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Addressing Health Disparities in Disadvantaged and Vulnerable Groups
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Addressing Health Disparities in Disadvantaged and Vulnerable Groups

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 13888

Special Issue Editor

Dr. Olav Muurlink

E-Mail Website
Guest Editor
1. School of Business and Law, CQUniversity Brisbane, Brisbane, QLD 4000, Australia
2. Centre for Regional Economies and Supply Chains, Appleton Institute, North Rockhampton, QLD 4702, Australia
Interests: Bangladesh; rural and remote healthcare provision; climate change and vector-borne disease; social epidemiology

Special Issue Information

Dear Colleagues,

The ongoing COVID-19 crisis has underlined how even a relatively novel health threat impacts unevenly on a population. Ethnic and cultural minorities have been heavily overrepresented in mortality in the general population and amongst health care workers. Understanding how economic, physical, social, psychological and cultural group members interact to produce such health disparities is an important step in ensuring health systems are able to support vulnerable and disadvantaged groups, as well as implementing public health interventions sensitively in the community to reduce vulnerability. Group ‘membership’ is at least partially a socially medicated notion with even ‘natural’ categories such as gender and race now understood as being an oversimplification. At the other end of the spectrum, groups where membership is seen as a ‘choice’, such as religious groups or subcultures, may also expose the individual to disadvantage in the health system. Intersectionality theory, which refers to ways in which an individual’s identity can expose them to overlapping forms of discrimination or marginalization as a result of ‘membership’ of multiple groups (e.g., ‘Hispanic’ and ‘female’), has led to greater appreciation of the potential compounding effects of group memberships. This Special Issue seeks submissions that go beyond merely demonstrating health disparities in disadvantaged and vulnerable groups, to begin to answer the questions “how does individual or multiple group membership lead to health decrements?” and “how can public health and primary health care systems be restructured to address the disadvantage suffered by vulnerable groups?”

Dr. Olav Muurlink
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social epidemiology
  • health inequalities
  • health systems
  • intersectionality
  • group membership
  • identity

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Published Papers (4 papers)

