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Discrimination as a Social Determinant of Health and Healthcare Inequities
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Discrimination as a Social Determinant of Health and Healthcare Inequities

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 31 July 2026 | Viewed by 2437

Special Issue Editor

Prof. Dr. Anuli Njoku

E-Mail Website
Guest Editor
Department of Public Health, College of Health and Human Services, Southern Connecticut State University, New Haven, CT 06515, USA
Interests: socioecological determinants of health disparities; health equity; health promotion and education; environmental health; rural health; cultural competence in higher education; scholarship of teaching and learning; curriculum development
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Social determinants of health (SDOHs) are the non-medical, environmental, and social conditions that impact health outcomes and well-being, such as the following:

  • Systemic racism and discrimination, poverty and unequal access to resources;
  • Economic stability (housing instability, substandard housing conditions, food insecurity and nutritional challenges, employment and income barriers);
  • Education access and quality (high school dropout rates, limited career opportunities);
  • Healthcare access and quality (limited primary care access, rural healthcare disparities);
  • Neighborhood and physical/built environment (lack of healthy food options, crime and violence, environmental health concerns, and lack of transportation);
  • Social and community context (community resources, religious and cultural affiliations, community engagement), and;
  • Early abuse, violence and trauma.

SDOHs, including racism and discrimination, directly contribute to health disparities among communities of color and marginalized populations (e.g., women and girls, children, rural residents, low-income individuals, the LGBTQ+ population, individuals with disabilities, undocumented immigrants, migrants, and refugees, indigenous communities, incarcerated populations, and people experiencing homelessness) nationally and globally, threatening health equity.

Papers on all topics that explore the link between discrimination and health and investigate reforms that address systems of oppression are encouraged in this Special Issue.

New research papers, case reports, brief reports, methodological papers, articles, systematic reviews, and commentaries are welcome. The Special Issue welcomes manuscripts across multiple fields that adopt various quantitative, qualitative, and mixed methodologies.

Prof. Dr. Anuli Njoku
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 250 words) can be sent to the Editorial Office for assessment.

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. International Journal of Environmental Research and Public Health 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 2500 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

  • social determinants of health
  • racism
  • discrimination
  • environmental health
  • maternal health
  • mental health
  • health disparities
  • health equity
  • minority
  • health policy

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Published Papers (2 papers)

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Research

21 pages, 388 KB  
Article
Social Marketing for Health Equity: Promoting Preventive Health Behavior Among Women in Rural Communities
by Kamel Mouloudj, Sarah Ali Saeed Alameri, Marian A. Evans, Alaa Abdulkareem Ghaleb Almado, Basheer Ismail Mahmoud and Dachel Martínez Asanza
Int. J. Environ. Res. Public Health 2026, 23(5), 584; https://doi.org/10.3390/ijerph23050584 - 30 Apr 2026
Viewed by 391
Abstract
Preventive health behaviors play a critical role in reducing disease risks and improving public health outcomes, particularly among vulnerable populations such as women in rural communities. However, limited research has explored the determinants of intentions to adopt preventive health behaviors in developing contexts [...] Read more.
Preventive health behaviors play a critical role in reducing disease risks and improving public health outcomes, particularly among vulnerable populations such as women in rural communities. However, limited research has explored the determinants of intentions to adopt preventive health behaviors in developing contexts among women in rural communities. This study applies and extends the Theory of Planned Behavior (TPB) to examine these determinants in Algeria. A cross-sectional study was conducted using convenience sampling among 205 women in rural communities aged 20–60 years across five Algerian cities. Data were collected through a self-administered questionnaire and analyzed using hierarchical multiple regression. The results indicate that attitude, subjective norms, and perceived behavioral control have significant positive effects on behavioral intention. The inclusion of health literacy significantly enhances the model’s explanatory power, with higher literacy associated with stronger intentions. In contrast, perceived healthcare discrimination does not have a statistically significant effect. The extended model explains 57.5% of the variance in behavioral intention. These findings underscore the importance of psychosocial and informational factors in shaping preventive health intentions and support the extension of TPB in this context. They also provide practical implications for policymakers and healthcare practitioners to design targeted social marketing interventions aimed at improving preventive health behaviors and reducing health disparities among women in rural communities. Full article
(This article belongs to the Special Issue Discrimination as a Social Determinant of Health and Healthcare Inequities)
23 pages, 399 KB  
Article
Maternal Mortality Among Black Women in Brazil: A Retrospective Cohort Study
by Gustavo Gonçalves dos Santos, Anuli Njoku, Reginaldo Roque Mafetoni, Clara Fróes de Oliveira Sanfelice, Ana Izabel Oliveira Nicolau, Patrícia Wottrich Parenti, Cely de Oliveira, Leticia López-Pedraza, Ricardo José Oliveira Mouta, Karina Franco Zihlmann, Cindy Ferreira Lima, Cícero Ricarte Beserra Júnior, Cláudia de Azevedo Aguiar, Cesar Henrique Rodrigues Reis, Júlia Maria das Neves Carvalho, Ana Cristina Ribeiro da Fonseca Dias, Maria Luísa Santos Bettencourt, Mónica Alexandra Pinho da Silva, Maria João Jacinto Guerra and Giovana Aparecida Gonçalves Vidotti
Int. J. Environ. Res. Public Health 2026, 23(1), 94; https://doi.org/10.3390/ijerph23010094 - 9 Jan 2026
Viewed by 1478
Abstract
Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, [...] Read more.
Background: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020. Methods: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00–O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death. Results: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions. Conclusions: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare. Full article
(This article belongs to the Special Issue Discrimination as a Social Determinant of Health and Healthcare Inequities)
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