International Journal of Environmental Research and Public Health

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13 pages, 356 KiB

Open AccessArticle

Relationship between Live-In Grandparents and Grandchild’s Health and Well-Being in Palestinian Refugees in Lebanon

by Olfat B. Sheikomar, Hala Ghattas and Nadine R. Sahyoun

Int. J. Environ. Res. Public Health 2023, 20(1), 370; https://doi.org/10.3390/ijerph20010370 - 26 Dec 2022

Cited by 1 | Viewed by 2419

Abstract

Grandparents (GP) play influential roles in grandchildren’s health, behavior, and life. However, this relationship has not been examined in the Arab region. This study assesses whether the presence of GP in the household is associated with grandchildren’s health and wellbeing. Health status was [...] Read more.

Grandparents (GP) play influential roles in grandchildren’s health, behavior, and life. However, this relationship has not been examined in the Arab region. This study assesses whether the presence of GP in the household is associated with grandchildren’s health and wellbeing. Health status was determined by a child experiencing chronic health conditions or an acute illness, and wellbeing was determined based on school attendance and child labor. Data were collected through surveys conducted in 2010 and 2015 of representative samples of Palestinian refugees living in Lebanon. Multivariate logistic regression showed that, even after controlling for potential confounders, including the presence of parents in the household and household food insecurity (FI), the presence of live-in GP was associated with lower odds of children experiencing acute illnesses (OR 0.74 95% CI 0.62–0.92) and higher odds of attending school (OR 2.22 95% CI 1.28–5.33), but not child labor. The presence of GP in the household may be protective to grandchildren’s health status and school attendance in this population. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

16 pages, 384 KiB

Open AccessArticle

Barriers and Facilitators to Mental Health Help-Seeking and Experiences with Service Use among LGBT+ University Students in Chile

by Marcelo A. Crockett, Vania Martínez and Patricio Caviedes

Int. J. Environ. Res. Public Health 2022, 19(24), 16520; https://doi.org/10.3390/ijerph192416520 - 9 Dec 2022

Cited by 9 | Viewed by 3757

Abstract

Barriers limiting access to mental health care for lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) university students have not yet been explored in depth. The aim of this study was to explore the barriers and facilitators to mental health [...] Read more.

Barriers limiting access to mental health care for lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) university students have not yet been explored in depth. The aim of this study was to explore the barriers and facilitators to mental health help seeking and experiences with service use among LGBT+ university students. Participants were 24 LGBT+ students between 18 and 23 years of age from a university in Chile. Individual semi-structured interviews were conducted and analysed using thematic content analysis. Multiple barriers and facilitators influence mental health help-seeking of LGBT+ students, with some of these barriers being explicitly related to LGBT+ issues (e.g., fear of discrimination or accessing specialised services). Perceived effectiveness of services was closely related to access safe/affirming care. Trans students reported more barriers to help-seeking and negative experiences with professionals than their cisgender peers. Perceptions of university mental health services as safe spaces for LGBT+ students were related to a positive perception of the university regarding LGBT+ issues. Knowing the factors that either hinder or facilitate help-seeking and characterising service use experiences in this population is useful for improving access to mental health services and for the development of policies that promote affirmative care for LGBT+ people. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

14 pages, 372 KiB

Open AccessArticle

Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework

by Danni Xia, Yingjie Chen, Ruijie Chang, Chen Xu, Xiaoyue Yu, Yujie Liu, Hui Chen, Rongxi Wang, Shangbin Liu, Xin Ge, Yuxuan Wang, Ajuan Liang, Fan Hu, Yong Cai and Ying Wang

Int. J. Environ. Res. Public Health 2022, 19(23), 16161; https://doi.org/10.3390/ijerph192316161 - 2 Dec 2022

Cited by 4 | Viewed by 1947

Abstract

Studies examining the association between psychosocial problems and condomless anal sex (CAS) among transgender women (TGW) are rare. In this study, close attention was paid to the effect of co-occurring psychosocial problems on sexual risk behaviors. A cross-sectional study, including 247 TGW, was [...] Read more.

