Published in last 50 years
Articles published on Health Disparities
- New
- Research Article
- 10.1136/bmjopen-2024-095585
- Nov 7, 2025
- BMJ open
- Arafaat Valiani + 7 more
Genome Canada has committed significant resources to ensure that racialised groups are included in its initiatives; however, specific equity considerations related to engaging these communities in human genomic research continue to require deeper attention and exploration. This scoping review aims to widen the frame of analysis concerning inclusive human genomics by undertaking a synthesis that includes perspectives from genomicists, decision and policymakers, legal experts in bioethics and leaders from racialised communities. We conducted a comprehensive scoping review using the Arksey and O'Malley framework to examine the equitable participation of racialised communities in human genomic research. Our goal was to identify the barriers preventing these populations from equally participating in human genomic research. The review focused on studies from five countries: Canada, the USA, the UK, Australia and New Zealand which have similar immigration patterns and have received racialised populations from from some of the same communities around the globe. These features makes studying these particular countries germane to studying the common challenges they face in human genomics research. Our scoping review examined both academic and grey literature, including MEDLINE, EMBASE, PsycINFO (inception to 11 June 2025), CINAHL (to 12 June 2025) and Cochrane Central Register of Controlled Trials (CENTRAL) (to 19 June 2025), as well as Google Scholar and OAISter (October, 2023). Data were analysed using Braun and Clarke's thematic synthesis guidelines. These included familiarisation with the relevant texts in the selected articles, generating initial codes using an inductive approach, reviewing potential themes and finalising the themes based on the consensus of the research team. The study identified key barriers and facilitators to participation in human genomic research among racialised communities. The first theme (exclusion) highlighted obstacles such as a lack of transportation, limited knowledge of genetics and distrust stemming from concerns of stigmatisation and health disparities. The second theme (diversity of positions) described varied perceptions influenced by cultural values and motivations, with preferences for transparency and autonomy in research participation. Finally, the third theme (equity in genetic research) outlined the limited use of community-based participatory models and biobanking, underscoring the need for more inclusive and equitable research practices to fully engage racialised communities. Future research should prioritise strategies of authentic engagement with racialised communities to enhance both inclusivity and equity in genetic, human genomic, precision medicine and precision health research.
- New
- Research Article
- 10.1186/s12889-025-25078-w
- Nov 7, 2025
- BMC public health
- Keying Song + 2 more
Physical activity (PA) is a significant predictor of physical and mental health, particularly among older adults. In India and China, gendered social norms shape physical patterns, and the intensity of androcentric settings is different. As a result, the gendered perspective of physical activity and its association with health outcomes could be different in China and India. Therefore, the study examines gender differences in physical activity and their impact on health outcomes. This study utilizes nationally representative data from older adults aged 60 and above in India and China. Gender disaggregated physical activity is considered a key explanatory variable, and functional limitations (IADL/ADL), multimorbidity, and self-rated health are selected as outcome variables. Separate logistic regression analyses were conducted for males and females to examine the gender-specific associations between PA and health. Indian women show lower moderate PA (54.58%) than Chinese women (49.99%), with markedly fewer engaging in intense PA (12.35% vs. 24.01%). Health disparities are more severe in India: 56.15% report IADL limitations (China: 42.86%) and 25.2% ADL problems (China: 29.09%). While moderate PA strongly protects against poor SRH/ADL in both countries, Indian women face higher multimorbidity risks (aOR: 1.38 vs. China's Non-Significant) when inactive. This comparative study reveals that Indian women face greater physical activity disparities and worse functional health outcomes than Chinese women, highlighting the urgent need for gender-sensitive health interventions to address these inequities.
