Structural Determinants Research Articles

Forest management affects the functional traits of birds and mammals differently

AbstractForest management is an important component of global change as more than half of the world's forests are managed for human use. Although the effect of forest management on taxonomic diversity is well‐studied, we do not fully understand its impact on functional diversity. Understanding this is important to better predict how ecosystem processes will respond to global change scenarios and to implement efficient conservation actions. We conducted two large‐scale (~81 800 km2) research projects over 4 years in temperate forests of the northeastern USA to investigate how the functional structure of bird and mammal communities are affected by forest disturbance. We surveyed 85 bird species distributed in 115 sites using point counts, and 14 mammal species across 197 sites using camera traps. For each species, we selected functional traits that summarize key features of their biology, and for each site, we collected data on the level of forest disturbance based on forest loss events. We found that functional richness increased with forest disturbance for mammals but not for birds. Our results also showed that niche breadth (diet), morphological (body mass and wing length), and physiological (litter size) factors were the main determinants of the functional structure of both groups. These findings emphasize the complexity of making predictions about responses to forest management given the heavy dependence on the context and taxa studied. Overall we observed a limited response of functional diversity to forest management, which might indicate that the environmental changes generated by forest management in this region are less extreme than deforestation or conversion of natural forest to plantations of exotic species. Nonetheless, our results underscore the importance of investigating the effects of forestry on individual traits to develop strategies for managing for ecosystem functions.

What is the Relationship Between Older People's Housing Characteristics and Their Care Needs?

ABSTRACT Housing conditions and quality are well-established structural or social determinants of health. Poor quality housing also has the potential to affect care needs, but there is much less research on the topic, particularly on nonspecialist housing. Based on analysis of in-depth interviews with 44 people aged 65 and older living in England, their unpaid carers (N = 22), or as a carer-care recipient dyad (N = 6), (total N = 72), this study sought to explore the perceived relationship between people’s housing conditions and characteristics and their care needs. Findings indicate three key themes within this relationship: condition of home (cold and damp; state of repair; cleanliness and clutter); space and design (space, access); and legal relationship with the home (ability to carry out remedial work; precarity). There was variation in how and whether housing affected care needs by housing tenure, financial resources, and the type and level of care need. Care needs can increase requirement for warmer, less damp homes and be a barrier to improving homes. In turn, housing has a role to play in preventing the occurrence or worsening of care needs. Improving housing through policy and practice actions could reduce care needs and improve the lives of older people now and in the future.

"Will I survive this?": A qualitative exploration of the wider impacts of the COVID-19 pandemic on the health and well-being of pregnant and parenting youth and their children in Canada.

Pregnant and parenting youth in Canada face multiple challenges in fulfilling their parenting responsibilities while meeting their own unique needs. The COVID-19 pandemic and its associated public health restrictions exacerbated their challenges by reducing access to support networks, limiting opportunities to promote growth and well-being, and destabilizing their financial and economic standing. The impacts of the pandemic on the mental, physical, and emotional health of individuals are well-documented in the literature. However, there is limited research on how the pandemic influenced the lives, health, and well-being of pregnant and parenting youth and their children in Canada. Therefore, we aimed to examine the wider impacts (social and structural determinants that directly or indirectly impact health and well-being) of the pandemic and its implications for this population. We used a constructivist grounded theory approach to explore the experiences of pregnant and parenting youth during the pandemic and how certain social determinants of health intersected to shape health outcomes and influence their ability to access services. We conducted qualitative interviews using a semi-structured interview guide over Zoom. Using grounded theory principles, we inductively analyzed the data and categorized our findings into themes. We recruited a total of 50 participants from different regions in Canada. The findings from the interviews were categorized into the following themes: (1) "They bear the burden alone": Struggles of pregnant and parenting youth, (2) "How will I live the next day?": Concerns and consequences arising from the pandemic, and (3) "Try to keep your mask on": Navigating healthcare services while maintaining public health guidelines. Our findings highlight the various challenges encountered by the youth during the pandemic, particularly those associated with financial and economic constraints, lack of accessible health and social services, and increased stress from parenting responsibilities. Pregnant and parenting youth in Canada encountered various barriers while accessing health and social services, maintaining their well-being, and connecting with reliable sources of support during the pandemic. Our study findings emphasize the urgent need for adaptable and comprehensive support systems explicitly catering to the needs of pregnant and parenting youth during crises, such as the pandemic.

