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Health Disparities: The Emerging Trends and Pressing Challenges

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A special issue of European Journal of Investigation in Health, Psychology and Education (ISSN 2254-9625).

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 14035

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Prof. Keren Dopelt

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Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
Interests: health disparities; health promotion & education; health policy; sociology of health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Centers for Disease Control and Prevention (CDC) defines health disparities as “preventable differences in the burden, disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups and communities”.

Health disparities have a profound influence on communities and individuals, shaping their overall health, wellbeing, and social dynamics. Health disparities are often deeply rooted in societal inequities related to factors such as race, ethnicity, socioeconomic status, education, and access to resources. Health disparities contribute to unequal health outcomes, reduced community resilience, a lack of trust and cooperation, a burden on community resources, and disruption of wellbeing. Addressing health disparities requires a community-centered approach that involves collaboration between governments, healthcare providers, community organizations, policymakers, and individuals. By promoting health equity, improving access to healthcare, and addressing social determinants of health, communities can work towards reducing health disparities and creating healthier environments for all residents. While it is true that there have been increasing efforts to address health disparities in recent years, the persistence and complexity of these disparities present ongoing challenges. Continued research, data collection, and evaluation are essential to inform effective strategies and monitor progress in reducing health disparities.

The aim of this Special Issue is to raise awareness about the existence, magnitude, and impact of health disparities within specific populations or across various dimensions such as race, ethnicity, socioeconomic status, gender, or geographic location, to explore and deepen the understanding of the determinants of health disparities and to inform and influence policy development and healthcare practice.

Prof. Keren Dopelt
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. European Journal of Investigation in Health, Psychology and Education is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

health disparities and health inequality locally and globally
health justice and distributive justice
food insecurity
public vs. private health insurance
health of immigrants, minorities, LGBTQ
racism/ethnicity/diversity
health services utility among marginalized and vulnerable populations
public health policy
health workforce and services in peripheral areas
social determinants of health

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Published Papers (10 papers)

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18 pages, 358 KiB

Open AccessArticle

A Step Forward in Long COVID Research: Validating the Post-COVID Cognitive Impairment Scale

by Somayeh Pour Mohammadi, Razieh Etesamipour, Francisco Mercado Romero and Irene Peláez

Eur. J. Investig. Health Psychol. Educ. 2024, 14(12), 3001-3018; https://doi.org/10.3390/ejihpe14120197 - 1 Dec 2024

Viewed by 641

Abstract

Long COVID, or post-acute sequelae of SARS-CoV-2 infection, includes a variety of enduring symptoms that endure beyond the acute phase of the illness, impacting multiple facets of patients’ psychological and physical health. The persistent symptoms encompass fatigue, breathing difficulties, musculoskeletal pain, and cognitive impairments, which can significantly affect daily functioning and overall quality of life. The objective of this study was to create and validate the accuracy of the Post-COVID Cognitive Impairment Scale, which is used to evaluate cognitive impairments resulting from a COVID-19 infection. This study was conducted in Iran between January and September 2023. It consisted of three phases: developing the scale, evaluating its content validity with experts, and validating its structure with 454 participants using exploratory and confirmatory factor analysis. The exploratory factor analysis revealed two variables, namely memory and attention, which accounted for 40.38% of the variation. Confirmatory factor analysis verified the model’s fit, with indices indicating satisfactory alignment: CMIN/DF = 2.80, RMSEA = 0.06, SRMR = 0.05, CFI = 0.93, and TLI = 0.92. The factor loadings were statistically significant (p < 0.001), and Cronbach’s Alpha values indicated strong internal consistency (working memory = 0.81, attention = 0.80). These results affirm the Post-COVID Cognitive Impairment Scale is a valid and reliable instrument for evaluating cognitive deficiencies in individuals with long COVID. Its application in clinical and research environments aids in the prompt detection and tracking of the treatment of such impairments. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

18 pages, 483 KiB

Open AccessArticle

Determinants of Inequalities in the Exposure to and Adoption of Multiple Health Risk Behaviors among Brazilian Adolescents, 2009–2019

by Mariana Rebello Haddad and Flavia Mori Sarti

Eur. J. Investig. Health Psychol. Educ. 2024, 14(7), 2029-2046; https://doi.org/10.3390/ejihpe14070135 - 11 Jul 2024