- New
- Research Article
- 10.1186/s12912-025-04022-8
- Nov 7, 2025
- BMC nursing
- An-Chi O Yang + 6 more
Although volunteer service in Indigenous communities provides valuable experiential learning for nursing students, its impact on clinical competence remains underexplored. This study investigated associations among volunteer motivation, self-efficacy, and clinical competence in nursing students serving Indigenous communities. A cross-sectional, descriptive study was carried out among nursing students enrolled in five-year vocational and two-year technical programs in eastern Taiwan. Data were collected between July 1, 2021, and June 30, 2023, using structured questionnaires: the volunteer motivation scale, volunteer self-efficacy scale, and clinical internship competence scale. Statistical analyses included descriptive statistics, Pearson correlation, and stepwise multiple linear regression. A total of 123 nursing students were initially recruited; ten participants were excluded due to incomplete responses or withdrawal, yielding a final sample of 113 students (92% response rate; aged 17-25). Participants exhibited elevated levels of volunteer motivation (M = 94.42, SD = 10.30) and self-efficacy (M = 86.58, SD = 9.13), with moderate clinical competence (M = 58.04, SD = 6.88). Significant positive correlations were observed between clinical competence and both volunteer motivation (r = .87) and self-efficacy (r = .85). Stepwise multiple regression identified self-efficacy (β = 0.58, p < .001), internship grade (β = 0.14, p = .001), and volunteer motivation (β = 0.31, p = .001) as significant predictors, explaining 79% of the variance in clinical competence. Structured volunteer service in Indigenous communities appears to enhance nursing students' clinical competence, likely through increased motivation and self-efficacy. Integrating such experiences into nursing education may better prepare students for diverse clinical settings and improve readiness to address community health disparities. Future curricula should consider systematically incorporating structured, culturally responsive volunteer programs. Longitudinal studies are recommended to assess the long-term impact on professional development and health outcomes in underserved populations.
- New
- Research Article
- 10.1080/17533015.2025.2581966
- Nov 7, 2025
- Arts & health
- Carolina Borda-Nino-Wildman + 1 more
Approximately half of the global population resides in remote regions, yet healthcare resources remain disproportionately concentrated in urban areas. Social and geographical isolation exacerbate health disparities, resulting in limited access to services for rural, remote and island communities. This paper explores how arts-based health interventions respond to these inequalities. We conducted a literature review of research studies published over the past two decades. Arts-based health interventions have emerged as a promising approach to addressing disparities and enhancing overall health and wellbeing. The arts support healthcare literacy, individual agency, self-expression and a strengthened sense of community presence and identity. Creative practices rooted in local and Indigenous traditions foster sustainable and meaningful relationships between people and place, enabling a sense of connected belonging and intergenerational historicity. Active community participation, trustful relationships between stakeholders and communities, and an appreciation of cultural differences are seen to increase the effectiveness of these interventions. The findings of this review aim to inform policymakers, practitioners and researchers about the potential and challenges of arts-based health interventions in remote and marginalised communities.
- New
- Research Article
- 10.5171/2025.4536425
- Nov 6, 2025
- Communications of International Proceedings
- Joanna Niznik
The COVID-19 pandemic, which emerged unexpectedly in early 2020, presented a formidable challenge to health systems worldwide. No country was adequately prepared for such a threat arising from a previously unknown pathogen. Throughout the pandemic, numerous publications emerged that examined the transformations within health systems resulting from the COVID-19 pandemic. The literature highlighted the impact of health policy on health system operations, particularly in guaranteeing access to diagnostics and treatment, optimising the system’s capability to manage the rapidly increasing number of infected individuals, and utilising digital solutions for patient contact. The overall health condition induced by the pandemic of each nation was analysed in terms of life expectancy, population health, health disparities, health investment, and the readiness of health systems for future emergencies. Furthermore, emphasis was placed on the financing of healthcare care, noting the reduction in health premium revenues due to rising unemployment and the financial risk assumed by public payers, which subsequently modified payment mechanisms. The academic literature reveals an apparent deficiency in employing a cross-disciplinary methodology when evaluating the performance of health systems, particularly with regard to the epidemiological and financial implications of the pandemic. Furthermore, there exists a scarcity of publications that encompass the duration of the pandemic, rather than focussing on specific individual years.
- New
- Research Article
- 10.1016/j.pedhc.2025.09.011
- Nov 6, 2025
- Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
- Felesia R Bowen + 9 more
A Primer for Nurses on the Historical Policy of Redlining.
- New
- Research Article
- 10.1016/j.jocn.2025.111710
- Nov 6, 2025
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
- J Eleanor Seo + 6 more
Association of neighborhood disadvantage with clinical and healthcare utilization outcomes following traumatic brain injury.
