Model Of Social Determinants Research Articles

MENTAL HEALTH-ILLNESS PROCESS IN THE CONCEPTION OF PSYCHOLOGY GRADUATES

The objective was to understand, based on the narratives of students from an undergraduate psychology course, the social representation regarding the mental health and illness process. This is narrative research carried out at a public university in Bahia. Data collection took place online, using an electronic form made available in 2021, for data analysis dialectical hermeneutics was used. 34 students participated in the study. The results were presented in two empirical categories: biomedical model in the mental health and illness process and social determinants model in the mental health and illness process. The students narrated their social representation about the mental health and illness process, both from a perspective that favors the biomedical model and based on the psychosocial care model. Considering the analysis carried out, there is an urgent need for undergraduate courses in Psychology and other courses in the health field to review their curricula in order to meet the precepts of the Brazilian Psychiatric Reform, making use of mandatory and optional components with active methodologies of teaching-learning that address the topic, thus aiming to resolve stigmatized conceptions in the field of mental health and prepare professionals who base their work on the precepts of psychosocial care.

Individual- and community-level correlates of pediatric central nervous system tumor disparities in the US.

The aim of this study was, through comprehensive, multilevel models of social determinants of health (SDoH) factors, including the Yost Index socioeconomic status (SES) score, to determine whether community- or individual-level SDoH factors quantifiably influence pediatric CNS tumor disparities more in care and prognosis across the US. The authors performed a retrospective cohort study assessing specialized Surveillance, Epidemiology, and End Results data of pediatric patients (≤ 19 years old) with nonmalignant and malignant tumors of the CNS from 2010 to 2018. A census-level Yost Index SES score and rurality/urbanicity measures were incorporated with individual characteristics of age, sex, and race/ethnicity. Chi-square analyses for clinical and demographic descriptions, multivariate Cox proportional hazards logistic regressions for survival, and multivariate logistic regressions for resection, radiation treatment, treatment delay, and advanced staging on preliminary presentation were performed. Across 18,236 patients, age-adjusted analyses showed substantially increased mortality risk among 6 of 11 subtypes (highest hazard ratio [HR] 1.91, 95% CI 1.59-2.28, p < 0.001 for glioma NOS), decreased odds of first-line therapy among 7 of 18 subtypes (lowest OR 0.36, 95% CI 0.11-0.97, p = 0.043 for resection of choroid plexus papilloma), increased odds of treatment delay among 6 of 11 subtypes (highest OR 2.47, 95% CI 1.01-6.49, p = 0.047 for germinoma), increased odds of advanced staging on preliminary presentation among 3 of 10 malignant subtypes (highest OR 2.56, 95% CI 1.27-5.52, p = 0.008 for malignant ependymomas), and increased odds of receipt of radiation therapy among 3 of 10 malignant subtypes (highest OR 2.30, 95% CI 1.87-2.84, p < 0.001) observed across many disease subtypes contributed by certain individual- and community-level SDoH factors. Through comprehensive analyses combining individual- and community-level SDoH factors, this study identified detrimental interrelated SDoH associations with poorer care and prognosis of pediatric patients with CNS tumors, delineating how both levels differentially contribute to observed disparities across different subtypes.

Understandings of Vulnerability and Social Determinants of Health in Forensic and Expert Social Anthropology: A Scoping Review

Forensic and expert social anthropology (FESA) is a branch of social anthropology that specialises in the provision of evidence to legal-administrative processes, which are overseen by courts and other legally empowered bodies, and which give regard to the social cultures of legally and administratively involved individuals and communities (LAIICs). Despite a preoccupation with political advocacy in the broader philosophy of social anthropology, FESA literature does not typically give regard to LAIIC vulnerability defined qualitatively in terms of social determinants of health, including physical, mental, and social well-being. This paper presents findings from a JBI/PRISMA-ScR scoping review of n=1,674 texts, identifying eight recurrent practice concerns in the relevant literature. Findings indicate that LAIIC vulnerability ranks only sixth among FESA practice concerns. This article serves as a study of FESA models of LAIIC vulnerability and social determinants of health and an unprecedented demonstration of scoping review methodology applied to social anthropological literature.

Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries.

A progressive decrease in exclusive breastfeeding (BF) is observed in Latin America and the Caribbean compared with global results. The possibility of being breastfed and continuing BF for > 6 months is lower in low birth weight than in healthy-weight infants. To identify factors associated with BF maintenance and promotion, with particular attention to low- and middle-income countries, by studying geographic, socioeconomic, and individual or neonatal health factors. A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States. The extracted data with common characteristics were synthesized and categorized into two main themes: (1) Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America; and (2) individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants. This study identified maternal age, educational level, maternal economic capacity, social stratum, exposure to BF substitutes, access to BF information, and quality of health services as mediators for maintaining BF. Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.

Exploring men's health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants.

Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.

Identifying Factors That Influence Physical Activity and Healthy Aging Among Older Latino Adults.

For older Latinos, some benefits of leisure-time physical activity (LTPA) include enhanced cognitive functioning, decreased loneliness, and reduced premature mortality. Despite LTPA benefits, adults ≥50 years are one of the most inactive age groups in the United States. This qualitative study aimed to add to the limited evidence of LTPA in older Latino adults by exploring the barriers and facilitators for fitness class uptake and park use. Guided by a Social-Ecological Model of Health and Social Determinants of Health theoretical and a phenomenological research design, qualitative research data were collected via 27 personal interviews with Latino adults using a semistructured interview guide. Participants were recruited using purposive sampling strategies in collaboration with community partners. Bicultural data collectors conducted the semistructured interviews over Zoom. Thematic analysis was performed using Dedoose, following an inductive and deductive approach. The main barriers to fitness class attendance and park use were family and/or work commitments, perceived safety, and perceived discrimination. Conversely, the critical facilitators for participation were socialization into a group, social connectedness with group members, fitness instructor characteristics, and exercise history. Findings from this study hold important implications for the design of fitness programming and park-based recreation, including the need to increase the cultural diversity of recreation staff and culturally relevant programming. Future research is needed on time poverty related to family/work commitments and whether discriminatory practices at fitness centers, like ageism and race/ethnicity, influence physical activity behavior.

The ecology of online hate speech: Mapping expert perspectives on the drivers for online hate perpetration with the Delphi method

AbstractOnline hate speech (OHS) is a prevalent issue on social media with harmful consequences for individuals and society. Counteracting this issue requires a better understanding of the factors that drive behaviors such as posting hate speech or making hateful comments. The present study contributes to this need by investigating the personal, social, and digital determinants for OHS perpetration. By conducting a two‐round Delphi study, data was collected from an interdisciplinary sample of experts. Practitioners were included in this sample to bridge gaps between research and fieldwork on OHS. The first survey collected information through open‐ended questions, which was then organized in different themes and lists of determinants in a thematic analysis. These determinants were rated for relevance in a follow‐up survey. Data analysis of the second survey used nonparametric statistics. From a total list of 129 determinants, the participants reached a consensus on 27 determinants as most relevant (median &gt; 4) for facilitating the production and dissemination of OHS. An ecological perspective was applied to interpret these findings. As a result, we propose an ecological model of personal, social, and digital determinants for online hate perpetration to illustrate their influence on individual behavior as well as their possible connections. The model provides a comprehensive overview of factors facilitating OHS perpetration, which can help to identify points for intervention.

