social cohesion as a function of member's levels and types of group involvement. Describes types ranked according to degree of involvement (identification, alienation, autonomy,…

  15. Social Determinants in Communication Events in a Small Bilingual Community in New Mexico.

    ERIC Educational Resources Information Center

    Oliver, Joseph D.

    The purpose of this report is to present an outline of actual occurrences in communication and their social determinants in the small Spanish-English bilingual community of Los Ojos, New Mexico, with some emphasis on difference in occurrences as related to age. These generalizations are linked to past and current educational practices and social…

  16. Cultural, Human, and Social Capital as Determinants of Corporal Punishment: Toward an Integrated Theoretical Model.

    ERIC Educational Resources Information Center

    Xu, Xiaohe; Tung, Yuk-Ying; Dunaway, R. Gregory

    2000-01-01

    This article constructs a model to predict the likelihood of parental use of corporal punishment on children in two-parent families. Reports that corporal punishment is primarily determined by cultural, human, and social capital that are available to, or already acquired by parents. Discusses an integrated, resource-based theory for predicting use…

  17. Determination and Interpretation of the Norm Values of Preschool Social Skills Rating Scale Teacher Form

    ERIC Educational Resources Information Center

    Omeroglu, Esra; Buyukozturk, Sener; Aydogan, Yasemin; Cakan, Mehtap; Cakmak, Ebru Kilic; Ozyurek, Arzu; Akduman, Gulumser Gultekin; Gunindi, Yunus; Kutlu, Omer; Coban, Aysel; Yurt, Ozlem; Kogar, Hakan; Karayol, Seda

    2015-01-01

    This study aimed to determine and interpret norms of the Preschool Social Skills Rating Scale (PSSRS) teacher form. The sample included 224 independent preschools and 169 primary schools. The schools are distributed among 48 provinces and 3324 children were included. Data were obtained from the PSSRS teacher form. The validity and reliability…

  18. Enhancing John Rawls's Theory of Justice to Cover Health and Social Determinants of Health1

    PubMed Central

    Ekmekci, Perihan Elif; Arda, Berna

    2015-01-01

    The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice. PMID:27340331

  19. Persons Living with HIV/AIDS: Employment as a Social Determinant of Health

    ERIC Educational Resources Information Center

    Hergenrather, Kenneth C.; Zeglin, Robert J.; Conyers, Liza; Misrok, Mark; Rhodes, Scott D.

    2016-01-01

    Purpose: For persons living with HIV/AIDS (PLWHA), the advent of highly active antiretroviral therapy has increased their longevity and quality of life. As HIV progresses, many PLWHA present declined domains of functioning that impede their ability to work. The authors explore employment as a social determinant of health to identify issues…

  20. Enhancing Curriculum through Service Learning in the Social Determinants of Health Course

    ERIC Educational Resources Information Center

    Rooks, Ronica Nicole; Rael, Christine Tagliaferri

    2013-01-01

    Service learning bridges classroom learning and community volunteerism and is anchored in the curriculum, classroom discussion, and community. We incorporated service learning projects (SLP) into three Social Determinants of Health courses (2008-2010) to promote: experiential learning; undergraduate scholarship; faculty career development through…

  1. Human Capital, Social Classes, and the Earnings Determination Process in Brazilian Agriculture.

    ERIC Educational Resources Information Center

    Neves, Jorge A.; Haller, Archibald O.; Fernandes, Danielle C.

    This paper examines the process of earnings determination in the agricultural sector of Brazil. Among the main causal factors analyzed are human capital (education and work experience), labor market segmentation, gender, social class position, level of development/modernization, and concentration of land ownership. Data on individuals employed in…

  2. The role of the social sciences in determining the constitutionality of capital punishment.

    PubMed

    White, W S

    1975-07-01

    This paper examines the probable role of social science data in determining the legal validity of capital punishment, drawing upon approaches already employed by the Supreme Court to analyze the legal significance of studies relating to various aspects of capital punishment.

  3. Psycho-Social Determinants of Gender Prejudice in Science, Technology, Engineering and Mathematics

    ERIC Educational Resources Information Center

    Nnachi, N. O.; Okpube, M. N.

    2015-01-01

    This work focused on the "Psycho-social Determinants of Gender Prejudice in Science, Technology, Engineering and Mathematics (STEM)". The females were found to be underrepresented in STEM fields. The under-representation results from gender stereotype, differences in spatial skills, hierarchical and territorial segregations and…

  4. A Single Case Design Evaluation of a Software and Tutor Intervention Addressing Emotion Recognition and Social Interaction in Four Boys with ASD

    ERIC Educational Resources Information Center

    Lacava, Paul G.; Rankin, Ana; Mahlios, Emily; Cook, Katie; Simpson, Richard L.

    2010-01-01

    Many students with Autism Spectrum Disorders (ASD) have delays learning to recognize emotions. Social behavior is also challenging, including initiating interactions, responding to others, developing peer relationships, and so forth. In this single case design study we investigated the relationship between use of computer software ("Mind Reading:…

  5. Chronic Neglect and Services without Borders: A Guiding Model for Social Service Enhancement to Address the Needs of Parents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Azar, Sandra T.; Robinson, Lara R.; Proctor, Stephon N.

    2012-01-01

    Child neglect has negative effects throughout the life span. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this article argues for a more fine-grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of…

  6. Teaching about Modern Germany: Instructional Materials for the Social Studies Classroom. Correlation Charts Indicating Content and Skills Addressed by Each Lesson.

    ERIC Educational Resources Information Center

    Goethe House, New York, NY.

    This instructional booklet for the social studies classroom is a companion to a series about modern day Germany. The materials describe the documents in the series and present correlation charts for content and skills: (1) "A Kid Like Me across the Sea"; (2) "Communities and Regions"; (3) "Overview of Germany"; (4) "Germany in Europe"; (5)…

  7. Providing Effective Support to Teachers in Addressing Social, Emotional and Behavioural Difficulties in Mainstream Classrooms in a Bangalore Pre-Primary School

    ERIC Educational Resources Information Center

    D'Souza, Mildred; Jament, Johnson

    2015-01-01

    This article reports a study conducted on children's social, emotional and behavioural difficulties (SEBD) in a single pre-primary school in Bangalore, with the objective of developing a behaviour management policy for use by teachers. Limited evidence is available in the Indian literature in the area of SEBD and it remains important to know how…

  8. Framing a Transdisciplinary Research Agenda in Health Education to Address Health Disparities and Social Inequities: A Road Map for SOPHE Action

    ERIC Educational Resources Information Center

    Gambescia, Stephen F.; Woodhouse, Lynn D.; Auld, M. Elaine; Green, B. Lee; Quinn, Sandra Crouse; Airhihenbuwa, Collins O.

    2006-01-01

    SOPHE leaders continue to challenge us to be true to the call for an "open society." SOPHE has supported the Healthy People 2010 goal of eliminating health disparities through its Strategic Plan. SOPHE held an Inaugural Health Education Research Disparities Summit, Health Disparities and Social Inequities: Framing a Transdisciplinary Research…

  9. Social determinants and psychological distress among Aboriginal and Torres Strait islander adults in the Australian state of Victoria: a cross-sectional population based study.

    PubMed

    Markwick, Alison; Ansari, Zahid; Sullivan, Mary; McNeil, John

    2015-03-01

    Aboriginal and Torres Strait Islander adults in the Australian state of Victoria have a higher prevalence of psychological distress than their non-Aboriginal and Torres Strait Islander counterparts. We sought to explain this inequality, focussing on the social determinants of health. We used population-based survey data from the 2008 Victorian Population Health Survey; a cross-sectional landline computer-assisted telephone survey of 34,168 randomly selected adults. We defined psychological distress as a score of 22 or more on the Kessler 10 Psychological Distress scale. We used logistic regression to identify socio-demographic characteristics and social capital indicators that were associated with psychological distress. We then created multivariable models to explore the association between psychological distress and Aboriginal and Torres Strait Islander status that incorporated all significant socioeconomic status (SES) and social capital variables, adjusting for all non-SES socio-demographic characteristics. Aboriginal and Torres Strait Islander Victorians (24.5%) were more than twice as likely than their non-Aboriginal and Torres Strait Islander counterparts (11.3%) to have psychological distress (odds ratio (OR) = 2.56, 95% confidence interval; 1.67-3.93). Controlling for SES, negative perceptions of the residential neighbourhood, lack of social support from family, social and civic distrust, and all non-SES socio-demographic variables (age, sex, marital status, household composition, and rurality), rendered the previously statistically significant inequality in the prevalence of psychological distress, between Aboriginal and Torres Strait Islander Victorians and their non-Aboriginal and Torres Strait Islander counterparts, insignificant at the p = 0.05 level (OR = 1.50; 0.97-2.32). Psychological distress is an important health risk factor for Aboriginal and Torres Strait Islander adults that has yet to be widely acknowledged and addressed. Addressing the

  10. The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

    PubMed Central

    2013-01-01

    Background The Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia. Methods Sixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government. Results While respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services’ responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse “dilemmatic space” in their work. Conclusions The absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health’s recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and

  11. Invited Commentary: Multigenerational Social Determinants of Health—Opportunities and Challenges.

    PubMed

    Cohen, Alison K; Lê-Scherban, Félice

    2015-10-01

    An emerging area of social epidemiology examines the relationship between grandparental education and grandchild health. In an accompanying article, Huang et al. (Am J Epidemiol. 2015;182(7):568-578) join the small but growing body of research on this topic. It is useful to contextualize Huang et al.'s work within the much larger body of research examining relationships between education and health within a single generation or across 2 generations. These investigators have generally concluded that higher educational attainment is robustly associated with better health. There are many potential mechanisms through which education and other social exposures may affect health outcomes in a single generation or across generations, and estimating direct and indirect effects can be helpful for assessing specific mechanisms. Researchers conducting multigenerational analyses are faced with several challenges, including limited availability of data for some measures (e.g., educational attainment, and sometimes for 1 grandparent only), limited age ranges of participants, disparate social and political contexts in which study participants of different generations have lived, and patterns of social class reproduction. We encourage future researchers to weave together the careful analytical considerations illustrated by Huang et al. with a rich understanding of the social context for each of the generations studied to help overcome these challenges and advance our understanding of multigenerational social determinants of health.

  12. Global health governance: commission on social determinants of health and the imperative for change.

    PubMed

    Bell, Ruth; Taylor, Sebastian; Marmot, Michael

    2010-01-01

    In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005-2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration--the universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships--with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse.

  13. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    PubMed

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care.

  14. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    PubMed

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care. PMID:27127266

  15. Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool

    PubMed Central

    2013-01-01

    Introduction The residents of many Australian rural and remote communities do not have the essential infrastructure and services required to support healthy living conditions and community members choosing healthy lifestyle options. Improving these social determinants of health is seen to offer real opportunities to improve health among such disadvantaged populations. In this paper, we describe the development and trialling of a tool to measure, monitor and evaluate key social determinants of health at community level. Methods The tool was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders and trialling the tool in remote Indigenous communities in the Northern Territory of Australia. Results The indicators were found to be robust, and by testing the tool on a number of different levels, face validity was confirmed. The scoring system was well understood and easily followed by Indigenous and non-Indigenous study participants. A facilitated small group process was found to reduce bias in scoring of indicators. Conclusion The Healthy Community Assessment Tool offers a useful vehicle and process to help those involved in planning, service provision and more generally promoting improvements in community social determinants of health. The tool offers many potential uses and benefits for those seeking to address inequities in the social determinants of health in remote communities. Maximum benefits in using the tool are likely to be gained with cross-sector involvement and when assessments are part of a continuous quality improvement program. PMID:23442804

  16. Association of social determinants of health with self-rated health among Australian gay and bisexual men living with HIV.

    PubMed

    Koelmeyer, Rachel; English, Dallas R; Smith, Anthony; Grierson, Jeffrey

    2014-01-01

    Despite a vast improvement in the survival of people living with HIV (PLHIV) since the introduction of combination antiretroviral treatment (cART), little change in the self-rated health of PLHIV has been observed since the introduction of cART in Australia. Difficulties with attaining employment or achieving financial security have been noted as some of the key challenges still facing PLHIV in the post-cART era. As a result, we investigated the independent association of a number of key social determinants of health with self-rated health among HIV-positive gay and bisexual men in Australia. Data from two recent national, cross-sectional surveys of PLHIV (the HIV Futures 5 and 6 surveys) were used. Logistic regression was used to assess the independent association of ethnicity, region of residence, education level, employment status, after-tax income, experience of HIV-related discrimination, level of social support, relationship status and recent sexual activity with reporting good-excellent self-rated health, after adjusting for clinical factors and other social determinants of health. Multiple imputation was used to estimate missing data for variables with >5% missing data. Of the 1713 HIV-positive gay/bisexual men who responded to the HIV Futures 5 and 6 surveys, information on self-rated health was available for 99.3%. Close to three-quarters of these respondents (72.1%) reported their self-rated health as good or excellent; the remainder (27.9%) reported their self-rated health as poor or fair. In multivariable analysis involving 89.3% of respondents, being employed, reporting recent sexual activity, a greater number of sources of social support and a higher weekly after-tax income were found to be independently associated with reporting good-excellent self-rated health. Despite the inability of this study to detect causal associations, addressing barriers to employment and sexual activity, and mechanisms to increase social support, is likely to have

  17. Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

    PubMed Central

    2012-01-01

    Introduction In recent years, the country of Mongolia (population 2.8 million) has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy) to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons from Mongolia mirror other

  18. Position of Social Determinants of Health in Urban Man-Made Lakes

    PubMed Central

    Shojaei, Parisa; Karimlou, Masoud; Mohammadi, Farahnaz; Afzali, Hosein Malek; Forouzan, Ameneh Setareh

    2013-01-01

    Background and Objective: A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. Method: This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Results: Participants’ points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. Conclusion: This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community’s health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration

  19. Childhood Intelligence, Locus of Control and Behaviour Disturbance as Determinants of Intergenerational Social Mobility: British Cohort Study 1970

    ERIC Educational Resources Information Center

    von Stumm, Sophie; Gale, Catherine R.; Batty, G. David; Deary, Ian J.

    2009-01-01

    Determinants of intergenerational social mobility were examined in 8287 men from the British Cohort Study 1970. Confirming previous research, parental social class, childhood intelligence, and educational qualifications were the strongest predictors of occupational social class at the age of 30. Locus of control and childhood behaviour disturbance…

  20. 20 CFR 220.37 - When a child's disability determination is governed by the regulations of the Social Security...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Inclusion as a disabled child in the employee's annuity rate under the social security overall minimum. (2... governed by the regulations of the Social Security Administration. 220.37 Section 220.37 Employees... Disability Determinations Governed by the Regulations of the Social Security Administration § 220.37 When...

  1. A Systems-Based Conceptual Framework for Assessing the Determinants of a Social License to Operate in the Mining Industry

    NASA Astrophysics Data System (ADS)

    Prno, Jason; Slocombe, D. Scott

    2014-03-01

    The concept of a "social license to operate" (SLO) was coined in the 1990s and gained popularity as one way in which "social" considerations can be addressed in mineral development decision making. The need for a SLO implies that developers require the widespread approval of local community members for their projects to avoid exposure to potentially costly conflict and business risks. Only a limited amount of scholarship exists on the topic, and there is a need for research that specifically addresses the complex and changeable nature of SLO outcomes. In response to these challenges, this paper advances a novel, systems-based conceptual framework for assessing SLO determinants and outcomes in the mining industry. Two strands of systems theory are specifically highlighted—complex adaptive systems and resilience—and the roles of context, key system variables, emergence, change, uncertainty, feedbacks, cross-scale effects, multiple stable states, thresholds, and resilience are discussed. The framework was developed from the results of a multi-year research project which involved international mining case study investigations, a comprehensive literature review, and interviews conducted with mining stakeholders and observers. The framework can help guide SLO analysis and management efforts, by encouraging users to account for important contextual and complexity-oriented elements present in SLO settings. We apply the framework to a case study in Alaska, USA before discussing its merits and challenges. We also illustrate knowledge gaps associated with applications of complex adaptive systems and resilience theories to the study of SLO dynamics, and discuss opportunities for future research.

  2. A systems-based conceptual framework for assessing the determinants of a social license to operate in the mining industry.