Studies examining the association between psychosocial problems and condomless anal sex (CAS) among transgender women (TGW) are rare. In this study, close attention was paid to the effect of co-occurring psychosocial problems on sexual risk behaviors. A cross-sectional study, including 247 TGW, was conducted in Kunming and Shenyang, China. The prevalence of condomless anal sex among TGW in the previous 6 months was 30.8%. Most of the psychosocial factors were associated with one another in bivariate logistic regression models. Low self-esteem (ORm = 2.99, 95% CI = 1.25–7.18), sexual compulsivity (ORm = 2.13, 95% CI = 1.13–4.00), and intimate partner violence (ORm = 2.21, 95% CI = 1.19–4.11) were discovered to be related to condomless anal sex in the multivariate regression model. No significant interactive effects of the syndemic factors on condomless anal sex were detected. More programmatic and effective HIV prevention interventions targeting psychosocial problems are required to reduce HIV infection within the population. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

10 pages, 368 KiB

Open AccessArticle

Meanings and Practices in Intercultural Health for International Migrants

by Consuelo Cruz-Riveros, Alfonso Urzúa, Gustavo Macaya-Aguirre and Báltica Cabieses

Int. J. Environ. Res. Public Health 2022, 19(20), 13670; https://doi.org/10.3390/ijerph192013670 - 21 Oct 2022

Cited by 2 | Viewed by 2038

Abstract

In this article, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the city of Antofagasta in northern Chile. Methodology: The methodology was qualitative with a phenomenological descriptive design, through which [...] Read more.

In this article, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the city of Antofagasta in northern Chile. Methodology: The methodology was qualitative with a phenomenological descriptive design, through which discourses from health personnel in the public primary and secondary care system were explored (n = 23). Next, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the northern Chilean city of Antofagasta. Results: The participants presented trees of thematic categories. There were three thematic categories overall: (1) The meaning of interculturality included features of understanding of the concept, with respect for culture being the transversal axis in all discourses. (2) Practices in health care, where voluntariness, references, and the adequacy or non-technicality of the language are fundamental axes. (3) Training in the intercultural approach, where there is often self-knowledge and lack of supply in the health system. Conclusions: The findings show essential elements to consider in the care of international migrants, including the training and awareness of staff about the intercultural approach through strategies following the local reality in which each health establishment exists. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

7 pages, 295 KiB

Open AccessArticle

Religiosity Is Associated with Reduced Risk of All-Cause and Coronary Heart Disease Mortality among Jewish Men

by Sigal Eilat-Adar, Devora Hellerstein and Uri Goldbourt

Int. J. Environ. Res. Public Health 2022, 19(19), 12607; https://doi.org/10.3390/ijerph191912607 - 2 Oct 2022

Cited by 5 | Viewed by 2242

Abstract

Previous studies have found an inverse association between religiosity and mortality. However, most of these studies were carried out with Christian participants. This longitudinal study aimed to determine whether a composite variable based on self-reported religious education and religious practices is associated with [...] Read more.

Previous studies have found an inverse association between religiosity and mortality. However, most of these studies were carried out with Christian participants. This longitudinal study aimed to determine whether a composite variable based on self-reported religious education and religious practices is associated with coronary heart disease (CHD) and all-cause mortality in 9237 Jewish men aged 40–65 years at baseline, over a 32-year follow-up. Jewish men were characterized by their degree of religiosity, from the Ultra-Orthodox (“Haredim”)—the strictest observers of the Jewish religious rules, and in descending order: religious, traditional, secular, and agnostic. Demographic and physical assessments were made in 1963 with a 32-year follow-up. The results indicate that Haredim participants, in comparison to the agnostic participants, had lower CHD mortality. Hazard ratio (HR) and 95% confidence interval (95% CI)—adjusted by age, cigarette smoking, systolic blood pressure, diabetes, socioeconomic status, BMI, and cholesterol, was: [HR = 0.68 (95% CI 0.58,0.80)] for Haredim; [HR = 0.82 (95% CI 0.69,0.96)] for religious; [HR = 0.85 (95% CI 0.73–1.00)] for traditional; and [HR = 0.92 (95% CI 0.79–01.06) for secular, respectively (p for trend = 0.001). The same pattern was observed for total mortality. This study shows an association between religious practice among men and a decreased rate of CHD and total mortality. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

13 pages, 474 KiB

Open AccessArticle

Characterization of Communes with Quality Accredited Primary Healthcare Centers in Chile

by Juan Coss-Mandiola, Jairo Vanegas-López, Alejandra Rojas, Raúl Carrasco, Pablo Dubo and Maggie Campillay-Campillay

Int. J. Environ. Res. Public Health 2022, 19(15), 9189; https://doi.org/10.3390/ijerph19159189 - 27 Jul 2022

Cited by 4 | Viewed by 2385

Abstract

The accreditation process of primary healthcare centers in Chile has not had the same progress as in hospitals, which show high levels of compliance. The purpose of this research is to characterize the communes that have accredited family healthcare centers (CESFAMs) through socio-economic, [...] Read more.