Social determinants of health during and after coronavirus: a qualitative study

BackgroundHealth has multiple dimensions influenced not only by individual factors but also by broader social, economic, cultural, and political structures. The widespread COVID-19 pandemic has multidimensional effects on people’s lives, which can have effects on individuals’ lifestyles after the COVID-19. This study aimed to speculate the social determinants of health during and after the COVID-19, which can lead to more effective planning for promoting community health.MethodsThe present study interviewed 21 experts in social and medical fields during four months. The sampling method was snowball. The interviews were semi-structured and administered in-person or electronic. All interviews were transcribed and analyzed according to the Brown and Clarke’s six-stage framework to extract themes.Resultsthe participants were 13 males, eight experts in social field, all had PhD, 17 were academic members, and 10 were members of the Social Determinants of Health Research Center. The qualitative content analysis induced seven different social themes that affect the health which included: justice (3 Subcategories), integration (4 Subcategories), acceptance (4 Subcategories), participation (2 Subcategories), adaptation (3 Subcategories), flourishing (4 Subcategories), and cohesion (3 Subcategories).ConclusionsAccording to the present study, a grand plan to cover all positive and negative social effects of COVID-19 should have at least seven different dimensions. However, the present models of effective social determinants in health do not have such comprehensiveness. Future studies may provide a proper model to be used in clinical and research fields.

Perceptions of COVID-19 Vaccines: Lessons from Selected Populations Who Experience Discrimination in the Australian Healthcare System

COVID-19 vaccination is particularly challenging among populations who have experienced discrimination in healthcare settings. This paper presents qualitative findings from in-depth interviews about COVID-19 vaccination conducted in Australia between October 2020 and November 2021. Data from four different studies are presented; each population has unique experiences of discrimination within the healthcare system: Aboriginal people; people who inject drugs (PWID); people living with HIV (PLHIV); and gay and bisexual men (GBM). Analyses were guided by the behavioural and social determinants model that forms the basis of the World Health Organization’s “data for action: achieving high uptake of COVID-19 vaccines” interim guidance. All populations viewed vaccination as necessary for community protection, although narratives of community care were most common among Aboriginal people. Concerns about vaccine safety were expressed by all participant groups, although participants living with HIV and GBM were more trusting of vaccines possibly because of their ongoing and usually positive past experiences with biomedical technologies for HIV management and sexual health. Aboriginal participants reported distrust of mainstream government and participants who inject drugs expressed a more generalised suspicion about COVID-19 and its origins. Practical problems related to transport, booking appointments for vaccination and so forth, were more common among participants living with HIV and GBM, possibly because these specific interviews were conducted throughout 2021 when vaccines were more available, whereas data for the other populations were collected before the vaccine rollout. Findings show that vaccine willingness is shaped by past experiences of discrimination in healthcare setting, but different histories of discrimination can differently impact vaccine willingness. Promotional messaging and delivery must take account of these important differences so to not treat these populations homogenously.

Strategies to Reduce Racial and Ethnic Inequities in Stroke Preparedness, Care, Recovery, and Risk Factor Control: A Scientific Statement From the American Heart Association.

Stroke is a disease of disparities, with tremendous racial and ethnic inequities in incidence, prevalence, treatment, and outcomes. The accumulating literature on the relationship between stroke and social determinants of health (ie, the structural conditions of the places where people live, learn, work, and play) contributes to our understanding of stroke inequities. Several interventions have been tested concurrently to reduce racial and ethnic inequities in stroke preparedness, care, recovery, and risk factor control. It is regrettable that no common theoretical framework has been used to facilitate comparison of interventions. In this scientific statement, we summarize, across the stroke continuum of care, trials of interventions addressing racial and ethnic inequities in stroke care and outcomes. We reviewed the literature on interventions to address racial and ethnic inequities to identify gaps and areas for future research. Although numerous trials tested interventions aimed at reducing inequities in prehospital, acute care, transitions in care, and poststroke risk factor control, few addressed inequities in rehabilitation, recovery, and social reintegration. Most studies addressed proximate determinants (eg, medication adherence, health literacy, and health behaviors), but upstream determinants (eg, structural racism, housing, income, food security, access to care) were not addressed. A common theoretical model of social determinants can help researchers understand the heterogeneity of social determinants, inform future directions in stroke inequities research, support research in understudied areas within the continuum of care, catalyze implementation of successful interventions in additional settings, allow for comparison across studies, and provide insight into whether addressing upstream or downstream social determinants has the strongest effect on reducing inequities in stroke care and outcomes.