- New
- Research Article
- 10.9734/jsrr/2025/v31i113683
- Nov 6, 2025
- Journal of Scientific Research and Reports
- Deo Narayan + 4 more
In India, where hockey holds a place of national pride and historical relevance, junior hockey players represent both the future of the sport and a vulnerable group undergoing critical transitions. A comparative exploration of positive mental health among tribal junior hockey players across different Indian states can help identify contextual strengths and gaps, thereby enabling the development of targeted mental health promotion strategies in sports academies and policy frameworks. The present study aimed to compare positive mental health among tribal junior national hockey players from four Indian states: Jharkhand, Odisha, Chhattisgarh, and Maharashtra. A total of 100 participants (N = 100), aged 14 to 18 years, were purposively selected, with 25 players representing each state. Positive mental health was assessed using the Positive Mental Health Inventory. Employing a Static Group Comparison Design (SGCD), descriptive statistics were calculated to characterise mental health levels. To examine differences in positive mental health scores across states, a one-way Analysis of Variance (ANOVA) was conducted at the 0.05 significance level, preceded by Levene’s test to confirm homogeneity of variances. Significant differences among state groups were further explored using the Sidak post hoc test. Results revealed a statistically significant difference in positive mental health scores, with an F-value of 8.11 exceeding the critical value of 2.69, indicating that the state of origin significantly influences the positive mental health of tribal junior national hockey players. The test revealed statistically significant differences between the mean scores of Jharkhand and Chhattisgarh (p = .045), Jharkhand and Maharashtra (p = .000), and Odisha and Maharashtra (p = .002). These results support the earlier ANOVA findings, reinforcing the conclusion that regional disparities in mental health do exist, particularly between states with more developed sports support systems and those with relatively limited resources or psychological support mechanisms for tribal junior athletes. In conclusion, the study underscores the impact of state-level disparities on the positive mental health of tribal junior hockey players in India.
- New
- Research Article
- 10.47772/ijriss.2025.910000144
- Nov 6, 2025
- International Journal of Research and Innovation in Social Science
- Salleh + 4 more
Environmental health disparities notably affect communities that lack access to real-time air quality data, which is crucial for making informed public health decisions. This study develops and evaluates a solar-powered IoT environmental health monitoring system to address environmental health information inequities through sustainable, community-centered implementation. Temperature-humidity sensor, barometric pressure sensor, gas sensor, and optical dust sensor are integrated with ESP32 microcontroller and Things Board IoT platform, powered by solar panels, for energy autonomy. Mobile interface provide community members with real-time environmental data and local air quality information. Field deployment in Malacca, Malaysia, showed successful continuous operation with a highly cost-effective system that saved money compared to commercial alternatives and had zero operational electricity expenses due to solar autonomy. Results showed large multi-dimensional outcomes, including increased community environmental health awareness, social cohesion supporting collaborative action, and strong connection with six Sustainable Development Goals (SDG). The implementation greatly improved community access to real-time air quality data, addressing environmental health inequities and laying the groundwork for community-based activism. Environmental sustainability assessment found little ecological footprint with renewable energy operation supporting climate mitigation through fossil fuel displacement and adaptation through community monitoring capability. This study offers a reproducible, economically viable paradigm for technical innovation, community empowerment, environmental preservation, and sustainable development. The findings affect environmental health policy, community-based surveillance expansion, and environmental justice through accessible monitoring technology.
- New
- Research Article
- 10.3389/frcha.2025.1665928
- Nov 6, 2025
- Frontiers in Child and Adolescent Psychiatry
- Maria Cuervo + 1 more
Latina immigrants seeking asylum in the U.S. report high levels of trauma exposure and posttraumatic distress. Our clinical and research experiences highlight the prevalence of these health disparities for pregnant migrants, with serious consequences for them as well as for the developmental trajectory of their children. This minireview focuses on asylum seeking Latina pregnant migrants, and the implications current polices, and circumstances have on their health and wellbeing as well as their children's health and well-being.
