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A woman spends a year with her mentally challenged sister.

Despite the perceptible feminisation of migration globally and in New Zealand, there remains a noticeable absence of a gendered perspective of the Healthy Migrant Effect (HME). In this paper, we seek to articulate a critical perspective on ethnic and migrant women's reproductive health deploying two established bodies of scholarship, the Social Determinants of Health (SDoH) and Social Practices theory. While the former highlights gender-specific structural barriers and inequities, the latter refers to the routinised everyday behaviours and habits built around shared cultural and social meanings. The data for the study is drawn from thirty-one interviews with reproductive health practitioners and ethnic migrant parents of young children. The analyses point to an array of influences on migrant women's reproductive health decisions including inequitable access, cultural traditions and practices, as well as the inability to exercise the reproductive choices that many skilled migrant women were accustomed to in their home countries. Overall, the paper critiques the focus on socio-economic status within HME theory as a reason for sub-optimal reproductive health outcomes - for ethnic migrant women, the broader canvas of societal factors includes gendered values, structures, and norms.

Alternatives assessment and green chemistry share a common goal of supporting the transition to safer, more sustainable chemicals, materials, and products. Yet the two fields, and their respective scientific communities, are not well integrated. To better understand the nexus between alternatives assessment and green chemistry as complementary approaches to support the development and adoption of safer, more sustainable chemicals for specific functional uses, this article discusses the foundations of the two fields and examines two case examples in which companies have utilized the tools and approaches of both disciplines in developing safer chemical solutions. This research demonstrates the importance and utility of the overlapping skillsets and tools of the two disciplines and the potential benefit of educational opportunities and collaborative spaces in jointly strengthening both fields. Additionally, the literature and case examples identify a number of research and practice needs that would bolster the application of both alternatives assessment and green chemistry in supporting the transition to safer, more sustainable chemistry, including: clearer definitions and criteria of what is 'safer'; improved approaches to evaluate potential unintended consequences of chemical applications; and more effective tools to evaluate toxicity, consider inherent exposure trade-offs, and combine multiple attributes to make an informed decision.

The healthy migrant effect scholarship makes limited, if any, connections between the impacts of the physical environments of the host country on the health outcomes of migrants. The aim of this paper is to understand environmental racism/racialisation in the context of migrant-concentrated neighbourhoods in urban settings. Focusing on interactions between built structural spaces and meaning-embodied places, this paper adapts international literature to map intentional and unintentional actions that have racialised outcomes on health determinants, and perceptions and experiences of physical health and wellbeing. Data are drawn from a mixed-method study comprising surveys, key informant and residents' interviews, focus groups and observations carried out in Auckland's City Centre (CBD), an urban area with high concentrations of ethnic and migrant populations. The analysis highlights two facets of environmental racialisation: first, it points to disproportionate urban investment that shapes the structural determinants impacting ethnic residents' exposure to environmental harm and in turn, health outcomes. Secondly, it introduces the concept of the 'migrant middle', a specific group constituted and affected by intricate processes of racialised exclusion and the retention of places of living and consumption. Overall, the paper demonstrates how the distinctive racialisation of urban space constitutes a determinant of ethnic and migrant health.