    PubMed

    Prno, Jason; Slocombe, D Scott

    2014-03-01

    The concept of a "social license to operate" (SLO) was coined in the 1990s and gained popularity as one way in which "social" considerations can be addressed in mineral development decision making. The need for a SLO implies that developers require the widespread approval of local community members for their projects to avoid exposure to potentially costly conflict and business risks. Only a limited amount of scholarship exists on the topic, and there is a need for research that specifically addresses the complex and changeable nature of SLO outcomes. In response to these challenges, this paper advances a novel, systems-based conceptual framework for assessing SLO determinants and outcomes in the mining industry. Two strands of systems theory are specifically highlighted-complex adaptive systems and resilience-and the roles of context, key system variables, emergence, change, uncertainty, feedbacks, cross-scale effects, multiple stable states, thresholds, and resilience are discussed. The framework was developed from the results of a multi-year research project which involved international mining case study investigations, a comprehensive literature review, and interviews conducted with mining stakeholders and observers. The framework can help guide SLO analysis and management efforts, by encouraging users to account for important contextual and complexity-oriented elements present in SLO settings. We apply the framework to a case study in Alaska, USA before discussing its merits and challenges. We also illustrate knowledge gaps associated with applications of complex adaptive systems and resilience theories to the study of SLO dynamics, and discuss opportunities for future research. PMID:24375075

  3. [Social and cultural determinants of dental health practices in Morocco: results of a qualitative study].

    PubMed

    Msefer, Souad; Taleb, Wafae; Naji, Jamaleddine

    2004-01-01

    The objective of any health education program is to inculcate healthy life habits to improve the health status of the target population. The evaluation of an oral hygiene health education program for Moroccan schoolchildren implemented a decade ago by oral surgeons does not reveal any improvement of their dental health. To understand the obstacles to the acquisition of good oral hygiene habits, we conducted a qualitative survey of knowledge, attitude, and practices, based on semi-directive interviews with focus groups of children who had participated in the program. The results show that social and cultural determinants play an important role in the lack of impact of these programs and that Bourdieu's theory of action should be applied to understand the processes by which living conditions affect individuals'practices. Thus to inculcate healthy lifestyle habits, an ecological approach that takes into consideration the social, cultural, and economic environment is most likely to induce the emergence of favourable social conditions.

  4. Female Gender Is a Social Determinant of Diabetes in the Caribbean: A Systematic Review and Meta-Analysis

    PubMed Central

    Sobers-Grannum, Natasha; Murphy, Madhuvanti M.; Nielsen, Anders; Guell, Cornelia; Samuels, T. Alafia; Bishop, Lisa; Unwin, Nigel

    2015-01-01

    Background Diabetes (DM) is estimated to affect 10–15% of the adult population in the Caribbean. Preventive efforts require population wide measures to address its social determinants. We undertook a systematic review to determine current knowledge about the social distribution of diabetes, its risk factors and major complications in the Caribbean. This paper describes our findings on the distribution by gender. Methods We searched Medline, Embase and five databases through the Virtual Health Library, for Caribbean studies published between 2007 and 2013 that described the distribution by gender for: known risk factors for Type 2 DM, prevalence of DM, and DM control or complications. PRISMA guidance on reporting systematic reviews on health equity was followed. Only quantitative studies (n>50) were included; each was assessed for risk of bias. Meta-analyses were performed, where appropriate, on studies with a low or medium risk of bias, using random effects models. Results We found 50 articles from 27 studies, yielding 118 relationships between gender and the outcomes. Women were more likely to have DM, obesity, be less physically active but less likely to smoke. In meta-analyses of good quality population-based studies odds ratios for women vs. men for DM, obesity and smoking were: 1.65 (95% CI 1.43, 1.91), 3.10 (2.43, 3.94), and 0.24 (0.17, 0.34). Three studies found men more likely to have better glycaemic control but only one achieved statistical significance. Conclusion and Implications Female gender is a determinant of DM prevalence in the Caribbean. In the vast majority of world regions women are at a similar or lower risk of type 2 diabetes than men, even when obesity is higher in women. Caribbean female excess of diabetes may be due to a much greater excess of risk factors in women, especially obesity. These findings have major implications for preventive policies and research. PMID:25996933

  5. Social determinants of health and periodontal disease in Brazilian adults: a cross- sectional study

    PubMed Central

    2013-01-01

    Background Recently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants. Methods A cross-sectional study was performed using a sample of 743 adults (aged 35–49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health. Results The periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4–5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9–12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4–5 mm. The members of this group were typically white men aged 40–44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers

  6. Fundamental Interventions: How Clinicians Can Address the Fundamental Causes of Disease.

    PubMed

    Reich, Adam D; Hansen, Helena B; Link, Bruce G

    2016-06-01

    In order to enhance the "structural competency" of medicine-the capability of clinicians to address social and institutional determinants of their patients' health-physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We then outline the sorts of "fundamental interventions" that physicians might make in order to address the fundamental causes. PMID:27022923

  7. Asian Indian views on diet and health in the United States: importance of understanding cultural and social factors to address disparities.

    PubMed

    Mukherjea, Arnab; Underwood, Kelsey Clark; Stewart, Anita L; Ivey, Susan L; Kanaya, Alka M

    2013-01-01

    This study describes Asian Indian immigrant perspectives surrounding dietary beliefs and practices to identify intervention targets for diabetes and heart disease prevention. Participants were asked about conceptualizations of relationships between culture, food, and health during 4 focus groups (n = 38). Findings reveal influences of beliefs from respondents' native India, preservation of cultural practices within the US social structure, conflicts with subsequent generations, and reinterpretation of health-related knowledge through a lens, hybridizing both "native" and "host" contexts. Galvanization of ethnically valued beliefs incorporating family and community structures is needed for multipronged approaches to reduce disproportionate burdens of disease among this understudied minority community.

  8. Determinants of arsenicosis patients' perception and social implications of arsenic poisoning through groundwater in Bangladesh.

    PubMed

    Sarker, M Mizanur Rahman

    2010-10-01

    Adverse human health effects ranging from skin lesions to internal cancers as well as widespread social and psychological problems caused by arsenic contaminated drinking water in Bangladesh may be the biggest arsenic calamity in the world. From an arsenicosis patients survey, this paper empirically analyzes the determinants of arsenicosis patients' perception about chronic arsenic poisoning and social and psychological implications of arsenicosis. In this study, cross-sectional data were collected from the Matlab and Hajiganj Upzillas of Chandpur district which are known to be highly contaminated with arsenic in their underground water. Respondents informed that arsenic poisoning causes a wide range of social and psychological problems. Female respondents were less vulnerable in the case of social problems (p < 0.01) and more vulnerable for the psychological problems (p < 0.001) of arsenicosis than male respondents. The results based on logit analysis showed that education (p < 0.01) and household income (p < 0.05) were significantly correlated to respondents' perception about arsenicosis. The arsenicosis related special program (s) needs a clear understanding of people's perception about arsenic exposure for abating the health burden as well as social and psychological problems.

  9. Moving policies upstream to mitigate the social determinants of early childbearing.

    PubMed

    SmithBattle, Lee

    2012-01-01

    The teen birth rate in the United States is one of the highest in the post-industrialized world. International comparisons suggest that U.S. rates reflect high levels of social disadvantage and misguided policies that frame teen parenting as costly for mothers, children, and taxpayers. Studies that control for background factors that predispose teens to become parents highlight the social inequities that contribute to early childbearing and unfavorable maternal-child outcomes, regardless of maternal age. After reviewing these studies, federal policies that target and scrutinize teenage and single mothers are described and critiqued for the ways they disregard the social determinants of early childbearing and further the marginalization and social exclusion of low-income families. This review calls for public health nurses to challenge the ideological assumptions driving downstream policies and to advocate for comprehensive reforms that reduce the wide and growing inequities in education, income, and health among U.S. citizens. Building the public support and political will to move upstream will remain daunting in light of the pervasive stereotypes of teen parents and the ideological assumptions that early childbearing and poor maternal-child outcomes stem more from individual choices and lifestyles than from social inequities.

  10. Does walkable mean sociable? Neighborhood determinants of social capital among older adults in Japan.

    PubMed

    Hanibuchi, Tomoya; Kondo, Katsunori; Nakaya, Tomoki; Shirai, Kokoro; Hirai, Hiroshi; Kawachi, Ichiro

    2012-03-01

    Why are some communities more cohesive than others? The answer to the puzzle has two parts: (a) due to variations in the attributes of residents, and/or (b) due to variations in the attributes of places. However, few studies have sought to examine the community-level determinants of social capital. In the present study, we examined the associations between social capital and different area characteristics: (1) neighborhood walkability, (2) date of community settlement, and (3) degree of urbanization. We based our analysis on 9414 respondents from the Aichi Gerontological Evaluation Study (AGES), conducted in 2003. No significant positive association was found between the walkability score and any of the social capital indices. In contrast, community age and degree of urbanization were associated with many of the social capital indicators, even after controlling for characteristics of the residents. Community social capital thus appears to be more consistently linked to the broader historical and geographic contexts of neighborhoods, rather than to the proximal built environment (as measured by walkability).

  11. How events determine spreading patterns: information transmission via internal and external influences on social networks

    NASA Astrophysics Data System (ADS)

    Liu, Chuang; Zhan, Xiu-Xiu; Zhang, Zi-Ke; Sun, Gui-Quan; Hui, Pak Ming

    2015-11-01

    Recently, information transmission models motivated by the classical epidemic propagation, have been applied to a wide-range of social systems, generally assume that information mainly transmits among individuals via peer-to-peer interactions on social networks. In this paper, we consider one more approach for users to get information: the out-of-social-network influence. Empirical analyzes of eight typical events’ diffusion on a very large micro-blogging system, Sina Weibo, show that the external influence has significant impact on information spreading along with social activities. In addition, we propose a theoretical model to interpret the spreading process via both internal and external channels, considering three essential properties: (i) memory effect; (ii) role of spreaders; and (iii) non-redundancy of contacts. Experimental and mathematical results indicate that the information indeed spreads much quicker and broader with mutual effects of the internal and external influences. More importantly, the present model reveals that the event characteristic would highly determine the essential spreading patterns once the network structure is established. The results may shed some light on the in-depth understanding of the underlying dynamics of information transmission on real social networks.

  12. WHO European review of social determinants of health and the health divide.

    PubMed

    Marmot, Michael; Allen, Jessica; Bell, Ruth; Bloomer, Ellen; Goldblatt, Peter

    2012-09-15

    The European region has seen remarkable heath gains in those populations that have experienced progressive improvements in the conditions in which people are born, grow, live, and work. However, inequities, both between and within countries, persist. The review reported here, of inequities in health between and within countries across the 53 Member States of the WHO European region, was commissioned to support the development of the new health policy framework for Europe: Health 2020. Much more is understood now about the extent, and social causes, of these inequities, particularly since the publication in 2008 of the report of the Commission on Social Determinants of Health. The European review builds on the global evidence and recommends policies to ensure that progress can be made in reducing health inequities and the health divide across all countries, including those with low incomes. Action is needed--on the social determinants of health, across the life course, and in wider social and economic spheres--to achieve greater health equity and protect future generations.

  13. Social psychological determinants of the use of performance-enhancing drugs by gym users.

    PubMed

    Wiefferink, C H; Detmar, S B; Coumans, B; Vogels, T; Paulussen, T G W

    2008-02-01

    The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention to use such drugs and also on their background characteristics and beliefs, such as their attitudes, social influences and self-efficacy. While all social psychological determinants correlated with intention to use these drugs, the most important predictors were personal norms, beliefs about performance outcomes and the perceived behavior of others. Non-users held more restrictive norms about using performance-enhancing drugs, were less optimistic about the performance-enhancing outcomes and believed that fewer significant others used performance-enhancing drugs than users and ex-users. The results of this study indicate that users attribute advantages to performance-enhancing drugs and are inclined to overlook the risks of using them. Preventive interventions should focus on influencing personal norms and social processes.

  14. The Social Determinants of Health: It's Time to Consider the Causes of the Causes

    PubMed Central

    Gottlieb, Laura

    2014-01-01

    During the past two decades, the public health community's attention has been drawn increasingly to the social determinants of health (SDH)—the factors apart from medical care that can be influenced by social policies and shape health in powerful ways. We use “medical care” rather than “health care” to refer to clinical services, to avoid potential confusion between “health” and “health care.” The World Health Organization's Commission on the Social Determinants of Health has defined SDH as “the conditions in which people are born, grow, live, work and age” and “the fundamental drivers of these conditions.” The term “social determinants” often evokes factors such as health-related features of neighborhoods (e.g., walkability, recreational areas, and accessibility of healthful foods), which can influence health-related behaviors. Evidence has accumulated, however, pointing to socioeconomic factors such as income, wealth, and education as the fundamental causes of a wide range of health outcomes. This article broadly reviews some of the knowledge accumulated to date that highlights the importance of social—and particularly socioeconomic—factors in shaping health, and plausible pathways and biological mechanisms that may explain their effects. We also discuss challenges to advancing this knowledge and how they might be overcome. PMID:24385661

  15. Social determinants and risk factors for tuberculosis in national surveillance systems in Europe

    PubMed Central

    Hovhannesyan, A.

    2015-01-01

    Setting: National tuberculosis programmes (NTPs) of the 53 Member States of the World Health Organization (WHO) European Region. Objectives: To identify the social determinants and underlying risk factors for tuberculosis (TB) as routinely monitored by NTPs and to identify those feasible and appropriate to be included in the annual reporting to the joint European Centre for Disease Prevention and Control (ECDC) WHO reporting platform. Design: A semi-structured questionnaire sent to 53 national TB surveillance correspondents. Results: A total of 47 countries submitted questionnaires; most of the countries collect a number of social determinants and risk factors that are not requested for reporting to the Joint ECDC-WHO Reporting Platform. Occupation/employment, homelessness, diabetes mellitus and use of alcohol are collected by the majority of countries, but without standardised definitions. Conclusions: Four social determinants/risk factors are already included in the national TB surveillance systems of the majority of countries and could be incorporated in the annual reporting to the Joint ECDC/WHO Reporting Platform. Standardised epidemiological case definitions need to be adopted. PMID:26399291

  16. Social determinants of health predict state incidence of HIV and AIDS: a short report.

    PubMed

    Zeglin, Robert J; Stein, J Paul

    2015-01-01

    There are approximately 1.2 million people living with HIV/AIDS (PLWHA) in the USA. Each year, there are roughly 50,000 new HIV diagnoses. The World Health Organization Commission on Social Determinants of Health (CSDH) identified several social determinants of health and health inequity (SDH) including childcare, education, employment, gender equality, health insurance, housing, and income. The CSDH also noted the significant impact the SDH can have on advocacy for social change, social interventions to reduce HIV prevalence, and health monitoring. The current analysis evaluated the predictive ability of five SDH for HIV and AIDS incidence on the state level. The SDH used in the analysis were education, employment, housing, income, and insurance; other SDH were not included because reliable and appropriate state-level data were not available. The results of multiple regression analyses indicate that the use of these five SDH create statistically significant models predicting HIV incidence (adjusted R(2) = .54) and AIDS incidence (adjusted R(2) = .37) and account for a sizable portion of the variance for each. Stepwise variable selection reduced the necessary SDH to two: (1) education and (2) housing. These models are also statistically significant and account for a notable portion of variance in HIV incidence (adjusted R(2) = .55) and AIDS incidence (adjusted R(2) = .40). These outcomes demonstrate that state-level SDH, particularly education and housing, offer significant explanatory power regarding HIV and AIDS incidence rates. Congruent with the recommendations of the CSDH, the results of the current analysis suggest that state-sponsored policy and social interventions should consider and target SDH, especially education and housing, in attempts to reduce HIV and AIDS incidence rates.

