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Introduces a vision for the future of health equity and explains practical policy measures for how to achieve it. Health inequity is one of the defining problems of our time. But current efforts to address the problem focus on mitigating the harms of injustice rather than confronting injustice itself. In Equal Care, Seth A. Berkowitz, MD, MPH, offers an innovative vision for the future of health equity by examining the social mechanisms that link injustice to poor health. He also presents practical policies designed to create a system of social relations that ensures equal care for everyone. As Berkowitz illustrates, the project of social democracy works to improve health by bringing relationships of equality to the sites of human cooperation: in civil society, in political processes, and in economic activities. This book synthesizes three elements necessary for such a project—normative justification, mechanistic knowledge, and technical proficiency—into a practical vision of how to create health equity. Drawing from the fields of medicine, social epidemiology, sociology, economics, political science, philosophy, and more, Berkowitz makes clear that health inequity is social failure embodied, and the only true cures are political. Equal Care is essential reading for anyone concerned with the future of health equity.

Social and political policy, human activities, and environmental change affect the ways in which microbial communities assemble and interact with people. These factors determine how different social groups are exposed to beneficial and/or harmful microorganisms, meaning microbial exposure has an important socioecological justice context. Social and political policy, human activities, and environmental change affect the ways in which microbial communities assemble and interact with people. These factors determine how different social groups are exposed to beneficial and/or harmful microorganisms, meaning microbial exposure has an important socioecological justice context. Therefore, greater consideration of microbial exposure and social equity in research, planning, and policy is imperative. Here, we identify 20 research questions considered fundamentally important to promoting equitable exposure to beneficial microorganisms, along with safeguarding resilient societies and ecosystems. The 20 research questions we identified span seven broad themes, including the following: (i) sociocultural interactions; (ii) Indigenous community health and well-being; (iii) humans, urban ecosystems, and environmental processes; (iv) human psychology and mental health; (v) microbiomes and infectious diseases; (vi) human health and food security; and (vii) microbiome-related planning, policy, and outreach. Our goal was to summarize this growing field and to stimulate impactful research avenues while providing focus for funders and policymakers.

This bookexamines ways in which cancer health disparities exist due to class and context inequities even in the most advanced society of the world.This volume, while articulating health disparities in the St.Louis, Missouri metropolitan area, including East St.Louis, Illinois, seeks to move beyond deficit models to focus on health equity.

Integrates the various disciplines of the science of health disparities in one comprehensive volume The Science of Health Disparities Research is an indispensable source of up-to-date information on clinical and translational health disparities science. Building upon the advances in health disparities research over the past decade, this authoritative volume informs policies and practices addressing the diseases, disorders, and gaps in health outcomes that are more prevalent in minority populations and socially disadvantaged communities. Contributions by recognized scholars and leaders in the field—featuring contemporary research, conceptual models, and a broad range of scientific perspectives—provide an interdisciplinary approach to reducing inequalities in population health, encouraging community engagement in the research process, and promoting social justice. In-depth chapters help readers better understand the specifics of minority health and health disparities while demonstrating the importance of advancing theory, refining measurement, improving investigative methods, and diversifying scientific research. In 26 chapters, the book examines topics including the etiology of health disparities research, the determinants of population health, research ethics, and research in African American, Asians, Latino, American Indian, and other vulnerable populations. Providing a unified framework on the principles and applications of the science of health disparities research, this important volume: * Defines the field of health disparities science and suggests new directions in scholarship and research * Explains basic definitions, principles, and concepts for identifying, understanding and addressing health disparities * Provides guidance on both conducting health disparities research and translating the results * Examines how social, historical and contemporary injustices may influence the health of racial and ethnic minorities * Illustrates the increasing national and global importance of addressing health disparities * Discusses population health training, capacity-building, and the transdisciplinary tools needed to advance health equity A significant contribution to the field, The Science of Health Disparities Research is an essential resource for students and basic and clinical researchers in genetics, population genetics, and public health, health care policymakers, and epidemiologists, medical students, and clinicians, particularly those working with minority, vulnerable, or underserved populations.