In the first major study of women in an Arab country s Jewish community, Rachel Simon examines the changing status of Jewish women in Libya from the second half of the nineteenth century until 1967, when most Jews left the country. Simon shows how social, economic, and political changes in Libyan society as a whole affected its Jewish minority and analyzes the developments in women s social position, family life, work, education, and participation in public life. Jews lived in Libya for more than two thousand years. As a result of their isolation from other Jewish centers and their extended coexistence with Berber and Arab Muslims, the Jews of Libya were strongly influenced by the manners, customs, regulations, and beliefs of the Muslim majority. The late nineteenth century witnessed a growing European cultural and economic penetration of Ottoman Liibya, which increased after the Italian occupation of Libya in 1911. Italian rule continued until a British Military Administration was established in 1942-43. Libya became independent in late 1951. The changing political regimes presented the Jewish minority with different models of social and cultural behavior. These changes in the foci of inspiration and imitation had significant implications for the position of Jewish women, as Jewish traditional society was exposed to modernizing and Westernizing influences. Economic factors had a strong impact on the position of women. Because of recurring economic crises in the late nineteenth century, Jewish families became willing to allow women to work outside the home. Some families also allowed their daughters to pursue vocational training and thus exposed them also to academic studies, especially at schools operated by representatives of European Jewish organizations. Although economic and educational opportunities for women increased, the Jewish community as a whole remained traditional in its social structure, worldview, and approach to interpersonal relations. The principles upon which the community operated did not change drastically, and the male power structure did not alter in either the private or the public domain. Thus the position of women changed little within these spheres, despite the expansion of opportunities for women in education and economic life. Change was slow, evolutionary, and within the framework of traditional society.

To study racial disparities in therapeutic interventions and hospitalization outcomes for hepatocellular cancer (HCC) in the United States. Using the 2011 Nationwide Inpatient Sample (comprising hospitalizations between January 1 and December 31, 2011), we identified patients with HCC-related admissions using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification codes. Among these, we also identified those that were procedure-related (associated with liver transplantation, hepatic resection, radiofrequency ablation, or transarterial chemoembolization). Multivariate regression was performed to identify the contribution of race to therapeutic interventions and outcomes. A total of 22,933 HCC-related hospitalizations were included, of which 10,285 were procedure related (45%). Blacks had a smaller proportion (35%) of procedure-related HCC hospitalizations than did whites (46%) (odds ratio [OR], 0.65; 95% CI, 0.49-0.86). Specifically, blacks had lower odds of liver transplantation (OR, 0.43; 95% CI, 0.26-0.71), hepatic resection (OR, 0.57; 95% CI, 0.33-0.98), and ablation (OR, 0.46; 95% CI, 0.29-0.74) (P=.002) than did whites. Overall, 10.9% of HCC-related admissions resulted in death in blacks as compared with 6.4% in whites (OR, 1.58; 95% CI, 1.12-2.24). Among patients admitted for HCC-related hospitalizations, blacks were less likely to receive liver transplantation, hepatic resection, and ablation than whites and had higher inhospital mortality. Identifying racial disparities in health care is a necessary first step to appropriately address and eliminate them.

Background Nigeria is the seventh-most populous country in the world. Its high fertility rate and unmet need for family planning contribute to the increasing population size. To reduce this gap, the Federal Government of Nigeria, in collaboration with Injectables Access Collaborative and other public and private sector players, introduced the subcutaneous depot medroxyprogesterone acetate (DMPA-SC) to the contraceptive method mix in 2017. We conducted an assessment to document the implementation experiences and best practices from the introduction of provider-administered and self-injection (SI) of DMPA-SC from the perspective of the government and implementing partners across states and federal governments levels from the supply-side. This is meant to serve as a learning resource to provide empirical evidence to help inform the DMPA-SC programming. Methods A cross-sectional study design that employed a mixed-method approach to data collection was used for this assessment. Our methods included desk review of existing DMPA-SC implementation documents and key informant interviews conducted on 13 government and implementing partners across states and federal levels. Narrative summarization and graphical trend analysis were used for the presentation of information obtained from document review while Nvivo software (version 12) was used for the analysis of transcripts of the KIIs. Results This assessment revealed a positive trend in the use of provider-administered and self-injection DMPA-SC from 2020 to 2023. This was supported by functional policies and guidelines. Implementing the Task Shifting and Task Sharing policy continuously; strengthening referral systems for provider-administered and self-injection DMPA-SC programme; and decentralising family planning services were suggested mechanisms for strengthening DMPA-SC programme implementation in Nigeria. However, funding gaps, human resource constraints, and weak coordination mechanisms impeded DMPA-SC implementation scale up. Conclusion This assessment illustrates the influence of an enabling environment and stakeholder commitment on the positive trend in provider-administered and self-injection DMPA-SC uptake in Nigeria. Training service providers and improving funding through the use of innovative financing were recommended as levers for DMPA-SC programme sustainability and service scale-up.