  17. Personal and social determinants sustaining smoking practices in rural China: a qualitative study

    PubMed Central

    2014-01-01

    Introduction Tobacco use in China is disproportionally distributed among rural and urban populations with rural people smoking more. While there is a wealth of evidence on the association between tobacco use among rural people and their lower socio-economic status (SES), how social structural factors contribute to rural smoking is not well understood. Guided by a socio-ecological model, the objective of this study was to explore the personal and social determinants that play a key role in sustaining smoking practices among Chinese rural people. Methods An ethnographic study was conducted in a rural area of Central Jiangsu, China. Participants (n = 29) were recruited from families where there was at least one smoking resident and there were young children. In-depth interviews and unstructured observations were used to collect data, which were then analyzed with an interpretive lens. Results Although individuals had limited knowledge about the risks of smoking and lack of motivation to quit, social factors were in effect the main barriers to quitting smoking. Cigarette exchange and cigarette gifting permeated every aspect of rural family life, from economic activities to leisure pastimes, in family and wider social interactions. Traditional familism and collectivism interplayed with the pro-smoking environment and supported rural people’s smoking practices at the community level. Living in the rural area was also a barrier to quitting smoking because of the lack of information on smoking cessation and the influence of courtyard-based leisure activities that facilitated smoking. Conclusion Development of comprehensive smoking cessation interventions in rural China needs to extend beyond an individual level to take into account the social determinants influencing smoking practices. PMID:24484610

  18. Social determinants of health predict state incidence of HIV and AIDS: a short report.

    PubMed

    Zeglin, Robert J; Stein, J Paul

    2015-01-01

    There are approximately 1.2 million people living with HIV/AIDS (PLWHA) in the USA. Each year, there are roughly 50,000 new HIV diagnoses. The World Health Organization Commission on Social Determinants of Health (CSDH) identified several social determinants of health and health inequity (SDH) including childcare, education, employment, gender equality, health insurance, housing, and income. The CSDH also noted the significant impact the SDH can have on advocacy for social change, social interventions to reduce HIV prevalence, and health monitoring. The current analysis evaluated the predictive ability of five SDH for HIV and AIDS incidence on the state level. The SDH used in the analysis were education, employment, housing, income, and insurance; other SDH were not included because reliable and appropriate state-level data were not available. The results of multiple regression analyses indicate that the use of these five SDH create statistically significant models predicting HIV incidence (adjusted R(2) = .54) and AIDS incidence (adjusted R(2) = .37) and account for a sizable portion of the variance for each. Stepwise variable selection reduced the necessary SDH to two: (1) education and (2) housing. These models are also statistically significant and account for a notable portion of variance in HIV incidence (adjusted R(2) = .55) and AIDS incidence (adjusted R(2) = .40). These outcomes demonstrate that state-level SDH, particularly education and housing, offer significant explanatory power regarding HIV and AIDS incidence rates. Congruent with the recommendations of the CSDH, the results of the current analysis suggest that state-sponsored policy and social interventions should consider and target SDH, especially education and housing, in attempts to reduce HIV and AIDS incidence rates. PMID:25225050

  19. An interdisciplinary perspective on social and physical determinants of seismic risk

    NASA Astrophysics Data System (ADS)

    Lin, K.-H. E.; Chang, Y.-C.; Liu, G.-Y.; Chan, C.-H.; Lin, T.-H.; Yeh, C.-H.

    2015-10-01

    While disaster studies researchers usually view risk as a function of hazard, exposure, and vulnerability, few studies have systematically examined the relationships among the various physical and socioeconomic determinants underlying disasters, and fewer have done so through seismic risk analysis. In the context of the 1999 Chi-Chi earthquake in Taiwan, this study constructs three statistical models to test different determinants that affect disaster fatality at the village level, including seismic hazard, exposure of population and fragile buildings, and demographic and socioeconomic vulnerability. The Poisson regression model is used to estimate the impact of these factors on fatalities. Research results indicate that although all of the determinants have an impact on seismic fatality, some indicators of vulnerability, such as gender ratio, percentages of young and aged population, income and its standard deviation, are the important determinants deteriorating seismic risk. These findings have strong social implications for policy interventions to mitigate such disasters.

  20. Reaching for Health Equity and Social Justice in Baltimore: The Evolution of an Academic-Community Partnership and Conceptual Framework to Address Hypertension Disparities.

    PubMed

    Cooper, Lisa A; Purnell, Tanjala S; Ibe, Chidinma A; Halbert, Jennifer P; Bone, Lee R; Carson, Kathryn A; Hickman, Debra; Simmons, Michelle; Vachon, Ann; Robb, Inez; Martin-Daniels, Michelle; Dietz, Katherine B; Golden, Sherita Hill; Crews, Deidra C; Hill-Briggs, Felicia; Marsteller, Jill A; Boulware, L Ebony; Miller, Edgar R Iii; Levine, David M

    2016-07-21

    Cardiovascular health disparities persist despite decades of recognition and the availability of evidence-based clinical and public health interventions. Racial and ethnic minorities and adults in urban and low-income communities are high-risk groups for uncontrolled hypertension (HTN), a major contributor to cardiovascular health disparities, in part due to inequitable social structures and economic systems that negatively impact daily environments and risk behaviors. This commentary presents the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities as a case study for highlighting the evolution of an academic-community partnership to overcome HTN disparities. Key elements of the iterative development process of a Community Advisory Board (CAB) are summarized, and major CAB activities and engagement with the Baltimore community are highlighted. Using a conceptual framework adapted from O'Mara-Eves and colleagues, the authors discuss how different population groups and needs, motivations, types and intensity of community participation, contextual factors, and actions have shaped the Center's approach to stakeholder engagement in research and community outreach efforts to achieve health equity.

  1. Reaching for Health Equity and Social Justice in Baltimore: The Evolution of an Academic-Community Partnership and Conceptual Framework to Address Hypertension Disparities.

    PubMed

    Cooper, Lisa A; Purnell, Tanjala S; Ibe, Chidinma A; Halbert, Jennifer P; Bone, Lee R; Carson, Kathryn A; Hickman, Debra; Simmons, Michelle; Vachon, Ann; Robb, Inez; Martin-Daniels, Michelle; Dietz, Katherine B; Golden, Sherita Hill; Crews, Deidra C; Hill-Briggs, Felicia; Marsteller, Jill A; Boulware, L Ebony; Miller, Edgar R Iii; Levine, David M

    2016-01-01

    Cardiovascular health disparities persist despite decades of recognition and the availability of evidence-based clinical and public health interventions. Racial and ethnic minorities and adults in urban and low-income communities are high-risk groups for uncontrolled hypertension (HTN), a major contributor to cardiovascular health disparities, in part due to inequitable social structures and economic systems that negatively impact daily environments and risk behaviors. This commentary presents the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities as a case study for highlighting the evolution of an academic-community partnership to overcome HTN disparities. Key elements of the iterative development process of a Community Advisory Board (CAB) are summarized, and major CAB activities and engagement with the Baltimore community are highlighted. Using a conceptual framework adapted from O'Mara-Eves and colleagues, the authors discuss how different population groups and needs, motivations, types and intensity of community participation, contextual factors, and actions have shaped the Center's approach to stakeholder engagement in research and community outreach efforts to achieve health equity. PMID:27440977

  2. Identifying Social Determinants of Health and Legal Needs for Children With Special Health Care Needs.

    PubMed

    DeJong, Neal A; Wood, Charles T; Morreale, Madlyn C; Ellis, Cameron; Davis, Darragh; Fernandez, Jorge; Steiner, Michael J

    2016-03-01

    Children with special health care needs (CSHCN) require comprehensive care with high levels of community and government assistance. Medical-legal partnerships may be particularly suited to address needs for this population. To explore this, we conducted in-depth telephone interviews of families of CSHCN cared for in the primary care practice of our tertiary care children's hospital. The majority of the sample (N = 46) had been late on housing payments and 17% of homeowners had been threatened with foreclosure. Families frequently reported denial of public benefits. Approximately 10% had executed advance planning documents such as guardianship plans for the children or wills for the parents. A minority of families had sought help from community agencies or lawyers. Less than one third had ever discussed any of the issues with health care providers, but two thirds were likely or very likely to in the future. CSHCN may especially benefit from the social support of a medical-legal partnership. PMID:26130392

  3. Clustering social cues to determine social signals: developing learning algorithms using the "n-most likely states" approach

    NASA Astrophysics Data System (ADS)

    Best, Andrew; Kapalo, Katelynn A.; Warta, Samantha F.; Fiore, Stephen M.

    2016-05-01

    Human-robot teaming largely relies on the ability of machines to respond and relate to human social signals. Prior work in Social Signal Processing has drawn a distinction between social cues (discrete, observable features) and social signals (underlying meaning). For machines to attribute meaning to behavior, they must first understand some probabilistic relationship between the cues presented and the signal conveyed. Using data derived from a study in which participants identified a set of salient social signals in a simulated scenario and indicated the cues related to the perceived signals, we detail a learning algorithm, which clusters social cue observations and defines an "N-Most Likely States" set for each cluster. Since multiple signals may be co-present in a given simulation and a set of social cues often maps to multiple social signals, the "N-Most Likely States" approach provides a dramatic improvement over typical linear classifiers. We find that the target social signal appears in a "3 most-likely signals" set with up to 85% probability. This results in increased speed and accuracy on large amounts of data, which is critical for modeling social cognition mechanisms in robots to facilitate more natural human-robot interaction. These results also demonstrate the utility of such an approach in deployed scenarios where robots need to communicate with human teammates quickly and efficiently. In this paper, we detail our algorithm, comparative results, and offer potential applications for robot social signal detection and machine-aided human social signal detection.

  4. Smoking status moderates the contribution of social-cognitive and environmental determinants to adolescents' smoking intentions.

    PubMed

    Victoir, An; Eertmans, A; Van den Broucke, S; Van den Bergh, O

    2006-10-01

    In this study, it was tested whether attitudes, self-efficacy, social influences and the perception of the school and home environments had different associations with intentions for adolescent non-smokers, occasional smokers and daily smokers. A regression model allowing for separate slopes of social-cognitive and environment variables accounted for 72% of the variation in intentions. For non-smokers, ease of refusing to smoke (beta = -0.06) and social influences favouring smoking (beta = 0.05) were linked to intentions. Occasional and daily smokers' intentions were associated with health consequences (beta = -0.05 and beta = -0.06, respectively) and ease of smoking/buying cigarettes (beta = 0.05 and beta = 0.24, respectively). Social influences favouring smoking (beta = 0.10) were also associated with intentions in daily smokers. In an extended model for current smokers (adjusted R(2) = 0.45), context-cued nicotine cravings (beta = 0.27) were linked to daily smokers', but not occasional smokers' intentions. The results suggest that motivating adolescents to abstain from or to quit smoking implies working on different combinations of determinants in non-smokers, occasional smokers and daily smokers. Interventions for daily smokers should supplement motivational techniques with stratagems that allow smokers to reduce the number of cravings they experience in specific contexts.

  5. The determinants of misreporting weight and height: The role of social norms.

    PubMed

    Gil, Joan; Mora, Toni

    2011-01-01

    Given the lack of availability of measured anthropometric data for the whole of Spain, this paper combines data from the 2006 Catalan Health and Health Examination Surveys to compute the size of weight and height self-reporting biases. The underlying determinants of these biases are then analyzed, placing special emphasis on the role played by social norms. Our findings show that social norms regarding "ideal" weight (proxied by the average weight of a reference group based on gender and age) tend to affect the self-reporting weight (relative) bias. This finding suggests that the more satisfied individuals feel with their own body image the less prone they are to under-report their weight, although this effect is contingent upon the definition of social norms and the correction of endogeneity. However, we found no evidence of a similar impact caused by the social norms governing height. The relationship found between the measured and self-reported anthropometric data was applied to the Spanish National Health Survey (NHS) so as to correct the self-reported information contained in it. After correcting for self-reporting errors, both the BMI and the prevalence of obesity were found to be significantly underestimated, with instances of misreporting being more prevalent among women.

  6. An Interprofessional Approach to Exploring the Social Determinants of Health with Dental Hygiene Students.

    PubMed

    Lapidos, Adrienne; Gwozdek, Anne

    2016-01-01

    The University of Michigan (U-M) Dental Hygiene Program collaborated with the U-M School of Social Work in developing a course entitled "Skills for Patient- and Family-Centered Care with Diverse Populations." Drawing upon disciplines including dentistry, social work, psychology, and sociology, this course transformed mandatory outreach rotations in safety-net dental settings from a freestanding senior-year experience to an integrated part of the dental hygiene curriculum. The course provided a space in which to discuss the interpersonal aspects of patient care, particularly those related to the social determinants of health. Among the students, a broad range of emotions, frustrations, and hopes were evident, suggesting that there is a need for forums through which students can connect their affective experiences to their practice of patient-centered care. While the course was designed for bachelor's level dental hygiene students, the content and process presented in this paper may be of interest to faculty housed within any allied health professional program, because core themes such as social justice, service-learning, and self-reflection transcend all health professions.

  7. An Interprofessional Approach to Exploring the Social Determinants of Health with Dental Hygiene Students.

    PubMed

    Lapidos, Adrienne; Gwozdek, Anne

    2016-01-01

    The University of Michigan (U-M) Dental Hygiene Program collaborated with the U-M School of Social Work in developing a course entitled "Skills for Patient- and Family-Centered Care with Diverse Populations." Drawing upon disciplines including dentistry, social work, psychology, and sociology, this course transformed mandatory outreach rotations in safety-net dental settings from a freestanding senior-year experience to an integrated part of the dental hygiene curriculum. The course provided a space in which to discuss the interpersonal aspects of patient care, particularly those related to the social determinants of health. Among the students, a broad range of emotions, frustrations, and hopes were evident, suggesting that there is a need for forums through which students can connect their affective experiences to their practice of patient-centered care. While the course was designed for bachelor's level dental hygiene students, the content and process presented in this paper may be of interest to faculty housed within any allied health professional program, because core themes such as social justice, service-learning, and self-reflection transcend all health professions. PMID:27585625

  8. Media communication strategies for climate-friendly lifestyles - Addressing middle and lower class consumers for social-cultural change via Entertainment-Education

    NASA Astrophysics Data System (ADS)

    Lubjuhn, S.; Pratt, N.

    2009-11-01

    This paper argues that Entertainment-Education (E-E) is a striking communication strategy for reaching middle and lower socio-economic classes with climate-friendly lifestyle messages. On the international level (e.g. in the US and the Netherlands) E-E approaches are being theoretically grounded, whereas in Germany they are not yet. Therefore further theoretical discussion and mapping of E-E approaches is central for future research. As a first step towards providing further theoretical foundations for E-E in the field of sustainability, the authors suggest a threefold mapping of E-E approaches. The threefold mapping of E-E approaches for communicating climate-friendly lifestyles to middle and lower class consumers is based on recent results from academic research and practical developments on the media market. The commonalities among the three is that they all promote pro-sustainability messages in an affective-orientated rather than cognitive-orientated, factual manner. Differences can be found in: the sender of the sustainability message, the targeted consumer groups and the media approach in use. Based on this, the paper draws the conclusion that two new paths for further research activities in the field of Entertainment-Education can be proposed: (1) Improving the existing approaches in practice by using theoretical foundation from the E-E field. This comprises at its core (A) to do formative, process and summative effect research on the messages and (B) to use E-E theory from the field of social psychology, sociology and communication science for further improvement and (2) Generating new E-E theories by analyzing the existing practical approaches in the media to communicate climate change.

  9. Social induction of maturation and sex determination in a coral reef fish.

    PubMed Central

    Hobbs, Jean-Paul A.; Munday, Philip L.; Jones, Geoffrey P.

    2004-01-01

    Labile maturation and sex determination should be advantageous where the probability of finding a mating partner is unpredictable. Here we tested the hypothesis that the presence of a potential mating partner induces maturation and sex determination in a coral-dwelling fish, Gobiodon erythrospilus. In natural populations at Lizard Island (Great Barrier Reef), single individuals were less likely to be mature than paired individuals and they matured at a larger size, indicating plasticity in the timing of maturation. By manipulating group structure we demonstrated that both the timing of maturation and the sex of maturing individuals are socially controlled. Single juveniles did not mature, but maturation was rapidly induced by the presence of an adult partner. In addition, sex determination was found to be labile, with juveniles maturing into the opposite sex of the partner encountered. To our knowledge, this is the first experimental demonstration of social induction of maturation in conjunction with labile sex determination at maturation in vertebrates. This flexibility enables individuals to maximize their reproductive success in an environment where the timing of mate acquisition and the sex of their future partner are unpredictable. PMID:15475329

  10. Difference in health inequity between two population groups due to a social determinant of health.

    PubMed

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-01-01

    The World Health Organization defines social determinants of health as "complex, integrated, and overlapping social structures and economic systems" that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in health inequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors. PMID:25522048

  11. Difference in health inequity between two population groups due to a social determinant of health.

    PubMed

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-12-01

    The World Health Organization defines social determinants of health as“complex, integrated, and overlapping social structures and economic systems” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in healthinequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors. PMID:25590095

  12. Difference in health inequity between two population groups due to a social determinant of health.

    PubMed

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-12-01

    The World Health Organization defines social determinants of health as“complex, integrated, and overlapping social structures and economic systems” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in healthinequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors.

  13. Difference in health inequity between two population groups due to a social determinant of health.

    PubMed

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-12-16

    The World Health Organization defines social determinants of health as "complex, integrated, and overlapping social structures and economic systems" that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in health inequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors.