Cited by 1 | Viewed by 765

Abstract

The occurrence of multiple risk behaviors among adolescents imposes challenges in the context of public policies of health, particularly in low- and middle-income countries. Evidence on the conditions leading to the exposure to and adoption of multiple risk behaviors allows the identification of vulnerable groups of adolescents, and may support the proposition of targeted strategies directed to individuals at risk. Therefore, the aim of this study was to perform a quantitative analysis to identify recent trends in the exposure to and adoption of multiple health risk behaviors among Brazilian adolescents, highlighting individual-, household-, and school-level characteristics linked to inequalities among social groups. The analysis was based on cross-sectional data from the National Student Health Survey (PeNSE), conducted by the Brazilian Institute for Geography and Statistics in 2009, 2012, 2015, and 2019. The trends in the occurrence of multiple risk behaviors among adolescents were estimated according to social strata, allowing the calculation of concentration indexes and their disaggregation into major determinants of inequalities in the exposure and adoption of risk behaviors. The analyses were conducted using a complex survey design to allow representativeness at the population level. The results showed a rise in the incidence of multiple risk behaviors among youngsters in Brazil from 2009 to 2019. Factors influencing inequalities in the exposure to multiple risk behaviors were socioeconomic status and the characteristics of the household and school environments, whilst the adoption of multiple risk behaviors was also influenced by early exposure to multiple risk behaviors. Furthermore, trends in inequalities in the exposure to and adoption of multiple risk behaviors showed an intensification from 2009 to 2019, being initially concentrated among wealthier adolescents, followed by a transition to higher incidence in the lower socioeconomic strata in 2012 and 2015, respectively. The findings underscore the role of support systems for adolescents at risk within the familial and school contexts, whereas strategies of public policies of health based on the strengthening of community ties may require improvements to tackle socioeconomic inequalities in the occurrence of risk behaviors among youngsters. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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13 pages, 483 KiB

Open AccessArticle

Disparity in the Burden of Caring for Older Persons between Families Living in Housing Estates and Traditional Communities in Thailand

by Nadila Mulati, Myo Nyein Aung, Saiyud Moolphate, Thin Nyein Nyein Aung, Yuka Koyanagi, Siripen Supakankunti and Motoyuki Yuasa

Eur. J. Investig. Health Psychol. Educ. 2024, 14(6), 1514-1526; https://doi.org/10.3390/ejihpe14060100 - 28 May 2024

Viewed by 1449

Abstract

Thailand’s rapid population aging and reliance on family-based long-term care requires research into disparities in family caregiver burden. Since the type of residence matters to the caregiving outcome, this research aimed to examine the difference in caregiver burden between residents of private housing estates and traditional village communities. This cross-sectional study was conducted with 1276 family caregivers of community-dwelling Thai older adults, in Chiang Mai province, Thailand. The caregiver burden was examined using the Caregiver Burden Inventory (CBI), and the care recipients’ dependency status was examined using Barthel’s Activity of Daily Living (ADL). Descriptive analysis, multivariate analysis of variance test, and multiple logistic regression analysis were performed. Family caregivers living in a traditional village community were 1.607 times more likely to experience emotional burden (adj. OR 1.607, 95% CI: 1.049, 2.462) and 2.743 times more likely to experience overall caregiver burden (adj. OR: 1.163, 95% CI: 1.163, 6.471) compared to those in the private housing estate group. Our findings showed significant differences in caregiver burden based on residential area, contributing with insights to evidence-based policies, interventions, and programs to minimize disparities and promote family caregivers’ health and well-being. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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13 pages, 1218 KiB

Open AccessArticle

by Eduardo Melguizo-Ibáñez, José Luis Ubago-Jiménez, Daniel Sanz-Martín and José Manuel Alonso-Vargas

Eur. J. Investig. Health Psychol. Educ. 2024, 14(5), 1140-1152; https://doi.org/10.3390/ejihpe14050075 - 24 Apr 2024

Viewed by 1220

Abstract

The Mediterranean diet is considered a healthy eating pattern. It has been shown to improve people’s quality of life. When a person suffers injuries, their quality of life suffers. This research aims to accomplish the following: (a) to study the differences in the effect of the health-related quality of life on injuries according to the degree of adherence to the Mediterranean diet, (b) to analyse the existing differences in the variables that make up the health-related quality of life according to the degree of adherence to the Mediterranean diet, and (c) to analyse the degree of adherence to the Mediterranean diet according to whether the participants have suffered any injury. The study was descriptive, cross-sectional, and exploratory in a sample of 556 physical education students. The PREDIMED questionnaire, the SF-36 questionnaire, and a self-administered questionnaire were used. The results showed that high adherence to the Mediterranean diet was associated with higher quality of life and lower injury rates. It was also observed that high adherence to the Mediterranean diet improved the effect of the quality of life on injuries. In conclusion, the Mediterranean diet is beneficial for the quality of life of young university students. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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15 pages, 1548 KiB

Open AccessArticle

Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases

by Ryusuke Matsumoto, Eishi Motomura and Motohiro Okada

Eur. J. Investig. Health Psychol. Educ. 2024, 14(4), 1086-1100; https://doi.org/10.3390/ejihpe14040071 - 21 Apr 2024