ObjectivesRecent research from the UK, USA, Australia and Canada point to male-favouring sex ratios at birth (SRB) among their Asian minority populations, attributed to son preference and sex-selective abortion within these cultural groups. The present study conducts a similar investigation of SRBs among New Zealand’s Asian minority and migrant populations, who comprise 15% of the population.Setting and participantsThe study focused on Asian populations of New Zealand and comparisons were made with NZ European, Māori, Pacific Island and Middle-Eastern, Latin American and African groups. Secondary data were obtained from the New Zealand historical census series between 1976 and 2013 and a retrospective birth cohort in New Zealand was created using the Stats NZ Integrated Data Infrastructure from 2003 to 2018.Primary and secondary outcome measuresThe primary outcome measure was SRBs and sex ratios between the ages 0 and 5 by ethnicity. A logistic regression was conducted and adjusted for selected variables of interest including visa group, parity, maternal age and deprivation. Finally, associations between family size, ethnicity and family sex composition were examined in a subset of this cohort (families with two or three children).ResultsThere was no evidence of ‘missing women’ or gender bias as indicated by a deviation from the biological norm in New Zealand’s Asian population. However, Indian and Chinese families were significantly more likely to have a third child if their first two children were female compared with two male children.ConclusionThe analyses did not reveal male-favouring sex ratios and any conclusive evidence of sex-selective abortion among Indian and Chinese populations. Based on these data, we conclude that in comparison to other western countries, New Zealand’s Asian migrant populations present as an anomaly. The larger family sizes for Indian and Chinese populations where the first two children were girls suggested potentially ‘soft’ practices of son preference.

Background Understanding the diversity and multiplicity of identities experienced by youth in Aotearoa (Te reo Māori name of the country) New Zealand (NZ) is vital to promoting their wellbeing. Ethnic minority youth (EMY) in NZ (defined as those identifying with Asian, Middle Eastern, Latin American and African ethnic origins) have been historically under-studied and under-counted, despite reporting high levels of discrimination, a major determinant of mental health and wellbeing and potentially a proxy for other inequities. In this paper, we describe the protocol for a multi-year study that examines, using an intersectional approach, how multiple marginalised identities impact mental and emotional wellbeing of EMY. Methods This is a multiphase, multi-method study designed to capture the diversity of lived realities of EMY who self-identify with one or more additional marginalised intersecting identity (the population referred here as EMYi). Phase 1 (Descriptive study) will involve secondary analyses of national surveys to examine the prevalence and relationships between discrimination and wellbeing of EMYi. Phase 2 (Study on public discourse) will analyse data from media narratives, complemented by interviews with stakeholders to explore discourses around EMYi. Phase 3 (Study on lived experience) will examine lived experiences of EMYi to discuss challenges and sources of resilience, and how these are influenced by public discourse. Phase 4 (Co-design phase) will use a creative approach that is youth-centered and participatory, and will involve EMYi, creative mentors and health service, policy and community stakeholders as research partners and advisors. It will employ participatory generative creative methods to explore strengths-based solutions to discriminatory experiences. Discussion This study will explore the implications of public discourse, racism and multiple forms of marginalisation on the wellbeing of EMYi. It is expected to provide evidence on the impacts of marginalisation on their mental and emotional wellbeing and inform responsive health practice and policy. Using established research tools and innovative creative means, it will enable EMYi to propose their own strength-based solutions. Further, population-based empirical research on intersectionality and health is still nascent, and even more scarce in relation to youth. This study will present the possibility of expanding its applicability in public health research focused on under-served communities.