  14. Slum Sanitation and the Social Determinants of Women's Health in Nairobi, Kenya.

    PubMed

    Corburn, Jason; Hildebrand, Chantal

    2015-01-01

    Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements.

  15. Slum Sanitation and the Social Determinants of Women's Health in Nairobi, Kenya

    PubMed Central

    Corburn, Jason; Hildebrand, Chantal

    2015-01-01

    Inadequate urban sanitation disproportionately impacts the social determinants of women's health in informal settlements or slums. The impacts on women's health include infectious and chronic illnesses, violence, food contamination and malnutrition, economic and educational attainment, and indignity. We used household survey data to report on self-rated health and sociodemographic, housing, and infrastructure conditions in the Mathare informal settlement in Nairobi, Kenya. We combined quantitative survey and mapping data with qualitative focus group information to better understand the relationships between environmental sanitation and the social determinants of women and girls' health in the Mathare slum. We find that an average of eighty-five households in Mathare share one toilet, only 15% of households have access to a private toilet, and the average distance to a public toilet is over 52 meters. Eighty-three percent of households without a private toilet report poor health. Mathare women report violence (68%), respiratory illness/cough (46%), diabetes (33%), and diarrhea (30%) as the most frequent physical burdens. Inadequate, unsafe, and unhygienic sanitation results in multiple and overlapping health, economic, and social impacts that disproportionately impact women and girls living in urban informal settlements. PMID:26060499

  16. Ranking the Effects of Urban Development Projects on Social Determinants of Health: Health Impact Assessment

    PubMed Central

    Shojaei, Parisa; Karimlou, Masoud; Nouri, Jafar; Mohammadi, Farahnaz; Afzali, Hosein Malek; Forouzan, Ameneh Setareh

    2014-01-01

    Background and Objective: Health impact assessment (HIA) offer a very logical and interesting approach for those aiming to integrate health issues into planning processes. With a lot of works and plans waiting to be done (e.g., developing and updating plans, counseling planning commissions, cooperation with other organizations), planners find it difficult to prioritize health among a variety of possible issues and solutions they confront. Method: In the present article, first, the list of social determinants of health associated with Chitgar man-made lake was extracted out using a qualitative method and with content analysis approach, and then they were prioritized using analytic hierarchy process. Results: 28 social determinants of health including “intermediary” and “structural” determinants were extracted out. Regarding positive effects of lake on these determinants, “recreational services” and “traffic” received the highest and the lowest weights with 0.895 and 0.638 respectively among structural determinants and with consideration to “construction” option. Furthermore, among intermediary determinants for “construction” option, sub-criteria of both “physical activity” and “air quality” received the final highest weight (0.889) and “pathogenesis” indicated the lowest weight with 0.617. Moreover, lake demonstrated the highest negative effects on “housing” among “structural” determinants which it takes the highest weight (0.476) in “non-construction” option. Additionally, lake had the highest negative effects on “noise pollution” among “intermediary determinants” and it takes the highest weight (0.467) in “non-construction” option. Conclusion: It has been shown that urban development projects such as green spaces, man-made lakes … have a huge range of effects on community’s health, and having not considered these effects by urban planners and mangers is going to confront urban health with many

  17. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    PubMed

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. PMID:26174867

  18. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    PubMed

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration.

  19. Linear and non-linear associations of gonorrhea diagnosis rates with social determinants of health.

    PubMed

    Moonesinghe, Ramal; Fleming, Eleanor; Truman, Benedict I; Dean, Hazel D

    2012-09-03

    Identifying how social determinants of health (SDH) influence the burden of disease in communities and populations is critically important to determine how to target public health interventions and move toward health equity. A holistic approach to disease prevention involves understanding the combined effects of individual, social, health system, and environmental determinants on geographic area-based disease burden. Using 2006-2008 gonorrhea surveillance data from the National Notifiable Sexually Transmitted Disease Surveillance and SDH variables from the American Community Survey, we calculated the diagnosis rate for each geographic area and analyzed the associations between those rates and the SDH and demographic variables. The estimated product moment correlation (PMC) between gonorrhea rate and SDH variables ranged from 0.11 to 0.83. Proportions of the population that were black, of minority race/ethnicity, and unmarried, were each strongly correlated with gonorrhea diagnosis rates. The population density, female proportion, and proportion below the poverty level were moderately correlated with gonorrhea diagnosis rate. To better understand relationships among SDH, demographic variables, and gonorrhea diagnosis rates, more geographic area-based estimates of additional variables are required. With the availability of more SDH variables and methods that distinguish linear from non-linear associations, geographic area-based analysis of disease incidence and SDH can add value to public health prevention and control programs.

  20. Recent Updates in the Social and Environmental Determinants of Sleep Health

    PubMed Central

    Emanuele, Erin; James, Sarah

    2016-01-01

    In this brief review article, we provide an overview of recent (since 2010) scientific contributions to our understanding of the social and environmental determinants of sleep health. In particular, we focus on three areas where we saw the most contributions to the determinants of sleep health among children, adolescents, and adults. First, studies of neighborhood context and sleep health find that sleep quality and quantity are lower in disadvantaged neighborhoods. These negative associations are often stronger for women than for men. Second, family factors matter for sleep health. Children from families with more parental resources sleep better than do children from families without such resources. Adults with children sleep less than those without, and work-family conflict is an impediment to good sleep. Third, media use is problematic for sleep health. Around the world, higher levels of screen media use are associated with lower quality and quantity of sleep. Future research on the social and environmental determinants of sleep health will grow out of these three areas of current research. In addition, we anticipate new research in the international realm and in the area of interventions designed to improve the population’s sleep health. PMID:27540510

  1. "Never mind the logic, give me the numbers": former Australian health ministers' perspectives on the social determinants of health.

    PubMed

    Baum, Frances E; Laris, Paul; Fisher, Matthew; Newman, Lareen; Macdougall, Colin

    2013-06-01

    The articulation of strong evidence and moral arguments about the importance of social determinants of health (SDH) and health equity has not led to commensurate action to address them. Policy windows open when, simultaneously, an issue is recognised as a problem, policy formulation and refinement happens and the political will for action is present. We report on qualitative interviews with 20 former Australian Federal, State or Territory health ministers conducted between September 2011 and January 2012 concerning their views about how and why the windows of policy opportunity on the SDH did or did not open during their tenure. Almost all ex-health ministers were aware of the existence of health inequalities and SDH but their complexity meant that this awareness rarely crystalised into a clear problem other than as a focus on high needs groups, especially Aboriginal people. Formulation of policies about SDH was assisted by cross-portfolio structures, policy entrepreneurs, and evidence from reviews and reports. It was hindered by the complexity of SDH policy, the dominance of medical power and paradigms and the weakness of the policy community advocating for SDH. The political stream was enabling when the general ideological climate was supportive of redistributive policies, the health care sector was not perceived to be in crisis, there was support for action from the head of government and cabinet colleagues, and no opposition from powerful lobby groups. There have been instances of Australian health policy which addressed the SDH over the past twenty five years but they are rare and the windows of opportunity that made them possible did not stay open for long. PMID:23631789

  2. Diet quality, social determinants and weight status in 12-year-old Puerto Rican children

    PubMed Central

    Torres, Roxana; Santos, Elvia; Orraca, Luis; Elias, Augusto; Palacios, Cristina

    2014-01-01

    Diet quality may be influenced by social determinants and weight status. This has not been studied in Puerto Rico (PR); therefore, this cross-sectional study examined if diet quality, assessed by the Healthy Eating Index-2005 (HEI-2005), differs by social determinants (gender, school type and region) and weight status in children in PR. As part of an “island-wide” study to evaluate oral health in 1,550 12-year-old children, dietary intake was assessed in a representative subset (n=796) using a 24-hr diet recall. Diet quality was evaluated from the diet recall results using the HEI-2005. Overall mean HEI-2005 score was 40.9, out of a total maximum score of 100. Girls had significantly higher scores for whole fruit, total vegetables, whole grains, and sodium but lower scores for total grains and milk compared to boys (p<0.05). Children from public schools had higher scores for total fruit, whole fruit, dark-green and orange vegetables and legumes, but lower scores for whole grains and milk compared to those from private schools (p<0.05). Children from the Central Mountains had higher scores for the dark-green and orange vegetables and legumes and whole fruit compared to the other regions (p<0.05). Overweight children had significantly higher scores for total vegetables and milk but lower scores for total fruit and sodium as compared to non-overweight children (p<0.01). In conclusion, some components of diet quality were associated with the social determinants studied and with weight status in this sample. Overall diet quality needs improvement in PR children so that it is better aligned with dietary recommendations. PMID:24656710

  3. Teaching critical health literacy in the US as a means to action on the social determinants of health

    PubMed Central

    Mogford, Elizabeth; Gould, Linn; DeVoght, Andra

    2011-01-01

    In spite of improvements in global health over the 20th century, health inequities are increasing. Mounting evidence suggests that reducing health inequities requires taking action on the social determinants of health (SDOH), which include income, education, employment, political empowerment and other factors. This paper introduces an alternative health education curriculum, developed by the US-based non-profit organization Just Health Action, which teaches critical health literacy as a step towards empowering people to achieve health equity. Critical health literacy is defined as an individual's understanding of the SDOH combined with the skills to take action at both the individual and the community level. Prior to describing our curricular framework, we connect the recommendations of the World Health Organization Commission on the SDOH with the objectives of the Ottawa Charter for Health Promotion by arguing that achieving them is reliant on critical health literacy. Then we describe our four-part curricular framework for teaching critical health literacy. Part 1, Knowledge, focuses on teaching the SDOH and the paradigm of health as a human right. Part 2, Compass, refers to activities that help students find their own direction as a social change agent. Part 3, Skills, refers to teaching specific advocacy tools and strategies. Part 4, Action, refers to the development and implementation of an action intended to increase health equity by addressing the SDOH. We describe activities that we use to motivate, engage and empower students to take action on the SDOH and provide examples of advocacy skills students have learned and actions they have implemented. PMID:20729240

  4. Is Social Capital a Determinant of Oral Health among Older Adults? Findings from the English Longitudinal Study of Ageing.

    PubMed

    Rouxel, Patrick; Tsakos, Georgios; Demakakos, Panayotes; Zaninotto, Paola; Chandola, Tarani; Watt, Richard Geddie

    2015-01-01

    There are a number of studies linking social capital to oral health among older adults, although the evidence base mainly relies on cross-sectional study designs. The possibility of reverse causality is seldom discussed, even though oral health problems could potentially lead to lower social participation. Furthermore, few studies clearly distinguish between the effects of different dimensions of social capital on oral health. The objective of the study was to examine the longitudinal associations between individual social capital and oral health among older adults. We analyzed longitudinal data from the 3rd and 5th waves of the English Longitudinal Study of Ageing (ELSA). Structural social capital was operationalized using measures of social participation, and volunteering. Number of close ties and perceived emotional support comprised the functional dimension of social capital. Oral health measures were having no natural teeth (edentate vs. dentate), self-rated oral health and oral health-related quality of life. Time-lag and autoregressive models were used to explore the longitudinal associations between social capital and oral health. We imputed all missing data, using multivariate imputation by chained equations. We found evidence of bi-directional longitudinal associations between self-rated oral health, volunteering and functional social capital. Functional social capital was a strong predictor of change in oral health-related quality of life - the adjusted odds ratio of reporting poor oral health-related quality of life was 1.75 (1.33-2.30) for older adults with low vs. high social support. However in the reverse direction, poor oral health-related quality of life was not associated with changes in social capital. This suggests that oral health may not be a determinant of social capital. In conclusion, social capital may be a determinant of subjective oral health among older adults rather than edentulousness, despite many cross-sectional studies on the

  5. Integrating social determinants of health in the universal health coverage monitoring framework.

    PubMed

    Vega, Jeanette; Frenz, Patricia

    2013-12-01

    Underpinning the global commitment to universal health coverage (UHC) is the fundamental role of health for well-being and sustainable development. UHC is proposed as an umbrella health goal in the post-2015 sustainable development agenda because it implies universal and equitable effective delivery of comprehensive health services by a strong health system, aligned with multiple sectors around the shared goal of better health. In this paper, we argue that social determinants of health (SDH) are central to both the equitable pursuit of healthy lives and the provision of health services for all and, therefore, should be expressly incorporated into the framework for monitoring UHC. This can be done by: (a) disaggregating UHC indicators by different measures of socioeconomic position to reflect the social gradient and the complexity of social stratification; and (b) connecting health indicators, both outcomes and coverage, with SDH and policies within and outside of the health sector. Not locating UHC in the context of action on SDH increases the risk of going down a narrow route that limits the right to health to coverage of services and financial protection.

  6. Psychiatric, Psychological, and Social Determinants of Health in the Nurses’ Health Study Cohorts

    PubMed Central

    Chen, Ying; Singh, Ankura; Okereke, Olivia I.; Kubzansky, Laura D.

    2016-01-01

    Objectives. To review the contribution of the Nurses’ Health Studies (NHS) on factors that influence mental and physical health. Methods. Narrative review of all published articles using data from the NHS, the NHS II, and the Growing Up Today Study focusing on mental health conditions (e.g., depression, posttraumatic stress disorder, anxiety) and psychosocial resources and stressors (e.g., job strain, interpersonal violence, social relationships, sexual orientation) between 1990 and 2016. Results. Studies have considered a broad array of determinants (e.g., genes, biomarkers, air pollution) and consequent behavioral and disease-related outcomes (e.g., body weight, smoking, cardiometabolic diseases, cancer, autism). Findings suggest anxiety, posttraumatic stress disorder, childhood violence, caregiver burden, and job insecurity may increase the risk of coronary heart disease and diabetes, whereas findings with cancer are mixed. This work directly affects public health actions, as demonstrated by recent inclusion of a gender expression measure in state surveys. Conclusions. The NHS cohorts have produced novel and influential research on the interplay of psychological and social factors with health. Psychological and social variables are important contributors to the maintenance or decline of physical and mental health. PMID:27459447

  7. Social determinants and access to induced abortion in burkina faso: from two case studies.

    PubMed

    Ouédraogo, Ramatou; Sundby, Johanne

    2014-01-01

    Unsafe abortion constitutes a major public health problem in Burkina Faso and concerns mainly young women. The legal restriction and social stigma make abortions most often clandestine and risky for women who decide to terminate a pregnancy. However, the exposure to the risk of unsafe induced abortion is not the same for all the women who faced unwanted pregnancy and decide to have an abortion. Drawn from a qualitative study on the issue of abortion in Ouagadougou, Burkina Faso's capital, the contrasting cases of two young women who had abortion allow us to show how the women's personal resources (such as the school level, financial resources, the compliance to social norms, the social network, etc.) may determine the degree of vulnerability of women, the delay to have an abortion, the type of care they are likely to benefit from, and the cost they have to face. This study concludes that the poorest always pay more (cost and consequences), take longer to have an abortion, and have more exposure to the risk of unsafe abortion. PMID:24790605

  8. Social Determinants and Access to Induced Abortion in Burkina Faso: From Two Case Studies

    PubMed Central

    Ouédraogo, Ramatou

    2014-01-01

    Unsafe abortion constitutes a major public health problem in Burkina Faso and concerns mainly young women. The legal restriction and social stigma make abortions most often clandestine and risky for women who decide to terminate a pregnancy. However, the exposure to the risk of unsafe induced abortion is not the same for all the women who faced unwanted pregnancy and decide to have an abortion. Drawn from a qualitative study on the issue of abortion in Ouagadougou, Burkina Faso's capital, the contrasting cases of two young women who had abortion allow us to show how the women's personal resources (such as the school level, financial resources, the compliance to social norms, the social network, etc.) may determine the degree of vulnerability of women, the delay to have an abortion, the type of care they are likely to benefit from, and the cost they have to face. This study concludes that the poorest always pay more (cost and consequences), take longer to have an abortion, and have more exposure to the risk of unsafe abortion. PMID:24790605

  9. Social and Environmental Determinants of Child Physical Activity in a Rural Mexican-Origin Community.

    PubMed

    Schaefer, Sara E; Gomez-Camacho, Rosa; Martinez, Lisa; Sadeghi, Banafsheh; German, J Bruce; de la Torre, Adela

    2016-04-01

    California's rural agricultural communities face an increased burden of obesity and metabolic disease. The present objective is to define the social and environmental influences to child obesity and physical activity within Mexican-origin communities in California's Central Valley. A range of data (anthropometric, socioeconomic, demographic, cultural and environmental) were collected on more than 650 children enrolled in Niños Sanos, Familia Sana. Physical activity data were gathered from a subsample of children 4-7 years of age (n = 148) via accelerometer. Cross sectional analyses explored the relationship between BMI and physical activity and the influence of numerous social and environmental variables. In this sample 45 % of children were determined to be overweight or obese. Boys had a higher daily average moderate-to-vigorous physical activity than girls (p = 0.008). Chi square analyses showed weight status was associated with activity level in girls (p = 0.03) but not boys. Multivariate regression revealed several social and environmental indicators influenced BMI and physical activity (p = 0.004). In this population of school-age children of Mexican-origin, girls may benefit more from targeted efforts to increase MVPA. Family and community support systems may also boost child participation in physical activities.