The accreditation process of primary healthcare centers in Chile has not had the same progress as in hospitals, which show high levels of compliance. The purpose of this research is to characterize the communes that have accredited family healthcare centers (CESFAMs) through socio-economic, municipal management, clinical management, and population variables by performing a principal components analysis (PCA) with biplot analysis and a grouping of communes through a hierarchical analysis. The biplot analysis and hierarchical analysis yielded the formation of three large groups of communes with accredited CESFAMs, characterized mainly by population size, number of people registered in the municipal health system, socioeconomic indicators, and financial management and clinical management variables. It was found that the communes that have accredited CESFAMs are characterized by dissimilar behavior in relation to the variables analyzed. Through the model used, it was possible to establish at least three groups of communes according to their behavior against these variables. Of these, the variables of a municipal financial nature were not decisive in achieving the accreditation of the CESFAMs of these communes. Therefore, it is possible that there are other variables or factors that could be facilitating the achievement of accreditation processes. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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15 pages, 482 KiB

Open AccessArticle

Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh

by Md. Nazmul Huda, Moin Uddin Ahmed, Md. Bakhtiar Uddin, Md Kamrul Hasan, Jalal Uddin and Tinashe Moira Dune

Int. J. Environ. Res. Public Health 2022, 19(3), 1906; https://doi.org/10.3390/ijerph19031906 - 8 Feb 2022

Cited by 12 | Viewed by 5494

Abstract

Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no [...] Read more.

Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15–49 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores/ulcers among ever-married women aged 15–49 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25–34 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple’s joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women’s sexual and reproductive health in Bangladesh. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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16 pages, 1004 KiB

Open AccessFeature PaperArticle

Four-Year Trajectories of Health-Related Quality of Life in People Living with HIV: Impact of Unmet Basic Needs across Age Groups in Positive Spaces, Healthy Places

by Phan Sok, Mary V. Seeman, Rosane Nisenbaum, James Watson, Sean B. Rourke and on behalf of the PSHP Team

Int. J. Environ. Res. Public Health 2021, 18(22), 12256; https://doi.org/10.3390/ijerph182212256 - 22 Nov 2021

Cited by 2 | Viewed by 3087

Abstract

Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL [...] Read more.

Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL over a 4-year period in persons with HIV. Physical and mental HRQoL scores from the Positive Spaces, Healthy Spaces cohort interviewed in 2006 (n = 538), 2007 (n = 506), and 2009 (n = 406) were examined across three age groups according to their unmet needs for food, clothing, and housing. Individual growth curve model analyses were used to investigate changes over time, adjusting for demographics, employment, living conditions, social supports, HIV status, and health behavior risks. Low scores on physical and mental HRQoL were positively associated with higher number of unmet basic needs (β = −6.40, standard error (SE) = 0.87, p < 0.001 and β = −7.39, SE = 1.00, p < 0.001, respectively). There was a slight improvement in physical and mental HRQoL over 4 years in this HIV cohort, but the burden of unmet basic needs took its toll on those over 50 years of age. Regularly assessing unmet basic needs is recommended given the impact these can have on HRQOL for people living with HIV. Recognition of unmet needs is vital, as is the development of timely interventions. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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18 pages, 832 KiB

Open AccessArticle

Patient Satisfaction Determinants of Inpatient Healthcare

by Beata Gavurova, Jan Dvorsky and Boris Popesko

Int. J. Environ. Res. Public Health 2021, 18(21), 11337; https://doi.org/10.3390/ijerph182111337 - 28 Oct 2021

Cited by 39 | Viewed by 9889

Abstract

The aim of the study was to analyse and evaluate the determinants influencing the overall satisfaction of patients with inpatient healthcare in the conditions of the Czech Republic. A total of the 1425 patients, who experienced hospitalisation and agreed to participate, were questioned [...] Read more.

