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Social and Structural Determinants of Health Disparities

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

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 13827

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Dr. Samuel D. Towne, Jr.

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Guest Editor

School of Global Health Management and Informatics, University of Central Florida, Orlando, FL 32816, USA
Interests: structural and social determinants of health disparities; global health; aging; health services research; place-based health inequalities

Special Issue Information

Dear Colleagues,

A better understanding of social and structural determinants of health disparities is critically important for population health. While health disparities have been separately linked to individual-level factors (e.g., education, income, race, ethnicity, gender), place-based factors (e.g., rurality, health care provider availability), and policy-level factors (e.g., geopolitical factors), the study of the intersectionality of individuals within these broader contextual settings can provide an even more informed and holistic perspective.

For example, individual-level characteristics (e.g., whether one identifies as a member of an aboriginal population) can be combined with place (e.g., whether one resides in a rural area) to identify a broader understanding of access to quality health care among rural-residing populations by aboriginal status. Furthermore, the contextual environment can include, but is not limited to, various measures of the built environment (e.g., objective measures of neighbourhood walkability or age-friendly and/or activity-friendly community design) and/or geopolitical context (e.g., variation in health-related policy implementation by location). Moreover, policy-relevant work is not limited to what might be seen as traditional health policies because public policies at multiple levels, whether intentionally framed as health policies or not (e.g., public transportation-related policies that may support active transportation), can impact population health and health-related outcomes.

Studies that incorporate the intersection of multiple factors at different levels are critical in addressing health disparities. This Special Issue is meant to highlight work relevant to health disparities with preference given to quantitative empirical work that integrates both social and structural determinants of health disparities in a theoretically driven, innovative, and evidence-informed approach.

Dr. Samuel D. Towne, Jr.
Guest Editor

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Keywords

social and structural determinants of health disparities
place-based health inequalities
health disparities
geographic disparities
health inequities
health inequalities
built environment
structural inequities
public health
population health

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Published Papers (4 papers)

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Research

18 pages, 2369 KiB

Open AccessArticle

Disparities in Childhood Obesity Prevalence and Spatial Clustering Related to Socioeconomic Factors in Isaan, Thailand

by Hiranya Sritart, Somchat Taertulakarn and Hiroyuki Miyazaki

Int. J. Environ. Res. Public Health 2023, 20(1), 626; https://doi.org/10.3390/ijerph20010626 - 29 Dec 2022

Cited by 3 | Viewed by 2883

Abstract

Globally, rapid economic growth has contributed to an overall increase in the incidence of childhood obesity. Although the prevalence of obesity has been well recognized, the disparities related to a region’s socioeconomic environment in terms of the incidence of obesity are still less understood. Therefore, the purpose of this study was to examine the spatial pattern of childhood obesity and identify the potential associations between childhood obesity and socioeconomic environment in the northeastern region of Thailand, Isaan. Using nationally collected obesity data from children aged 0–5 years in 2019, we employed a geographic information system (GIS) to perform obesity cluster analysis at the smaller regional level, investigating a total of 322 districts in study area. Global and local statistical approaches were applied to calculate spatial associations between the socioeconomic status of neighborhoods and childhood obesity. The study revealed that 12.42% of the total area showed significant clusters at the district level, with high values observed in the western and northeastern areas. The results of the spatial statistical model revealed that childhood obesity was significantly positively associated with areas exhibiting high levels of socioeconomic environment factors. Identifying the associated factors and highlighting geographic regions with significant spatial clusters is a powerful approach towards understanding the role of location and expanding the knowledge on the factors contributing to childhood obesity. Our findings, as a first step, offer valuable references that could support policy-makers and local authorities in enhancing policy development with the aim of reducing childhood obesity and improving public health. Full article

(This article belongs to the Special Issue Social and Structural Determinants of Health Disparities)

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26 pages, 5359 KiB

Open AccessArticle

Social Behavior and COVID-19: Analysis of the Social Factors behind Compliance with Interventions across the United States

by Morteza Maleki, Mohsen Bahrami, Monica Menendez and Jose Balsa-Barreiro

Int. J. Environ. Res. Public Health 2022, 19(23), 15716; https://doi.org/10.3390/ijerph192315716 - 25 Nov 2022