- New
- Research Article
- 10.1186/s13293-025-00777-6
- Nov 6, 2025
- Biology of sex differences
- María Calderón-Domínguez + 13 more
The term "metabolically healthy obesity" is used to define those patients with obesity that do not present elements of metabolic syndrome. The causes behind this temporary reduction of the cardiovascular risk are still unknown, although these patients are characterized by a conserved expansion capacity of the adipose tissue, preventing ectopic accumulation of fat. Since hormones are key regulators in adipogenesis, we hypothesize that there are sex-specific differences in visceral white adipose tissue (vWAT) biology that may contribute to metabolic health disparities between men and women. 60 patients attending the Morbid Obesity Unit from the Hospital Universitario de Getafe for elective bariatric surgery were enrolled. Prior to the surgery, a full biochemical panel was carried out. During the procedure, a portion of vWAT was excised and snap-frozen for histological analysis and for the study of the transcriptomic fingerprint in 8 metabolically healthy (MH) and 8 metabolically unhealthy (MU) patients using a transcript expression microarray. The results were validated by qPCR. Functional enrichment analysis of the differentially expressed transcripts (DETs) revealed a similar vWAT transcriptome between MH and MU patients, with differences related to immune response and metabolism homeostasis. However, when we stratified the patients by sex, the number of DETs multiplied by 10, showing sex-specific signatures. MH men presented a reduced pro-inflammatory and oxidative stress profile in comparison to MU men. Thus, the transition from MH to a MU state in men led to a disruption of the normal biology of the tissue, which correlates to the apparition of comorbidities. Surprisingly, MH females exhibited the most deleterious profile, with alterations of key pathways related to inflammation, extracellular matrix organization and metabolism in comparison to MU females. Even those common processes (extracellular remodeling and inflammation) that were observed in men and women cohorts presented a unique signature. These results suggest that vWAT in females suffers an exaggerated pathological state in response to the increased demand to store energy in comparison to men. These findings suggest that obesity should be treated as a different entity in men and women and highlight the need of early intervention in female patients with obesity, even in the absence of comorbidities. Obesity is often linked to metabolic problems, but some patients with obesity do not show typical signs of metabolic syndrome, a situation referred to as "metabolically healthy obesity." The reasons behind this are not fully understood, but it is thought that these individuals have healthier adipose tissue that prevents the accumulation of fat in other organs. Since hormones play an important role in fat storage, we examined if there are gender differences in how adipose tissue responds to fat accumulation. In this study, we analyzed the genes that were expressed in the visceral adipose tissue of patients with obesity who were metabolically healthy (MH) and those who were metabolically unhealthy (MU). When we compared the results, we found that men and women had different gene activity patterns. For men, MH adipose tissue had less inflammation and stress compared to MU adipose tissue. However, MH women tissue showed worse signs of inflammation, fibrosis and metabolism problems than MU women. Between genders, there are several differences in the pathways that are triggered by obesity, with women having a more pathological profile. Even those processes that were common had a worst profile than in men. This suggests that women adipose tissue does not adapt equally to the increased demand for energy storage, even in the absence of metabolic abnormalities. These results suggest that obesity should be treated differently in men and women and emphasize the importance of early intervention for women, even if they do not show metabolic alterations.
- New
- Research Article
- 10.26685/urncst.904
- Nov 6, 2025
- Undergraduate Research in Natural and Clinical Science and Technology (URNCST) Journal
- Sofia Beaucage + 1 more
Introduction: Cardiovascular disease (CVD) is the leading cause of death among Indigenous Peoples in Canada, who experience significantly higher rates of chronic illnesses compared to non-Indigenous populations. Despite this disparity, Indigenous communities remain underrepresented in CVD research, contributing to ongoing gaps in care and prevention. One major contributor is substance misuse (SM), which is both a consequence of intergenerational trauma and a key risk factor for CVD. This scoping review explores the social determinants that drive SM in Indigenous populations and contribute to their elevated CVD risk. Methods: This scoping review synthesized peer-reviewed studies from major academic databases using MeSH (medical subject headings) terms related to Indigenous health, SM, CVD, and social determinants of health. It identified and categorized key social determinants influencing health outcomes in Indigenous populations in Canada, guided by the WHO framework and assessed for relevance and feasibility based on available data. Results: Substance misuse among Indigenous communities is embedded in systemic, intergenerational, and structural inequities—many of which also elevate CVD risk. Three primary determinants emerged as most influential: (1) Historical trauma stemming from colonization, (2) barriers to healthcare quality, access and systemic discrimination, and (3) poverty and inadequate infrastructure. These interconnected factors contributed to different outcomes such as chronic stress, maladaptive coping strategies, and limited access to timely, quality care—all linked to poor cardiovascular health. Discussion: Our findings reveal a critical need for research and policy that center on Indigenous perspectives and address the structural roots of health disparities. Interventions must move beyond individual-level treatments and engage with the broader sociohistorical context of colonization, historical trauma, and systemic exclusion. Conclusion: Historical trauma, barriers to healthcare access and quality, built environment and poverty are central social determinants impacting SM and CVD in Canadian Indigenous populations. Long-term, ethical engagement with indigenous knowledge systems and community leadership is essential to achieving sustainable health equity.