  10. Sources and determinants of social support for caregivers of persons with AIDS.

    PubMed

    Turner, H A; Pearlin, L I; Mullan, J T

    1998-06-01

    This study examines the determinants of social support among a sample of 642 caregivers of persons with AIDS living in San Francisco and Los Angeles. Respondents include both traditional family caregivers (mothers, spouses, other relatives) and non-traditional caregivers (friends, homosexual partners). Multiple regression analyses are conducted to assess the independent effects of six sets of variables on emotional and instrumental support: social-structural factors (age, education, employment status), caregiver's relationship to the person with AIDS, situational variables (caregiver's HIV status, patient's functional disability, interpersonal conflict), social network factors (contact with family, contact with friends, community integration), personal resources (mastery, caregiving competence), and use of formal community services (patient-directed services, caregiver-directed services). A number of factors and conditions appear to be relevant for caregiver support. For example, results indicate that network factors, including frequency of contact, conflict, and community integration, are importantly related to caregivers' perceptions of emotional support. There is also a trend suggesting lower emotional support among traditional family caregivers, relative to nonfamily caregivers, within gender categories. With respect to instrumental assistance with caregiving, factors that place greater demands and time constraints on caregivers, such as being employed and caring for an AIDS patient with greater functional limitations, appear to increase the level of informal instrumental support the caregiver receives. Partners and spouses, however, receive significantly lower instrumental assistance, independent of other factors. Implications of the findings are discussed.

  11. Cultural and community determinants of subjective social status among Cherokee and White youth

    PubMed Central

    Brown, Ryan A.; Adler, Nancy E.; Worthman, Carol M.; Copeland, William E; Costello, E. Jane; Angold, Adrian

    2014-01-01

    Background Subjective social status (SSS) is associated with physical and mental health in diverse samples. However, community, cultural, and ethnic influences on SSS are poorly understood, especially among rural and American Indian populations. Objective We aimed to examine similarities and differences in how community poverty, family context, and life course attainment predict SSS among Cherokee and White youth in Appalachia. Design We assessed culturally and developmentally appropriate aspects of life course attainment among 344 Cherokee and White youth (age 19–24) using the Life Trajectory Interview for Youth (Brown et al. 2006. International Journal of Methods in Psychiatric Research, 15, 192–206). Combined with information regarding community context and family history, these data were used to examine common patterns and ethnic differences in community, family, and cultural influences on SSS. Results Overall, both Cherokee and White youth rank their families lower in SSS than previously studied US youth. Family poverty during childhood and low parental education negatively influence family SSS, Cherokee youth rank higher on subjective socioeconomic status (SES) than Whites, as do participants in high poverty areas. However, White youth rank higher on peer SSS. Ethnographically generated items perform better than standard demographic markers in predicting SSS. Educational attainment is associated with peer SSS among Cherokee (but not White) youths. Conclusions Cultural identity, community context, and local reference groups are crucial determinants of SSS. Both White and Cherokee youth in Appalachia exhibit SSS rankings consistent with socioeconomic and cultural marginalization. On a local scale, however, living in high poverty areas or minority communities may buffer individuals from some negative social comparisons regarding subjectively perceived SES. Meanwhile, social monitoring in small minority communities may constrain optimistic bias in assessments

  12. Making mental health an integral part of sustainable development: the contribution of a social determinants framework.

    PubMed

    De Silva, M J

    2015-04-01

    There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.

  13. Mainstream media and the social determinants of health in Canada: is it time to call it a day?

    PubMed

    Raphael, Dennis

    2011-06-01

    This article explores the dearth of coverage of the social determinants of health by the Canadian mainstream media. It is argued that this neglect is primarily a reflection of political and economic societal structures that has been associated with increasing corporate control of the mainstream media. Applying a critical political economy lens, it is argued that the barriers to having the Canadian mainstream media report on the social determinants of health are so numerous that it may indeed be 'time to call it a day' in regard to having them assist in the dissemination of social determinants of health findings. Recognizing this reality should spur the development of alternative means of communicating with the public in order to develop a citizens' movement to create health-promoting public policy. Recent dissemination efforts related to the Social Determinants of Health: The Canadian Facts provide an example of how this might be accomplished. PMID:21303787

  14. Mainstream media and the social determinants of health in Canada: is it time to call it a day?

    PubMed

    Raphael, Dennis

    2011-06-01

    This article explores the dearth of coverage of the social determinants of health by the Canadian mainstream media. It is argued that this neglect is primarily a reflection of political and economic societal structures that has been associated with increasing corporate control of the mainstream media. Applying a critical political economy lens, it is argued that the barriers to having the Canadian mainstream media report on the social determinants of health are so numerous that it may indeed be 'time to call it a day' in regard to having them assist in the dissemination of social determinants of health findings. Recognizing this reality should spur the development of alternative means of communicating with the public in order to develop a citizens' movement to create health-promoting public policy. Recent dissemination efforts related to the Social Determinants of Health: The Canadian Facts provide an example of how this might be accomplished.

  15. Getting serious about the social determinants of health: new directions for public health workers.

    PubMed

    Raphael, Dennis

    2008-09-01

    International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that as compared to other wealthy nations Canada presents a mediocre population health profile and public policy environments increasingly less supportive of health, the Canadian public health gaze is firmly - and narrowly - focused on lifestyle issues of diet, physical activity and tobacco use. Much of this has to do with Canada being identified as being driven by a liberal political economy, a situation shared with a cluster of other developed nations. Reasons for Canada's neglect of structural and public policy issues are explored and ways by which public health workers in Canada and elsewhere can help to shift policymakers and the general public's understandings of the determinants of health are outlined.

  16. Addressing the Social, Academic, and Behavioral Needs of Students with Challenging Behavior in Inclusive and Alternative Settings. Highlights from the Forum on Comprehensive Programming for a Diverse Population of Children and Youth with Challenging Behavior: Addressing Social, Academic, and Behavioral Needs within Inclusive and Alternative Settings (Las Vegas, Nevada, February 9-10, 2001).

    ERIC Educational Resources Information Center

    Bullock, Lyndal M., Ed.; Gable, Robert A., Ed.

    This document presents the texts of 11 major presentations and conference highlights from a February 2001 conference on the social, academic, and behavioral needs of students with challenging behavior in inclusive and alternative settings as required under the 1997 amendments to the Individuals with Disabilities Education Act. The presentations…

  17. Social Determinants of Tooth Loss among a Group of Iranian Female Heads of Household

    PubMed Central

    Movahhed, Taraneh; Ajami, Behjatalmolook; Dorri, Mojtaba; Biouki, Nima; Ghasemi, Hadi; Shakeri, Mohammad Taghi; Dehghani, Mahboobe

    2015-01-01

    Background and aims. Tooth loss may lead to mastication disability, which in turn has important impact on individual’s quality of life. Social and psychological factors have been shown to be associated with tooth loss. This study aimed to investigate the social determinants and prevalence of tooth loss, and presence of functional dentition among female heads of household under support of Welfare Organization in Mashhad, Iran. Materials and methods. In current study 556 participants aged 16-76 years were recruited. Sociodemographic characteristics (age, level of education, family size, and monthly income) were collected using interviewer-led questionnaire. Data about number of teeth and functional dentition were obtained by oral examination. The data were analyzed using Chi-square, Kruskal-Wallis, T-test and binary logistic regression analysis. Results. Four percent of participants were edentulous. Tooth loss was significantly associated with level of education, age and family size (P < 0.001). There was no significant association between level of income and tooth loss (P = 0.88). Only 37.5% of dentate subjects had functional dentition (anterior and premolar teeth). Women older than 40 years were 0.63 times less likely to have functional dentition than those younger than 40 years. Females with at least a high-school diploma were six times more likely to have functional dentition than their illiterate counterparts. Conclusion. Social determinants of functional dentition should be taken into account when planning oral health promoting programs for female heads of household. For reducing oral health inequalities access to dental services should be facilitated. PMID:26236441

  18. Message Design Strategies to Raise Public Awareness of Social Determinants of Health and Population Health Disparities

    PubMed Central

    Niederdeppe, Jeff; Bu, Q Lisa; Borah, Porismita; Kindig, David A; Robert, Stephanie A

    2008-01-01

    Context Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. Methods This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Findings Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. Conclusions The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well-being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities. PMID:18798887

  19. Exploring the influence of social determinants on HIV risk behaviors and the potential application of structural interventions to prevent HIV in women

    PubMed Central

    Edwards, Arlene E.; Collins, Charles B.

    2016-01-01

    When seeking to prevent HIV/AIDS in women, attending to aspects of their lived experience provides opportunities to address the presence of social determinants in prevention strategies. According to the CDC, in 2010, the rate of new HIV infections among Black women was 20 times that of White women, while among Hispanic/Latino women it was 4 times the rate of White women. Additionally, 86% of HIV infections in women were attributed to heterosexual contact and 14% to injection drug use. The WHO indicates that worldwide, 49% of individuals infected by HIV are women, with a predominant source of infection tied to heterosexual transmission. This paper presents social determinants as influential factors in terms of women’s sexual behavior decision-making, along with suggested structural interventions to address the social determinants of their HIV risks. Secondary analysis was conducted on data from an earlier study (Abdul-Quader and Collins, 2011) which used concept-mapping to examine the feasibility, evaluability, and sustainability of structural interventions for HIV prevention. The current analysis focused on structural interventions applicable to women and their HIV prevention needs. Three themes emerged: economic interventions, responses to violence against women, and integrated health service delivery strategies. The themes provide a foundation for next steps regarding research, policy planning, and intervention implementation that is inclusive of women’s lived experience. The paper concludes with suggestions such as attention to innovative projects and a paradigm shift regarding policy planning as key next steps towards HIV prevention that reflects the contextual complexity of women’s lived experiences. PMID:27134801

  20. A Response to "Social Privilege, Social Justice, and Group Counseling: An Inquiry": Social Privilege--Counselors' Competence with Systemically Determined Inequalities

    ERIC Educational Resources Information Center

    Roysircar, Gargi

    2008-01-01

    The literature is extensive about explanatory behavioral and social effects with an individual or micro focus. A somewhat less programmatic literature exits in social justice that considers systemic or macro factors: for example, mental health service and its structures that perpetuate inequity and disparity in service delivery. Social privilege…

  1. Globalization and social determinants of health: Introduction and methodological background (part 1 of 3).

    PubMed

    Labonté, Ronald; Schrecker, Ted

    2007-06-19

    Globalization is a key context for the study of social determinants of health (SDH). Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives.In this first article of a three-part series, we describe the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We explain our rationale for defining globalization with reference to the emergence of a global marketplace, and the economic and political choices that have facilitated that emergence. We identify a number of conceptual milestones in studying the relation between globalization and SDH over the period 1987-2005, and then show that because globalization comprises multiple, interacting policy dynamics, reliance on evidence from multiple disciplines (transdisciplinarity) and research methodologies is required. So, too, is explicit recognition of the uncertainties associated with linking globalization - the quintessential "upstream" variable - with changes in SDH and in health outcomes.

  2. Drivers of tuberculosis epidemics: the role of risk factors and social determinants.

    PubMed

    Lönnroth, Knut; Jaramillo, Ernesto; Williams, Brian G; Dye, Christopher; Raviglione, Mario

    2009-06-01

    The main thrust of the World Health Organization's global tuberculosis (TB) control strategy is to ensure effective and equitable delivery of quality assured diagnosis and treatment of TB. Options for including preventive efforts have not yet been fully considered. This paper presents a narrative review of the historical and recent progress in TB control and the role of TB risk factors and social determinants. The review was conducted with a view to assess the prospects of effectively controlling TB under the current strategy, and the potential to increase epidemiological impact through additional preventive interventions. The review suggests that, while the current strategy is effective in curing patients and saving lives, the epidemiological impact has so far been less than predicted. In order to reach long-term epidemiological targets for global TB control, additional interventions to reduce peoples' vulnerability for TB may therefore be required. Risk factors that seem to be of importance at the population level include poor living and working conditions associated with high risk of TB transmission, and factors that impair the host's defence against TB infection and disease, such as HIV infection, malnutrition, smoking, diabetes, alcohol abuse, and indoor air pollution. Preventive interventions may target these factors directly or via their underlying social determinants. The identification of risk groups also helps to target strategies for early detection of people in need of TB treatment. More research is needed on the suitability, feasibility and cost-effectiveness of these intervention options.

  3. Globalization and social determinants of health: Introduction and methodological background (part 1 of 3)

    PubMed Central

    Labonté, Ronald; Schrecker, Ted

    2007-01-01

    Globalization is a key context for the study of social determinants of health (SDH). Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In this first article of a three-part series, we describe the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We explain our rationale for defining globalization with reference to the emergence of a global marketplace, and the economic and political choices that have facilitated that emergence. We identify a number of conceptual milestones in studying the relation between globalization and SDH over the period 1987–2005, and then show that because globalization comprises multiple, interacting policy dynamics, reliance on evidence from multiple disciplines (transdisciplinarity) and research methodologies is required. So, too, is explicit recognition of the uncertainties associated with linking globalization – the quintessential "upstream" variable – with changes in SDH and in health outcomes. PMID:17578568

  4. Social determinants of child mortality in Niger: Results from the 2012 National Verbal and Social Autopsy Study

    PubMed Central

    Koffi, Alain K; Maina, Abdou; Yaroh, Asma Gali; Habi, Oumarou; Bensaïd, Khaled; Kalter, Henry D

    2016-01-01

    Background Understanding the determinants of preventable deaths of children under the age of five is important for accelerated annual declines – even as countries achieve the UN’s Millennium Development Goals and the target date of 2015 has been reached. While research has documented the extent and nature of the overall rapid decline in child mortality in Niger, there is less clear evidence to provide insight into the contributors to such deaths. This issue is the central focus of this paper. Methods We analyzed a nationally representative cross–sectional sample of 620 child deaths from the 2012 Niger Verbal Autopsy/Social Autopsy (VASA) Survey. We conducted a descriptive analysis of the data on preventive and curative care, guided by the coverage of proven indicators along the continuum of well child care and illness recognition and care–seeking for child illnesses encompassed by the BASICS/CDC Pathway to Survival model. Results Six hundred twenty deaths of children (1–59 months of age) were confirmed from the VASA survey. The majority of these children lived in households with precarious socio–economic conditions. Among the 414 children whose fatal illnesses began at age 0–23 months, just 24.4% were appropriately fed. About 24% of children aged 12–59 months were fully immunized. Of 601 children tracked through the Pathway to Survival, 62.4% could reach the first health care provider after about 67 minutes travel time. Of the 306 children who left the first health care provider alive, 161 (52.6%) were not referred for further care nor received any home care recommendations, and just 19% were referred to a second provider. About 113 of the caregivers reported cost (35%), distance (35%) and lack of transport (30%) as constraints to care–seeking at a health facility. Conclusion Despite Niger’s recent major achievements in reducing child mortality, the following determinants are crucial to continue building on the gains the country has made

  5. The influence of socio-demographic indicators economic determinants and social recognition on sport participation in Germany.

    PubMed

    Hallmann, Kirstin; Breuer, Christoph

    2014-01-01

    This article analyses sport participation using a demographic-economic model which was extended by the construct 'social recognition'. Social recognition was integrated into the model on the understanding that it is the purpose of each individual to maximise his or her utility. A computer-assisted telephone interview survey was conducted in the city of Rheinberg, Germany, producing an overall sample of n=1934. Regression analyses were performed to estimate the impact of socio-demographic, economic determinants, and social recognition on sport participation. The results suggest that various socio-economic factors and social recognition are important determinants of sport participation on the one hand, and on sport frequency on the other. Social recognition plays a significant yet different role for both sport participation and sport frequency. While friends' involvement with sport influences one's sport participation, parents' involvement with sport influences one's sport frequency.