The aim of the study was to analyse and evaluate the determinants influencing the overall satisfaction of patients with inpatient healthcare in the conditions of the Czech Republic. A total of the 1425 patients, who experienced hospitalisation and agreed to participate, were questioned in the study. A research questionnaire was used to obtain data on satisfaction with hospitalisation. The subject of the research consisted of the indicators related to the following factors: (i) satisfaction with the hospital, clinic, room and meals; (ii) satisfaction with medical staff—nurses, physician expertise and other staff; (iii) the quality of the treatment provided; (iv) satisfaction with leaving the hospital. The formulated statistical hypotheses were evaluated through structural equation modelling. The results of the analyses brought interesting findings. Satisfaction with medical staff is the most significant factor which has a positive effect on satisfaction with hospitalisation. Physician expertise (with trust and good communication skills) is more important for patients than satisfaction with nurses or other staff. The results obtained from the study represent valuable information for policymakers, regional healthcare plans, as well as for managers of hospitals. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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14 pages, 315 KiB

Open AccessArticle

“Be the Dream Queen”: Gender Performativity, Femininity, and Transgender Sex Workers in China

by Eileen Y. H. Tsang

Int. J. Environ. Res. Public Health 2021, 18(21), 11168; https://doi.org/10.3390/ijerph182111168 - 24 Oct 2021

Cited by 2 | Viewed by 4532

Abstract

An under-researched aspect of transgender sex workers in China pertains to their desires and expressions of femininity. Male-to-Female (MTF) transgender sex workers are a high-risk population prone to depression and stress regarding body image, intimate relationships marked by violence, and social stigma, rendering [...] Read more.

An under-researched aspect of transgender sex workers in China pertains to their desires and expressions of femininity. Male-to-Female (MTF) transgender sex workers are a high-risk population prone to depression and stress regarding body image, intimate relationships marked by violence, and social stigma, rendering them vulnerable to hate crimes and discrimination. Ethnographic data from in-depth interviews with 49 MTF transgender sex workers indicate that sex, gender and feminine desire are mutable in the construction of self and subjectivity. This study uses the conceptual framework of gender performativity, that is, gender is performative and distinct from physical bodies and binary classifications. It is not only an individual’s normative gender expressions which are based on the sex assigned at birth, but it also reinforces the normative gender performances of the gender binary. This article argues that the 49 MTF transgender sex workers are embodiments of gendered performances, displaying femininity to ameliorate hate crimes and discrimination as well as reinforce the masculinity and sexuality of their clients and intimate sex partners. Embracing their femininity constitutes a self-help program, enabling them to build self-confidence and develop a positive self-image in the face of overwhelming social disapproval. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

17 pages, 3625 KiB

Open AccessArticle

“My 9 to 5 Job Is Birth Work”: A Case Study of Two Compensation Approaches for Community Doula Care

by Anu Manchikanti Gomez, Stephanie Arteaga, Jennet Arcara, Alli Cuentos, Marna Armstead, Renee Mehra, Rachel G. Logan, Andrea V. Jackson and Cassondra J. Marshall

Int. J. Environ. Res. Public Health 2021, 18(20), 10817; https://doi.org/10.3390/ijerph182010817 - 14 Oct 2021

Cited by 21 | Viewed by 5994

Abstract

With the increased policy emphasis on promoting doula care to advance birth equity in the United States, there is a vital need to identify sustainable and equitable approaches for compensation of community doulas, who serve clients experiencing the greatest barriers to optimal pregnancy-related [...] Read more.

With the increased policy emphasis on promoting doula care to advance birth equity in the United States, there is a vital need to identify sustainable and equitable approaches for compensation of community doulas, who serve clients experiencing the greatest barriers to optimal pregnancy-related outcomes. This case study explores two different approaches for compensating doulas (contractor versus hourly employment with benefits) utilized by SisterWeb San Francisco Community Doula Network in San Francisco, California. We conducted qualitative interviews with SisterWeb doulas in 2020 and 2021 and organizational leaders in 2020. Overall, leaders and doulas reported that the contractor approach, in which doulas were paid a flat fee per client, did not adequately compensate doulas, who regularly attend trainings and provide additional support for their clients (e.g., referrals to promote housing and food security). Additionally, this approach did not provide doulas with healthcare benefits, which was especially concerning during the COVID-19 pandemic. As hourly, benefited employees, doulas experienced a greater sense of financial security and wellbeing from receiving consistent pay, compensation for all time worked, and benefits such as health insurance and sick leave, allowing some to dedicate themselves to birth work. Our study suggests that efforts to promote community doula care must integrate structural solutions to provide appropriate compensation and benefits to doulas, simultaneously advancing birth equity and equitable labor conditions for community doulas. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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19 pages, 2448 KiB