Viewed by 1583

Abstract

In Japan, suicide mortalities consistently decreased before the COVID-19 pandemic (from 2009 to 2019) but, conversely, increased after the pandemic outbreak from 2020 to 2022. To provide up-to-date suicide statistics in Japan, this study determined the temporal fluctuations of standardized suicide mortalities (SMRs), disaggregated by sex and age, by joinpoint regression analysis using the government suicide database, named the “Basic Data on Suicide in Region”. From January 2009 to December 2023, three temporal fluctuation patterns of SMRs pertaining to working age and older adults were detected, such as attenuations of decreasing trends before the COVID-19 pandemic (from around the mid-2010s), a sharply increasing trend that coincided with the pandemic outbreak, and gradually decreased during the pandemic, but no changes at the end of the COVID-19 pandemic. In particular, the SMRs of working-age females sharply increased concurrently with the pandemic outbreak, whereas those of males did not change. However, before the pandemic, decreasing trends of the SMRs of working-age males diminished in the mid-2010s, but those of females consistently decreased. The SMRs of working-age males indicated non-significant but sharply increasing trends in early 2022, a trend that was not observed for females. In contrast to working-age adults, the SMRs of adolescents already began to increase in the mid-2010s and also indicated consistently increasing trends between the periods during and after the pandemic. These results suggest, contrary to our expectations, that the impacts of both the outbreak and end of the COVID-19 pandemic were limited regarding the increase in SMRs from 2020. Therefore, when revising suicide prevention programs in the post-COVID-19 era, it should be noted that focusing on pandemic-associated factors alone is not sufficient. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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12 pages, 436 KiB

Open AccessArticle

Factors Contributing to the Health of 0- to 5-Year-Old Low-Birth-Weight Children in the United States: Application of the Multiple Disadvantage Model

by Tyrone C. Cheng and Celia C. Lo

Eur. J. Investig. Health Psychol. Educ. 2024, 14(1), 203-214; https://doi.org/10.3390/ejihpe14010013 - 9 Jan 2024

Viewed by 1377

Abstract

This secondary data analysis of 1731 low-birth-weight children and their parents in the United States investigated children’s health and its associations with social disorganization, social structural factors, social relationships, health/mental health, and access to health insurance/services. The study drew on data from the 2021 National Survey of Children’s Health. Logistic regression yielded results showing low-birth-weight children’s excellent/very good/good health to be associated positively with parents’ education and health. In turn, child health was associated negatively with being Black, having a family income at or below the 100% federal poverty level, difficulty parenting the child, child chronic health condition(s), parent mental health, and substance use in the family. The implications of the present findings in terms of interventions promoting maternal and child health as well as participation in government assistance programs for low-income families are discussed. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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15 pages, 1655 KiB

Open AccessArticle

Injury as a Result of Children and Adolescent Labor—An Association with Ethnicity and Peripherality: A Retrospective Cohort Study Based on the Israeli Trauma Registry

by Bella Savitsky, Irina Radomislensky, Eldad Katorza and Arielle Kaim

Eur. J. Investig. Health Psychol. Educ. 2024, 14(1), 133-147; https://doi.org/10.3390/ejihpe14010009 - 31 Dec 2023

Viewed by 1394

Abstract

Background: Working children and adolescents face a heightened risk of work-related injuries. This research aimed to assess the rate of hospitalizations resulting from work-related injuries among children and adolescents in Israel, with a specific focus on disadvantaged populations. Methods: This nationwide retrospective cohort study utilized The Israeli National Trauma Registry (INTR). It included 642 children and adolescents aged 13–17 hospitalized due to work-related injuries from 2015–2022. Results: Arab children had over five times the risk of hospitalization due to work-related injuries compared to Jewish (RR = 5.5, 95% CI: 4.7–7.4). Despite the 2018 law prohibiting young people from entering this type of work, the most common type of work leading to hospitalization was construction, accounting for 40.2% of Arab and 11.9% of Jewish injuries (p < 0.001). After adjustment, road traffic accidents and falls presented the highest odds of at least severe injury. Arabs had three times significantly higher odds of at least moderate injury compared to Jews. Conclusions: Prioritizing the creation of safe job opportunities for Arab teenagers is imperative. Strict enforcement measures, particularly within the construction industry, especially among Arab youth and during night shifts, are essential. These initiatives should focus on establishing secure and sustainable employment opportunities for children and young individuals, effectively reducing the risks associated with hazardous labor practices. In addition, the implementation of educational programs in the school curriculum covering essential aspects of youth employment is vital. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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13 pages, 286 KiB