Capital market liberalization and corporate debt maturity structure: evidence from the Shanghai-Shenzhen-Hong Kong Stock connect

PurposeThis paper takes the Shanghai-Shenzhen-Hong Kong Stock Connect as a quasi-natural experiment and investigates the impact of capital market liberalization on the corporate debt maturity structure. It also aims to provide some policy implications for corporate debt financing and further liberalization of the capital market in China.Design/methodology/approachEmploying the exogenous event of Shanghai-Shenzhen-Hong Kong Stock Connect and using the data of Chinese A-share firms from 2010 to 2020, this study constructs a difference-in-differences model to examine the relationship between capital market liberalization and corporate debt maturity structure. To validate the results, this study performed several robustness tests, including the parallel test, the placebo test, the Heckman two-stage regression and the propensity score matching.FindingsThis paper finds that capital market liberalization has significantly increased the proportion of long-term debt of target firms. Further analyses suggest that the impact of capital market liberalization on the debt maturity structure is more pronounced for firms with lower management ownership and non-Big 4 audit. Channel tests show that capital market liberalization improves firms’ information environment and curbs self-interested management behavior.Originality/valueThis research provides empirical evidence for the consequences of capital market liberalization and enriches the literature on the determinants of corporate debt maturity structure. Further this study makes a reference for regulators and financial institutions to improve corporate financing through the governance role of capital market liberalization.

Interventions employed to address vaccine hesitancy among Black populations outside of African and Caribbean countries: a scoping review.

Black people are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities. This scoping review explored interventions that have been employed to address vaccine hesitancy among Black population outside of African and Caribbean countries. This review provides several strategies for addressing this deep-rooted public health problem. The scoping review followed the five-step framework outlined by Arksey and O'Malley. It complies with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Research studies that examined interventions utilized to promote vaccine confidence within Black populations living outside of African and Caribbean countries were reviewed. A total of 20 articles met the inclusion criteria for this study: 17 were quantitative studies and three were mixed-method studies. This scoping review highlighted six themes: educational advancement, messaging, multi-component approaches, outreach efforts, enhancing healthcare access, and healthcare provider leadership. The review identified effective interventions for addressing vaccine hesitancy among Black populations outside Africa and the Caribbean, emphasizing education, multidimensional approaches, and healthcare provider recommendations. It calls for more qualitative research and interventions in countries like Canada and the UK to enhance vaccine confidence and reduce mistrust.

Stigma trajectories, disclosure, access to care, and peer-based supports among African, Caribbean, and Black im/migrant women living with HIV in Canada: findings from a cohort of women living with HIV in Metro Vancouver, Canada.

