Pre-existing Inequalities Research Articles

Paternity leave take-up in a segmented labor market: A cautionary tale of rapid policy expansion in Spain

To evaluate the success of paternity leave as a progressive, equal-access policy instrument, it is essential to assess it against the backdrop of preexisting labor market inequalities that condition its use. We investigate the recent and rapid expansion of paternity leave entitlements in Spain where leave was extended from four to 16 weeks over the course of just three years. Analyses of an original survey administered to cohorts of fathers with leave entitlements of varying lengths show that average take-up surges but does so unevenly. As uptake rates soar among fathers in stable employment, fathers in temporary jobs, the self-employed, and those at the bottom and top of the income distribution maintain lower levels of usage. These results align with the ‘Matthew Effect' of social policy, whereby reforms disproportionately benefit well-positioned socioeconomic groups, and imply bleak prospects for the reform’s capacity to generate social change across social strata. The results thus tell a cautionary tale of the rapid expansion of paternity leave in a segmented labor market where work culture and gender norms are slower to adjust. With the enforcement of the 2019 EU Work-Life Balance Directive, other European Member States are looking to extend paternity leave swiftly, thus increasing the relevance of these results for policy considerations.

Challenges and Resiliency: Social Determinants of Health, COVID-19, and the Disproportionate Impact on Immigrants and Refugees Living with HIV.

The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue. HIV continues to disproportionately affect marginalized populations, including immigrants and refugees living with HIV (IRLHIV). This study investigated and captured the experiences of IRLHIV using the social determinants of health framework. This study examined the intersecting factors affecting the health and well-being of IRLHIV in Alberta, Canada, prior to and during the COVID-19 pandemic. Concurrent mixed methods were used. Employing an online survey (n = 124) and photovoice methodology (n = 13), the researchers identified five salient themes: experiences of racism and discrimination, challenges accessing nutrition, healthcare, and affordable housing, and precarious employment situations. The findings underscored the amplification of pre-existing inequities during the COVID-19 pandemic, intensifying the discrimination and stigma faced by IRLHIV due to both their health status and immigration background. These findings highlight the urgent need for targeted, evidence-based interventions to address the social determinants of health that adversely affect IRLHIV. The researchers recommend further participatory research action into health disparities for IRLHIV to create responsive and culturally safe services for IRLHIV.

Famished for Freedom: Pellagra and Medical Clemency at the Mississippi State Penitentiary.

This paper provides a case study of one medical experiment conducted in 1915 by the United States Public Health Service in collaboration with the Mississippi State Penitentiary. The experiment was non-therapeutic and its objective was to induce pellagra (a vitamin deficiency disease) in twelve healthy White male prisoners to confirm its etiology. Extant archival records produced by the convict participants, state politicians, and health researchers underscore that the men selected for the pellagra experiment were unique among incarcerated people in Mississippi at the time: they were White, wealthy, and politically well-connected. This paper contends that the convict participants leveraged a wide range of social and political connections to secure their participation in the pellagra experiment as an expeditious pathway to pre-arranged executive pardon, a phenomenon that I term medical clemency. By situating the 1915 pellagra prison experiment amid the broader landscape of incarceration, public health research, and systems of political patronage in Mississippi, this paper highlights the ways in which penal systems are embedded in broader social and political contexts. Not only did the experiment exacerbate pre-existing social inequalities behind bars, it also had lasting consequences for those involved in prison medical research - namely, the power to determine which kinds of convicts could ultimately re-enter the social order.

Trends in Maternal Mortality in South America after the Covid-19 Pandemic: A Systematic Review

