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Health Inequities: Structural Causes, Intervention Strategies, and Methodological Challenges

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 874

Special Issue Editors


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Guest Editor

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Guest Editor
Centre for Health and Development (CHAD), University of Staffordshire, Stoke-on-Trent ST4 2DF, UK
Interests: mental health; health inequalities

Special Issue Information

Dear Colleagues,

Health inequalities, the observable differences in health outcomes between individuals and groups defined by socio-economic status, geography, demographic characteristics, and other social determinants, have been well-documented. Critically, many of these differences constitute health inequities: avoidable, unjust disparities rooted in systemic social, economic, and political structures. Despite longstanding recognition and their place on both political and public health agendas, these inequities persist. Global challenges, including climate change, political instability and conflict, forced displacement, and prolonged periods of economic austerity, compound existing inequities, disproportionately affecting the most vulnerable. Addressing health inequities is, therefore, an increasingly urgent priority for research, policy, and practice. Those trying to intervene face substantial challenges, including the need to act at multiple levels to influence the complex systems that create and perpetuate these disparities. Researchers also encounter methodological hurdles—ranging from diverse ways of measuring inequalities and varying guidance and checklists, to contextual differences between low- and middle-income versus high-income countries, and the inherent complexity in understanding causes and designing effective interventions.

This Special Issue invites contributions that advance knowledge on health equity in terms of methodology or implementation. We welcome papers that explore new approaches to measuring inequalities, the development or evaluation of approaches to tackling health inequities, and systems-level perspectives. Submissions focusing on underserved and marginalised populations, where the impacts of inequity are most pronounced, are also encouraged.

Prof. Dr. Christopher J. Gidlow
Dr. Naomi Ellis
Guest Editors

Manuscript Submission Information

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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

  • health inequality
  • equity
  • disparities
  • disadvantage

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Published Papers (2 papers)

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Research

17 pages, 789 KB  
Article
Developing an Index to Measure Structural Racism: Methodological Process, Challenges, and Considerations
by Christopher M. Amissah, Alisha A. Crump, Yu-Hua Fu, Sheela Khadka, Jennifer Contreras, Salene M. W. Jones, Bryce B. Reeve and Ester Villalonga-Olives
Int. J. Environ. Res. Public Health 2026, 23(2), 200; https://doi.org/10.3390/ijerph23020200 - 3 Feb 2026
Viewed by 264
Abstract
Access to valid and reliable measures of structural racism is essential for addressing health inequities, yet few validated ecological-level indices exist for assessing structural racism affecting Black and Hispanic populations in the United States. Guided by the National Institute on Minority Health and [...] Read more.
Access to valid and reliable measures of structural racism is essential for addressing health inequities, yet few validated ecological-level indices exist for assessing structural racism affecting Black and Hispanic populations in the United States. Guided by the National Institute on Minority Health and Health Disparities framework, our interdisciplinary team undertook the development of an ecological-level structural racism index. In the process, we encountered substantive methodological and data-related challenges that warrant explicit documentation. This paper describes the methodological process used to identify and select indicators of structural racism, including a modified Delphi consensus process involving social epidemiologists, health inequality researchers, community members, economic inequality specialists, and psychometricians. We outline a five-step approach for extracting and harmonizing geographic-level data from publicly available sources and discuss key challenges encountered, including limited availability of granular geographic data, insufficient data documentation guidelines, inconsistent reporting frequencies, and difficulties in adapting publicly available datasets for structural racism measurement. Rather than presenting a finalized index, this paper serves as a methodological guide and cautionary account for researchers seeking to develop ecological measures of structural racism, emphasizing the importance of transparency, adaptability, and rigorous data selection in advancing public health equity research. Full article
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25 pages, 1013 KB  
Article
Statewide Assessment of Public Park Accessibility and Usability and Playground Safety
by Iva Obrusnikova, Cora J. Firkin, Riley Pennington, India Dixon and Colin Bilbrough
Int. J. Environ. Res. Public Health 2026, 23(1), 139; https://doi.org/10.3390/ijerph23010139 - 22 Jan 2026
Viewed by 331
Abstract
Accessible and inclusive community environments support physical activity and health equity for people with disabilities, yet gaps in design, maintenance, and communication limit safe, independent use. This statewide cross-sectional audit assessed park accessibility and usability and playground safety in publicly accessible, non-fee-based Delaware [...] Read more.
Accessible and inclusive community environments support physical activity and health equity for people with disabilities, yet gaps in design, maintenance, and communication limit safe, independent use. This statewide cross-sectional audit assessed park accessibility and usability and playground safety in publicly accessible, non-fee-based Delaware community parks with playgrounds. Fifty stratified sites were evaluated using the Community Health Inclusion Index and the America’s Playgrounds Safety Report Card by trained raters with strong interrater reliability. Descriptive analyses summarized accessibility, usability, communication, and safety features by county, with exploratory urban-suburban/micropolitan contrasts. Most sites provided wide, smooth paths, shade, and strong playground visibility, but foundational accessibility varied. Only 30% had a nearby transit stop, fewer than 10% of crossings included auditory or visual signals. Curb-ramp completeness was inconsistent, with detectable warnings frequently absent. Restrooms commonly lacked low-force doors or operable hardware, and multi-use trails often had obstacles or lacked wayfinding supports. Playground accessibility features were present at approximately two-thirds of sites, and 62% were classified as safe, although 10% were potentially hazardous or at-risk. Higher playground accessibility scores were strongly associated with lower life-threatening injury risk. Overall, gaps in transit access, pedestrian infrastructure, amenities, and communication support limit equitable, health-supportive park environments and highlight priority improvement areas. Full article
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