Official-language minorities in Canada may face specific issues in accessing health care services that can lead to negative consequences on their health, utilization of health care services and satisfaction with the health care system. A secondary data analysis of the 2006 Survey on the Vitality of Official-Language Minorities revealed significant differences between the Anglophone minority (n=5,161) and the Francophone minority (n=12,029) with regards to general health, and access to and use of health care services. Important predictors of these outcomes included age, education level, household income, marital status and place of residence (urban/rural). Access to health care services in the minority language was associated with self-perceived health in the Anglophone minority only. Health policy recommendations elaborated in light of the findings include working on both the supply and the demand of health care services offered in the two official languages, while taking into consideration important contextual differences between regions.

Disaster vulnerability and health status are determined by the intersecting social identities individuals possess in a given context. Based on two months fieldwork in Bangladesh, this study employs a comparative exploratory case study methodology to understand the way in which the Canadian International Development Agency (CIDA), Oxfam and Gonoshasthaya Kendra construct and deploy the concepts of gender, empowerment and women’s health within their disaster management policies and programs. It finds that disaster management interventions that fail to understand the intersectional nature of women’s vulnerability risk entrenching or creating forms of both privilege and oppression. Combining intersectionality, Moser’s Practical and Strategic Gender Needs and Sen’s Capability Approach, this study aims to deconstruct the embedded view of women in disaster management by suggesting that a social determinants of health approach, paired with intersectionality, could provide important insights into disaster management interventions and their effectiveness in addressing the gendered realities of women facing disasters.

Introduction: Tuberculosis (TB) is an infectious disease that causes significant morbidity and mortality. Despite the fact that the total burden of TB has decreased dramatically, the distribution of that burden across the Canadian population has not changed. A century ago, the Indigenous population of Canada had a significantly higher TB mortality than the non-Indigenous population. This gap still exists today. TB is a disease of poverty, and understanding the role of the social determinants of health (SDH) may provide insights into the causes of persistence of TB in the Indigenous population. Research questions: This thesis tackles three questions: 1) Can a TB outbreak that took place over a century ago be reconstructed? 2) What can we learn about the relationship between the disease, the population it afflicted, and the environment in which the outbreak took place? 3) How can reconstruction of a TB outbreak be used to evaluate policy interventions? Area studied: Analyses were limited to the Qu’Appelle Agency, located in Southeastern Saskatchewan. Methodology: An agent-based model of socioeconomic environment of the Qu’Appelle Agency was developed to study the relationship between TB and SDH. Data on TB mortality, demographics, agricultural production, material circumstances, and economic factors of production were used to study the relationship between TB and SDH at the aggregate level. Results: 1) Extensive aggregate data analyses were carried out and an agent-based model of TB transmission and of the socioeconomic environment of the Qu’Appelle Agency was developed. 2) Results of these analyses identify a number of important parameters responsible for the high TB mortality in the Agency. These parameters include biological factors, housing, social characteristics, agricultural output, and policies of the Department of Indian Affairs. Conclusions: This research demonstrates that reconstruction of an outbreak of an infectious disease that took place over a century ago is a complex undertaking that hinges on availability of data and significant expertise in a variety of fields, such as health sciences, economics, mathematics, and modelling approaches. The further one goes into the past, the more one is forced to rely on assumptions, which make the reconstructed web of relationships between agent, host, and environment that caused the outbreak less certain. Despite the inherent uncertainty, the process of outbreak reconstruction provides a deep and multi-faceted understanding of the interactions among the agent, the host, and the environment. The resulting model is a useful way of studying policy interventions that could be applied in other contexts as well – to other infectious diseases or TB outbreaks on other reserves. Keywords: [population health, epidemiology, tuberculosis, Indigenous peoples, agent-based modelling, social determinants of health]

Ongoing research indicates that the burden of infection and mortality from the coronavirus disease 2019 (COVID-19) has been disproportionately borne by Latinx populations in the United States (U.S.). While Latinx people account for 18.4% of the U.S. population, they make up 23.1% of total COVID-19 cases and almost 38% of all COVID-19-related-deaths in the U.S. Latinx people face systemic socioeconomic and political challenges that adversely impact their risk of exposure to and recovery from COVID-19. This investigation will discuss the health disparities experienced by the U.S. Latinx population that have been exacerbated by the COVID-19 pandemic, with a particular focus on the social determinants of health (SDOH) and the unmet social needs for this population.

Thesis advisor: Rebekah L. Coley / Recent decades have witnessed the increasing spatial concentration of poverty and affluence in the United States (Biscoff & Reardon, 2013). Given well-documented links between neighborhood economic contexts and wellbeing (Chow et al., 2005), this has the potential to exacerbate disparities in health, particularly for people with limited neighborhood choice. However, limited research has systematically examined the neighborhood features underlying these links. A more nuanced understanding of why neighborhood poverty matters is essential for promoting equitable neighborhood development. Using rigorous analytic techniques that account for the dynamic nature of neighborhoods and help adjust for selection bias, I considered two complementary questions: 1) do observed neighborhood resources and stressors mediate associations between neighborhood poverty and wellbeing within and between individuals; and 2) how do observed versus perceived changes in neighborhood features mediate links between neighborhood poverty and wellbeing? I combined individual-level longitudinal data from the Post-Katrina Study of Resilience and Recovery with administrative neighborhood data drawn from the Census Bureau, FBI, and EPA. Analyses focused on a sample of 606 participants – primarily young Black mothers with low levels of income – who were affected by Hurricane Katrina, most of whom experienced some period of forced relocation. Participants were surveyed once before (2003/04) and twice after (2006/07; 2009) the hurricane. Results paint a complex picture. Contrasting with prior research, total effects of neighborhood poverty on wellbeing were limited. However, changes in neighborhood poverty were linked to wellbeing indirectly through intermediary neighborhood features, with results pointing to benefits and detriments of rising neighborhood poverty. Results were driven by those who changed neighborhoods over the course of the study. For participants that lived in the same New Orleans neighborhood across waves, changes in neighborhood poverty proved less consequential. Overall, results suggest that rather than treating neighborhood poverty as uniformly problematic for wellbeing, efforts to promote health equity should identify and build upon existing assets of neighborhoods, like affordability and amenity access, while also reducing stressors. / Thesis (PhD) — Boston College, 2021. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