Introduction: Maternal mortality is a critical indicator of public health, reflecting access to and quality of healthcare. The COVID-19 pandemic exacerbated existing inequalities, negatively affecting maternal mortality in South America. Objectives: The overall objective of the study was to investigate maternal mortality trends in South America during and after the COVID-19 pandemic, with specific objectives to compare maternal mortality rates before, during, and after the pandemic, and to analyze socioeconomic and health factors that influence maternal mortality, with an emphasis on vulnerable populations. Methodology: A systematic review was conducted in academic databases such as PUBMED, SCOPUS, DIALNET, and SCIELO, using specific terms related to maternal mortality and COVID-19. Relevant studies and official data from WHO and PAHO were included. Results: The study revealed a significant increase in maternal mortality in the early years of the pandemic, followed by a gradual decline. The main causes included obstetric hemorrhage and hypertensive disorders. Indigenous and Afro-descendant women were disproportionately affected. Discussion: The pandemic redirected health resources, affecting primary care and reproductive health programs. Structural inequalities and lack of access to quality services were determining factors in the increase in maternal mortality. Conclusions: In conclusion, the COVID-19 pandemic had a devastating impact on maternal mortality in South America, revealing critical failures in health systems and exacerbating pre-existing inequalities. It is crucial to implement robust public policies and comprehensive approaches to reduce maternal mortality and ensure universal access to quality health care.

So close and yet so far: Comparing the experiences of university non-traditional students before and after the pandemic

This paper explores the impact of the COVID-19 pandemic on the objective and subjective experiences of working-class non-traditional students in Higher Education (HE). Against the backdrop of increased access to tertiary education, the study delves into the challenges faced by historically under-represented groups, analyzing educational vulnerabilities and inequalities. More specifically, the contribution analyses how the pandemic scenario change students’ experience—in terms of the emergence of new forms of inequality—. With this aim, the research involves 20 in-depth interviews with working-class non-traditional students in a Catalan public university before the pandemic (2018) and 12 interviews after the pandemic (2022). Results reveal that while these students already encountered significant hurdles before the pandemic, the crisis further amplified difficulties, hindering their academic success and deepening pre-existing inequalities. Unexpectedly, elements initially designed to facilitate the situation, such as non-presential teaching, contributed to an unsatisfactory experience, fostering isolation and loss of specific links and codes within the academic field. The findings underscore the pandemic’s detrimental effects on European HE systems, representing a setback in terms of equity and a substantial loss of opportunities for non-traditional students.

Social, Cultural and Economic Analysis of Post-Pandemic Public Health (COVID-19) in the Case of Peru: an Evaluation of Approaches to Promote Health and Well-Being Within the Framework of the SDG

Objective: To examine the social, cultural, and economic consequences of the pandemic on public health in Peru, recognizing challenges and possibilities to strengthen the system, given that the pandemic aggravated existing inequalities, disproportionately impacting vulnerable groups, such as rural communities and individuals living in poverty, an evaluation of approaches to promote health and well-being within the framework of the SDG. Theoretical framework: This research analyzes the way in which the pandemic has impacted several aspects of public health in the country, in a post-COVID-19 pandemic scenario that showed and aggravated the already existing weaknesses in the Peruvian health system, marked by its fragmentation and restrictions in infrastructure and human resources. Method: A qualitative approach based on a documentary review and critical analysis was used for the development of the research. Research implications: Lack of access to high-quality health services and unfavorable living conditions contributed to an increase in COVID-19 incidence and mortality in these groups. In cultural terms, distrust of the official health system and inclination towards traditional medicines impacted the community reaction to the virus. In economic terms, the pandemic severely impacted the middle class, decreasing its magnitude from 43.6% in 2019 to 24% in 2020, canceling out a decade of economic progress. Results and discussion: The infodemic, or excess of information, including rumors and misinformation, made it difficult to implement effective public health strategies. In addition to job losses and reduced incomes, they restrict access to health services, intensifying pre-existing inequalities. Originality/Value: To enhance public health in Peru after the pandemic, it is crucial to address social inequalities.

Social Determinants as Mediators of the Emotional State of People With Type 2 Diabetes and/or Hypertension During the COVID-19 Pandemic in Ecuador and Spain.

