Geographic information in the French national health data system: Key challenges for territorial health studies.

Over the past four decades, researchers have used different theoretical and methodological approaches to study social inequalities in health, so the aim of this study is to analyze the main approaches to studying social and socio-economic inequalities in health: materialist (based on income), psychosocial (based on social inequalities), cultural and behavioral (based on health / lifestyle behaviors) and intersectional (used to identify social inequalities in health among many social groups appear at the intersection between different identities of the individual). There are also the fundamental cause theory, in which SES and social class are defined as the "fundamental cause" of health, disease, disability and death, and the life-course theory covering all the models that explain health inequalities within research of social inequalities in health. Social inequalities in health are understood as differences in health between social groups based on such social determinants as gender, age, income, level of education, occupation, employment / unemployment, marital status, presence of children in the family, living conditions, place of residence, etc., which are reproducing over the time. Social inequalities in health are unjust, so in civilized societies governments tackling social inequalities in health. Health equity means that everyone should be able to reach their full potential in health. Health equity is not the same as health equality, because those who have greater needs but fewer resources need more support to equalize opportunities. Empirical studies, including those conducted in Ukraine, have shown the relationship between different social and economic determinants and health inequalities and have confirmed the existence of social inequalities in health among different socio-economic and demographic groups.

College administrators and their prevention staff face numerous challenges when attempting to reduce the prevalence and severity of alcohol consumption and alcohol-related harm on their campuses. For example, drinking, and particularly binge drinking have been shown to be pervasive and persistent behaviors among college students (Wechsler et al. 2000). In addition, until a few years ago research assessing the effectiveness of various prevention approaches in the college setting was scarce, making it difficult to identify effective measures. In recent years, however, several studies have looked more closely at approaches to preventing college drinking. For example, Dowdall and Wechsler (2002), Borsari and Carey (2001), Perkins (2002a), and Berkowitz (2004) reviewed or analyzed prevention approaches among college populations. Another important contribution was the final report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Task Force on College Drinking (NIAAA 2002), which reviewed epidemiological and intervention research on college drinking and issued recommendations for prevention strategies. This article describes the motivation for focusing on college student drinking and summarizes the Task Force's findings and recommendations. Why Target College Student Drinking? Given the all-too-common reports in the press of occasional tragic deaths and of mass celebrations or riots among college students that are accompanied by alcohol consumption, the answer to this question may seem obvious. But these singular events do not accurately reflect the actual prevalence of death and injury associated with alcohol use among college students. Based on epidemiological data from a variety of sources, Hingson and colleagues (2002) generated the following estimates of the consequences of college student drinking: * More than 1,400 college students die annually in alcohol-related events, primarily traffic crashes. * More than 2 million college students (of a total of 8 million) occasionally drive under the influence of alcohol, and more than 3 million students ride with a drinking driver. * More than 500,000 students annually suffer unintentional injury under the influence of alcohol. * More than 600,000 students annually are hit or assaulted by another student who has been drinking. In addition to these acute consequences of drinking, evidence suggests that alcohol consumption can lead to longer term cognitive impairment (Spear 2002; White 2003). The college environment itself (specifically, such factors as peer influence and alcohol availability) may contribute to college students' risk of alcohol-related harm. O'Malley and Johnston (2002) found that although college-bound high school students drink less than their peers, their alcohol consumption surpasses that of their noncollege peers during the college years, only to decrease again after they finish college. In light of these observations, drinking among college students deserves special attention. The NIAAA Task Force on College Drinking The NIAAA Task Force on College Drinking commissioned several review papers on various aspects of drinking among college students (e.g., drinking patterns and consequences of alcohol consumption). (1) With respect to prevention research, however, the Task Force found that studies evaluating prevention approaches focused mostly on interventions aimed at individual student drinkers rather than on interventions aimed at entire college populations (i.e., universal interventions). The Task Force's findings regarding the efficacy of individual-level interventions have been reviewed and summarized by Larimer and Cronce (2002), who distinguish between educational or awareness programs, cognitive-behavioral interventions, and motivational enhancement techniques. With one or two exceptions, this review found little evidence to support the effectiveness of purely educational or awareness programs. …

Social inequalities in health and oral health continue to present a major challenge to public health. Progress towards the development of interventions to reduce health inequalities is currently being hampered by an incomplete understanding of the causes of inequalities in health. This paper aims to provide oral health researchers with an overview of four current explanations for inequalities in oral health and to suggest further areas of research needed to advance our understanding of the causes of social inequalities in oral health.