Purpose of ReviewUsing the WHO Conceptual Framework for Action on the Social Determinants of Health, this review provides a discussion of recent epidemiologic, mechanistic, and intervention studies of structural and social determinants of health and asthma outcomes covering the period from 2014 to 2019.Recent FindingsA majority of studies and interventions to date focus on the intermediary determinants of health (e.g., housing), which as the name suggests, exist between the patient and the upstream structural determinants of health (e.g., housing policy). Race/ethnicity remains a profound social driver of asthma disparities with cumulative risk from many overlapping determinants. A growing number of studies on asthma are beginning to elucidate the underlying mechanisms that connect social determinants to human disease. Several effective interventions have been developed, though a need for large-scale policy research and innovation remains.SummaryStrong evidence supports the key role of the structural determinants, which generate social stratification and inequity, in the development and progression of asthma; yet, interventions in this realm are challenging to develop and therefore infrequent. Proximal, intermediary determinants have provided a natural starting point for interventions, though structural interventions have the most potential for major impact on asthma outcomes. Further research to investigate the interactive effect of multiple determinants, as well as intervention studies, specifically those that are cross-sector and propose innovative strategies to target structural determinants, are needed to address asthma morbidities, and more importantly, close the asthma disparity gap.

Transgender people experience intersecting forms of social marginalization and are disproportionately affected by health inequities. We elucidate a novel conceptual framework for transgender health research that theorizes the constructs and pathways through which social inequities produce health inequities for transgender populations. Drawing on theories of intersectionality and structural injustice, Intersectionality Research for Transgender Health Justice (IRTHJ) posits that social and health inequities affecting transgender populations are the result of status quo power relations produced within and between oppressive structures, institutional systems, and socio-structural processes. The IRTHJ framework delineates three main actions for improving transgender health research: (i) name intersecting power relations, (ii) disrupt the status quo, and (iii) center embodied knowledge. The authors show how IRTHJ provides tools for researchers to transform the design, implementation, and interpretation of transgender health research, and they discuss implications for programs, policy, and action for transgender health justice.

INTRODUCTION Social determinants of health (SDH) are recognized as contributing factors to cognitive disorders, but their collective influence on dementia risk remains unclear. METHODS A gender‐disaggregated analysis was conducted on 12,896 community‐dwelling older Australians (mean ± SD age: 75.2 ± 4.3 years; 54% women) without major cognitive impairment upon enrollment. Latent class analysis identified clusters from 72 SDH (70 individual‐level and 2 neighborhood‐level), while Cox proportional hazards regression estimated dementia risk over 12 years (median: 8.4) follow‐up. RESULTS Four clusters were identified: least disadvantaged (Class 1: 31.5% men; 30.6% women), most disadvantaged (Class 2: 20.2% men; 19.4% women), high social support with Class 1 features (Class 3: 22.2% men; 24.1% women), and high social support with Class 2 features (Class 4: 26.1% men; 25.7% women). Compared to Class 1, men (HR: 1.49, 95% CI: 1.12–1.98) and women (HR: 1.56, 95% CI: 1.17–2.07) in Class 2, and women in Class 4 (HR: 1.66, 95% CI: 1.28–2.16) had a higher dementia risk. DISCUSSION Socioeconomic disadvantage was associated with incident dementia. Despite stronger social support, women's cognitive capacity appeared to be disproportionately impacted by adverse SDH. Highlights Four distinct multidimensional clusters were identified from a wide range of 72 social determinants of health. These clusters were associated with dementia risk differently in men and women. In both men and women, the most socioeconomically disadvantaged group had a higher risk of dementia. Despite stronger interpersonal social support, women had a greater risk of dementia. The addition of known dementia risk factors in cluster analysis did not change the findings, suggesting that social determinants of health independently predict dementia risk.