We aimed to explore the impact of the COVID-19 pandemic and the resulting restrictions on the emotional state of people with type 2 diabetes mellitus (T2DM) and/or hypertension in Ecuador and Spain. Given the differences in sociopolitical and socioeconomic contexts between these two countries, the research focused on how these diverse environments and their management of social policies and pandemic strategies influenced the emotional well-being of individuals with chronic illnesses. We conducted 36 semi-structured telephone interviews between August and December 2020 with adults diagnosed with T2DM and/or hypertension (19 in Ecuador, 17 in Spain). The interviews were recorded, anonymized and transcribed for thematic analysis. This approach allowed us to systematically identify and analyse themes related to the participants' emotional experiences during the pandemic. The results revealed a significant deterioration in the emotional state of participants, attributable to the stress generated by the health crisis and concerns related to their chronic illnesses. The situation elicited a range of emotions among participants, from boredom and apathy to fear, uncertainty and depression. The study highlighted how the impact on emotional well-being was shaped by the interplay between conjunctural determinants (measures to control COVID-19 infections) and structural factors driving inequalities (social class, gender, ethnicity). We developed a conceptual framework illustrating how measures to control COVID-19 infections directly influenced economic, health and social determinants, which interacted with pre-existing inequalities and had a differential impact on individuals' emotional well-being. This framework can be useful for designing more effective and equitable social policies during future health crises, ensuring they address social needs and safeguard psychological and emotional well-being, particularly among vulnerable groups such as those with chronic illnesses. Thirty-six participants diagnosed with T2DM and/or hypertension (19 in Ecuador, 17 in Spain) contributed to the study by sharing their emotional experiences during the pandemic. Their detailed accounts enriched the research by providing valuable insights into how the pandemic affected their emotional well-being. There was no additional involvement or contribution from the public in the design, conduct, analysis or interpretation of the study, nor in the preparation of the manuscript.

Cleaning up shaʿbi: Music and class-cultural divides in cairo

Egyptian shaʿbi music is typically positioned as a somewhat vulgar style produced and consumed by the working-class masses. But in practice, numerous individuals have long been attempting to sanitise it to appeal to audiences deemed more elite. This article, based on 21 months of ethnographic fieldwork with musicians and producers in Cairo, investigates how this mainstream, mass-mediated, commercially successful version of shaʿbi, known as ‘clean shaʿbi’ ( shaʿbi nadif) is produced and distributed. I explore how three different cultural brokers try to clean up shaʿbi in distinctive ways. I argue that their success does not reveal a straightforward crossing of class-cultural divides, as it might at first appear; in each instance boundaries are in some ways crossed, and in other ways reinforced. Cleaning up shaʿbi does not necessarily benefit the musicians: the processes through which their music is sanitised and mediated are often exploitative, serving to entrench pre-existing social inequalities.

Food systems modelling to evaluate interventions for food and nutrition security in an African urban context

AbstractIn the context of rapidly growing African cities, a thorough understanding of the complexities of urban food systems is essential for addressing the challenges of food insecurity and undernourishment for city dwellers. Particularly in South Africa, where pre-existing inequalities drive disparities in food access and diet-related health outcomes, a comprehensive perspective including the spatial distribution of malnutrition in urban environments is required to develop effective interventions. The present study examines the essential elements of an urban food system by employing a Bayesian network as a causal framework. By integrating survey data from households and food outlets with spatial information, a food systems model was created to test policy interventions. The study demonstrates the challenges of intervening in complex urban food systems, where dietary choices are shaped by various factors, often in a spatially heterogeneous manner. Interventions do not always benefit the targeted groups and are sometimes ineffective as result of system interactions. Our study shows that Bayesian network models provide a powerful tool to effectively analyse the complex interactions within such systems, thereby enabling the identification of optimal combinations of multifactor interventions. In our case study for Worcester, South Africa, the results reveal that the largest potential for improvement of food and nutrition security lies in the informal food sector, and support for affordable and local fresh produce is a viable measure for enhancing local nutrition, though the extent of impact varies across the city.

Two sides of trust: How cancer survivors’ communication with healthcare providers and on social media predicted healthy behaviors during COVID-19

ObjectivesCOVID-19 exacerbated pre-existing social inequalities. Using three theories linking clinical and media contexts to patients’ health outcomes, our study investigated (1) potential factors of cancer patients’ trust in healthcare providers and social media; (2) how such trust may influence healthy lifestyles during COVID-19. MethodsUsing structural equation modeling, we investigated effects of key patient-provider communication variables and media factors on healthy behaviors among cancer survivors (N = 1130) using a nationally representative dataset (HINTS-SEER restricted use files, January-July 2021). ResultsMore healthy behaviors since COVID-19 began were associated with more trust in healthcare providers, lower trust in social media about COVID-19, and more use of social media for health purposes. More trust in social media about COVID-19 was associated with more use of social media for health purposes (p < .01). More trust in healthcare providers about COVID-19 was associated with increased perceptions of patient-provider communication (p < .01). ConclusionsFindings can inform interventions to connect at-risk cancer patients (e.g., those younger and with lower educational background) with providers in trust-enhancing conversations during situations like COVID-19. Practice ImplicationsPartnership building between providers and patients can be supplemented with scientific videos on popular social media sites like YouTube during public health crises and emergencies.