Emerging Frameworks in Health and Education: Conceptual Evolution in Pursuit of School-Based Health.

This paper presents a historical account of conceptual development at the intersection of American education and health. Beginning with early advancements from the Association for Supervision and Curriculum Development and the World Health Organization, the authors show the movement from early considerations of the codependency of health and education. The authors suggest that more than fifty years of theoretical innovations at the nexus of health and education culminated in the 2014 introduction of "Whole School, Whole Community, Whole Child" (WSCC). At the same time, the authors show that the trajectory of this movement was far from linear. In addition to explaining why WSCC is in many ways a critical revision of the social determinants model that serves today as a promising foundation of American school-based health, the authors examine opportunities and challenges that the pivot towards WSCC presents. Three particular areas are explored: assessment, funding, and collaboration.

Inequality in psychological distress among young adults: An integrative model of economic, social, and environmental determinants.

Differences in economic, social, and environmental circumstances lead to systematic and unfair health inequalities. Yet, this inequality is modifiable. Drawing on the social determinants approach to health this study explored: (a) the association between economic, social-relational, and environmental stressors with psychological distress (PD) among a representative sample of young adults in Israel (N = 2,407); (b) the collective impact of these multiple stressors on PD and the extent to which the co-occurrence of stressors demonstrated a stepped relationship with PD. Social determinants included subjective poverty, perceived income adequacy, material deprivation indices, social trust, trust in institutions, perceived discrimination, loneliness, and indicators for the quality of the neighborhood environment. Bivariate analysis was used to assess associations between economic, social-relational, and environmental stressors with PD. Hierarchical linear regressions, estimated to predict PD, showed that the social determinants shaped PD in young adulthood, with each stressor domain making a distinct contribution to explaining PD. Subjective poverty, material deprivation, and loneliness were particularly detrimental. Social determinants were additive, constituting cumulative stressors that convey increased risk for young adults' mental well-being. The findings suggest that health inequality can be reduced by directly addressing its social determinants. Although important, improved access to social and mental health services alone is unlikely to relieve the burden of PD and its adverse consequences both for individual suffering and at the national level. Broader and combined policy measures are required to combat poverty and deprivation, discrimination, lack of trust, and loneliness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A dual-path psychosocial model of social determinants of health in the community: Results from the Cause Commune program.

We tested a dual-path psychosocial framework of social vulnerability that considers the impact of socioeconomic resources and cognitive social capital on health, and whether they were mediated by an enabling psychosocial path (collective efficacy) and a disabling path (loneliness). A total of 1401 people (53.6% female, Mage = 48.7, SD = 18.1) from a community in Switzerland participated in the study. Structural equation models showed that psychosocial factors were related to both social determinants and health outcomes and partially mediated their interrelation. Our model showed an adequate fit to the data (χ2 = 1,377.56, df = 341, p = 0.000, comparative fit index = 0.93, root mean square error of approximation = 0.05, standardized root mean-squared residual = 0.05). The findings highlight the role of psychosocial-relational factors in the processes of social vulnerability and would be of interest to researchers working on social vulnerability in the community.