Background Social determinants of Indigenous health are known to include structural determinants such as history, political climate, and social contexts. Relationships, interconnectivity, and community are fundamental to these determinants. Understanding these determinants from the perspective of Indigenous youth is vital to identifying means of alleviating future inequities. Methods In 2016, fifteen Yellowknives Dene First Nation (YKDFN) youth in the Canadian Northwest Territories participated in the 'On-the-Land Health Leadership Camp'. Using a strength- and community-based participatory approach through an Indigenous research lens, the YKDFN Wellness Division and university researchers crafted the workshop to provide opportunities for youth to practice cultural skills, and to capture the youth’s perspectives of health and health agency. Perspectives of a healthy community, health issues, and health priorities were collected from youth through sharing circles, PhotoVoice, mural art, and surveys. Results The overall emerging theme was that a connection to the land is an imperative determinant of YKDFN health. Youth identified the importance of a relationship to land including practicing cultural skills, Elders passing on traditional knowledge, and surviving off the land. The youth framed future health research to include roles for youth and an on-the-land component that builds YKDFN culture, community relations, and traditional knowledge transfer. Youth felt that a symbiotic relationship between land, environment, and people is fundamental to building a healthy community. Conclusion Our research confirmed there is a direct and critical relationship between structural context and determinants of Indigenous Peoples’ health, and that this should be incorporated into health research and interventions.

Background The built environment is a structural determinant of health and has been shown to influence health expenditures, behaviors, and outcomes. Traditional methods of assessing built environment characteristics are time-consuming and difficult to combine or compare. Google Street View (GSV) images represent a large, publicly available data source that can be used to create indicators of characteristics of the physical environment with machine learning techniques. The aim of this study is to use GSV images to measure the association of built environment features with health-related behaviors and outcomes at the census tract level. Methods We used computer vision techniques to derive built environment indicators from approximately 31 million GSV images at 7.8 million intersections. Associations between derived indicators and health-related behaviors and outcomes on the census-tract level were assessed using multivariate regression models, controlling for demographic factors and socioeconomic position. Statistical significance was assessed at the α = 0.05 level. Results Single lane roads were associated with increased diabetes and obesity, while non-single-family home buildings were associated with decreased obesity, diabetes and inactivity. Street greenness was associated with decreased prevalence of physical and mental distress, as well as decreased binge drinking, but with increased obesity. Socioeconomic disadvantage was negatively associated with binge drinking prevalence and positively associated with all other health-related behaviors and outcomes. Conclusions Structural determinants of health such as the built environment can influence population health. Our study suggests that higher levels of urban development have mixed effects on health and adds further evidence that socioeconomic distress has adverse impacts on multiple physical and mental health outcomes.

Background Advancing health equity is a global priority within public health, requiring a focus on structural determinants of health and power imbalances. Community organizing is one strategy to cultivate community power and advance health equity by challenging oppressive systems. While examples of public health partnering with community-organizing groups and utilizing organizing methods can be found in the literature, these strategies remain an underdeveloped area for practice. This rapid review aims to uncover the benefits, challenges, and outcomes of governmental, non-profit, and academic public health partnering with community organizers and/or applying community-organizing methods. Methods A rapid review was conducted using PubMed and Cochrane databases. Articles were included if they focused on public health applying community-organizing methods and/or partnering with community-organizing groups, and if they reported benefits, limitations, and/or outcomes for community and/or public health. Eligible articles were primary research, practice reports, or systematic reviews, and were published between 2000 and August 10, 2023. Articles were excluded if they were published outside of Canada, United States, Europe, Australia, or New Zealand; not in English or available online; and unrelated to public health and community organizing. Results Twenty-four articles met inclusion criteria, including 17 primary research studies and seven practice reports. Topics varied, with environmental health and justice being the most common. Three quantitative articles investigated social capital. Qualitative outcomes revealed 10 themes describing seven benefits and three challenges for public health. Benefits include increased public health effectiveness, set or changed priorities, built community power, enhanced data collection and research, policy changes, built community capacity, and increased social capital. Challenges include administrative barriers, approach differences, and challenges associated with community organizing. Overall, the evidence base reveals a scarcity of research on public health partnering with community organizers or utilizing community-organizing methods. Conclusion The review underscores the capacity of community organizing to advance health equity, enhance public health effectiveness, and contribute diverse benefits to communities. It emphasizes the value of community-organizing partnerships and methods as promising approaches for public health practice, revealing alignment in addressing social and structural determinants of health. The full French translation of this article is available via https://nccdh.ca/fr/resources/entry/community-organizing-and-public-health-a-rapid-review .