African, Caribbean, and Black im/migrant women experience a disproportionate burden of HIV relative to people born in Canada, yet there is scarce empirical evidence about the social and structural barriers that influence access to HIV care. The objectives of this study is to estimate associations between African, Caribbean, and Black background and stigma and non-consensual HIV disclosure outcomes, and to understand how experiences of stigma and im/migration trajectories shape access to HIV care and peer supports among African, Caribbean, and Black im/migrant women living with HIV in Canada. This mixed-methods analysis draws on interviewer-administered questionnaires and semi-structured interviews with self-identifying African, Caribbean, and Black women living with HIV in the community-based SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment) cohort. Bivariate and multivariable logistic regression using generalized estimating equations (GEE) were performed to estimate associations between African, Caribbean, and Black background and stigma and non-consensual HIV disclosure outcomes. Drawing on a social and structural determinants of health framework, qualitative analysis of interviews elucidated the interplay between migration trajectories, stigma, racialization, and HIV. Amongst our participants (n = 291), multivariable GEE analysis revealed that African, Caribbean, and Black participants (n = 15) had significantly higher odds of recently being outed without consent as living with HIV (AOR 2.34, 95% CI 0.98-5.57). Additionally, African, Caribbean, and Black participants had higher odds of recent verbal or physical abuse due to their HIV status (AOR 2.11, 95% CI 0.65-6.91). Reflecting on their im/migration trajectories, participants' narratives (n = 9) highlighted experiences of political violence and conflict, trauma, stigma, and discrimination associated with HIV in their place of origin and the racialization and stigmatization of HIV in Canada. Fear of disclosure without consent was linked to barriers of accessing care and peer-based supports. Our findings indicate that im/migration trajectories of African, Caribbean, and Black women living with HIV are critically related to accessing HIV care and supports in Canada and compound HIV stigma and discrimination. HIV disclosure without consent complicates access to care and social/peer support, underscoring the need for privacy, confidentiality, and the importance of building trust in the context of clinical encounters. The results of this study emphasize the critical need for culturally sensitive trauma-informed care models rooted in peer-based approaches.

Regulating Spin‐Crossover Behavior in Iron(II) Complexes: Control over SCO Temperatures by Varying NCE‒ Co‐ligands

In this research, we introduce new members to the [Fe(bzL)(NCE)2] complex series by incorporating NCS− and NCBH3− as co‐ligands, expanding on our established tetradentate bzL ligand. The synthesis of three isostructural structures has allowed for a systematic tuning of SCO temperatures, with T1/2 values ranging from 85 K for the S‐α complex, featuring approximately 15 K thermal hysteresis, to 194 K for the Se‐α complex, and a stable low‐spin state up to 300 K for the B‐α complex. This work demonstrates the efficacy of modulating SCO properties through variation of the NCE− ancillary ligands. Furthermore, we conducted a comparative analysis of 21 analogs within this family. This analysis aims to elucidate the similarities and differences among the complexes and their correlation with SCO properties, furthering our understanding of the structural determinants that influence SCO behavior.

Stagnating Life Expectancy Among American Indians and Alaska Natives: Understanding the Drivers and Recommendations for Research, Policy, and Practice.

Life expectancy among American Indians and Alaska Natives (AI/ANs) has declined from 72 years in 2019 to 68 years in 2021. This current life expectancy for AI/ANs is equivalent to the overall life expectancy in the United States population in the 1940s. The significant and persistent nature of AI/AN health inequities, and the lack of clarity around what is driving them, requires urgent action. The purpose of this article is threefold. First, we provide a comprehensive conceptual framework of health that presents Indigenous perspectives of health and recognizes settler colonialism as a key structural determinant of the health of AI/ANs. Second, we underscore the importance of Tribal self-determination and sovereignty in public health research and practice and identify successful initiatives centering these efforts. Finally, we conclude with recommendations for future research, practice, and policy.

Determinants of chemoselectivity in ubiquitination by the J2 family of ubiquitin-conjugating enzymes.

Ubiquitin-conjugating enzymes (E2) play a crucial role in the attachment of ubiquitin to proteins. Together with ubiquitin ligases (E3), they catalyze the transfer of ubiquitin (Ub) onto lysines with high chemoselectivity. A subfamily of E2s, including yeast Ubc6 and human Ube2J2, also mediates noncanonical modification of serines, but the structural determinants for this chemical versatility remain unknown. Using a combination of X-ray crystallography, molecular dynamics (MD) simulations, and reconstitution approaches, we have uncovered a two-layered mechanism that underlies this unique reactivity. A rearrangement of the Ubc6/Ube2J2 active site enhances the reactivity of the E2-Ub thioester, facilitating attack by weaker nucleophiles. Moreover, a conserved histidine in Ubc6/Ube2J2 activates a substrate serine by general base catalysis. Binding of RING-type E3 ligases further increases the serine selectivity inherent to Ubc6/Ube2J2, via an allosteric mechanism that requires specific positioning of the ubiquitin tail at the E2 active site. Our results elucidate how subtle structural modifications to the highly conserved E2 fold yield distinct enzymatic activity.