Cited by 7 | Viewed by 4477

Abstract

Since its emergence, COVID-19 has caused a great impact in health and social terms. Governments and health authorities have attempted to minimize this impact by enforcing different mandates. Recent studies have addressed the relationship between various socioeconomic variables and compliance level to these interventions. However, little attention has been paid to what constitutes people’s response and whether people behave differently when faced with different interventions. Data collected from different sources show very significant regional differences across the United States. In this paper, we attempt to shed light on the fact that a response may be different depending on the health system capacity and each individuals’ social status. For that, we analyze the correlation between different societal (i.e., education, income levels, population density, etc.) and healthcare capacity-related variables (i.e., hospital occupancy rates, percentage of essential workers, etc.) in relation to people’s level of compliance with three main governmental mandates in the United States: mobility restrictions, mask adoption, and vaccine participation. Our aim was to isolate the most influential variables impacting behavior in response to these policies. We found that there was a significant relationship between individuals’ educational levels and political preferences with respect to compliance with each of these mandates. Full article

(This article belongs to the Special Issue Social and Structural Determinants of Health Disparities)

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14 pages, 1309 KiB

Open AccessArticle

A Good App Is Hard to Find: Examining Differences in Racialized Sexual Discrimination across Online Intimate Partner-Seeking Venues

by Ryan M. Wade and Matthew M. Pear

Int. J. Environ. Res. Public Health 2022, 19(14), 8727; https://doi.org/10.3390/ijerph19148727 - 18 Jul 2022

Cited by 9 | Viewed by 3217

Abstract

Young sexual minority Black men (YSMBM) report widespread instances of Racialized Sexual Discrimination (RSD) when seeking intimate partners online. RSD is associated with negative psychological health outcomes; however, little is known about the differences between virtual environments, and whether users are exposed to differential types/frequencies of RSD across different virtual environments. Using data from a cross-sectional web survey of YSMBM (N = 548), a multivariate Kruskal–Wallis test was conducted comparing those who primarily used Jack’d and those who primarily used Grindr to meet intimate partners; the frequency with which these two groups encountered six RSD domains was compared. Men who primarily used Grindr reported more frequent instances of White superiority and rejection from White men compared with men who primarily used Jack’d. Men who primarily used Jack’d reported more frequent instances of physical objectification from Black men compared with men who primarily used Grindr. RSD may manifest differentially based on the specific venue that YSMBM use. Such differences may reflect the sociodemographic makeup of these spaces, as well as differences in acceptability/normalization of different forms of RSD. These findings have implications for the development of anti-RSD initiatives that target the specific sociocultural norms that are unique to different virtual environments. Full article

(This article belongs to the Special Issue Social and Structural Determinants of Health Disparities)

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17 pages, 5321 KiB

Open AccessArticle

Health Disparity Resulting from the Effect of Built Environment on Temperature-Related Mortality in a Subtropical Urban Setting

by Zhe Huang, Emily Ying-Yang Chan, Chi-Shing Wong, Sida Liu and Benny Chung-Ying Zee

Int. J. Environ. Res. Public Health 2022, 19(14), 8506; https://doi.org/10.3390/ijerph19148506 - 12 Jul 2022

Cited by 1 | Viewed by 2421

Abstract

Whereas previous studies have assessed the overall health impact of temperature in Hong Kong, the aim of this study was to investigate whether the health impact is modified by local temperature of small geographic units, which may be related to the diverse socioeconomic characteristics of these units. The effects of local temperature on non-accidental and cause-specific mortality were analyzed using Bayesian spatial models at a small-area level, adjusting for potential confounders, i.e., area-level air pollutants, socioeconomic status, and green space, as well as spatial dependency. We found that a 10% increase in green space density was associated with an estimated 4.80% decrease in non-accidental mortality risk and a 5.75% decrease in cardiovascular disease mortality risk in Hong Kong, whereas variation in local annual temperature did not significantly contribute to mortality. We also found that the spatial variation of mortality within this city could be explained by the geographic distribution of green space and socioeconomic factors rather than local temperature or air pollution. The findings and methodology of this study may help to further understanding and investigation of social and structural determinants of health disparities, particularly place-based built environment across class-based small geographic units in a city, taking into account the intersection of multiple factors from individual to population levels. Full article

(This article belongs to the Special Issue Social and Structural Determinants of Health Disparities)

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