Open AccessArticle

A Tale of Two Solitudes: Loneliness and Anxiety of Family Caregivers Caring in Community Homes and Congregate Care

by Sharon Anderson, Jasneet Parmar, Bonnie Dobbs and Peter George J. Tian

Int. J. Environ. Res. Public Health 2021, 18(19), 10010; https://doi.org/10.3390/ijerph181910010 - 23 Sep 2021

Cited by 21 | Viewed by 4231

Abstract

We surveyed 604 family caregivers residing in the province of Alberta to better understand the impact of the COVID-19 pandemic on anxiety, loneliness, and care work. We assessed anxiety with the Six-Item State Anxiety Scale and loneliness with the DeJong-Gierveld Loneliness Scale. The [...] Read more.

We surveyed 604 family caregivers residing in the province of Alberta to better understand the impact of the COVID-19 pandemic on anxiety, loneliness, and care work. We assessed anxiety with the Six-Item State Anxiety Scale and loneliness with the DeJong-Gierveld Loneliness Scale. The COVID-19 pandemic created two contexts giving rise to feelings of solitude for family caregivers. Family caregivers of Albertans living in private community homes were overwhelmed with caregiving needs while those caring for Albertans living in congregate settings were restricted from caregiving. The results indicated that before the COVID-19 pandemic, 31.7% of family caregivers were anxious and 53.5% were lonely. The proportions of those who were anxious rose to 78.8% and lonely to 85.9% during the pandemic. The qualitative responses of family caregivers connected being overwhelmed with care work either in community homes or as the designated essential caregiver in congregate living settings, as well as being unable to care in congregate care settings, with anxiety and loneliness. The caregivers reporting improvements in their health and relationships with care-receivers credited spending time with the receiver doing pleasant activities together, rather than purely performing onerous care tasks. Policymakers need to consider organizing health and community services to ensure family caregivers are not overwhelmed with care tasks or excluded from caring in congregate care. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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13 pages, 643 KiB

Open AccessArticle

Socioeconomic Inequalities in Human Immunodeficiency Virus (HIV) Sero-Prevalence among Women in Namibia: Further Analysis of Population-Based Data

by Michael Ekholuenetale, Herbert Onuoha, Charity Ehimwenma Ekholuenetale, Amadou Barrow and Chimezie Igwegbe Nzoputam

Int. J. Environ. Res. Public Health 2021, 18(17), 9397; https://doi.org/10.3390/ijerph18179397 - 6 Sep 2021

Cited by 18 | Viewed by 4244

Abstract

Socioeconomic inequality is a major factor to consider in the prevention of human immunodeficiency virus (HIV) transmission. The aim of this study was to investigate socioeconomic inequalities in HIV prevalence among Namibian women. Data from a population-based household survey with multistage-stratified sample of [...] Read more.

Socioeconomic inequality is a major factor to consider in the prevention of human immunodeficiency virus (HIV) transmission. The aim of this study was to investigate socioeconomic inequalities in HIV prevalence among Namibian women. Data from a population-based household survey with multistage-stratified sample of 6501 women were used to examine the link between socioeconomic inequalities and HIV prevalence. The weighted HIV prevalence was 13.2% (95% CI: 12.1–14.3%). The HIV prevalence among the poorest, poorer, middle, richer, and richest households was 21.4%, 19.7%, 16.3%, 11.0%, and 3.7%, respectively. Similarly, 21.2%, 21.7%, 11.8%, and 2.1% HIV prevalence was estimated among women with no formal education and primary, secondary, and higher education, respectively. Women from poor households (Conc. Index = −0.258; SE = 0.017) and those with no formal education (Conc. Index = −0.199; SE = 0.015) had high concentration of HIV infection, respectively. In light of these findings, HIV prevention strategies must be tailored to the specific drivers of transmission in low socioeconomic groups, with special attention paid to the vulnerabilities faced by women and the dynamic and contextual nature of the relationship between socioeconomic status and HIV infection. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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13 pages, 368 KiB