Abstract 4125263: Influence of sexual orientation-related nondiscrimination laws on 30-year CVD risk among sexual minority and heterosexual adults

Introduction: Discriminatory policies are associated with worse mental health and substance use outcomes among sexual minority adults. Despite a higher risk of cardiovascular disease (CVD) than heterosexual adults, there is limited evidence on structural determinants of cardiovascular health among sexual minority adults. Therefore, we examined whether changes in sexual orientation-related nondiscrimination laws were associated with 30-year CVD risk among sexual minority and heterosexual adults. Hypothesis: We hypothesized that changes in sexual orientation-related nondiscrimination laws would be more strongly associated with 30-year CVD risk among sexual minority adults relative to exclusively heterosexual adults. Methods: We used longitudinal data from Waves III (2001-2002), IV (2008-2009), and V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health. We assessed changes in four state-level sexual orientation-related nondiscrimination laws (i.e., employment discrimination, same-sex marriage, hate crime statutes, and same-sex adoption) between Waves III and IV. Changes in sexual orientation-related nondiscrimination laws were categorized as unchanged (reference), improved, or worsened. We assessed 30-year CVD risk using the Framingham Risk Score at Wave V. We ran sex-stratified linear regression models adjusted for demographic factors to examine whether the association between change in nondiscrimination laws with 30-year CVD risk was moderated by sexual orientation (i.e., exclusively heterosexual, mostly heterosexual, homosexual/bisexual). Results: The sample included 3,827 participants with a mean age of 28.7 (±1.75) years, of whom 83.1% identified as exclusively heterosexual, 51% as female, and 15% as Black. Compared to heterosexual participants of the same sex, an improvement in nondiscrimination laws was associated with lower 30-year CVD risk among mostly heterosexual women (B -4.57, 95% CI = -8.06, -1.08) and homosexual/bisexual men (B -10.91, 95% CI = -19.33, -2.49). In contrast, compared to exclusively heterosexual women, a worsening of nondiscrimination laws was associated with higher 30-year CVD risk among homosexual/bisexual women (B 5.26, 95% CI = 0.30, 10.21). No differences were found between mostly heterosexual and exclusively heterosexual men. Conclusions: Findings suggest that efforts to enhance policies prohibiting sexual orientation-related discrimination may significantly reduce CVD risk among sexual minority adults.

Beyond accreditation: unraveling the narrative of public health through a critical race praxis lens

IntroductionRecognizing and addressing health inequities among minority populations are pivotal to public health. Further, public health strives to understand the complexities between race and health without limiting discussions around race as a trivial variable. This commitment toward equity demonstrates considerable similarities to Critical Race Theory (CRT) which led to the creation of the Public Health Critical Race (PHCR) Praxis to instill CRT within public health. However, the literature on how public health education incorporates critical race studies remains limited. The goal of this study was to examine how public health curriculum currently aligns with the PHCR praxis and meets public health's goal of health equity.MethodsThis qualitative study employed document analysis to evaluate academic syllabi from CEPH-accredited MPH programs. Stratified random sampling was applied across two sampling pools, Schools of Public Health (SPH), and Public Health Programs (PHP). Course overviews, course objectives, course curricular information, and course policies were identified and extracted from each syllabus for analysis. A total of 53 syllabi were obtained from a final sample of nine public universities and one private.ResultsThrough inductive and directed content analysis, a priori themes of Structural Determinism, Voice, Critical Approaches, Ordinariness of Racism, Social Construction of Knowledge, Intersectionality, Disciplinary Self-Critique, Primacy of Racialization, Race as a Social Construct, Race Consciousness, and their respective categories arose as salient. Two new themes, Antiracism Practices and Culture of Inclusivity, were also present.DiscussionThis study is the first to explore public health education's current curricular practices concerning CRT and antiracist praxes. The results confirm the interwoven nature of public health education with critical race studies, as all principles of PHCR praxis were present. However, the prevalence of these principles varied, suggesting gaps in the alignment of public health curricula and CRT. It is essential that public health educators ensure that the foundational competencies students are expected to display align with public health's goal of health equity. This work can equip MPH programs and public health educators with the ability to revise or bolster their current curricular and instructional efforts to support the pursuit of health, racial equity, and social justice.