The relationship between social determinants of health and girls’ age at menarche based on the world health organization model: path analysis

ObjectivesGiven the descending trend of menarche age and the effect of social determinants of health on menarche, the present study was conducted to examine the relationship model of social determinants of health with menarche age of girls. Materials and methodsThe present cross-sectional study enrolled 840 mothers and their 6-17 year-old daughters in the city of Kashan, Iran (2020). Questionnaires used included: demographic-family questionnaire for mothers and daughters, question about age at menarche, Perceived Social Support, Physical Activity, Socioeconomic Status, Spiritual Health, General Health Questionnaire, the quality of couple's relationship and the family communication pattern. The statistical analysis was performed in SPSS-16, and the relationship model was examined using path analysis method in LISREL-8.8. ResultsThe girls' menarche age was directly affected by sister's (b = 0.83) and mother's menarche age (b = 0.05), BMI (b = 0.01), physical activity (b = -0.06), conversation orientation (b = -0.002), socioeconomic status (b = -0.01) and maternal general health (b = 0.009). It was also indirectly affected by mother's menarche age, social support, socioeconomic status, and maternal spiritual health and parents relationships. ConclusionsThe results showed that the numerous factors affect the girls’ age at menarche directly and indirectly. Considering mutual interaction of factors revealed in the proposed model, it is recommended this model be used as an appropriate framework in research, design and implementation of programs relating to adolescent girls.

Mobile Health Tobacco Cessation Interventions to Promote Health Equity: Current Perspectives.

Although US tobacco use trends show overall improvement, social disadvantage continues to drive significant disparities. Traditional tobacco cessation interventions and public policy initiatives have failed to equitably benefit socially-disadvantaged populations. Advancements in mobile digital technologies have created new opportunities to develop resource-efficient mobile health (mHealth) interventions that, relative to traditional approaches, have greater reach while still maintaining comparable or greater efficacy. Their potential for affordability, scalability, and efficiency gives mHealth tobacco cessation interventions potential as tools to help redress tobacco use disparities. We discuss our perspectives on the state of the science surrounding mHealth tobacco cessation interventions for use by socially-disadvantaged populations. In doing so, we outline existing models of health disparities and social determinants of health (SDOH) and discuss potential ways that mHealth interventions might be optimized to offset or address the impact of social determinants of tobacco use. Because smokers from socially-disadvantaged backgrounds face multi-level barriers that can dynamically heighten the risks of tobacco use, we discuss cutting-edge mHealth interventions that adapt dynamically based on context. We also consider complications and pitfalls that could emerge when designing, evaluating, and implementing mHealth tobacco cessation interventions for socially-disadvantaged populations. Altogether, this perspective article provides a conceptual foundation for optimizing mHealth tobacco cessation interventions for the socially-disadvantaged populations in greatest need.

Mapping the Intellectual Structure of Medical Sociology: A Co-Word Analysis.

Medical sociology is concerned with the relationship between social factors and health, and with the application of sociological theory and research techniques to questions related to health and the health care system. Considering the wide range of studies in the field that each examined different aspects, to promote health in community, bibliometrics analysis in this area is felt. In this descriptive-analytical study with a scientometric approach, the data about "medical sociology" were retrieved from PubMed in MEDINE format, including 1226 records over the period 1945-2018. By using Co-word analysis, clustering methods, and strategic diagram with the help of SPSS, UcInet 6 software the data were analyzed. The keyword "Attitude to Health" and two pairs of frequently used keywords, namely "Power (Psychology)*Professional Autonomy" were the most frequent in medical sociology. The results shaped the concepts of medical sociology in 7 clusters. The clusters "Attitude of health personnel", "Health Policy" and "Sociology of Medical Education" are topics that may be emerging or disappearing. The "Physicians", "Models of Social Determinants of Health" and "medical philosophy" are immature clusters. This research used co-word networks that indicate the important links between keywords of research areas. Considering the frequency of keywords along with the clusters obtained, it seems that the most research approach was seen on the medical aspect rather than the sociological aspect. Despite the importance of sociological aspects such as social rooting of disease, sociability, medicine as a social institution and etiological studies, these subjects have not been sufficiently considered.