The unequal spread of digital neighbourhood platforms in urban neighbourhoods: A multilevel analysis of socio-demographic predictors and their relation to neighbourhood social capital

Digital neighbourhood platforms (DNPs) – also called online neighbourhood networks or neighbourhood social networks – are still a relatively novel phenomenon, and little is known about their actual reach among citizens and about neighbourhood conditions which foster or impede their spread. We consider DNPs as a digital extension of conventional neighbourhood social capital and analyse their spread in comparison with the latter using a recent community survey in two large German cities with a probability sample of 2900 respondents in 139 neighbourhoods. The analysis is guided by the scholarly discussion on the potential of DNPs to reduce current inequalities in the distribution of social capital. The results showed that 18% of respondents in Cologne and 12% of respondents in Essen have used DNPs. Multilevel analyses revealed a strong negative association of neighbourhood ethnic diversity with user rates, in parallel to the same negative effect on conventional neighbourhood social capital. It is therefore reasonable to assume that pre-existing inequalities in social capital are replicated by DNPs. On the individual level, the use of DNPs was less dependent on strong social bonds than on conventional social capital. Comparing respondents who use DNPs to those who do not, the former group proves to be socially more connected, more trusting and more satisfied with their neighbourhoods.

Survey to identify barriers and enablers to implementation of genomics in pharmacy practice across healthcare sectors in a rural community

Abstract Introduction The potential for genomics to improve patient outcomes is being harnessed via national strategy to embed genomic testing into NHS practice, and drive use of precision medicines and pharmacogenomics1. The national pharmacy genomics education and training strategic framework aims to empower the pharmacy workforce, across all sectors, to use genomics to support medicines optimisation2. Cornwall, a rural and coastal county, has areas of marked deprivation with poorer health outcomes3 and challenges in recruiting and retaining healthcare professionals. It is key that rural/coastal communities have equitable access to genomic services and expertise to avoid exacerbating pre-existing health inequalities. Aim To identify barriers and enablers to the implementation of genomics into pharmacy practice in a rural community. Methods Pharmacists and pharmacy technicians working in Cornwall were eligible to participate. An anonymised survey was compiled via Microsoft Forms of closed, multiple choice and optional open questions. Following piloting, the survey link was disseminated via email by pharmacy leaders in community pharmacy, primary and secondary care in May 2024. Responses were stored securely via NHS password protected IT systems and analysed via quantitative and thematic analysis. As this project is defined as a service evaluation, according to the UK NHS Health Research Authority, ethical approval was not required. Results Fourteen pharmacists and 7 pharmacy technicians participated, from primary and secondary care and community hospitals, with no participants from community pharmacy. Seven had received prior training in genomics (teaching sessions (n=5), webinars (n=1), podcasts (n=1), articles in journals (n=2)). One participant had received formal undergraduate training. Key barriers to the implementation of genomics included a lack of education and training (n=5), perceived cost of genomic testing (n=2), difficulty in accessing genomic services (n=1) and lack of expert panels (n=1). It was also felt that genomics services were limited to secondary/tertiary care (n=2). Respondents stated that the rural location impacted the availability of face-to-face training and resources to support training (n=17). Key enablers were the opportunity for precision prescribing (n=8), and improved patient outcomes (n=7). Genomics education and training (n=5) and resources to support training (n=11) were viewed as being pivotal to supporting the mainstreaming of genomics. Discussion and conclusion Participants were keen to further their genomics knowledge, with a preference for face-to-face training. Respondents also highlighted the need for allocated resources to support training. As emphasised in the strategic framework2, workforce upskilling is vital to the successful mainstreaming of genomics, particularly when the majority of pharmacy staff had not received any formal training. There were no participants from community pharmacy, indicating a requirement to further explore barriers and enablers in this cohort. Community pharmacy staff may be reluctant to participate if they perceive genomics to relate solely to secondary/tertiary care. Survey methodology also limited the detail that could be obtained from respondents. This provides helpful preliminary insights on barriers and enablers to genomics implementation into pharmacy practice in rural/coastal areas. Themes could be further explored via semi-structured interviews, with the aim of shaping interventions necessary to ensure equitable provision of genomics services and expertise to these communities.