Groundbreaking Research from NIDA Addressing the Challenges of the Opioid Epidemic.

The 2024 ACMT Ward and Ryan Donovan Memorial Fund lecture was presented by Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH). This article in an edited version of her keynote address during ACMT's 2024 Annual Scientific Meeting. During the course of her talk, Dr. Volkow discussed the historical factors contributing to the ongoing global opioid epidemic, examined the evidence behind different front-line and policy strategies used to battle the opioid epidemic, and highlighted the importance of recent cultural changes that support more deliberate screening for substance use disorders and pathways for initiating treatment of opioid use disorders in vulnerable populations. An urgent need exists to improve inclusion of social and structural determinants of health in implementation science addressing opioid use disorders, with better attention to special populations, including Native American Indians and Alaskan Natives, African Americans, those over 65years of age, and teenagers.

Gender, race, and economic factors influencing screening practices in hidradenitis suppurativa: a cross-sectional analysis.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients' quality of life. Despite its substantial burden, HS remains underdiagnosed and undertreated, particularly among marginalized populations. This study aimed to elucidate the primary social determinants of health (SDOH) and structural determinants of health (StDOH) influencing rates and patterns of screening for patients diagnosed with HS. Using data from the All of Us Research Program database, participants with HS were identified using ICD-10 codes and stratified based on various sociodemographic factors, including race, gender, and income. The primary outcome variables were participation in viral screening and disease screening among HS patients. Statistical analyses were performed to assess the relationship between sociodemographic factors and screening practices. Income and gender had significant impacts on screening practices. Higher-income patients were more likely to receive necessary disease screening and less likely to receive unnecessary disease screening compared to lower-income patients. Non-male patients had significantly higher rates of unnecessary disease and viral screening than male patients. While differences in screening practices within each income level were significant, there were no significant differences across different income brackets or racial groups. These findings suggest that subjectivity associated with individual physicians' recommendations may contribute to disparities in screening outcomes, especially in lower-income and non-male HS patients. The study highlights the need for more clearly delineated screening guidelines and continued research on the role of SDOH in improving patient health outcomes.

Qualitative Evidence to Inform Municipal Government Actions to Increase Recreation Space Usage and Promote Equitable Participation in Leisure-Time Physical Activity

Municipal recreation infrastructure is critical for enhancing people’s opportuni-ties to be physically active during leisure time and reducing usage inequities. Yet, the literature on municipal equity-sensitive strategies is limited. To address this gap, we combined a socio-ecological framework with equity, diversity, and inclu-sion (EDI) and health equity lenses to examine intersecting social and structural determinants of municipal recreation (indoor and outdoor) infrastructure usage. We used data from 22 focus groups involving youth, adult regular users, and adult non-regular users. The intersecting factors influencing people’s utilization experi-ences were organized at intrapersonal, socio-cultural environment, organization, and built and natural environment levels. Policy and practice implications for mu-nicipal governments vis-à-vis EDI and health equity considerations are discussed. Recommendations include public transportation improvement, design of strategic communication plans, and linking activities with opportunities for socialization, among others.

A Narrative Review of Congenital Syphilis in the United States: Innovative Perspectives on a Complex Public Health and Medical Disease.