Open AccessArticle

Lived Experiences of African Migrants Crossing the Strait of Gibraltar to Europe: A Cross-Cultural Approach to Healthcare from a Qualitative Methodology

by José Antonio Ponce-Blandón, Rocío Romero-Castillo, Nerea Jiménez-Picón, Juan Carlos Palomo-Lara, Aurora Castro-Méndez and Manuel Pabón-Carrasco

Int. J. Environ. Res. Public Health 2021, 18(17), 9379; https://doi.org/10.3390/ijerph18179379 - 6 Sep 2021

Cited by 6 | Viewed by 3183

Abstract

Background: The migratory flow from the African continent to Europe is intense and the European countries should apply a humanitarian, health and social response to this emerging problem. Migrants coming from Africa to Europe are a very vulnerable population. Healthcare professionals should be [...] Read more.

Background: The migratory flow from the African continent to Europe is intense and the European countries should apply a humanitarian, health and social response to this emerging problem. Migrants coming from Africa to Europe are a very vulnerable population. Healthcare professionals should be prepared for answering their needs from a transcultural approach, which requires a better understanding of this phenomenon. Thus, the aim of this study was to improve nursing and healthcare professionals’ awareness and better understanding of migrant life experiences during the migration journey. An exploratory descriptive qualitative research was conducted. In-depth interviews were conducted involving four key informants and content analysis were performed with the transcriptions. Results: Three themes merged: life situations in their countries of origin; motivations that led them to undertake the migratory journey; and experiences they lived during the migratory journey. The results described the dramatic experience and motivations for crossing the strait of Gibraltar from Africa to Europe, including feelings, fears, hopes and lived experiences. The determination of immigrants to fight for a better life opportunity and the physical damage and psychological consequences they suffer were revealed. Conclusions: This study would help healthcare professionals to better understand this complex reality and deliver culturally adapted care. Knowledge of the starting reality of these populations can help health professionals to incorporate a cross-cultural approach that improves the relational, ethical and affective competences to provide quality care to the migrant population, as well as the development of health measures to fight against inequalities suffered by these population groups. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

14 pages, 342 KiB

Open AccessArticle

Exploring Tertiary Health Science Student Willingness or Resistance to Cultural Competency and Safety Pedagogy

by Sowbhagya Micheal, Anita Eseosa Ogbeide, Amit Arora, Stewart Alford, Rubab Firdaus, David Lim and Tinashe Dune

Int. J. Environ. Res. Public Health 2021, 18(17), 9184; https://doi.org/10.3390/ijerph18179184 - 31 Aug 2021

Cited by 6 | Viewed by 3548

Abstract

There is an increasing body of literature that considers the relevance and experiences of cultural competency and safety training in health professional students. However, less is written about Australian tertiary learners’ experiences of engaging with cultural competency training. The aim of this study [...] Read more.

There is an increasing body of literature that considers the relevance and experiences of cultural competency and safety training in health professional students. However, less is written about Australian tertiary learners’ experiences of engaging with cultural competency training. The aim of this study is to explore tertiary students’ willingness or resistance to cultural competency and safety pedagogy. Qualitative student feedback to a teaching unit was collected and triangulated with data from focus groups with tutors. Results were thematically analyzed. Willingness and resistance to cultural competency and safety teaching emerged as two key themes. Willingness to engage with the unit was largely due to student interest in the content, teaching environment and relevance of cultural competency to students’ future practice. Resistance was linked to the students feeling personally attacked, or culturally confronted, with tutors noting the topics around sexuality and white privilege being more resisted. Acknowledging reasons for student resistance and developing strategies to reduce resistance can facilitate more student engagement with cultural competency topics, ultimately leading to their future provision of culturally competent healthcare. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

11 pages, 1954 KiB

Open AccessArticle

Boundary Objects: Engaging and Bridging Needs of People in Participatory Research by Arts-Based Methods

by Barbara Groot and Tineke Abma

Int. J. Environ. Res. Public Health 2021, 18(15), 7903; https://doi.org/10.3390/ijerph18157903 - 26 Jul 2021

Cited by 15 | Viewed by 4101

Abstract

Background: Participatory health research (PHR) is a research approach in which people, including hidden populations, share lived experiences about health inequities to improve their situation through collective action. Boundary objects are produced, using arts-based methods, to be heard by stakeholders. These can bring [...] Read more.