- New
- Research Article
- 10.1371/journal.pone.0333546
- Nov 6, 2025
- PloS one
- Yuehong Zhang + 3 more
With the rapid progression of aging, mental health challenges among the elderly have become increasingly pronounced. Addressing these issues is vital for enhancing older adults' quality of life and maintaining social stability. This study investigates the impact of China's Critical Illness Insurance (CII) policy, a pivotal component of the national healthcare system, on the mental health of older adults. This study leverages data from the China Health and Retirement Longitudinal Study (CHARLS) and utilizes the staggered implementation of the CII policy across regions as a "quasi-natural experiment." A multi-period difference-in-differences (DID) approach is employed to estimate the policy's effects. The analysis focuses on depression tendencies and scores among older adults, controlling for key sociodemographic and economic covariates. The findings reveal three key insights: The CII policy significantly reduced depressive tendencies and depression scores among older adults, demonstrating marked improvements in their mental health.The policy effects exhibit substantial heterogeneity, with more pronounced benefits observed among middle- and high-income groups, individuals with chronic illnesses, and older adults in central and western regions.Mechanism analysis indicates that the policy alleviates psychological distress and enhances household financial stability by increasing access to healthcare services, sharing medical expenses, and mitigating financial risks. The CII policy has proven effective in improving the mental health of older adults, with significant variations across income levels, health conditions, and regional economic development. By reducing financial stress and improving access to healthcare, the policy not only addresses mental health disparities but also bolsters household economic resilience. These findings underscore the critical importance of tailored health insurance policies to address the diverse needs of an aging population effectively.
- New
- Research Article
- 10.1159/000549409
- Nov 6, 2025
- Caries research
- Sara Björns + 4 more
Dental caries remains a prevalent condition with significant health and economic repercussions. To address persistent oral health disparities and reduce the burden of dental caries among preschoolers in Sweden, this study aims to evaluate the clinical and economic impact of implementing a theory-based behavioural intervention delivered by health promoters in clinics serving children at elevated risk for caries. A retrospective cohort design was applied, comparing clinics using a theory-based behavioural intervention led by health promoters with clinics using the Recommended Programme for Caries Treatment (RPCT). The cohort were children aged 3-6 years identified as being at increased caries risk in Region Västra Götaland during 2021-2023. Three analytic approaches were employed: (1) budget impact analysis (BIA) to measure net costs and resource shifts; (2) difference-in-differences (DiD) to compare mean decayed, extracted or filled teeth (deft) in intervention versus control clinics; and (3) cost-effectiveness analysis (CEA) to estimate the incremental cost-effectiveness ratio (ICER). The BIA showed that the theory-based behavioural intervention led by health promoters incurred higher initial personnel costs than the RPCT but required fewer clinical hours - an opportunity cost that, if redeployed to clinical activity, could partially offset these expenses. The DiD showed that, over 3 years, clinics implementing the intervention achieved a statistically significant reduction of 0.26 deft among 6-year-olds. The CEA estimated the ICER to be 2142 SEK (199 EUR) per deft prevented, which improved to 513-810 SEK (48-75 EUR) when the economic value of the liberated work hours was included. A theory-based behavioural intervention led by health promoters reduced caries risk among high-risk preschoolers and may enable improved resource allocation, contingent on the redeployment of freed hours. Despite higher initial personnel costs, the approach demonstrated favourable cost-effectiveness over time, supporting its integration into public dental care systems.