Gendered impacts of climate change: evidence from weather shocks

Abstract Climate change is a critical challenge of our era, and its effects on human well-being are undeniable. It may not be immediately apparent that its impacts can vary by gender. Drawing from lessons learned during the COVID-19 pandemic, it is clear that a shock can affect men and women differently, due to social norms and pre-existing gender differences. This paper reviews economic studies on how weather shocks—such as floods, droughts, and extreme temperatures—affect a broad spectrum of outcomes, ranging from endowments to economic opportunities and agency. Although specific physiological vulnerabilities exist (e.g. boys are more vulnerable to prenatal shocks, while girls and women are more vulnerable to heat), the most significant gendered impacts stem from pre-existing inequalities and societal responses to these shocks. In regions with a strong preference for boys, families facing resource shortages from shocks might prioritize boys for food and other resources, pull girls from school, marry them off young, or withdraw women from agricultural work so they can focus on household chores. Conversely, boys and men might leave school or migrate to seek alternative income sources during or after such shocks. Without gender-responsive climate policies, climate change is likely to exacerbate existing gender inequalities.

Perceived Access to HIV Prevention Services Amidst the COVID-19 Pandemic Among Men Who Have Sex with Men (MSM) and MSM Sex Workers in France, Russia, and Türkiye.

This study examined the association between self-identification as a sex worker (SW) and perceived access to pharmacologic and non-pharmacologic HIV prevention methods among MSM in France, Russia, and Türkiye amidst the COVID-19 pandemic. Globally, 17,250 MSM recruited through a geosocial networking smartphone application completed the COVID-19 disparities survey, which was administered between October and November 2020. Approximately 38% of survey respondents were identified as living in France (n = 1269), Russia (n = 3882), and Türkiye (n = 3141) at the time of survey completion. Given the diverse sociodemographic factors and attitudes toward both MSM behavior and commercial sex work in these countries, we conducted a secondary analysis of survey data exploring the relationship between SW status and perceived access to pharmacologic and non-pharmacologic HIV prevention methods during the COVID-19 pandemic. Among respondents in Russia and France, MSM SW status was associated with a reduction in perceived access to condoms/lubricants (p = .001 in Russia, p < .001 in France). MSM SW in France were less likely to report never using PrEP as compared to non-SW peers (RR = 0.40, p = .005). Our findings highlight the disparities in access to HIV prevention for MSM SW living in these three countries during the COVID-19 pandemic. Based on our findings, COVID-19 may have exacerbated pre-existing inequities in HIV prevention among populations experiencing intersecting stigmas.

Cross-National Trends in Adolescents Psychological and Somatic Complaints Before and After the Onset of COVID-19 Pandemic

PurposeBuilding on research suggesting that the COVID-19 pandemic may have led to an exacerbation of deteriorating trends in mental health among adolescents, this paper examined trends in adolescents' psychological and somatic complaints across 35 countries from 2010 to 2022, and tested trends in sociodemographic inequalities in these outcomes between 2018 and 2022. MethodsUsing data from 792,606 adolescents from 35 countries (51% girls; mean age = 13.5; standard deviation 1.6) across four Health Behaviour in School-aged Children surveys (2010, 2014, 2018, 2022), hierarchical multilevel models estimated cross-national trends in adolescent psychological and somatic complaints. We tested whether observed values in 2022 were in line with predicted values based on 2010–2018 linear trends. Finally, moderation effects of age, family affluence, and family structures on the outcomes were tested (2018–2022). ResultsBoth girls and boys showed substantially higher levels of psychological complaints in 2022 compared with the predicted values. For somatic complaints, higher levels than predicted in 2022 were observed only in girls. Moderation analyses revealed an increase from 2018 to 2022 in age gaps and a narrowing in the socioeconomic gap for both outcomes. Also, there was a widening gap between adolescents living with 2 parents and those living in a single parent household in 2022 compared to 2018. DiscussionCross-national increases in adolescent psychological and somatic complaints were higher than expected in 2022, based on previous trends. Magnitudes of change varied across different sociodemographics groups, with implications for pre-existing mental health inequalities.