This thesis investigates the impact of social determinants on life expectancy in 16 transition economies from 1995 to 2012 by a panel data regression analysis. The regression result suggests that, air quality, coverage for tertiary education, spending in health care have statistically positive associations with life expectancy. To be specific, 1 microgram per cubic meter reduction in PM 2.5 air pollution(mean annual exposure) is associated with a gain of 2.16 months of life expectancy at birth. 100 dollars increase in health expenditure per capita is associated with a gain of 2.4 months of life expectancy at birth. 10% points increase in the gross enrolment ratio for tertiary school is associated with a gain of 3.6 months of life expectancy. But the proxy variable of democracy(Unified Democracy Sores), Economic Freedom and out-of-pocket health expenditure are not significant factors of life expectancy.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / The emergence and development of electronic health records have contributed to an abundance of patient data that can greatly be used and analyzed to promote health outcomes and even eliminate health disparities. However, challenges exist in the data received with factors such as data inconsistencies, accuracy issues, and unstructured formatting being evident. Furthermore, the current electronic health records and clinical information systems that are present do not contain the social determinants of health that may enhance our understanding of the characteristics and mechanisms of disease risk and transmission as well as health disparities research. Linkage to external population health databases to incorporate these social determinants of health is often necessary. This study provides an opportunity to identify and analyze health disparities using geographical information systems on two important sexually transmitted diseases in chlamydia and gonorrhea using Marion County, Indiana as the geographical location of interest. Population health data from the Social Assets and Vulnerabilities Indicators community information system and electronic health record data from the Indiana Network for Patient Care will be merged to measure the distribution and variability of greatest chlamydia and gonorrhea risk and to determine where the greatest areas of health disparities exist. A series of both statistical and spatial statistical methods such as a longitudinal measurement of health disparity through the Gini index, a hot-spot and cluster analysis, and a geographically weighted regression will be conducted in this study. The outcome and broader impact of this research will contribute to enhanced surveillance and increased effective strategies in identifying the level of health disparities for sexually transmitted diseases in vulnerable localities and high-risk communities. Additionally, the findings from this study will lead to improved standardization and accuracy in data collection to facilitate subsequent studies involving multiple disparate data sources. Finally, this study will likely introduce ideas for potential social determinants of health to be incorporated into electronic health records and clinical information systems.

Background: Gender inequality is widespread throughout Latin America, in large part due to a ‘machista’ culture in which women tend to be regarded as inferior to men. In Colombia, especially in low-income areas, women and girls are consistently excluded and marginalized. As a result of this, adolescent girls are susceptible to gang recruitment, teen pregnancy, and substance abuse. In similar settings globally, sport has been shown to be an effective tool for development and for the socialization and inclusion of youth. Few studies have taken place in Latin America, however, and hardly any of them have focused specifically on marginalized girls. This study aims to address this gap in literature by exploring how sport can break down barriers of exclusion and promote inclusion of marginalized, adolescent girls in Colombia. Methods: This qualitative, multi-methods study involved the analysis of data collected from semi-structured and key informant interviews, as well as participant observation sessions. All data collection was conducted in Cazucá, Colombia with participants from local NGO Tiempo de Juego (TDJ). Semi-structured interviews were conducted with adolescent girls between the ages of 11-18 who were participating in at least 1 sport at TDJ. Key informant interviews were conducted with TDJ staff and a guardian of several girls who participate in TDJ. Interview transcripts and participant observation memos and reflections were reviewed and coded to identify themes through thematic analysis. Results: All participants interviewed indicated that sport had a positive impact on their day to day lives. Three main themes and two sub-themes were identified during data analysis: 1) ‘Machismo’ in Colombia with sub-themes: i) Gender Roles and ii) Gender Norms, 2) Exclusion and marginalization, and 3) Empowerment through sport. Most participants spoke about the prevalence of machismo in Colombian society and how gender roles and norms limit the types of opportunities that are available to them. Participants expressed how, although they are marginalized based on where they live, sport provided them with a healthy activity to engage in as an alternative to the negative behaviours that they are susceptible to in their neighbourhoods. Sport provided them with an outlet to escape from their daily problems, and they felt that through sport, they were able to realize their self-worth and gain confidence in themselves. Conclusion: These findings suggest that sport can become a useful tool for promoting the inclusion of marginalized girls through empowerment. While sport was shown to break down some barriers of exclusion, further work must be done to explore its potential role in breaking down gender stereotypes that remain prevalent in Colombian culture. These results highlight the need for more sport programs that focus on marginalized girls in Latin American countries where women and girls remain a neglected population.

No description available.