- New
- Research Article
- 10.3390/ijerph22111683
- Nov 6, 2025
- International Journal of Environmental Research and Public Health
- Belay Tizazu Mengistie + 2 more
In recent years, public discourse on pesticide impacts has increasingly recognized institutional and structural racism as key drivers of health disparities in Black, Indigenous, and People of Color (BIPOC) communities. While pesticides are vital for crop protection from causing yield losses, extensive research highlights their adverse effects on environmental quality and human health. These impacts disproportionately burden BIPOC populations, making pesticides a major environmental justice (EJ) concern like many other environmental pollutants. Despite progress in understanding these effects and advancing EJ, significant technical, social, and policy gaps remain. The objective of this review is to systematically examine critical gaps in technical, social, and policy dimensions, as well as the environmental and human health impacts of pesticide exposure on BIPOC communities in the United States, through the lens of environmental justice. This review synthesizes 128 sources peer-reviewed articles, books, reports on pesticides, EJ, and BIPOC communities in the U.S. Key findings reveal uneven distribution of pesticide-related health and environmental burdens along racial, ethnic, and socioeconomic lines. Non-Hispanic Blacks and Mexican Americans exhibit higher pesticide biomarkers and greater exposure risks than non-Hispanic Whites. Structural racism and classism, rooted in historical systems, perpetuate these inequities, compounded by regulatory failures and power imbalances. In addition, the EPA has flagged 31 pesticide manufacturing facilities for “Significant Violations” of key environmental laws, including the Clean Air Act, Clean Water Act, and Resource Conservation and Recovery Act. These systemic issues underscore urgent needs for transparency, accountability, and equitable policy reform. An EJ framework exposes critical knowledge gaps and calls for structural changes to ensure equal protection and responsive policies for the most affected communities.
- New
- Research Article
- 10.1111/jphd.70019
- Nov 6, 2025
- Journal of public health dentistry
- Jihee Song + 1 more
To examine the association between rural/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss. Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including 79,571 U.S adults from 12 states, was analyzed. Inadequate dental visits were defined as having last visited a dentist more than one year ago. Significant tooth loss was defined as the loss of six or more permanent teeth due to decay or gum disease. Multivariable logistic regression models were applied to assess the effects of rural/urban status and ACEs on both outcomes, adjusting for sociodemographic factors. Rural residents had higher odds of reporting inadequate dental visits (AOR: 1.17, 95% CI: 1.07-1.29) and significant tooth loss (AOR: 1.36, 95% CI: 1.21-1.53) compared to urban residents. ACEs were significantly associated with both outcomes, with individuals reporting 4 or more ACEs showing the highest prevalence of inadequate dental visits and significant tooth loss. Although no statistically significant interaction between rural/urban status and ACEs was found, rural residents generally had worse oral health outcomes than their urban counterparts. Both rural/urban status and ACEs independently contribute to oral health disparities, with rural populations facing greater challenges in maintaining oral health. The findings emphasize the need for targeted interventions that address geographic and psychosocial determinants, particularly in rural areas, and highlight the importance of trauma-informed care in dental practice.
- New
- Research Article
- 10.1007/s40615-025-02719-9
- Nov 5, 2025
- Journal of racial and ethnic health disparities
- Kathrin Rothermich + 10 more
Effective communication is critical for equitable healthcare delivery. In situations where there is language discordance between patients and providers, with one person speaking a shared language more proficiently, communication challenges may exacerbate disparities, particularly for racially or ethnically minoritized patients. Even when patients and providers are both fluent enough in English to not need interpretation, communication challenges intensify when patients are required to use their second language (L2) to interact with a native English (L1) speaking healthcare provider. Communication accommodation encompasses speech adjustments used to mitigate these barriers. Because communication accommodation strategies are not explicitly taught in healthcare training, it is unknown how healthcare providers adjust and the role a patient's English proficiency plays in guiding provider language choices. This experimental study tested how L1 physician assistant students modify their communication during intake interviews with Latine L2 avatar patients of varying English proficiency, using the mixed-reality simulation platform Mursion. Data from 41 physician assistant students in 2023-2024 were analyzed for acoustic (i.e., speech rate, pitch modulation) and lexical adjustments (i.e., word frequency, contextual diversity). Results revealed significant accommodations: students reduced their speech rate, narrowed their pitch range, and used higher-frequency vocabulary when interacting with lower-proficiency L2 avatars. The results demonstrate that communication accommodation occurs and could be a potential mechanism for the widening or narrowing of healthcare disparities in patient outcomes. Future work should consider identifying which accommodations improve patients' comprehension of medical advice and their relationships with healthcare providers.