BackgroundIn 2009, the World Health Organization’s Commission on Social Determinants of Health set out its recommendations for action, which included establishing equity from early childhood onwards by enabling all children and their mothers to benefit from a comprehensive package of quality programmes. In order to address social inequalities in health, it is recommended that action be taken from early childhood, and actions providing support for parenting are an effective lever in this respect.The aim of this review of systematic reviews is to analyse, on the one hand, the components and characteristics of effective interventions in parenting support and, on the other, the extent to which the reviews took into account social inequalities in health.MethodsA total of 796 reviews were selected from peer-reviewed journals published between 2009 and 2016 in French or English. Of these, 21 reviews responding to the AMSTAR and selected ROBIS criteria were retained. These were analysed in relation to the consideration they gave to social inequalities in health according to PRISMA-equity.ResultsThe reviews confirmed that parenting support programmes improved infants’ sleep, increased mothers’ self-esteem and reduced mothers’ anger, anxiety and stress levels. The mainly authors noted that the contexts in which the interventions had taken place were described either scantly or not at all, making it difficult to evaluate them.Only half of the reviews had addressed the question of social inequalities in health. In particular, there had been little research conducted on the relational aspect and the social link.ConclusionIn terms of addressing social inequalities in perinatal health, the approach remains both modest and reductive. Understanding how, for whom and in what conditions interventions operate is one way of optimising their results. Further research is needed to study the interactions between the interventions and their contexts.

Social inequalities in health have been widely demonstrated. However, the mechanisms underlying these inequalities are not completely understood. The objective of the study was to examine the contribution of various types of occupational exposures to social inequalities in self-reported health (SRH). The study population was based on a random sample of 3,463 men and 2,593 women of the population of employees in west central France (response rate: 85-90%). Data were collected through a voluntary network of 110 occupational physicians in 2006-2007. Occupational factors included biomechanical, physical, chemical and psychosocial exposures. All occupational factors were collected by occupational physicians, except psychosocial work factors, which were measured using a self-administered questionnaire. Social position was measured using occupational groups. Strong social gradients were observed for a large number of occupational factors. Marked social gradients were also observed for SRH, manual workers and clerks/service workers being more likely to report poor health. After adjustment for occupational factors, social inequalities in SRH were substantially reduced by 76-134% according to gender and occupational groups. The strongest impacts in reducing these inequalities were observed for biomechanical exposures and decision latitude. Differences in the contributing occupational factors were observed according to gender and occupational groups. This study showed that poor working conditions contributed to explain social inequalities in SRH. It also provided elements for developing specific preventive actions for manual workers and clerks/service workers. Prevention towards reducing all occupational exposures may be useful to improve occupational health and also to reduce social inequalities in health.

Objective: This study examined ethnic disparities in antipsychotic therapy in a population with significant Asian representation. Methods: Using a cross-sectional retrospective study design, self-reported ethnicity data pooled from three cycles of the Canadian Community Health Survey were linked to 2005 administrative data on physician, hospital, and pharmaceutical use in British Columbia, Canada. Logistic regression was used to model the association between ethnicity and the likelihood of filling one or more prescriptions for any antipsychotic, with controls for sex, age, residence, immigrant status, income, health status, and diagnoses of schizophrenia, bipolar disorder, depression, and dementia. Results: Of the 27,658 individuals in the sample, 2.2% filled at least one antipsychotic prescription. The proportion varied across ethnic groups: Chinese, 1.0%; other Asians, 1.2%; whites, 2.3%; nonwhite non-Asians, 2.8%; and mixed ethnicity, 4.3%. After adjustment for patient characteristics and diagnoses of schizophrenia and bipolar disorder, the likelihood of filling a prescription was found to be lower among Chinese (odds ratio [OR]=.47, 95% confidence interval [CI]=.24–.90) and higher among persons of mixed ethnicity (OR=3.19, CI=1.49–6.83). Further adjustment for depression and dementia diagnoses did not significantly change the ORs for the Chinese (OR=.49, CI=.25–.98) and the mixed ethnic groups (OR=2.97, CI=1.30–6.80). Conclusions: Consistent with the existing literature on ethnic disparities in antipsychotic therapy, the study found evidence of persistent disparities in a population that has a significant number of Asians. Further studies should be done to identify possible causes of these disparities and to identify potential interventions that may reduce or eliminate them. (Psychiatric Services 62:1026–1031, 2011)