Over the past two decades, congenital syphilis cases have risen 11-fold in the United States. While disparities across geography, race, and ethnicity exist, lack of timely screening or treatment is identified in 88% of cases nationally. Congenital syphilis is a public health and medical problem rooted in systematic and societal structural determinants of health and healthcare limitations. Early syphilis in pregnancy leads to congenital syphilis if untreated in 50 - 70% of cases, with risk for fetal demise, and among survivors, congenital anomalies, organ damage, and central nervous system disease. Prevention of congenital syphilis lies in early detection and treatment in pregnant persons. In this narrative review, we describe the evolving epidemiology of syphilis and congenital syphilis, highlighting unique aspects among women. We explore the role of novel screening and treatment strategies, public health policy, and medical considerations in terms of congenital syphilis prevention. Readers of this review will understand CS as a complex public health and medical disease that can be prevented through innovative and coordinated strategies in public health policy, expanded screening and research opportunities.

Structural determinants of protein kinase A essential for CFTR channel activation

Cystic Fibrosis Transmembrane Conductance Regulator (CFTR), the anion channel mutated in cystic fibrosis (CF) patients, is activated by the catalytic subunit of protein kinase A (PKA-C). PKA-C activates CFTR both noncatalytically, through binding, and catalytically, through phosphorylation of multiple serines in CFTR's regulatory (R) domain. Here, we identify key molecular determinants of the CFTR/PKA-C interaction essential for these processes. By comparing CFTR current activation in the presence of ATP or an ATP analog unsuitable for phosphotransfer, as well as pseudosubstrate peptides of various lengths, we identify two distinct specific regions of the PKA-C surface which interact with CFTR to cause noncatalytic and catalytic CFTR stimulation, respectively. Whereas the "substrate site" mediates CFTR phosphorylation, a distinct hydrophobic patch (the "docking site") is responsible for noncatalytic CFTR activation, achieved by stabilizing the R domain in a "released" conformation permissive to channel gating. Furthermore, by comparing PKA-C variants with different posttranslational modification patterns, we find that direct membrane tethering of the kinase through its N-terminal myristoyl group is an unappreciated fundamental requirement for CFTR activation: PKA-C demyristoylation abolishes noncatalytic, and profoundly slows catalytic, CFTR stimulation. For the F508del CFTR mutant, present in ~90% of CF patients, maximal activation by demyristoylated PKA-C is reduced by ~10-fold compared to that by myristoylated PKA-C. Finally, in bacterial genera that contain common CF pathogens, we identify virulence factors that demyristoylate PKA-C in vitro, raising the possibility that during recurrent bacterial infections in CF patients, PKA-C demyristoylation may contribute to the exacerbation of lung disease.

The role of the primary healthcare research community in addressing the social and structural determinants of health: a call to action from NAPCRG 2023.

The need for effective primary healthcare to address social and structural determinants of health and to mitigate health inequalities has been well established. Here, we report on the international forum of the 2023 NAPCRG (formerly known as North American Primary Care Research Group) Annual Meeting. The aim of the forum was to develop principles for action for the primary healthcare research community on addressing social and structural determinants of health. From this forum, 10 key recommendations for the primary care research community were identified.

Distribution of evapotranspiration components along vertical layers and their controls in dry days of larch plantation in the Liupan Mountains of northwest China