- New
- Research Article
- 10.1371/journal.pone.0334396
- Nov 5, 2025
- PLOS One
- Feng Xie + 10 more
BackgroundGastroesophageal reflux disease (GERD) represents a major global health challenge with varied regional epidemiological patterns. This study aimed to comprehensively analyze temporal trends, health inequalities, and driving factors of GERD.MethodsUsing Global Burden of Disease 2021 data, we extracted GERD prevalence across 204 territories. Age-standardized prevalence rate (ASPR) was calculated and analyzed using age-period-cohort framework. An autoregressive integrated moving average model was employed to project future trends to 2036. Health inequalities were assessed using slope index and concentration index.ResultsGlobal GERD prevalence surged from 450,765,455 cases in 1990–825,603,654 in 2021, with an annual percentage change of 0.04% in ASPR. Significant regional disparities were observed across Socio-demographic Index (SDI) quintiles: middle SDI regions exhibited the steepest ASPR increase (0.22% annually), contrasting with declining trends in high-middle (−0.26%) and high SDI regions (−0.18%). Latin American countries demonstrated the highest burden, with Paraguay, Brazil, and El Salvador leading globally. The United States and China revealed notable post-2010 prevalence rebounds. Notably, populations aged 25–34 years showed the most rapid prevalence growth (>0.3% annually), challenging traditional age-risk paradigms. The slope index increased from −1978.5 to −2053.4, signifying worsening absolute health disparities, with low SDI nations bearing a disproportionate GERD burden.ConclusionsThe increasing prevalence of GERD has resulted in major health burdens over the past three decades. Future strategies should prioritize targeted interventions for high-risk populations and modifiable risk factors, enhanced healthcare accessibility, and integration of GERD management within non-communicable disease frameworks to address this emerging public health challenge.
- New
- Research Article
- 10.1111/nzg.70011
- Nov 5, 2025
- New Zealand Geographer
- Shinya Uekusa + 6 more
ABSTRACT This study explores how rural informal caregivers in Aotearoa New Zealand navigated caregiving during the COVID‐19 pandemic, focusing on rural challenges, habitus and resilience. Despite heightened care demands and reduced access to services, many participants—primarily older adults—demonstrated preparedness, adaptability, and social capital. We conceptualise this as ‘rural habitus’, shaped by ongoing experiences of structural disadvantages. Moving beyond idealised notions of self‐sufficiency and rural resilience, we highlight how social marginalisation and structural constraints influenced rural caregiving experiences. These findings contribute to discussions on rural health disparities, caregiving under crisis, and the limits and possibilities of rural resilience amid social disruptions.
- New
- Research Article
- 10.1007/s40615-025-02691-4
- Nov 5, 2025
- Journal of racial and ethnic health disparities
- Suchita Singh + 7 more
India's tribal population, comprising 104.3 million people from 705 ethnic groups, faces significant health disparities, particularly in rural areas with limited access to healthcare. Traditional tribal healers serve as primary healthcare providers to tribal communities and indigenous populations, utilizing local flora, minerals, and culturally significant practices. Despite their importance, these practices are increasingly at risk due to the shift towards modern medicine. This scoping review aims to map existing literature on traditional tribal healing practices and their integration into the healthcare system, highlighting benefits, challenges, and areas for future research. This scoping review protocol will follow the Joanna Briggs Institute (JBI) methodology and cover literature from January 2000 to May 2025. A systematic search will be conducted across key databases such as MEDLINE, EMBASE, CINAHL, Web of Science, ProQuest, SCOPUS, Google Scholar, Cochrane library, and gray literature sources, such as government reports and other relevant sources of information from government websites in India. Data will be extracted and analyzed to assess prevalence, geographical distribution, types of traditional healers, and their healthcare practices. The review will explore the role of healers in the community, various treatment modalities, and the integration of these practices with modern healthcare systems. Findings will be presented in narrative, tabular, and diagrammatic formats. By mapping the available evidence, researchers can identify areas requiring further investigation and design new studies. The review will provide a comprehensive understanding of traditional tribal healer practices, emphasizing the need to safeguard indigenous knowledge and ensure the integration of best traditional healing practices into the modern healthcare system for better healthcare outcomes in tribal communities, particularly in remote areas.