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Research

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19 pages, 375 KiB  
Article
Health System Factors Affecting the Experience of Non-Invasive Ventilation Provision of People with Neuromuscular Disorders in New Zealand
by Meredith A. Perry, Bernadette Jones, Matthew Jenkins, Hemakumar Devan, Alister Neill and Tristram Ingham
Int. J. Environ. Res. Public Health 2023, 20(6), 4758; https://doi.org/10.3390/ijerph20064758 - 8 Mar 2023
Cited by 3 | Viewed by 1899
Abstract
Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorders (NMD), supporting those with respiratory failure to achieve adequate respiration and improve their quality of life. The aim of this study was to explore the experiences of access to, consent, [...] Read more.
Non-invasive ventilation (NIV) is a critical therapy for many patients with neuromuscular disorders (NMD), supporting those with respiratory failure to achieve adequate respiration and improve their quality of life. The aim of this study was to explore the experiences of access to, consent, uptake, maintenance and safe use of non-invasive ventilation by people with NMD. Semi-structured individual interviews were conducted with 11 people with NMD, each using NIV for more than 12 months. A critical realism ontological paradigm with contextualism epistemology guided the Reflexive Thematic Analysis. An Equity of Health Care Framework underpinned the analysis. Three themes were interpreted: Uptake and informed consent for NIV therapy; Practicalities of NIV; and Patient-clinician relationships. We identified issues at the system, organization and health professional levels. Conclusions: We recommend the development of national service specifications with clear standards and dedicated funding for patients with NMD and call on the New Zealand Ministry of Health to proactively investigate and monitor the variations in service delivery identified. The specific areas of concern for patients with NMD suggest the need for NMD-related NIV research and service provision responsive to the distinct needs of this population. Full article
(This article belongs to the Special Issue Addressing Health Disparities in Disadvantaged and Vulnerable Groups)
14 pages, 581 KiB  
Article
Social Determinants of Mental, Physical, and Oral Health of Middle-Aged and Older African Americans in South Los Angeles
by Edward Adinkrah, Babak Najand, Arash Rahmani, Najmeh Maharlouei, Tavonia Ekwegh, Sharon Cobb and Hossein Zare
Int. J. Environ. Res. Public Health 2022, 19(24), 16765; https://doi.org/10.3390/ijerph192416765 - 14 Dec 2022
Viewed by 2169
Abstract
Background. A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans. Aim. We investigated the separate and joint effects [...] Read more.
Background. A growing body of research suggests that financial difficulties could weaken the protective effects of socioeconomic status (SES) indicators, including education and income, on the health status of marginalized communities, such as African Americans. Aim. We investigated the separate and joint effects of education, income, and financial difficulties on mental, physical, and oral self-rated health (SRH) outcomes in African American middle-aged and older adults. Methods. This cross-sectional study enrolled 150 middle-aged and older African Americans residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics (education, income, and financial difficulties), and self-rated health (mental, physical, and oral health) were collected. Three linear regression models were used to analyze the data. Results. Higher education and income were associated with a lower level of financial strain in a bivariate analysis. However, according to multivariable models, only financial difficulties were associated with poor mental, physical, and oral health. As similar patterns emerged for all three health outcomes, the risk associated with financial difficulties seems robust. Conclusions. According to our multivariable models, financial strain is a more salient social determinant of health within African American communities than education and income in economically constrained urban environments such as South Los Angeles. While education and income lose some protective effects, financial strain continues to deteriorate the health of African American communities across domains. Full article
(This article belongs to the Special Issue Addressing Health Disparities in Disadvantaged and Vulnerable Groups)
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14 pages, 1616 KiB  
Article
The Effect of Neighborhood Deprivation on Mortality in Newly Diagnosed Diabetes Patients: A Countrywide Population-Based Korean Retrospective Cohort Study, 2002–2013
by Kyoung-Hee Cho, Juyeong Kim, Young Choi and Tae-Hyun Kim
Int. J. Environ. Res. Public Health 2022, 19(7), 4324; https://doi.org/10.3390/ijerph19074324 - 4 Apr 2022
Viewed by 1946
Abstract
Background: Neighborhood environmental factors along with individual factors are beginning to make a mark as factors which influence individual health outcomes. The goal of this study is to look at the combined impact of individual and neighborhood socioeconomic status on all-cause mortality in [...] Read more.
Background: Neighborhood environmental factors along with individual factors are beginning to make a mark as factors which influence individual health outcomes. The goal of this study is to look at the combined impact of individual and neighborhood socioeconomic status on all-cause mortality in diabetic patients who have just been diagnosed. Methods: The Korean National Health Insurance (2002–2013) was employed in this cohort research, which used a stratified random sample. During the years 2003–2006, a total of 15,882 individuals who were newly diagnosed with diabetes and using oral disease-controlling medication were included in the study. Individual income and neighborhood deprivation index were used to examine the combined effect on all-cause mortality. The frailty model was performed using Cox’s proportional hazard regression. Results: During the study period, 28.3 percent (n = 4493) of the 15,882 eligible individuals died. In a Cox regression analysis after adjusting for all covariates, with advantaged and disadvantaged neighborhoods classified according to individual household income, the adjusted HR for patients living in a disadvantaged area was higher compared to patients living in an advantaged area in patients with middle income, compared to the reference group (a high income within an advantaged neighborhood) (HR, 1.22; 95% CI, 1.09–1.35; HR, 1.13; 95% CI, 1.02–1.25, respectively). The adjusted HR for patients with low income who lived in a disadvantaged location was greater than for patients who lived in an advantaged area (HR, 1.34; 95% CI, 1.18–1.53 vs. HR, 1.28; 95% CI, 1.14–1.49). Conclusions: Individual SES has a greater impact on all-cause mortality among diabetic patients when they live in a low-income neighborhood. Full article
(This article belongs to the Special Issue Addressing Health Disparities in Disadvantaged and Vulnerable Groups)
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Review

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30 pages, 1115 KiB  
Review
Indigenous Cultural Safety Training for Applied Health, Social Work, and Education Professionals: A PRISMA Scoping Review
by Tammy L. MacLean, Jinfan Rose Qiang, Lynn Henderson, Andrea Bowra, Lisa Howard, Victoria Pringle, Tenzin Butsang, Emma Rice, Erica Di Ruggiero and Angela Mashford-Pringle
Int. J. Environ. Res. Public Health 2023, 20(6), 5217; https://doi.org/10.3390/ijerph20065217 - 22 Mar 2023
Cited by 10 | Viewed by 7174
Abstract
Anti-Indigenous racism is a widespread social problem in health and education systems in English-speaking colonized countries. Cultural safety training (CST) is often promoted as a key strategy to address this problem, yet little evidence exists on how CST is operationalized and evaluated in [...] Read more.
Anti-Indigenous racism is a widespread social problem in health and education systems in English-speaking colonized countries. Cultural safety training (CST) is often promoted as a key strategy to address this problem, yet little evidence exists on how CST is operationalized and evaluated in health and education systems. This scoping review sought to broadly synthesize the academic literature on how CST programs are developed, implemented, and evaluated in the applied health, social work and education fields in Canada, United States, Australia, and New Zealand. MEDLINE, EMBASE, CINAHL, ERIC, and ASSIA were searched for articles published between 1996 and 2020. The Joanna Briggs Institute’s three-step search strategy and PRISMA extension for scoping reviews were adopted, with 134 articles included. CST programs have grown significantly in the health, social work, and education fields in the last three decades, and they vary significantly in their objectives, modalities, timelines, and how they are evaluated. The involvement of Indigenous peoples in CST programs is common, but their roles are rarely specified. Indigenous groups must be intentionally and meaningfully engaged throughout the entire duration of research and practice. Cultural safety and various related concepts should be careful considered and applied for the relevant context. Full article
(This article belongs to the Special Issue Addressing Health Disparities in Disadvantaged and Vulnerable Groups)
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