Precise quantification of forest evapotranspiration (ETf) including transpiration from tree (Tt), shrub (Ts), and herb (Th) layers, as well as evaporation from litter (El) and soil (Es) layers, and elucidating their responses to environmental conditions and stand structures are crucial for forest water management in water-limited forests. In this study, we observed the Tt, Ts, Th, El, and Es, reference evapotranspiration (ETo), soil volumetric water content (SWC), litter water content (LWC), leaf area index (LAI) in tree, shrub, and herb layers, and canopy shade (Ksc) from tree layer of the Larix principis-rupprechtii plantation during the dry days from May to October of 2021 and 2022 to elucidate the distribution of evapotranspiration along vertical layers and their environmental and structural determinants. The results indicated that the contributions of Tt, Ts, Th, El, and Es to ETf during the dry days in 2021 (2022) were 42.1 % (44.7 %), 9.2 % (8.1 %), 8.2 % (8.6 %), 15.0 % (13.1 %), and 25.5 % (25.5 %), respectively. Although Tt and Ts demonstrated quadratic relationships with ETo, Th, El, and Es exhibited linear relationships. All ETcs demonstrated a saturated exponential relationship with either SWC or LWC. Furthermore, Tt, Ts, and Th showed a saturated exponential relationship with their respective LAI, whereas El and Es exhibited a cubic relationship with LAI in tree layers. All understory ETcs (Ts, Th, El, and Es) decreased exponentially with the Ksc. The multi-factor models of evapotranspiration component (ETc) from different vertical layers, which coupled the impacts of environmental conditions and vertical structure, were developed, and provided superior accuracy (R2 = 0.78–0.88, NSE = 0.78–0.86, RSME = 0.03–0.16). Such insights deepened the understanding of vertical structural distribution and multi-factor responses of ETcs in forest ecosystems and hold the potential to inform and optimise forest water management strategies.

Research on structural determinants and mental health in adolescents

Research on structural determinants and mental health in adolescents

Workplace mortality risk and social determinants among migrant workers: a systematic review and meta-analysis.

Migrant workers, a population of 170 million, often work in dangerous or unhealthy working environments and are likely to suffer workplace injuries and labour abuses. However, the risk of mortality in migrant workers compared with local workers is unknown. We aim to synthesise global evidence on migrant worker mortality risk and identify social determinants to inform health and safety protections for migrant workers. We conducted a systematic review and meta-analysis of peer-reviewed literature to examine mortality outcomes among migrant workers and associated risk factors. We searched MEDLINE, Embase, PsycINFO, and Ovid Global Health for studies published between Jan 1, 2000, and Jan 17, 2023, reporting quantitative primary research in English. A broad definition of migrant worker was used, including any worker who is foreign-born (ie, international first-generation migrant workers), either in paid employment or self-employment. Internal migrants, second-generation migrants, and foreign health-care workers were excluded. The primary outcome was any reported mortality, including all-cause mortality, cause-specific mortality, suicide, homicide, and fatal occupational injury. We used meta-analysis to compare outcomes between migrant worker and local worker populations, and a random-effects model to calculate pooled estimates. We used narrative synthesis to develop a data-driven conceptual framework capturing the intersectional social determinants of mortality in migrant workers. The study protocol is registered on PROSPERO, CRD42023372893. Of 11 495 identified records, 44 were included in the systematic review, of which 11 studies were pooled in meta-analyses. Data were from 16 countries, most of which were high-income countries, and included 44 338 migrant worker deaths, including migrants from the agriculture, construction, mining, and service industries. Compared with local workers, migrant workers had a higher risk of fatal occupational injury (pooled relative risk 1·71, 95% CI 1·22-2·38; eight studies; I2=99·4%), and a lower risk of all-cause mortality (0·94, 0·88-0·99; three studies, I2=90·7%). Migrant workers were more likely to die from external causes of death (such as falls or assaults) than internal causes of death (such as respiratory or digestive diseases) compared with local workers, with migrant workers also more likely to die from work-related homicides, especially in the retail and sex industries, with some evidence of higher suicide rates among female migrant workers compared with female local workers. Influential social determinants for poor fatality outcomes include migration-related factors (such as lower language proficiency, undocumented status, and long duration of stay) and labour-related factors (such as precarious employment, labour migration policies, and economic deregulation policies). Migrant workers have a higher risk of workplace fatal injury despite being generally healthier than local workers, which could be explained by structural determinants such as precarious employment and inadequate safety protection. This health inequity must be urgently addressed through future interventions that account for migration-related and labour-related social determinants of health at the structural level, such as extending labour protection laws to migrant workers, and improving occupational health and safety and workplace conditions for this vital and growing workforce. UK Medical Research Council and National Institute for Health and Care Research.