Open AccessArticle

Higher Education in Public Health as a Tool to Reduce Disparities: Findings from an Exploratory Study among the Bedouin Community in Israel

by Osnat Bashkin, Avia Suisa and Sharon Levi

Eur. J. Investig. Health Psychol. Educ. 2023, 13(10), 2082-2094; https://doi.org/10.3390/ejihpe13100147 - 30 Sep 2023

Viewed by 1402

Abstract

The Bedouin community is a minority disadvantaged population in Israel that suffers from a variety of health and socioeconomic disparities and limited access to higher education. The current study aimed to examine perceptions, successes, and challenges experienced by Bedouin students during their studies and to assess an internship program developed on the principles of a community-based participatory research approach to public health. In-depth interviews were conducted with 34 Bedouin students studying in the public health academic track between January and April 2023. Grounded Theory was used to analyze the data. Three main themes emerged from the analysis: (1) facilitators for the decision to pursue higher education in public health, (2) challenges and coping strategies, and (3) experiences of success. The internship program included eleven Bedouin students who conducted six community intervention projects covering a range of topics with different target Bedouin populations. Higher education is crucial for empowering minorities, producing leadership, and reducing socioeconomic and health gaps. The field internship enabled the necessary alignment between academia and public health practice. It is important to further reflect on the integration of minority groups in public health studies and its role in decreasing health inequity. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

14 pages, 310 KiB

Open AccessArticle

“I Believe More in the Ability of the Small Person to Make Big Changes”: Innovation and Social Entrepreneurship to Promote Public Health in Israel

by Keren Dopelt, Nila Mordehay, Shir Goren, Aviya Cohen and Paul Barach

Eur. J. Investig. Health Psychol. Educ. 2023, 13(9), 1787-1800; https://doi.org/10.3390/ejihpe13090130 - 13 Sep 2023

Cited by 1 | Viewed by 1641

Abstract

Social entrepreneurship has grown worldwide in recent decades as it attempts to create and implement innovative solutions to social and environmental issues through business strategies. The aim of this study was to explore what motivates public health social entrepreneurs to act, the challenges and barriers they face, achievements, and competencies required for success. As such, we interviewed 15 social entrepreneurs in Israel. Budget issues, regulatory barriers, and struggles against powerful companies were the frequent barriers to success. The interviewees indicated several achievements at the health policy level by positioning and becoming an authority in the field, positively influencing other people’s lives. They highlighted the importance of creativity, determination and courage, leadership, and the ability to persevere in the face of overwhelming adverse odds as essential for the social entrepreneur’s success. Social entrepreneurship in public health is essential when struggling with health disparities. Nevertheless, recognizing that social entrepreneurship is not a substitute for methodological government planning and accountability is crucial. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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18 pages, 855 KiB

Open AccessSystematic Review

Interculturality in the Development of Technology-Mediated Courses for Massive Health Education: A Systematic Review

by Priscila Sanara da Cunha, Ingridy Marina Pierre Barbalho, Felipe Ricardo dos Santos Fernandes, Manoel Honorio Romão, Janaina Luana Rodrigues da Silva Valentim, Karla Mônica Dantas Coutinho, Kaline Sampaio de Araújo, Ricardo Alexsandro de Medeiros Valentim, Aline de Pinho Dias, Natalia Araújo do Nascimento Batista, José Adailton da Silva, Heleni Aires Clemente, Maria de Fátima Pereira Alves and Karilany Dantas Coutinho

Eur. J. Investig. Health Psychol. Educ. 2024, 14(10), 2754-2771; https://doi.org/10.3390/ejihpe14100181 - 8 Oct 2024

Viewed by 1180

Abstract

Virtual Learning Environments have become innovative tools in health professionals education. Through Massive Open Online Courses, they enable different ways of connecting with knowledge, facilitating study autonomy, interaction, and closer alignment with professional practices and the context of course participants. MOOCs comprise an educational strategy for many fields, including health. As they educate health professionals about a variety of practices, MOOCs play a crucial role in interculturality by enabling professionals to approach cultural diversity in work settings. This study provides a review of the literature investigating the element of interculturality in the production of healthcare-related MOOCs intended for a variety of audiences, including practicing healthcare professionals, healthcare professional trainees, and the general public. Based on a systematic review protocol, we searched for peer-reviewed studies published between 2016 and 2023 in Science Direct, PubMed, ERIC, and Scopus. Fifteen studies were selected for final analysis, which highlighted MOOC development, its underlying processes, and its importance in promoting health and social well-being. MOOCs have (1) provided new approaches to technology-mediated learning in distance health education, (2) aided training, (3) disseminated knowledge, and (4) promoted interculturality. Continuous collaboration and innovation in MOOC development are essential to ensure their effectiveness and relevance in the contemporary educational scenario. Full article

(This article belongs to the Special Issue Health Disparities: The Emerging Trends and Pressing Challenges)

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