Background: Participatory health research (PHR) is a research approach in which people, including hidden populations, share lived experiences about health inequities to improve their situation through collective action. Boundary objects are produced, using arts-based methods, to be heard by stakeholders. These can bring about dialogue, connection, and involvement in a mission for social justice. This study aims to gain insight into the value and ethical issues of boundary objects that address health inequalities. A qualitative evaluation is conducted on three different boundary objects, created in different participatory studies with marginalized populations (mothers in poverty, psychiatric patients, and unemployed people). A successful boundary object evokes emotions among those who created the objects and those encountering these objects. Such objects move people and create an impulse for change. The more provocative the object, the more people feel triggered to foster change. Boundary objects may cross personal boundaries and could provoke feelings of discomfort and ignorance. Therefore, it is necessary to pay attention to ethics work. Boundary objects that are made by people from hidden populations may spur actions and create influence by improving the understanding of the needs of hidden populations. A dialogue about these needs is an essential step towards social justice. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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13 pages, 524 KiB

Open AccessArticle

Situation of Self-Reported Anxiety and Depression among Urban Refugees and Asylum Seekers in Thailand, 2019

by Nareerut Pudpong, Hathairat Kosiyaporn, Mathudara Phaiyarom, Watinee Kunpeuk, Pigunkaew Sinam, Sataporn Julchoo and Rapeepong Suphanchaimat

Int. J. Environ. Res. Public Health 2021, 18(14), 7269; https://doi.org/10.3390/ijerph18147269 - 7 Jul 2021

Cited by 3 | Viewed by 2851

Abstract

Academic evidence on the health of urban refugees and asylum seekers (URAS) in Thailand is extremely sparse, especially for neglected problems such as mental health disorders. This study aimed to investigate the prevalence of anxiety and depression and factors associated with these problems [...] Read more.

Academic evidence on the health of urban refugees and asylum seekers (URAS) in Thailand is extremely sparse, especially for neglected problems such as mental health disorders. This study aimed to investigate the prevalence of anxiety and depression and factors associated with these problems among URAS in Bangkok. A cross-sectional study was conducted in 2019. The URAS were randomly selected from the roster of the Bangkok Refugee Centre (BRC). A self-administered questionnaire was used and 180 samples were recruited. Descriptive statistics and multivariable logistic regression were used for the analysis. We found a prevalence of 70.0% for anxiety and 39.5% for depression. Compared to Southeast Asia and China, URAS from other regions were 3.4 times (95% CI 1.5–7.5, p < 0.05) and 4.0 times (95% CI 1.1–14.0, p < 0.05) more likely to experience anxiety and depression, respectively. URAS with chronic co-morbidities (OR = 3.4, 95% CI 1.2–9.4, p < 0.05) and being divorced or widowed (OR = 11.1, 95% CI 2.1–57.2, p < 0.05) faced greater odds of depression than those without co-morbidities and being single. Related health authorities should play a proactive role in providing mental healthcare services for URAS, with greater consideration for those of certain nationalities and with chronic diseases. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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14 pages, 530 KiB

Open AccessArticle

Socioecological Factors Influencing Sexual Health Experiences and Health Outcomes of Migrant Asian Women Living in ‘Western’ High-Income Countries: A Systematic Review

by Corie Gray, Gemma Crawford, Bruce Maycock and Roanna Lobo

Int. J. Environ. Res. Public Health 2021, 18(5), 2469; https://doi.org/10.3390/ijerph18052469 - 3 Mar 2021

Cited by 16 | Viewed by 5636

Abstract

Migrant health has been identified as one of the most pressing issues of the 21st century. Migration experiences are influenced by gender and gender norms and have important implications for the sexual health of migrant women. This systematic review explored socioecological factors influencing [...] Read more.