  6. Social and cultural determinants of oral cholera vaccine uptake in Zanzibar.

    PubMed

    Schaetti, Christian; Ali, Said M; Hutubessy, Raymond; Khatib, Ahmed M; Chaignat, Claire-Lise; Weiss, Mitchell G

    2012-09-01

    Effectiveness of mass cholera vaccination campaigns requires not only technical and financial capacity but also consideration of social and cultural factors affecting vaccine acceptance. This study examined the influence of local community views of cholera on oral cholera vaccine (OCV) uptake in a mass vaccination campaign in 2009 in peri-urban and rural areas of Zanzibar. It used data from interviews conducted before the campaign and followed previous research assessing determinants of anticipated OCV acceptance. OCV uptake was lower than the reported anticipated acceptance. Less than half of the 356 adult respondents (49.7%) drank the required two doses of OCV. Variables referring to socio-cultural features of diarrheal illness that respondents identified with a cholera case vignette explained uptake better than analysis only of socio-demographic characteristics. Somatic features of illness not specific for cholera were negative determinants. Recognition of unconsciousness as a serious sign of dehydration and concern that cholera outbreaks would overwhelm the local healthcare system in the rural area were positive determinants of acceptance. Female gender, rural residence and older age were also positive determinants of OCV uptake. For further vaccine action with OCVs, cholera as a cause of severe dehydration should be distinguished from other causes of diarrhea. Planning should acknowledge rural concern about the relationship of limited capacity of the healthcare system to cope with cholera outbreaks and the priority of a cholera vaccine. Findings recommend particular efforts to increase cholera immunization coverage among young adults, in peri-urban areas and for men. PMID:22894965

  7. Social determinants of health and health equity policy research: exploring the use, misuse, and nonuse of policy analysis theory.

    PubMed

    Embrett, Mark G; Randall, G E

    2014-05-01

    Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that "healthy public policies" are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms.

  8. Social determinants of health and health equity policy research: exploring the use, misuse, and nonuse of policy analysis theory.

    PubMed

    Embrett, Mark G; Randall, G E

    2014-05-01

    Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that "healthy public policies" are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms. PMID

  9. Social determinants of health inequalities: towards a theoretical perspective using systems science.

    PubMed

    Jayasinghe, Saroj

    2015-01-01

    A systems approach offers a novel conceptualization to natural and social systems. In recent years, this has led to perceiving population health outcomes as an emergent property of a dynamic and open, complex adaptive system. The current paper explores these themes further and applies the principles of systems approach and complexity science (i.e. systems science) to conceptualize social determinants of health inequalities. The conceptualization can be done in two steps: viewing health inequalities from a systems approach and extending it to include complexity science. Systems approach views health inequalities as patterns within the larger rubric of other facets of the human condition, such as educational outcomes and economic development. This anlysis requires more sophisticated models such as systems dynamic models. An extension of the approach is to view systems as complex adaptive systems, i.e. systems that are 'open' and adapt to the environment. They consist of dynamic adapting subsystems that exhibit non-linear interactions, while being 'open' to a similarly dynamic environment of interconnected systems. They exhibit emergent properties that cannot be estimated with precision by using the known interactions among its components (such as economic development, political freedom, health system, culture etc.). Different combinations of the same bundle of factors or determinants give rise to similar patterns or outcomes (i.e. property of convergence), and minor variations in the initial condition could give rise to widely divergent outcomes. Novel approaches using computer simulation models (e.g. agent-based models) would shed light on possible mechanisms as to how factors or determinants interact and lead to emergent patterns of health inequalities of populations. PMID:26303914

  10. Social determinants of health inequalities: towards a theoretical perspective using systems science.

    PubMed

    Jayasinghe, Saroj

    2015-08-25

    A systems approach offers a novel conceptualization to natural and social systems. In recent years, this has led to perceiving population health outcomes as an emergent property of a dynamic and open, complex adaptive system. The current paper explores these themes further and applies the principles of systems approach and complexity science (i.e. systems science) to conceptualize social determinants of health inequalities. The conceptualization can be done in two steps: viewing health inequalities from a systems approach and extending it to include complexity science. Systems approach views health inequalities as patterns within the larger rubric of other facets of the human condition, such as educational outcomes and economic development. This anlysis requires more sophisticated models such as systems dynamic models. An extension of the approach is to view systems as complex adaptive systems, i.e. systems that are 'open' and adapt to the environment. They consist of dynamic adapting subsystems that exhibit non-linear interactions, while being 'open' to a similarly dynamic environment of interconnected systems. They exhibit emergent properties that cannot be estimated with precision by using the known interactions among its components (such as economic development, political freedom, health system, culture etc.). Different combinations of the same bundle of factors or determinants give rise to similar patterns or outcomes (i.e. property of convergence), and minor variations in the initial condition could give rise to widely divergent outcomes. Novel approaches using computer simulation models (e.g. agent-based models) would shed light on possible mechanisms as to how factors or determinants interact and lead to emergent patterns of health inequalities of populations.

  11. Social Determinants and Educational Barriers to Successful Admission to Nursing Programs for Minority and Rural Students.

    PubMed

    Metcalfe, Sharon Elizabeth; Neubrander, Judy

    2016-01-01

    In 2010, the Institute of Medicine made a recommendation in The Future of Nursing Report to diversify the student population of the health care professions in order to provide increasing minority providers to meet the culturally competent needs of the growing multicultural populations of the United States (Institute of Medicine, 2010). The Nursing Network and Careers and Technology Nurse Mentoring Program provides a nursing mentor to underrepresented ethnic minority and educationally disadvantaged students and a significant scholarship and stipend for tuition and monthly living expenses. Ethnically diverse and rural students have lifelong familial and geographical educational barriers that prevent them from succeeding. There are a plethora of major environmental and familial factors that need to be addressed by society for these students to be successful. These factors include improvement of county schools by financial support, improving the home environment through social supportive services, and implementing improved parent-child bonding with nurse family partnerships. Nursing faculty must embrace new approaches for increasing the number of ethnically diverse nursing providers through novel admission criteria and collaborative cohort peer-mentoring programs. PMID:27649596

  12. Aboriginal health promotion through addressing employment discrimination.

    PubMed

    Ferdinand, Angeline S; Paradies, Yin; Perry, Ryan; Kelaher, Margaret

    2014-01-01

    The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered. PMID:25155236

  13. Aboriginal health promotion through addressing employment discrimination.

    PubMed

    Ferdinand, Angeline S; Paradies, Yin; Perry, Ryan; Kelaher, Margaret

    2014-01-01

    The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered.

  14. Quantification of Shared Air: A Social and Environmental Determinant of Airborne Disease Transmission

    PubMed Central

    Wood, Robin; Morrow, Carl; Ginsberg, Samuel; Piccoli, Elizabeth; Kalil, Darryl; Sassi, Angelina; Walensky, Rochelle P.; Andrews, Jason R.

    2014-01-01

    Background Tuberculosis is endemic in Cape Town, South Africa where a majority of the population become tuberculosis infected before adulthood. While social contact patterns impacting tuberculosis and other respiratory disease spread have been studied, the environmental determinants driving airborne transmission have not been quantified. Methods Indoor carbon dioxide levels above outdoor levels reflect the balance of exhaled breath by room occupants and ventilation. We developed a portable monitor to continuously sample carbon dioxide levels, which were combined with social contact diary records to estimate daily rebreathed litres. A pilot study established the practicality of monitor use up to 48-hours. We then estimated the daily volumes of air rebreathed by adolescents living in a crowded township. Results One hundred eight daily records were obtained from 63 adolescents aged between 12- and 20-years. Forty-five lived in wooden shacks and 18 in brick-built homes with a median household of 4 members (range 2–9). Mean daily volume of rebreathed air was 120.6 (standard error: 8.0) litres/day, with location contributions from household (48%), school (44%), visited households (4%), transport (0.5%) and other locations (3.4%). Independent predictors of daily rebreathed volumes included household type (p = 0.002), number of household occupants (p = 0.021), number of sleeping space occupants (p = 0.022) and winter season (p<0.001). Conclusions We demonstrated the practical measurement of carbon dioxide levels to which individuals are exposed in a sequence of non-steady state indoor environments. A novel metric of rebreathed air volume reflects social and environmental factors associated with airborne infection and can identify locations with high transmission potential. PMID:25181526

  15. Body fatness and its social and lifestyle determinants in young working males from Cracow, Poland.

    PubMed

    Suder, Agnieszka

    2009-01-01

    The aim of this study was to determine the degree to which general body fatness variation, presented by body mass index (BMI), the sum of the three skinfold thicknesses (TST) (triceps, subscapular, abdominal) and percentage of body fat (%FAT), can be explained by socioeconomic status (SES) and lifestyle. The cross-sectional, population-based survey was of 259 healthy working males aged 20-30 from the city of Cracow, Poland. Objective anthropometric measurements, bioelectrical impedance analysis, the results of motor fitness tests and social and lifestyle data from a questionnaire were analysed. The independent variables were: age, socioeconomic status (birthplace, place of residence until the age of 14, social class, educational level and the type of work done) and lifestyle elements (smoking habits, dietary habits, family obesity resemblance, sport activity in the past, leisure time physical activity and level of motor fitness). Three separate full models were created using stepwise straightforward regression with BMI, TST and %FAT as dependent variables. The highest autonomous influence on BMI and %FAT was ascribed to age and family obesity resemblance, whereas variation in TST was explained by level of motor fitness, age, city as a place of residence until the age of 14 and family obesity resemblance. Although the analysed variables explained only from 8% (BMI) to 13% (TST) of body fatness variation, indicating at the same time that most variations are explained by other variables, the impact of lifestyle family-shared factors on body fatness seems to be significant.

  16. Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions

    PubMed Central

    Kolahdooz, Fariba; Nader, Forouz; Yi, Kyoung J.; Sharma, Sangita

    2015-01-01

    Background Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations. Objective The purpose of this paper is to comprehensively examine the social determinants of health (SDH), in order to identify priorities for health promotion policies and actions. Design We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing) among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity. Results We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1) limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2) limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3) the limited number of studies involving the barriers to, and opportunities for, education. Conclusions These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc.) and intersectoral collaborations (e.g. community and various government departments) to reduce health disparities faced by Indigenous Canadians. PMID:26187697

  17. Forms of Address in Chilean Spanish

    ERIC Educational Resources Information Center

    Bishop, Kelley; Michnowicz, Jim

    2010-01-01

    The present investigation examines possible social and linguistic factors that influence forms of address used in Chilean Spanish with various interlocutors. A characteristic of the Spanish of Chile is the use of a variety of forms of address for the second person singular, "tu", "vos", and "usted", with corresponding verb conjugations (Lipski…

  18. The Antsy Social Network: Determinants of Nest Structure and Arrangement in Asian Weaver Ants.

    PubMed

    Devarajan, Kadambari

    2016-01-01

    Asian weaver ants (Oecophylla smaragdina) are arboreal ants that are known to form mutualistic complexes with their host trees. They are eusocial ants that build elaborate nests in the canopy in tropical areas. A colony comprises of multiple nests, usually on multiple trees, and the boundaries of the colony may be difficult to identify. However, they provide the ideal model for studying group living in invertebrates since there are a definite number of nests for a given substrate, the tree. Here, we briefly examine the structure of the nests and the processes involved in the construction and maintenance of these nests. We have described the spatial arrangement of weaver ant nests on trees in two distinct tropical clusters, a few hundred kilometres apart in India. Measurements were made for 13 trees with a total of 71 nests in the two field sites. We have considered a host of biotic and abiotic factors that may be crucial in determining the location of the nesting site by Asian weaver ants. Our results indicate that tree characteristics and architecture followed by leaf features help determine nest location in Asian weaver ants. While environmental factors may not be as influential to nest arrangement, they seem to be important determinants of nest structure. The parameters that may be considered in establishing the nests could be crucial in picking the evolutionary drivers for colonial living in social organisms.

  19. The Social Determinants of Health (SDH) in Iran: A Systematic Review Article

    PubMed Central

    BAHADORI, Mohammadkarim; SANAEINASAB, Hormoz; GHANEI, Mostafa; MEHRABI TAVANA, Ali; RAVANGARD, Ramin; KARAMALI, Mazyar

    2015-01-01

    Background: Many studies have been conducted in Iran in order to investigate the status of social determinants of health (SDH) and their associations with health indicators. This study aimed to review the Iranian studies conducted on SDH. Methods: A systematic review of all Iranian Persian and English languages articles published between 2005 and 2014 on the SDH was conducted using the search of SID, Iran Medex, Iran Doc, Medline, Embase, Scopus, and Google Scholar databases. The eligibility criteria were studies describing SDH status, designed based on the WHO conceptual framework of SDH, published in Persian or English languages, and full text articles. The structured narrative approach was used to synthesize the data. Results: The entire review process led to the selection of 21 papers. Most of studies had been conducted on the intermediary (38%) and structural (33%) components and determinants in Iran, 4 studies (19%) on the study of all components affecting the health and health inequality and, finally, the minimum number of studies (10%) on the context components and determinants. The focus of 43% of selected studies was on the WHO conceptual framework of SDH and had evaluated this model as an appropriate conceptual framework. Conclusion: In order to fill the gap in the scientific evidence of SDH and make appropriate policies and plans in Iran, it is needed to conduct studies on all SDH according to the WHO conceptual framework. PMID:26258086

  20. The Antsy Social Network: Determinants of Nest Structure and Arrangement in Asian Weaver Ants

    PubMed Central

    Devarajan, Kadambari

    2016-01-01

    Asian weaver ants (Oecophylla smaragdina) are arboreal ants that are known to form mutualistic complexes with their host trees. They are eusocial ants that build elaborate nests in the canopy in tropical areas. A colony comprises of multiple nests, usually on multiple trees, and the boundaries of the colony may be difficult to identify. However, they provide the ideal model for studying group living in invertebrates since there are a definite number of nests for a given substrate, the tree. Here, we briefly examine the structure of the nests and the processes involved in the construction and maintenance of these nests. We have described the spatial arrangement of weaver ant nests on trees in two distinct tropical clusters, a few hundred kilometres apart in India. Measurements were made for 13 trees with a total of 71 nests in the two field sites. We have considered a host of biotic and abiotic factors that may be crucial in determining the location of the nesting site by Asian weaver ants. Our results indicate that tree characteristics and architecture followed by leaf features help determine nest location in Asian weaver ants. While environmental factors may not be as influential to nest arrangement, they seem to be important determinants of nest structure. The parameters that may be considered in establishing the nests could be crucial in picking the evolutionary drivers for colonial living in social organisms. PMID:27271037

  1. Rearing-group size determines social competence and brain structure in a cooperatively breeding cichlid.

    PubMed

    Fischer, Stefan; Bessert-Nettelbeck, Mathilde; Kotrschal, Alexander; Taborsky, Barbara

    2015-07-01

    Social animals can greatly benefit from well-developed social skills. Because the frequency and diversity of social interactions often increase with the size of social groups, the benefits of advanced social skills can be expected to increase with group size. Variation in social skills often arises during ontogeny, depending on early social experience. Whether variation of social-group sizes affects development of social skills and related changes in brain structures remains unexplored. We investigated whether, in a cooperatively breeding cichlid, early group size (1) shapes social behavior and social skills and (2) induces lasting plastic changes in gross brain structures and (3) whether the development of social skills is confined to a sensitive ontogenetic period. Rearing-group size and the time juveniles spent in these groups interactively influenced the development of social skills and the relative sizes of four main brain regions. We did not detect a sensitive developmental period for the shaping of social behavior within the 2-month experience phase. Instead, our results suggest continuous plastic behavioral changes over time. We discuss how developmental effects on social behavior and brain architecture may adaptively tune phenotypes to their current or future environments. PMID:26098344

  2. Counting the Homeless: A Previously Incalculable Tuberculosis Risk and Its Social Determinants

    PubMed Central

    Teeter, Larry D.; Musser, James M.; Graviss, Edward A.