El impacto de la inteligencia artificial en el aprendizaje activo

This article reviews the impact of artificial intelligence (AI) on active learning, an educational approach in which students actively participate in their own learning process. AI, with its capacity for personalization, allows adjusting the pace and content to the needs of each learner, improving motivation and providing immediate feedback. However, its implementation presents challenges, such as the technological gap in disadvantaged regions, insufficient teacher training and ethical dilemmas related to data privacy. There are also warnings about the possibility of biases in the algorithms, which could reproduce pre-existing inequalities. Despite these challenges, AI has the potential to improve educational quality, enabling more effective and accessible learning experiences in diverse contexts. For successful implementation, it is critical to address ethical concerns and ensure a balance between technology and the development of critical and creative skills in students.

Has population mental health returned to pre-pandemic levels, among and between racialized groups and by immigration status?

The COVID-19 pandemic profoundly impacted population health, including mental health, in ways that were patterned unevenly by pre-existing systemic inequalities such as structural gendered racism and xenophobia. However, it remains unclear whether pandemic-related mental health deterioration has persisted over time. Drawing on theories of disruptive events and structural racism, we conceptualize the pandemic as a prolonged macro-level disruptive event with unequal ramifications for different racialized groups and by immigration status. We use six waves (2017–2022) of repeated cross-sectional data from the California Health Interview Survey (CHIS; N = 121,063) from men and women from nine racialized and immigration status groups (US-born citizens, naturalized citizens, and noncitizens of White, Latina/o, and Asian racialized groups, respectively). We use multivariable regression to examine changes in psychological distress within each group, and then assess patterns of racialized health disparities between Latina/o and Asian groups, respectively, compared to White US-born citizens, who occupy the most structurally privileged social status. Our analyses reveal several key findings. First, we observed persistent increases in psychological distress from 2020 through 2022, relative to the pre-pandemic period (2017–2019), for all racialized and immigration status groups, among men and women. Second, few groups had returned to pre-pandemic distress levels as of 2022. Third, there was a consistent health advantage for White US-born citizens across the pre-pandemic and pandemic years, whose highest post-pandemic distress measure was lower or equivalent to the pre-pandemic distress of US-born Latina/o and Asian groups. Fourth, the psychological distress gap between the White US-born population and US-born Latina/o and Asian groups, respectively, grew or held steady through 2022. Finally, the 2020–2022 period was associated with a reduction in pre-pandemic health advantages among Asian immigrant groups, relative to US-born White citizens, especially among men. Our findings provide strong evidence that population mental health has not recovered from the pandemic period.

11.K. Scientific session: Roots of public health: school health literacy to enhance population health outcomes in Europe

Abstract This workshop will present empirical results from three representative studies on health literacy and digital health literacy conducted in primary and secondary schools in Wales and Germany: (1) Digital Health Literacy in Schools, (2), HLCA HL-Kids, (3) WHO HBSC Wales. While research on child and adolescent health literacy has gained traction in the past decade, only a few studies focus on health literacy in schools. While the European Commission and WHO, as well as most European governments, highlight the importance of schools to support children’s health literacy, schools remain neglected as a research context. With only little evidence available, it is difficult to derive strategies and programs to promote health literacy in schools. We aim to provide practical novel knowledge and contribute to closing the school health literacy gap that is prevalent in Europe. In turn, this will also contribute to European public health development and population health outcomes. Levels of health literacy in child and adolescent populations across European countries and age groups are alarmingly low, making low health literacy a severe risk factor for health outcomes. Low health literacy is associated with worse health conditions and unhealthy behaviours, and in turn, impacts school attainment and educational outcomes. Evidence suggests that health literacy acts as a determinant of health and itself is influenced by other social determinants of health, such as education, intertwining health and education. All studies conducted so far provide evidence that low health literacy follows a social gradient, with children from less affluent families being more likely to have lower health literacy, widening preexisting health inequities observed in almost all health domains within Europe. While effective interventions on the individual and system levels are needed to enhance health literacy, implementation and evaluation research concerning children’s health literacy is rare. Workshop objectives The aim of this workshop is to present findings from three representative studies on health literacy and digital health literacy in primary and secondary schools: (i) The 1st speaker will introduce a study on health literacy and health behaviours of children aged 8-11 (ii) The 2nd speaker will discuss the influence of living environments on health literacy in 4th-grader school kids (iii) The 3rd presentation will have its focus on navigating the infodemic through digital health literacy in adolescent students (iv) The 4th speaker will show links between digital health literacy and health behaviour in adolescent students The format of this workshop will be 4x10-minute presentations followed by a 20-minute panel discussion with the audience, reflecting the relevance of the results to public health research, practice, and policy. The chairs will provide a brief introduction to the concept and moderate the presentations and panel discussion. Key messages • Our results show that health literacy should be addressed as early as in primary schools and that the places, households, and environments children grow up are critical social determinants of health. • Digital health literacy has proven to be a valid learning topic in secondary schools and is linked to digital and media literacy, allowing us to define it as a targeted curriculum item.