This study examined social inequalities in health in the second half of life. Data for empirical analyses came from the second wave of the German Ageing Survey (DEAS), an ongoing population-based, representative study of community dwelling persons living in Germany, aged 40–85 years (N = 2,787). Three different indicators for socioeconomic status (SES; education, income, financial assets as an indicator for wealth) and health (physical, functional and subjective health) were employed. It could be shown that SES was related to health in the second half of life: Less advantaged persons between 40 and 85 years of age had worse health than more advantaged persons. Age gradients varied between status indicators and health dimensions, but in general social inequalities in health were rather stable or increasing over age. The latter was observed for wealth-related absolute inequalities in physical and functional health. Only income-related differences in subjective health decreased at higher ages. The amount of social inequality in health as well as its development over age did not vary by gender and place of residence (East or West Germany). These results suggest that, in Germany, the influence of SES on health remains important throughout the second half of life.

Disparities in Vision Health and Eye Care: Where Do We Go from Here?

Understanding the construction of the social gradient in health is a major challenge in the field of social epidemiology, a branch of epidemiology that seeks to understand how society and its different forms of organization influence health at a population level. Attempting to answer these questions involves large datasets of varied heterogeneous data suggesting that Big Data approaches could be then particularly relevant to the study of social inequalities in health. Nevertheless, real challenges have to be addressed in order to make the best use of the development of Big Data in health for the benefit of all. The main purpose of this perspective is to discuss some of these challenges, in particular: (i) the perimeter and the particularity of Big Data in health, which must be broader than a vision centerd solely on care, the individual and his or her biological characteristics; (ii) the need for clarification regarding the notion of data, the validity of data and the question of causal inference for various actors involved in health, such data as researchers, health professionals and the civilian population; (iii) the need for regulation and control of data and their uses by public authorities for the common good and the fight against social inequalities in health. To face these issues, it seems essential to integrate different approaches into a close dialog, integrating methodological, societal, and ethical issues. This question cannot escape an interdisciplinary approach, including users or patients.

<titre>R&#233;sum&#233;</titre>En Afrique sub-saharienne, les mesures &#224; large &#233;chelle, sur l&#8217;ensemble d&#8217;un pays ou d&#8217;une r&#233;gion, montrent que le recours aux m&#233;thodes modernes de contraception tend &#224; progresser, mais lentement, donnant l&#8217;impression que les &#233;volutions ne peuvent que prendre du temps dans ce domaine. Pour mieux comprendre les raisons de cette faible diffusion, principalement en zone rurale, nous avons &#233;tudi&#233; de fa&#231;on d&#233;taill&#233;e l&#8217;histoire de la contraception dans une population rurale du S&#233;n&#233;gal, r&#233;sidant &#224; Bandafassi. En utilisant plusieurs sources d&#8217;information, nous avons pu retracer la progression du recours &#224; la contraception ann&#233;e apr&#232;s ann&#233;e et examiner quels en avaient &#233;t&#233; les facteurs. L&#8217;&#233;tude pr&#233;sent&#233;e ici montre que contrairement aux id&#233;es re&#231;ues, la contraception peut se diffuser tr&#232;s rapidement dans des campagnes africaines peu favoris&#233;es sur le plan socio-&#233;conomique mais que cette diffusion n&#8217;est que difficilement mesurable en raison d&#8217;une sous-d&#233;claration importante de la pratique contraceptive et que sa p&#233;rennit&#233; n&#8217;est pas assur&#233;e.