Application of epidemiological methods in health impact assessment

Health impact assessment (HIA) system has been listed in the Outline of the Healthy China 2030 Plan and the Law of Basic Health Care and Health Promotion of the People's Republic of China, however, the technique guideline of HIA needs to be established and improved. This paper summarizes the applications of different epidemiological methods in HIA and focus on the introduction of the application of ecology model of health social determinants as theory basis in the establishment of HIA system along with the introduction of HIA cases in the world. The applications of epidemiological methods in domestic HIA research are limited. Therefore, appropriate applications of epidemiological methods should be strengthened in HIA guideline and system development, especially the applications of big health data, mobile health techniques, systems epidemiology and implementation science, to facilitate data collection and potential health hazard evaluation and surveillance for HIA, establishment and improvement of HIA system and the implementation of Healthy China Strategy.

Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences.

The objective of this article is to call for integrating biological pathways of social experiences in the concept model of cancer disparities and social determinants of health (SDH) fields. Black, Indigenous, and People of Color (BIPOC) populations experience more negative outcomes across the cancer continuum. Social conditions are instrumental in better understanding the contemporary and historical constructs that create these patterns of disparities. There is an equally important body of evidence that points to the ways that social conditions shape biological pathways. To date, these areas of research are, for the most part, separate. This paper calls for a bridging of these two areas of research to create new directions for the field of cancer disparities. We discuss inflammation, epigenetic changes, co-morbidities, and early onset as examples of the biological consequences of social conditions that BIPOC populations experience throughout their lifespan that may contribute to disproportionate tumorigenesis and tumor progression.

The role of social determinants on unhealthy eating habits in an urban area in Mexico: A qualitative study in low-income mothers with a young child at home

Overweight and obesity are a severe public health problem in Mexico. National policies to fight unhealthy eating have been implemented but they don't target social and family environment determinants. Our study aimed to gain a deeper understanding of the determinants of unhealthy eating by exploring the perspectives and experiences of low-income Mexican women with a young child at home. We conducted a purposeful sampling to include participating kindergartens in Morelos, México. Women with a child enrolled in the kindergarten were invited to focus group discussions. Afterward, women with specific profiles were invited to in-depth interviews. During analysis we applied Dahlgren and Whitehead's model of social determinants of health (SDH). Overall, we found that participants have unhealthy habits, for example: low variability in consumption patterns, regular sugar-sweetened beverages intake and insufficient fruit and vegetable intake. By low variability we mean frequently consumed products (on most days of the week) limited to a restricted food set. As for the determinants of unhealthy habits, we found at the community level that families encourage unhealthy eating. At the household and work level, tight schedules for food preparation determine unhealthy eating. And, at a socio-economic level, lack of access and money constraints shape unhealthy habits. Unhealthy habits are determined by factors on multiple levels and using an SDH approach can be an effective way to inform comprehensive strategies targeting the overweight and obesity epidemic in Mexico and other low- and middle-income countries.

Social determinants of cell-phone market with customer value expectation approach

Background: The aim of this study was to provide a model of social determinants of cell-phone marketing with customer expected value approach. Methods: A mixed-method was used to identify the social components and indicators of the cell-phone marketing. The study population included marketing experts and professors in the qualitative section and managers and senior managers of marketing managers in the quantitative section. The sample size was 10 experts of marketing management in the qualitative section, and 384 people in qualitative section. To collect data, a semi-structured interview in the qualitative section and a questionnaire in the quantitative section were used. Construct validity using confirmatory factor analysis in SmartPLS software and its reliability was confirmed by using Cronbach's alpha coefficient in SPSS software. To analyze the data in the qualitative section, MAXQDA software was used. Confirmatory factor analysis and structural equation modeling tests were used to confirm the components and present the model in Smart PLS software. Results: Game making and advertising had a significant effect on consumer behavior, social media and expected value. The results showed that the components of consumer behavior, social media and expected value had an impact on the promotion of cell-phone marketing through the quality of customer journey from beginning to end. Conclusion: By identifying opportunities and threats, as well as identifying organizational strengths and weaknesses, with the help of web marketing and marketing through applications, recognizing customer needs and demands, obtaining information about user behavior, creating a suitable platform for easy connection and easy access.