    2013-01-01

    Tuberculosis (TB) surveillance among the homeless is not supported by the political will necessary for TB elimination. We merged the first stakeholder-accepted enumeration of homeless persons with existing surveillance data to assess TB risk among the homeless in Houston, Texas. The average incidence per 100 000 was 411 among homeless and 9.5 among housed persons. The homeless were more likely than the housed to be US-born, clustered, and in a larger-sized cluster. Multivariate analysis revealed that TB rates among the homeless were driven not by comorbidities but by social determinants. Homeless patients were hospitalized more days than the housed and required more follow-up time. Reporting of TB rates for populations with known health disparities could help reframe TB prevention and better target limited funds. PMID:23488504

  3. We Need Action on Social Determinants of Health – but Do We Want It, too?

    PubMed Central

    de Leeuw, Evelyne

    2016-01-01

    Recently a number of calls have been made to mobilise the arsenal of political science insights to investigate – and point to improvements in – the social determinants of health (SDH), and health equity. Recently, in this journal, such a rallying appeal was made for the field of public administration. This commentary argues that, although scholarly potential should justifiably be redirected to resolve these critical issues for humanity, a key ingredient in taking action may have been neglected. This factor is ‘community.’ Community health has been a standard element of the public health and health promotion, even political, repertoire for decades now. But this commentary claims that communities are insufficiently charged, equipped or appreciated to play the role that scholarship attributes (or occasionally avoids to identify) to them. Community is too important to not fully engage and understand. Rhetorical tools and inquiries can support their quintessential role. PMID:27285516

  4. Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya.

    PubMed

    Kimani, Violet N; Mitoko, Grace; McDermott, Brigid; Grace, Delia; Ambia, Julie; Kiragu, Monica W; Njehu, Alice N; Sinja, Judith; Monda, Joseph G; Kang'ethe, Erastus K

    2012-09-01

    The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium from urban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). One-hundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of non-dairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi.

  5. Action on the social determinants of health: views from inside the policy process.

    PubMed

    Carey, Gemma; Crammond, Brad

    2015-03-01

    It is now well documented that many of the key drivers of health reside in our everyday living conditions. In the last two decades, public health has urged political action on these critical social determinants of health (SDH). As noted by the World Health Organisation, encouraging action in this area is challenging. Recent research has argued that public health researchers need to gain a deeper understanding of the complex and changing rationalities of policymaking. This, it seems, is the crucial next step for social determinants of health research. In this paper, we turn our attention to the practitioners of 'the art of government', in order to gain insight into how to secure upstream change for the SDH. Through interviews with policy actors (including politicians, senior government advisors, senior public servants and experienced policy lobbyists) the research sought to understand the nature of government and policymaking, as it pertains to action on the SDH. Through exploring the policy process, we examine how SDH discourses, evidence and strategies align with existing policy processes in the Australian context. Participants indicated that approaches to securing change that are based on linear conceptualisations of the policy process (as often found in public health) may be seen as 'out of touch' with the messy reality of policymaking. Rather, a more dialogic approach that embraces philosophical and moral reasoning (alongside evidence) may be more effective. Based on our findings, we recommend that SDH advocates develop a deeper awareness of the political and policy structures and the discursive conventions they seek to influence within specific settings.

  6. Addressing psychiatric comorbidity.

    PubMed

    Woody, G E; McLellan, A T; O'Brien, C P; Luborsky, L

    1991-01-01

    Research studies indicate that addressing psychiatric comorbidity can improve treatment for selected groups of substance-abusing patients. However, the chances for implementing the necessary techniques on a large scale are compromised by the absence of professional input and guidance within programs. This is especially true in public programs, which treat some of the most disadvantaged, disturbed, and socially destructive individuals in the entire mental health system. One starting point for upgrading the level of knowledge and training of staff members who work in this large treatment system could be to develop a better and more authoritative information dissemination network. Such a system exists in medicine; physicians are expected to read appropriate journals and to guide their treatment decisions using the data contained in the journals. Standards of practice and methods for modifying current practice are within the tradition of reading new facts, studying old ones, and comparing treatment outcome under different conditions with what is actually being done. No such general system of information-gathering or -sharing exists, particularly in public treatment programs. One of the most flagrant examples of this "educational shortfall" can be found among those methadone programs that adamantly insist on prescribing no more than 30 to 35 mg/day for all patients, in spite of the overwhelming evidence that these dose levels generally are inadequate. In some cases, program directors are unaware of studies that have shown the relationship between dose and outcome. In other cases, they are aware of the studies but do not modify their practices accordingly. This example of inadequate dosing is offered as an example of one situation that could be improved by adherence to a system of authoritative and systematic information dissemination. Many issues in substance abuse treatment do not lend themselves to information dissemination as readily as that of methadone dosing

  7. Impact of Income Inequality and Other Social Determinants on Suicide Rate in Brazil

    PubMed Central

    Machado, Daiane Borges; Rasella, Davide; dos Santos, Darci Neves

    2015-01-01

    Studies about suicide worldwide have mainly focused on individual-level psychiatric risk factors. In Brazil, suicide is an important public health problem. Brazil has evidenced important socioeconomic changes over the last decades, leading to decreasing income inequality. However, the impact of income inequality on suicide rate has never been studied in the country. Purpose To analyze whether income inequality and other social determinants are associated with suicide rate in Brazil. Method This study used panel data from all 5,507 Brazilian municipalities from 2000 to 2011. Suicide rates were calculated by sex and standardized by age for each municipality and year. The independent variables of the regression model included the Gini Index, per capita income, percentage of individuals with up to eight years of education, urbanization, average number of residents per household, percentage of divorced people, of Catholics, Pentecostals, and Evangelicals. A multivariable negative binomial regression for panel data with fixed-effects specification was performed. Results The Gini index was positively associated with suicide rates; the rate ratio (RR) was 1.055 (95% CI: 1.011–1.101). Of the other social determinants, income had a significant negative association with suicide rates (RR: 0.968, 95% CI: 0.948–0.988), whereas a low-level education had a positive association (RR: 1.015, 95% CI: 1.010–1.021). Conclusions Income inequality represents a community-level risk factor for suicide rates in Brazil. The decrease in income inequality, increase in income per capita, and decrease in the percentage of individuals who did not complete basic studies may have counteracted the increase in suicides in the last decade. Other changes, such as the decrease in the mean residents per household, may have contributed to their increase. Therefore, the implementation of social policies that may improve the population’s socioeconomic conditions and reduce income inequality in

  8. Variable addressability imaging systems

    NASA Astrophysics Data System (ADS)

    Kubala, Kenneth Scott

    The use of variable addressability for creating an optimum human-machine interface is investigated. Current wide field optical systems present more information to the human visual system than it has the capacity to perceive. The axial resolution, and/or the field of view can be increased by minimizing the difference between what the eye can perceive and what the system presents. The variable addressability function was developed through the use of a human factors experiment that characterized the position of the eye during the simulated use of a binocular system. Applying the variable addressability function to a conventional optical design required the development of a new metric for evaluating the expected performance of the variable addressability system. The new metric couples psycho-visual data and traditional optical data in order to specify the required performance of the variable addressability system. A non-linear mapping of the pixels is required in order to have the system work most efficiently with the human visual system, while also compensating for eye motion. The non-linear mapping function, which is the backbone of the variable addressability technique, can be created using optical distortion. The lens and system design is demonstrated in two different spectral bands. One of the designs was fabricated, tested, and assembled into a prototype. Through a second human factors study aimed at measuring performance, the variable addressability prototype was directly compared to a uniform addressability prototype, quantifying the difference in performance for the two prototypes. The human factors results showed that the variable addressability prototype provided better resolution 13% of the time throughout the experiment, but was 15% slower in use than the uniform addressability prototype.

  9. Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil

    PubMed Central

    Rasella, Davide; Machado, Daiane Borges; Castellanos, Marcelo Eduardo Pfeirrer; Paim, Jairnilson; Szwarcwald, Celia Landmann; Lima, Diana; Magno, Laio; Pedrana, Leo; Medina, Maria Guadalupe; Penna, Gerson Oliveira; Barreto, Mauricio Lima

    2016-01-01

    Background The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH. PMID:26853898

  10. Social determinants of nonadherence to tuberculosis treatment in Buenos Aires, Argentina.

    PubMed

    Herrero, Maria Belen; Arrossi, Silvina; Ramos, Silvina; Braga, Jose Ueleres

    2015-09-01

    This study aimed to identify the individual and environmental determinants of nonadherence to tuberculosis (TB) treatment in selected districts in the Buenos Aires Metropolitan Area, in Argentina. We conducted a cross-sectional study using a hierarchical model. Using primary and secondary data, logistic regression was performed to analyze two types of determinants. The likelihood of nonadherence to treatment was greatest among male patients. The following factors led to a greater likelihood of nonadherence to treatment: patients living in a home without running water; head of household without medical insurance; need to use more than one means of transport to reach the health center; place of residence in an area with a high proportion of households connected to the natural gas network; place of residence in an area where a large proportion of families fall below the minimum threshold of subsistence capacity; place of residence in an area where a high proportion of households do not have flushing toilets and basic sanitation. Our results show that social and economic factors - related to both individual and environmental characteristics - influence adherence to TB treatment. PMID:26578022

  11. Social-cognitive determinants of condom use in a cohort of young gay and bisexual men.

    PubMed

    Franssens, Dirk; Hospers, Harm J; Kok, Gerjo

    2009-11-01

    The aim of this prospective study was to identify relevant determinants of young gay and bisexual men's (YGBM) condom use when having anal sex with casual partners. Respondents (185 YGBM in the midst of their coming-out; mean age 18.9 years) completed an online questionnaire on social-cognitive determinants of condoms use derived from the theory of planned behavior (Ajzen, 1991) at Wave 1. At six months follow-up (Wave 2) sexual behavior with casual partners was assessed. A total of 63 YGBM reported sex with a casual partner in the six months between Waves 1 and 2, of whom 49% (N=31) had anal sex. Of the YGBM who had anal sex, 42% (N=13) had unprotected anal sex. Condom use with casual partners was best predicted by the intention to always use condoms. Furthermore, attitude, descriptive and personal norms, and perceived control significantly predicted intention to always use condoms. Interventions, targeting YGBM, aiming to promote condom use with casual partners should focus on increasing attitudes and strengthening skills to negotiate and use condoms. PMID:20024726

  12. Identifying and Addressing Vaccine Hesitancy

    PubMed Central

    Kestenbaum, Lori A.; Feemster, Kristen A.

    2015-01-01

    In the 20th century, the introduction of multiple vaccines significantly reduced childhood morbidity, mortality, and disease outbreaks. Despite, and perhaps because of, their public health impact, an increasing number of parents and patients are choosing to delay or refuse vaccines. These individuals are described as vaccine hesitant. This phenomenon has developed due to the confluence of multiple social, cultural, political and personal factors. As immunization programs continue to expand, understanding and addressing vaccine hesitancy will be crucial to their successful implementation. This review explores the history of vaccine hesitancy, its causes, and suggested approaches for reducing hesitancy and strengthening vaccine acceptance. PMID:25875982

  13. The Quality of Social Networks: Its Determinants and Impacts on Helping and Volunteering in Macao

    ERIC Educational Resources Information Center

    Tong, Kwok Kit; Hung, Eva P. W.; Yuen, Sze Man

    2011-01-01

    Pro-social behaviors serve essential societal functions. This study examines the factors affecting the quality of social networks, in terms of network size and perceived respect. It further explores the role of social networks in enhancing helping intention and helping behaviors. Eight hundred and eighty people were randomly interviewed by phone.…

  14. Social relationships and physiological determinants of longevity across the human life span.

    PubMed

    Yang, Yang Claire; Boen, Courtney; Gerken, Karen; Li, Ting; Schorpp, Kristen; Harris, Kathleen Mullan

    2016-01-19

    Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose-response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age.

  15. Perceived Social Support from Friends as Determinant of Loneliness in a Sample of Primary School

    ERIC Educational Resources Information Center

    Kalkan, Melek; Epli-Koc, Hatice

    2011-01-01

    The peer group is the important social network in children's lives and has a high predictive value of an individual's later social and emotional adjustment. Therefore, the aim of this study is to examine the perceived social support from friends as predictor of the loneliness for primary school students. Two tools were used for data gathering.…

  16. Social relationships and physiological determinants of longevity across the human life span

    PubMed Central

    Yang, Yang Claire; Boen, Courtney; Gerken, Karen; Li, Ting; Schorpp, Kristen; Harris, Kathleen Mullan

    2016-01-01

    Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose–response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age. PMID:26729882

  17. Social determinants and health-related dimensions of quality of life in adult patients with haemophilia.

    PubMed

    Dolatkhah, R; Fakhari, A; Pezeshki, M Z; Shabanlouei, R; Tavassoli, N; Gholchin, M

    2014-05-01

    The availability of safe and effective factor replacement therapies, in persons with haemophilia (PWH), has in some countries answered the basic need for treatment of these patients. The findings suggest that adult patients who have always been on prophylaxis reported significantly better physical functioning, and thus better quality of life. This study is designed to evaluate the QoL in adult PWH, by focusing on social determinants of QoL and their relationship with health-related dimensions, in Tabriz, Iran. The survey instrument was a self-report 36 items questionnaire, 'A36 Hemofilia - QoL', which is a disease-specific questionnaire for the assessment of the health-related QoL in adults living with haemophilia. A total of 100 haemophilia A and B patients, aged over 17 years participated in this study within 1 year. QoL total score was 71.88 (±26.89 SD). Patients who treat in our Hemophilia Treatment Center, had better QoL score (P = 0.000), and education has a significant impact on the social aspects of QoL (P = 0.18). The QoL was very poor in urban area in contrast to patients who lived in the city (54.45 vs. 74.21 respectively). Single patients have a better QoL than married patients (76.56 vs. 68.50 respectively). Our results showed that low education and lack of awareness of the diseases among PWH lead to reduce of QoL and more disease complications. More and wider treatment and psychological care for improving quality of life of these patients are seriously recommended.

  18. The female athletic role as a status determinant within the social systems of high school adolescents.

    PubMed

    Kane, M J

    1988-01-01

    This study examined the relationship between female athletic participation and status attainment within the social status systems of high school adolescents. Although earlier research has consistently demonstrated that the athletic role for males is associated with greatest status within the school, findings regarding the status of female athletes have been contradictory: Some studies have found high status rankings for female athletes while others have revealed negative results. It was therefore argued that current research go beyond the general construct of "female athlete" and consider the type of sport with which the adolescent female is associated as a possible status determinant. Employing a sport typology proposed by Metheny (1967), it was predicted that females associated with sex-appropriate or "feminine" sports (e.g., tennis) would receive significantly higher status ratings than those identified with sex-inappropriate or "masculine" sports (e.g., basketball). One hundred and twenty-one male subjects were asked to indicate which female athlete (associated with a sex-appropriate versus a sex-inappropriate sport) they would most like to date, while 111 female subjects were asked to choose which female athlete they would most like to have as a friend. Chi-square analyses revealed that, as predicted, females associated with sex-appropriate sports were given significantly greater status than females identified with sex-inappropriate sports by both male and female subjects. These results suggest that social assessments made about female sport participation within high school status systems remain heavily influenced by traditional beliefs regarding feminine, "ladylike" behavior.

  19. Acknowledging individual responsibility while emphasizing social determinants in narratives to promote obesity-reducing public policy: a randomized experiment.

    PubMed

    Niederdeppe, Jeff; Roh, Sungjong; Shapiro, Michael A

    2015-01-01

    This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity's social determinants were less likely to engage in counterargument and felt more empathy for the story's main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity.

  20. Acknowledging Individual Responsibility while Emphasizing Social Determinants in Narratives to Promote Obesity-Reducing Public Policy: A Randomized Experiment

    PubMed Central

    Niederdeppe, Jeff; Roh, Sungjong; Shapiro, Michael A.

    2015-01-01

    This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity. PMID:25706743

  1. Determinants on the quality of social networks among Hong Kong Chinese.

    PubMed

    Rochelle, Tina L; Chan, O F

    2015-01-01

    The aim of the present study is to examine prospectively the quality of social networks of Hong Kong Chinese adults. A randomized household survey was employed. A total of 1170 Hong Kong Chinese respondents were recruited to the study. Participants ranged in age from 18 to 79 years, 43% of respondents were male. Findings revealed a negative association between familial trust and social network size. Network trust, social identification, and structural networks were all found to be positively associated with social network size and perceived respect from social network. The importance of family and the prioritization of the needs of the family over individual needs has implications on social network size and formation for Hong Kong Chinese individuals. More research is needed to further examine the importance of familial relationships and the prioritization of family and the impact this has on social network development and maintenance among Hong Kong Chinese.