Food insecurity is associated with poor mental health and health risk behaviors in Czechia

Abstract Background Food insecurity (FI) is one of social determinants of health and a profound public health concern because it leads to malnutrition and hence poor health. COVID-19 impacted people disproportionately and exacerbated preexisting social and health inequalities. The aim of this study was to understand how socioeconomic and health conditions affected one’s FI in Czechia during the pandemic using a representative panel of Czech adults from a longitudinal survey, Life During the Pandemic collected in October 2022 as part of a Czech longitudinal survey. Methods A study sample of 1,499 respondents was included in our multiple logistic regression models. Depressive symptoms and anxiety symptoms were assessed using validated questionnaires PHQ-2 and DAG-2. Results Approximately one third of the study sample (32.4%) reported being food insecure. In the fully-adjusted model, adults with depressive symptoms (OR 2.37, CI 1.49, 5.02), problems with sleeping (OR 2.20, CI 1.64, 2.96), smoking habit (OR 2.27, CI 1.68, 3.07), lower fruit and vegetable consumption (OR 1.50, CI 1.04, 2.17) had greater odds of experiencing FI. The lowest income group was associated with 6.2 times greater odds of reporting FI as compared to the high-income group (CI 3.96, 9.67). Lower education attainment also had higher odds of experiencing FI (OR 2.15, CI 1.40, 3.31). Anxiety was not a significant predictor for FI. Conclusions Our study highlights that food insecurity is associated with depressive symptoms, poor quality of sleep and lower consumption of fruit and vegetables among adults. Food insecurity was also evident among lower income and lower education attainment. Funding source This study was supported by The Charles University Grant Agency (GA UK). Key messages • Our study suggests that adults with poor mental health and diet quality experience food insecurity. • Given the established link between a balanced diet and mental well-being, interventions should encompass not only food security but also the quality of dietary intake.

Virtual clinics in oral surgery: an equitable service for all?

Introduction Teledentistry has become more prevalent in the provision of oral healthcare since the COVID-19 pandemic. Virtual consultation clinics were introduced at Birmingham Dental Hospital as an adjunct to face-to-face (F2F) consultation clinics. This service evaluation compares virtual and F2F consultation clinics in oral surgery, with particular focus on 'did not attend' (DNA) rates.Methodology Data were collected retrospectively from all clinics conducted within the oral surgery service in April 2021. Information collected included attendance, patient demographics and complications impeding the consultation, including technical difficulties. Patients' postcodes were used to generate deprivation deciles. All data were handled sensitively in line with the Caldicott principles.Results Binomial regression analysis showed that DNA rates were more likely to occur in virtual consultation clinics compared to F2F clinics (p <0.00). DNAs were less likely to occur at review appointments (p <0.00). Lower deprivation decile ratings were associated with higher rates of DNAs, independent of clinic type (eg review or new patient) or method of consultation (virtual versus F2F) (p <0.01).Conclusion While virtual clinics are advantageous for some patient demographics and have shown promising results in other studies, it is important that the delivery of these virtual services does not continue to marginalise vulnerable patient groups and enhance pre-existing oral health inequalities.