Socio-environmental Determinants Of Health Research Articles

Paving the complex path to building climate resilient cities through disaster health diplomacy and international public health policy

Disaster resilience defines society’s capabilities to resist/adapt/recover from hazardous events. Priorities for action were outlined at the Sendai Framework for Disaster Risk Reduction to reduce disaster risks by understanding the process, strengthening governance, investing in resilience, improving preparedness/effective response capacities/rehabilitation processes/reconstruction procedures. Disaster diplomacy is a fast growing interdisciplinary field. Natural disasters potentially generate opportunities for diplomatic interaction between rival parties/conflicting states. Climate crisis is growing. By large, Summer 2023 was globally the warmest on record. The 2015 Paris Agreement was a landmark; UNOHCHR proposes a universal decleration of disaster rights. Climate change has widespread impacts on human health. “The greatest health threat of the 21stcentury” affects socio environmental determinants of health, clean air/water/food/shelter. Ninety percent of all disasters are climate/weather related, resulting in >410,000deaths in the last decade, expected to cause 250,000 additional deaths/year from malnutrition/malaria,/diarrhoea/heat stress in 2030 2050. IFRC focuses on strengthening ownership/community leadership/outreach/funding/forecasting/anticipatory action. Climate related flashpoints are the early warnings of impending crises. Turkey Greece have a lot in common from a climate change/disaster resilience viewpoint. Successive earthquakes generated rescue responses/mutual aid/outpouring of sympathy between the two countries within the last decade. Extreme weather events, high temperatures, severe rainfalls continue to batter both countries. Global warming brought intense flooding/wildfires to Southeast Europe/Southwest Asia. Climate change is expected to become the strongest driver of human migration through complex mechanisms in the Mediterranean Basin. The sustainability of Greece’s migration policies may be challenged against the global climate crisis. Environmental change has potential impacts on human health. Health diplomacy in international relations focuses on protecting health/well being. In the past, health interventions as foreign policy were regarded not to be associated with diplomatic disaster efforts. This oral presentation challenges earlier opinions and proposes a “climate change health diplomacy model” for improving capacities in disaster resilience. Around the world, health care professionals speak a unique/universal language of their own. Countries with “otherwise conflicting interests,” stand in solidarity during natural disasters. Through further elaborating on the principles of sustainable collaboration on disaster risks/health diplomacy/climate change, a “first time disaster health diplomacy model” may be developed to serve the world. An outline is hereby presented, 1 to define paths of communication versus the current ad hoc disaster diplomacy efforts, 2 to incorporate risks into the disaster diplomacy plan, 3 to incorporate a well planned disaster health diplomacy agreement. As the Turkish saying goes, “HEALTH COMES FIRST”.

How much bilateral and multilateral climate adaptation finance is targeting the health sector? A scoping review of official development assistance data between 2009-2019.

Climate change is adversely affecting human health. Rapid and wide-scale adaptation is urgently needed given the negative impact climate change has across the socio-environmental determinants of health. The mobilisation of climate finance is critical to accelerate adaptation towards a climate resilient health sector. However, a comprehensive understanding of how much bilateral and multilateral climate adaptation financing has been channelled to the health sector is currently missing. Here, we provide a baseline estimate of a decade's worth of international climate adaptation finance for the health sector. We systematically searched international financial reporting databases to analyse 1) the volumes, and geographic targeting, of adaptation finance for the health sector globally between 2009-2019 and 2) the focus of health adaptation projects based on a content analysis of publicly available project documentation. We found that health was largely a co-benefit, not the principal objective, within the projects. We estimate that USD 1,431 million (4.9%) of total multilateral and bilateral adaptation has been committed to health activities across the decade. However, this is likely an overestimate of the true figure. Most health adaptation projects were in Sub-Saharan Africa, with average project funding comparable to East Asia and the Pacific and the MENA region. Fragile and conflict affected countries received 25.7% of total health adaptation financing. The paucity of health indicators as part of project monitoring and evaluation criteria and the lack of emphasis on local adaptation were particularly significant. This study contributes to the wider evidence base on global health adaptation and climate financing by quantifying adaptation funds directed towards the health sector and revealing specific gaps in financing health adaptation. We anticipate these results will support researchers in developing actionable research on health and climate finance and decision-makers in mobilizing funds to low-resource settings with high health sector adaptation needs.

The Social Determinants of Perinatal Maternal Distress.

This pilot study examined associations between prenatal individual and socioenvironmental determinants of health and symptoms of perinatal maternal distress (PMD) in women enrolled in midwifery practice and living in a rural state. Pearson's correlations between prenatal predictors and PMD scores were calculated. Having experienced emotional abuse in one's lifetime, total number of past year stressors, and everyday discrimination score were all statistically significant predictors of PMD at study enrollment and follow-up. Result suggest shifting to a multi-symptom, life course assessment and intervention paradigm, tailored to the context of specific populations, may improve perinatal care and reduce disparities.

Research to address socio-environmental determinants of health and access to healthcare in urban(izing) Africa

ABSTRACT Africa’s rapid population growth and high urban growth rates have been linked to increasing urbanisation of poverty and adverse urban health outcomes, raising intricate local and global policy questions. The specific focus on urban health in Africa is critical in answering key questions relevant to the health, livelihood and wellbeing of the urban poor who constitute the majority of city dwellers and whose indicators drive national indicators across the region. This special issue on urban health in Africa responds to these questions as part of the renewed search for pathways to fill the gaps in knowledge and support evidence-based policy and action in the region. The spectrum of work highlights new models and approaches, wider social determinants of health and its unique intersection with policy and practice relevant to the regional context and the urban health agendas in the SDGs, the African Union’s Agenda 2063 and the UN-Habitat New Urban Agenda.