  2. Addressivity in cogenerative dialogues

    NASA Astrophysics Data System (ADS)

    Hsu, Pei-Ling

    2014-03-01

    Ashraf Shady's paper provides a first-hand reflection on how a foreign teacher used cogens as culturally adaptive pedagogy to address cultural misalignments with students. In this paper, Shady drew on several cogen sessions to showcase his journey of using different forms of cogens with his students. To improve the quality of cogens, one strategy he used was to adjust the number of participants in cogens. As a result, some cogens worked and others did not. During the course of reading his paper, I was impressed by his creative and flexible use of cogens and at the same time was intrigued by the question of why some cogens work and not others. In searching for an answer, I found that Mikhail Bakhtin's dialogism, especially the concept of addressivity, provides a comprehensive framework to address this question. In this commentary, I reanalyze the cogen episodes described in Shady's paper in the light of dialogism. My analysis suggests that addressivity plays an important role in mediating the success of cogens. Cogens with high addressivity function as internally persuasive discourse that allows diverse consciousnesses to coexist and so likely affords productive dialogues. The implications of addressivity in teaching and learning are further discussed.

  3. Humanizing Oral Health Care through Continuing Education on Social Determinants of Health: Evaluative Case Study of a Canadian Private Dental Clinic.

    PubMed

    Lévesque, Martine; Levine, Alissa; Bedos, Christophe

    2016-01-01

    Primary care practitioners are frequently unprepared to take into account the effects of social determinants on underprivileged patients' health and health management. To address this issue among dental professionals, an original onsite continuing education (CE) course on poverty was co-developed by researchers, dental professionals, and community organizations. Integrating patient narratives and a short film, course material aims to elicit critical reflection and provide coaching for practice improvements. A qualitative case study conducted with a large Montreal Canada dental team reveals CE course participants' newfound understandings and increased sensitivity to the causes of poverty and the nature of life on welfare. Participants also describe revised interpretations of certain patient behaviors, subtle changes in communication with patients and improved equity in appointment-giving policy. Unintended outcomes include reinforced judgment and a tendency to moralize certain patient categories. Implications for health professional educators, researchers, and dental regulatory authorities are discussed. PMID:27524746

  4. Environmental and social determinants of youth physical activity intensity levels at neighborhood parks in Las Vegas, NV.

    PubMed

    Coughenour, Courtney; Coker, Lisa; Bungum, Tim J

    2014-12-01

    Parks can play an important role in youth activity. This study used observational data to evaluate the relationship of environmental and social determinants to youth physical activity intensity levels in Las Vegas neighborhood parks. System for observing play and leisure activity in youth was used to code activity levels as sedentary, walking, or vigorous in five low-income and five high-income parks. Environmental determinants included amenities, incivilities, size, high-speed streets, sidewalk condition, and temperature. Social determinants included percent minority and Hispanic, gender, and income. A multinomial logistic regression model was performed. We observed 1,421 youth, 59% male, 41% female; 21% were sedentary, 38% walking, and 41% vigorous. Males were more likely to be observed walking (OR 1.42) and vigorous (OR 2.21) when compared to sedentary. High-speed streets (OR 0.76), sidewalks condition (OR 0.34), and low-income neighborhoods (OR 0.07) was associated with decreased odds of vigorous activity; incivilities (OR 1.34) and amenities (OR 1.27) were associated with greater odds of being vigorous. Environmental and social determinants are associated with physical activity intensity levels at parks. Stakeholders should ensure quality parks, as they relate to physical activity levels in youth. Understanding environmental and social determinants that influence physical activity at parks is critical to utilizing their full potential in an effort to combat childhood obesity.

  5. Incorporating life course theory and social determinants of health into the LEND curriculum.

    PubMed

    Edwards, Karen; Towle, Patricia O; Levitz, Barbara

    2014-02-01

    The goal of this paper is to describe strategies for revising LEND curricula to incorporate a stronger focus on life course theory and social determinants of health (LCT/SDOH). The Maternal and Child Health Bureau (MCHB) includes a central focus on LCT/SDOH and states that a goal of Maternal and Child Health (MCH) training is to "Prepare and empower MCH leaders to promote health equity…and reduce disparities in health and health care." Two LEND programs engaged in a comprehensive process to strengthen LCT/SDOH in their curricula that included choosing content and themes and developing instructional strategies congruent with MCH Leadership Competencies and with the learning needs of LEND trainees. We describe: key elements of LCT/SDOH; the relationship of these to children with disabilities and to the MCH Leadership Competencies; LCT/SDOH resources for the LEND curriculum; a collaborative curriculum revision process for faculty; and LCT/SDOH content and themes for the LEND Curriculum and strategies for incorporating them. We present the results of our work in a format that may be used by other LEND programs undertaking curriculum revision to incorporate LCT/SDOH.

  6. Adaptive Policies for Reducing Inequalities in the Social Determinants of Health

    PubMed Central

    Carey, Gemma; Crammond, Brad; Malbon, Eleanor; Carey, Nic

    2015-01-01

    Inequalities in the social determinants of health (SDH), which drive avoidable health disparities between different individuals or groups, is a major concern for a number of international organisations, including the World Health Organization (WHO). Despite this, the pathways to changing inequalities in the SDH remain elusive. The methodologies and concepts within system science are now viewed as important domains of knowledge, ideas and skills for tackling issues of inequality, which are increasingly understood as emergent properties of complex systems. In this paper, we introduce and expand the concept of adaptive policies to reduce inequalities in the distribution of the SDH. The concept of adaptive policy for health equity was developed through reviewing the literature on learning and adaptive policies. Using a series of illustrative examples from education and poverty alleviation, which have their basis in real world policies, we demonstrate how an adaptive policy approach is more suited to the management of the emergent properties of inequalities in the SDH than traditional policy approaches. This is because they are better placed to handle future uncertainties. Our intention is that these examples are illustrative, rather than prescriptive, and serve to create a conversation regarding appropriate adaptive policies for progressing policy action on the SDH. PMID:26673337

  7. Toxic trace elements in maternal and cord blood and social determinants in a Bolivian mining city.

    PubMed

    Barbieri, Flavia L; Gardon, Jacques; Ruiz-Castell, María; Paco V, Pamela; Muckelbauer, Rebecca; Casiot, Corinne; Freydier, Rémi; Duprey, Jean-Louis; Chen, Chih-Mei; Müller-Nordhorn, Jacqueline; Keil, Thomas

    2016-01-01

    This study assessed lead, arsenic, and antimony in maternal and cord blood, and associations between maternal concentrations and social determinants in the Bolivian mining city of Oruro using the baseline assessment of the ToxBol/Mine-Niño birth cohort. We recruited 467 pregnant women, collecting venous blood and sociodemographic information as well as placental cord blood at birth. Metallic/semimetallic trace elements were measured using inductively coupled plasma mass spectrometry. Lead medians in maternal and cord blood were significantly correlated (Spearman coefficient = 0.59; p < 0.001; 19.35 and 13.50 μg/L, respectively). Arsenic concentrations were above detection limit (3.30 μg/L) in 17.9% of maternal and 34.6% of cord blood samples. They were not associated (Fischer's p = 0.72). Antimony medians in maternal and cord blood were weakly correlated (Spearman coefficient = 0.15; p < 0.03; 9.00 and 8.62 μg/L, respectively). Higher concentrations of toxic elements in maternal blood were associated with maternal smoking, low educational level, and partner involved in mining.

  8. Toxic trace elements in maternal and cord blood and social determinants in a Bolivian mining city

    PubMed Central

    Barbieri, Flavia L.; Gardon, Jacques; Ruiz-Castell, María; Paco V., Pamela; Muckelbauer, Rebecca; Casiot, Corinne; Freydier, Rémi; Duprey, Jean-Louis; Chen, Chih-Mei; Müller-Nordhorn, Jacqueline; Keil, Thomas

    2016-01-01

    This study assessed lead, arsenic, and antimony in maternal and cord blood, and associations between maternal concentrations and social determinants in the Bolivian mining city of Oruro using the baseline assessment of the ToxBol/Mine-Niño birth cohort. We recruited 467 pregnant women, collecting venous blood and sociodemographic information as well as placental cord blood at birth. Metallic/semimetallic trace elements were measured using inductively coupled plasma mass spectrometry. Lead medians in maternal and cord blood were significantly correlated (Spearman coefficient = 0.59; p < 0.001; 19.35 and 13.50 μg/L, respectively). Arsenic concentrations were above detection limit (3.30 μg/L) in 17.9 % of maternal and 34.6 % of cord blood samples. They were not associated (Fischer’s p = 0.72). Antimony medians in maternal and cord blood were weakly correlated (Spearman coefficient = 0.15; p < 0.03; 9.00 and 8.62 μg/L, respectively). Higher concentrations of toxic elements in maternal blood were associated with maternal smoking, low educational level, and partner involved in mining. PMID:26179629

  9. Incorporating life course theory and social determinants of health into the LEND curriculum.

    PubMed

    Edwards, Karen; Towle, Patricia O; Levitz, Barbara

    2014-02-01

    The goal of this paper is to describe strategies for revising LEND curricula to incorporate a stronger focus on life course theory and social determinants of health (LCT/SDOH). The Maternal and Child Health Bureau (MCHB) includes a central focus on LCT/SDOH and states that a goal of Maternal and Child Health (MCH) training is to "Prepare and empower MCH leaders to promote health equity…and reduce disparities in health and health care." Two LEND programs engaged in a comprehensive process to strengthen LCT/SDOH in their curricula that included choosing content and themes and developing instructional strategies congruent with MCH Leadership Competencies and with the learning needs of LEND trainees. We describe: key elements of LCT/SDOH; the relationship of these to children with disabilities and to the MCH Leadership Competencies; LCT/SDOH resources for the LEND curriculum; a collaborative curriculum revision process for faculty; and LCT/SDOH content and themes for the LEND Curriculum and strategies for incorporating them. We present the results of our work in a format that may be used by other LEND programs undertaking curriculum revision to incorporate LCT/SDOH. PMID:23852429

  10. Adaptive Policies for Reducing Inequalities in the Social Determinants of Health.

    PubMed

    Carey, Gemma; Crammond, Brad; Malbon, Eleanor; Carey, Nic

    2015-01-01

    Inequalities in the social determinants of health (SDH), which drive avoidable health disparities between different individuals or groups, is a major concern for a number of international organisations, including the World Health Organization (WHO). Despite this, the pathways to changing inequalities in the SDH remain elusive. The methodologies and concepts within system science are now viewed as important domains of knowledge, ideas and skills for tackling issues of inequality, which are increasingly understood as emergent properties of complex systems. In this paper, we introduce and expand the concept of adaptive policies to reduce inequalities in the distribution of the SDH. The concept of adaptive policy for health equity was developed through reviewing the literature on learning and adaptive policies. Using a series of illustrative examples from education and poverty alleviation, which have their basis in real world policies, we demonstrate how an adaptive policy approach is more suited to the management of the emergent properties of inequalities in the SDH than traditional policy approaches. This is because they are better placed to handle future uncertainties. Our intention is that these examples are illustrative, rather than prescriptive, and serve to create a conversation regarding appropriate adaptive policies for progressing policy action on the SDH. PMID:26673337

  11. Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation.

    PubMed

    Maroko, Andrew R; Doan, Thao M; Arno, Peter S; Hubel, Megan; Yi, Shirley; Viola, Deborah

    2016-01-01

    We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area's level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention. PMID:27634778

  12. Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation

    PubMed Central

    Doan, Thao M.; Arno, Peter S.; Hubel, Megan; Yi, Shirley; Viola, Deborah

    2016-01-01

    We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area’s level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention. PMID:27634778

  13. Social determinants of tobacco consumption among Nepalese men: findings from Nepal Demographic and Health Survey 2011

    PubMed Central

    2013-01-01

    Background In the 20th century, 100 million people across the globe lost their lives due to consumption of tobacco. Every year 15,000 deaths in Nepal are attributable to tobacco smoking and using other products of tobacco. This study aimed to establish the proportion and the social determinants of tobacco use among Nepalese men based on the Nepal Demographic and Health Survey (NDHS), 2011. Methods This study used the NDHS 2011 data. The prevalence of cigarette smoking, other forms of tobacco 16 smoking and use of tobacco in any form is reported as a percentage (%). The significance of association of the statistically significant variables established using Chi-square test was further tested by using multiple logistic regression. Results Of the 4121 participants, the prevalence of consuming any form of tobacco was 51.9% [95% confidence interval (CI) (49.6%- 54.3%)]; chewing/sniffing tobacco was 34.8% (95% CI: 32.4%- 37.3%) and tobacco smoking was 33.6% (95% CI 31.3%-36.0%). Men with no education [Odds Ratio (OR) 3.477; 95% CI (2.380-5.080)], from an older age group (36–49) [OR 2.399; 95% CI (1.858-3.096)] who were from a manual occupation [OR 1.538; 95% CI (1.188-1.985)], who were married[OR 1.938; 95% CI ( 1.552-2.420)], and who were from the Terai region [OR 1.351; 95% CI (1.083-1.684)] were more likely to consume tobacco. Men who watched television at least once a week [OR 0.642; 95% CI (0.504-0.819)] were less likely to consume tobacco. Conclusions The current study showed that over half of Nepalese men consume tobacco. There is an urgent need to fully implement Nepal’s Tobacco Control and Regulation Act which will ban smoking in public places; enforced plain packaging and display of health warnings over 75% of the packaging, and has banned selling of tobacco products to those under 18 years of age. There is a need to increase the social unacceptability of tobacco in Nepal by raising awareness through different electronic and cultural media. Anti

  14. Healthy dietary habits in relation to social determinants and lifestyle factors.

    PubMed

    Johansson, L; Thelle, D S; Solvoll, K; Bjørneboe, G E; Drevon, C A

    1999-03-01

    the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.

  15. Show Me Again What I Can Do: Documentation and Self-Determination for Students with Social Challenges

    ERIC Educational Resources Information Center

    Suarez, Stephanie Cox

    2010-01-01

    This article describes the use of documentation by teachers and their children with pervasive developmental disorder (PDD) to develop skills of self-determination. Visual feedback, such as photos and video, help teachers plan and children evaluate their performance in social situations, such as finding a friend to play with at recess. This…

  16. The Perceptions, Social Determinants, and Negative Health Outcomes Associated with Depressive Symptoms among U.S. Chinese Older Adults

    ERIC Educational Resources Information Center

    Dong, XinQi; Chang, E-Shien; Wong, Esther; Simon, Melissa

    2012-01-01

    Purpose of the Study: Recent demographic growth of the U.S. Chinese aging population calls for comprehensive understanding of their unique health needs. The objective of this study is to examine the perceptions, social determinants of depressive symptoms as well as their impact on health and well-being in a community-dwelling U.S. Chinese aging…

  17. Exploring the Social-Ecological Determinants of Physical Fighting in U.S. Schools: What about Youth in Immigrant Families?

    ERIC Educational Resources Information Center

    Hong, Jun Sung; Merrin, Gabriel J.; Peguero, Anthony A.; Gonzalez-Prendes, A. Antonio; Lee, Na Youn

    2016-01-01

    Background: Despite the growing presence of immigrant families in the US, little is known about physical fighting in school among youth from those families. Objective: The present study examines the social-ecological determinants of school physical fighting among youth in immigrant families. Implications for practice are also discussed. Method:…

  18. A Latent Class Growth Analysis of School Bullying and Its Social Context: The Self-Determination Theory Perspective

    ERIC Educational Resources Information Center

    Lam, Shui-fong; Law, Wilbert; Chan, Chi-Keung; Wong, Bernard P. H.; Zhang, Xiao

    2015-01-01

    The contribution of social context to school bullying was examined from the self-determination theory perspective in this longitudinal study of 536 adolescents from 3 secondary schools in Hong Kong. Latent class growth analysis of the student-reported data at 5 time points from grade 7 to grade 9 identified 4 groups of students: bullies (9.8%),…

  19. Preparing Ex-Offenders for Work: Applying the Self-Determination Theory to Social Cognitive Career Counseling

    ERIC Educational Resources Information Center

    Johnson, Kaprea F.

    2013-01-01

    Ex-offenders, persons with criminal and limited job histories, are being released into communities every year. Social cognitive career theory (SCCT) focuses on several cognitive-person variables and on the interaction effect with the environment. Conceptually, the author views the integration of SCCT and the self-determination theory as a…

  20. Smoking Status Moderates the Contribution of Social-Cognitive and Environmental Determinants to Adolescents' Smoking Intentions

    ERIC Educational Resources Information Center

    Victoir, An; Eertmans, A.; Van den Broucke, S.; Van den Bergh, O.

    2006-01-01

    In this study, it was tested whether attitudes, self-efficacy, social influences and the perception of the school and home environments had different associations with intentions for adolescent non-smokers, occasional smokers and daily smokers. A regression model allowing for separate slopes of social-cognitive and environment variables accounted…