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Health divides : where you live can kill you
Americans live three years less than their counterparts in France or Sweden. Scottish men survive two years less than English men. Across Europe, women in the poorest communities live up to ten years less than those in the richest. Revealing gaps in life expectancy of up to 25 years between places just a few miles apart, this important book demonstrates that where you live can kill you. Clare Bambra, a leading expert in public health, draws on case studies from across the globe to examine the social environmental, economic and political causes of these health inequalities, how they have evolved over time and what they are like today. Bambra concludes by considering how health divides might develop in the future and what should be done, so that where you live is not a matter of life and dealth. -- Provided by publisher.
Book
Equity, social determinants and public health programmes
This book was commissioned by the Department of Ethics, Equity, Trade and Human Rights as part of the work undertaken by the Priority Public Health Conditions Knowledge Network of the Commission on Social Determinants of Health, in collaboration with 16 of the major public health programs of WHO: alcohol-related disorders, cardiovascular diseases, child health, diabetes, food safety, HIV/AIDS, maternal health, malaria, mental health, neglected tropical diseases, nutrition, oral health, sexual and reproductive health, tobacco and health, tuberculosis, and violence and injuries. In addition to this, through collaboration with the Special Programme of Research, Development and Research Training in Human Reproduction, the Special Programme for Research and Training in Tropical Diseases, and the Alliance for Health Policy and Systems Research, 13 case studies were commissioned to examine the implementation challenges in addressing social determinants of health in low-and middle-income settings. The Priority Public Health Conditions Knowledge Network has analyzed the impact of social determinants on specific health conditions, identified possible entry-points, and explored possible interventions to improve health equity by addressing social determinants of health.
eBook
Investigating racial and gender disparities in virtual randomized clinical trial enrollment: Insights from the BE ACTIVE study
Randomized clinical trials (RCTs) often suffer from a lack of representation from historically marginalized populations, and it is uncertain whether virtual RCTs (vRCTs) enhance representativeness or if elements of their consent and enrollment processes may instead contribute to underrepresentation of these groups. In this study, we aimed to identify disparities in enrollment demographics in a vRCT, the BE ACTIVE study, which recruited patients within a single health system. We discovered that the proportions of eligible patients who were randomized differed significantly by gender and race/ethnicity (men 1.2%, women 2.0%, P < .001; White 1.8%, Black 1.3%, Hispanic 0.7%, Asian 0.9%; P < .001), and compared with White patients, non-White patients were less likely to have a valid email address on file and were less likely to click on the email link to the study webpage and begin enrollment.
Journal Article
Global perspectives on cancer : incidence, care, and experience
\"Two leading oncologists, along with experts spanning several medical disciplines, shed light on the global pandemic of cancer, particularly the difference in diagnosis, treatment, and care between global communities\"--Provided by publisher.
Book
ENOUGH: COVID-19, Structural Racism, Police Brutality, Plutocracy, Climate Change—and Time for Health Justice, Democratic Governance, and an Equitable, Sustainable Future
COVID-19 starkly reveals how structural injustice cuts short the lives of people subjected to systemic racism and economic deprivation.2 4 It is not, however, the only crisis at hand.Since the May 25, 2020, murder of George Floyd, a 46year-old African American man, by the Minneapolis, Minnesota, police, protests have coursed through cities and towns across the United States, denouncing structural racism and police violence,5-7 fueled, too, by COVID-19's disproportionate toll on US populations of color.2 4 In a context in which US police kill upwards of 1000 people peryear-nearly three per day, disproportionately Black Americans, and vastly more than in any other wealthy country5,6 -the last straw was Floyd's horrific murder.7 Floyd died because he could not breathe, because police officer Derek Chauvin knelt on his neck for an agonizing 8 minutes and 46 seconds-in open view, as videoed for all to see, while three other police standing nearby failed to intervene.The current upsurge ofprotest builds on the leadership of so many groups, perhaps most prominently Black Lives Matter, founded in 2013 by three radical Black women organizers-Alicia Garza, Patrisse Cullors, and Opal Tometi-in response to the acquittal of Trayvon Martin's vigilante murderer, George Zimmerman, and which rapidly grew in the wake of Michael Brown's killing by Ferguson, Missouri, police officer Darren Wilson in 2014.8 Also feeding these protests is the post-2016 rise in hate crimes,9 coupled with overt expressions of racism, both by word and by policies, at the highest levels of the US . 2,10 government.
Journal Article
Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa
Background
The National Development Plan (NDP) strives that South Africa, by 2030, in pursuit of Universal Health Coverage (UHC) achieve a significant shift in the equity of health services provision. This paper provides a diagnosis of the extent of socio-economic inequalities in health and healthcare using an integrated conceptual framework.
Method
The 2012 South African National Health and Nutrition Examination Survey (SANHANES-1), a nationally representative study, collected data on a variety of questions related to health and healthcare. A range of concentration indices were calculated for health and healthcare outcomes that fit the various dimensions on the pathway of access. A decomposition analysis was employed to determine how downstream need and access barriers contribute to upstream inequality in healthcare utilisation.
Results
In terms of healthcare need, good and ill health are concentrated among the socio-economically advantaged and disadvantaged, respectively. The relatively wealthy perceived a greater desire for care than the relatively poor. However, postponement of care seeking and unmet need is concentrated among the socio-economically disadvantaged, as are difficulties with the affordability of healthcare. The socio-economic divide in the utilisation of public and private healthcare services remains stark. Those who are economically disadvantaged are less satisfied with healthcare services. Affordability and ability to pay are the main drivers of inequalities in healthcare utilisation.
Conclusion
In the South African health system, the socio-economically disadvantaged are discriminated against across the continuum of access. NHI offers a means to enhance ability to pay and to address affordability, while disparities between actual and perceived need warrants investment in health literacy outreach programmes.
Journal Article
Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions
Introduction
Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment.
Methodology
Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap.
Results
We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer research, poor cancer education or awareness, inadequate screening or diagnostic facilities, lack of a well-organized and effective cancer registry system and access to care, shortage of specialized medical staff, high costs for screening, vaccination, and treatment, lack of technical capacity, poor vaccination response, and/or late presentation of patients for cancer screening. We also provide recommendations to address some of these obstacles to achieving cancer care equity. Our recommendations are divided into national-level initiatives and capacity-based initiatives, including cancer health promotion and awareness by healthcare professionals during every hospital visit, encouraging screening and vaccine uptake, ensuring operational regional and national cancer registries, improving healthcare budgeting for staff, equipment, and facilities, building expertise through specialty training, funding for cancer research, providing insurance coverage for cancer care, and implementing mobile health technology for telemedicine diagnosis.
Conclusion
Addressing challenges to cancer equity holistically would improve the likelihood of longer survival for cancer patients, lower the risk factors for groups that are already at risk, and ensure equitable access to cancer care on the continent. This study identifies the existing stance that African nations have on equity in cancer care, outlines the current constraints, and provides suggestions that could make the biggest difference in attaining equity in cancer care.
Journal Article