Homicides and socio-environmental determinants of health in Brazil: a systematic literature review.

Brazil currently has the highest absolute number of homicides in the world, which results from a complex range of factors. This study aimed at understanding the associations between socio-environmental determinants of health (SDH) and homicides in Brazil through a systematic literature review. The review followed PRISMA guidelines, selecting quantitative and qualitative studies published in Portuguese, English, and Spanish carried out between 2002 and 2017, available in the PubMed, MEDLINE, LILACS, SciELO and BVS-BIREME databases. Two trilingual reviewers tracked studies independently by basing on the eligibility criteria. We critically assessed the selected studies with the Critical Appraisal Skills Programme (CASP) or the Checklist for Analytical Cross-Sectional Studies, depending on the study design. We considered 60 studies and grouped their SDH into categories to develop a narrative synthesis about each SDH. These categories were: territory; race/ethnicity; gender; age; social inequalities and economic factors; development; education; work and employment; drugs and trafficking; other SDH. We found some SDH were more associated with homicides, such as being young, black, male, of low education level, and also people who lived in places of high social inequality, such as urban suburbs and agricultural frontiers. Unemployment and drug trafficking, as well as intersections between various SDH were also prominent. Education seems to be a protective factor for homicide. Despite the limited capacity of interpretation due to the high range of methodological approaches, this review shows the importance of considering SDH and their intersections when developing homicide prevention policies.

Analysis of policy towards improvement of perinatal mortality in the Netherlands (2004–2011)

Relatively high perinatal mortality and morbidity rates2 in the Netherlands resulted in a process which induced policy changes regarding the Dutch perinatal healthcare system. Aims of this policy analysis are (1) to identify actors, context and process factors that promoted or impeded agenda setting and formulation of policy regarding perinatal health care reform and (2) to present an overview of the renewed perinatal health policy.The policy triangle framework for policy analysis by Walt and Gilson was applied3. Contents of policy, actors, context factors and process factors were identified by triangulation of data from three sources: a document analysis, stakeholder analysis and semi-structured interviews with key stakeholders.Analysis enabled us to chronologically reconstruct the policy process in response to the perinatal mortality rates. The quantification of the perinatal mortality problem, the openness of the debate and the nature of the topic were important process factors. Main theme of policy was that change was required in the entire spectrum of perinatal healthcare. This ranged from care in the preconception phase through to the puerperium. Furthermore emphasis was placed on the importance of preventive measures and socio-environmental determinants of health. This required involvement of the preventive setting, including municipalities. The Dutch tiered perinatal healthcare system and divergent views amongst curative perinatal health care providers were important context factors. This study provides lessons which are applicable to health care professionals and policy makers in perinatal care or other multidisciplinary fields.

LIVE: A Tool to Support Student/Teacher Enactment of Community Health Nursing Praxis

Drawing on the authors' own experience, while working with students and faculty in a senior level undergraduate baccalaureate nursing program, a tool was developed to assist both faculty and student nurses in the process of praxis reflection in community health. The tool, LIVE, will be described and will provide a guide for students as they transition from hospital-based nursing to community nursing. The framework's four phases of learning, inviting, valuing and engaging are described. Key content areas and strategies for faculty to consider as they support students in their community health experience are provided. Students are invited to expand their understanding about nursing and to go beyond the medical model that underpins nursing in the hospital setting. The LIVE tool will assist faculty in guiding students in exploring the socio-environmental determinants of health, the standards of community nursing practices (CHNAC, 2003) and the process of becoming reflective practitioners.

Towards a Social Epidemiological Perspective on Physical Activity and Health: The Aims, Design, and Methods of the Physical Activity Longitudinal Study (PALS)

Background:The health benefits of physical activity are substantial; however, the lifetime and environmental determinants of sedentary living are poorly understood. The purpose of this article is to outline the conceptual background and methods of the Physical Activity Longitudinal Study (PALS), a follow-up study of a population- and place-based cohort. A secondary purpose is to report on the success of follow-up procedures.Methods:A rationale for conducting a 20-y follow-up of a nationally representative population- and place-based cohort is developed based on the extant literature dealing with socio-environmental determinants of health and on current advancements in thinking about the determinants of involvement in physical activity. Then, methods of the 2002-04 PALS (n = 2511, nonresponse = 29.8%) that began with the 1981 Canada Fitness Survey are described. Descriptive data pertaining to the success of follow-up procedures are outlined.Results:There is general consensus around the relevance of examining lifetime and environmental determinants of physical activity involvement. Longitudinal data represent one source of information for disentangling the relative importance of these determinants. Examination of PALS follow-up data show that there was no selection bias for key individual- (physical activity, other lifestyle, health) and area-level (median income, housing) variables, although fewer respondents than nonrespondents smoked or were underweight at baseline. Some demographic groups were under- or over-represented among the eligible cohort, but not among participants.Conclusions:The social epidemiological perspective emerging from PALS should help policymakers and public health practitioners make strides in changing socio-environmental factors to curb sedentary lifestyles and promote population health.