Combined estrogen and progestin should not be used for the prevention of osteoporosis or other chronic conditions in postmenopausal women, according to recommendations issued by the U.S. Preventive Services Task Force. Hormone therapy currently has Food and Drug Administration approval for use in the prevention of osteoporosis in postmenopausal women. The task force, an independent body of volunteers that advises the Department of Health and Human Services, issued the recommendations as an update of its 2005 statement on hormone therapy for prevention of disease in postmenopausal women. Using the most recent scientific evidence available, including long-term follow-up data from the Women's Health Initiative (WHI) studies of hormone therapy use in postmenopausal women, the task force reached the same conclusions as it had in 2005, advising against combined estrogen and progestin for prevention of chronic conditions, and also against the use of estrogen alone for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy. The task force emphasized that hormone therapy was still indicated for the management of menopausal symptoms, such as hot flashes or vaginal dryness. It additionally made clear that its recommendation against hormone therapy for disease prevention does not apply to women younger than 50 years of age who have undergone surgical menopause. Prior to the WHI studies, a series of government-funded trials that began in the 1990s, with follow-up ending in 2010, showed that hormones had been widely used for the prevention of bone disease in postmenopausal women. Both estrogen and combined estrogen and progestin are known to reduce fracture risk. However, both forms of hormone therapy were shown during the WHI studies to also increase the risk of serious adverse events, to the point where the trials were stopped early. In one randomized, placebo-controlled trial, estrogen alone was associated with a significantly higher risk of stroke, deep vein thrombosis, and gallbladder disease, while combined therapy was associated with an increased risk of stroke, invasive breast cancer, dementia, gallbladder disease, deep vein thrombosis, and pulmonary embolism. Reproductive endocrinologist Jan L. Shifren of the department of obstetrics and gynecology and reproductive biology at Harvard Medical School and director of the menopause program at Massachusetts General Hospital, both in Boston, said in an interview that the task force's updated position largely reflected the current consensus of the Ob/Gyn community, “which is that HT should not be used to prevent the diseases of aging.” The task force was “very careful to point out that they are not saying HT should not be used for the treatment of vasomotor symptoms or vaginal atrophy. It's not that hormones aren't indicated; they're just not indicated for prevention. They remain an appropriate treatment for otherwise healthy, very symptomatic women at the menopause transition,” said Dr. Shifren, who is not a task force member. FDA-approved indications for hormone therapy in postmenopausal women include treatment of menopausal symptoms and prevention of osteoporosis. A black box warning indicates that estrogen with or without progestin should be prescribed at the lowest effective dose and for the shortest time possible. The task force's findings were based on the dosages and formulations used in the WHI trials: oral conjugated equine estrogen (0.625 mg/day plus medroxyprogesterone acetate, 2.5 mg/day) or estrogen 0.625 mg/day alone. Dr. Shifren said that there are some practitioners “who believe that hormone therapy could still be appropriate for the prevention of osteoporosis in people who absolutely cannot tolerate any other therapy. But what I would argue is that it is incredibly rare that there is a patient who can't tolerate one of the very many other FDA-approved treatments for the prevention of osteoporosis.” The task force members declared no relevant financial conflict of interest.

The COVID-19 pandemic highlighted the United States' lack of a nationwide infrastructure for collecting, sharing, and using health data, especially for secondary uses (e.g., population health management and public health). The federal government is taking several important steps to upgrade the nation's health data ecosystem-notably, the Centers for Disease Control and Prevention's Data Modernization Initiative and the Office of the National Coordinator for Health Information Technology's Trusted Exchange Framework and Common Agreement. However, substantial barriers remain. Inconsistent regulations, infrastructure, and governance across federal and state levels and between states significantly impede the exchange and analysis of health data. Siloed systems and insufficient funding block effective integration of clinical, public health, and social determinants data within and between states. In this analytic essay, we propose strategies to develop a nationwide health data ecosystem. We focus on providing federal guidance and incentives to develop state-designated entities responsible for the collection, integration, and analysis of clinical, public health, social determinants of health, claims, administrative, and other relevant data. These recommendations include a regulatory clearinghouse, federal guidance, model legislation and templated regulation, funding to incentive enterprise architecture, regulatory sandboxes, and a 3-pronged research agenda. (Am J Public Health. 2024;114(2):209-217. https://doi.org/10.2105/AJPH.2023.307477).

Background:In 2023, JJ Pionke became President of the Midwest Chapter of the Medical Library Association (MWCMLA). He determined that for his presidential year, he would form a task force to determine the accessibility levels of the chapter and remediate accessibility issues as appropriate.Case Presentation:To accomplish the accessibility audit of the MWCMLA, Pionke formed an Accessibility Task Force that was time limited to one year. Task force meetings were held once a month to keep people accountable and to share out progress and requests for assistance. The task force was broken up into four teams: annual meeting, policy, social media, and website. Task force members could be on more than one team. The goals of each team were generally the same: what are other organizations doing, what do we have already if anything, and develop best practices/policy/etc. as needed.Conclusions:The teams fulfilled their mandate by creating best practices/guidelines/policies documents. Some accessibility remediation was needed for the chapter website. The task force's findings and materials were shared out among the MWCMLA as well as passed on to the presidents of the other chapters, many of whom had expressed interest in the results.

Recognizing the immense challenges posed by climate change and aligning with the UN Sustainable Development Goals (SDGs), particularly SDG 13, which focuses on climate action, the International Federation for Information Processing (IFIP) established the Digital Technology and Climate Change Task Force in December 2022. The Task Force aims to identify opportunities to leverage digital technologies effectively in combating climate change and to provide recommendations for professionals and relevant institutions. Since its inception, the Task Force has met regularly. After conducting a scoping exercise and defining a taxonomy, a comprehensive questionnaire was distributed twice among IFIP stakeholders, namely, technical committees and member societies, to gather insights and understand the diverse perspectives of the IFIP community on this specific matter. This document presents the Task Force's findings and is structured into two parts. The first part introduces the main concepts and challenges of climate change and digital technologies. It discusses the key challenges and concepts related to climate change, the widely adopted strategies for combating it, and the digital technologies and skills required to enhance the efficiency and effectiveness of these strategies. The second part of the document focuses on recommendations tailored to various stakeholders, including individuals, computer societies, governments, the information and communication technology (ICT) industry, the research and development sector, and specific industries considered strategic in the fight against climate change: energy, manufacturing, agriculture, and transportation. Additionally, it emphasizes the importance of public awareness and education. The Final Remarks section summarizes the findings and proposed actions, emphasizing the critical role of digital technologies in mitigating and addressing climate change. This section also presents general recommendations for various stakeholders. The Task Force Composition and Historical Background section introduces the task force members and provides a brief historical overview. Finally, the References section lists sources and additional reading materials. The illustration on the cover page, created by DALL·E on March 24, 2024, through interactions with Raimundo Macêdo, depicts two people shaking hands—one representing the green transition and the other representing the digital transition.

In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent the stigmatization of their discipline as well as to prevent its nefarious consequences. This paper presents a summary of the Task Force's findings and recommendations. The Task Force reviewed the literature concerning the image of psychiatry and psychiatrists in the media and the opinions about psychiatry and psychiatrists of the general public, of students of medicine, of health professionals other than psychiatrists and of persons with mental illness and their families. It also reviewed the evidence about the interventions that have been undertaken to combat stigma and consequent discrimination and made a series of recommendations to the national psychiatric societies and to individual psychiatrists. The Task Force laid emphasis on the formulation of best practices of psychiatry and their application in health services and on the revision of curricula for the training of health personnel. It also recommended that national psychiatric societies establish links with other professional associations, with organizations of patients and their relatives and with the media in order to approach the problems of stigma on a broad front. The Task Force also underlined the role that psychiatrists can play in the prevention of stigmatization of psychiatry, stressing the need to develop a respectful relationship with patients, to strictly observe ethical rules in the practice of psychiatry and to maintain professional competence.