Migrant health has been identified as one of the most pressing issues of the 21st century. Migration experiences are influenced by gender and gender norms and have important implications for the sexual health of migrant women. This systematic review explored socioecological factors influencing sexual health experiences and health outcomes of migrant Asian women living in “Western” high-income countries. PRISMA guidelines were followed and this study was registered with PROSPERO. Five academic databases were searched for peer-reviewed articles published between 2000 and 2019. Of 2415 studies retrieved, 17 met the selection criteria: 12 qualitative, 4 quantitative, and 1 mixed-methods study. The four levels of Bronfenbrenner’s socioecological model were applied to examine the individual, interpersonal, institutional, and societal factors of influence. Most studies (n = 13) reported individual level factors, focusing on knowledge and use of contraceptives. At a societal level, host country sociocultural factors, including gender and cultural norms, influenced knowledge, ability to access and utilise contraceptives, and access to health services. Findings suggest that the public health policy, practice, and research to improve the sexual health of migrant women requires greater consideration of the intersecting factors of gender, culture, and the migration process. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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12 pages, 366 KiB

Open AccessArticle

Physical and Mental Health Related Quality of Life and Their Influencing Factors on Sexual Minority Women in Korea

by Ssirai Kim and Smi Choi-Kwon

Int. J. Environ. Res. Public Health 2021, 18(4), 2115; https://doi.org/10.3390/ijerph18042115 - 22 Feb 2021

Cited by 5 | Viewed by 3278

Abstract

Korean sexual minority women (SMW) often experience discrimination, but their health-related quality of life (HRQoL) remains to be investigated. Therefore, we aimed to assess the levels of mental and physical HRQoL of Korean SMW and their influencing factors using data from the Korean [...] Read more.

Korean sexual minority women (SMW) often experience discrimination, but their health-related quality of life (HRQoL) remains to be investigated. Therefore, we aimed to assess the levels of mental and physical HRQoL of Korean SMW and their influencing factors using data from the Korean Sexual Minority Women’s Health Study (2017) in a cross-sectional study, which included lesbian and bisexual females (N = 736; age ≥19 years). The HRQoL was measured using SF-36v2^®; moreover, separate multiple linear regression analyses were conducted to identify the factors influencing mental and physical HRQoL. The physical and mental HRQoL scores were average (52.38 ± 7.65) and low (38.33 ± 12.64), respectively. Significant factors influencing the physical HRQoL were bisexuality, minority stress, perceived social support, and physical activity. The same factors—apart from physical activity—were associated with mental HRQoL. Therefore, to improve the HRQoL of SMW, it is necessary to lower their minority stress and increase social support. Moreover, special attention is needed regarding bisexual women in Korea. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

12 pages, 642 KiB

Open AccessArticle

Social Capital and Psychological Well-Being of Chinese Immigrants in Japan

by Shun Gong, Peng Xu and Senhu Wang

Int. J. Environ. Res. Public Health 2021, 18(2), 547; https://doi.org/10.3390/ijerph18020547 - 11 Jan 2021

Cited by 18 | Viewed by 5353

Abstract

Social capital in immigrants has drawn considerable attention from social scientists. Previous studies have paid attention to how immigrants’ bonding social capital (defined as social networks with co-ethnic residents) and bridging social capital (defined as social networks with native residents) are associated with [...] Read more.

Social capital in immigrants has drawn considerable attention from social scientists. Previous studies have paid attention to how immigrants’ bonding social capital (defined as social networks with co-ethnic residents) and bridging social capital (defined as social networks with native residents) are associated with their economic achievement. However, little attention has been paid to immigrants’ different social capital’s effects on psychological well-being. Drawing data from Chinese immigrants in Japan, we examined how these Chinese immigrants assimilated into Japanese society and how their bonding and bridging social capital related to their psychological well-being. The results show that bonding social capital directly affected immigrants’ psychological well-being, whereas bridging social capital indirectly improved their psychological well-being by improving economic status. This study contributes to previous literature on how immigrants’ different social capital is related to their psychological well-being. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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14 pages, 1294 KiB

Open AccessArticle

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data

by Tensae Mekonnen, Tinashe Dune, Janette Perz and Felix Akpojene Ogbo

Int. J. Environ. Res. Public Health 2021, 18(1), 193; https://doi.org/10.3390/ijerph18010193 - 29 Dec 2020

Cited by 13 | Viewed by 4168

Abstract

Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of [...] Read more.

Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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11 pages, 580 KiB

Open AccessArticle

Professional and Personal Physical Therapist Development through Service Learning in Collaboration with a Prisoner Reinsertion Program: A Qualitative Study

by Isabel Rodríguez-Costa, Ma Dolores González-Rivera, Catherine Ortega, Joana-Marina Llabrés-Mateu, María Blanco-Morales, Vanesa Abuín-Porras and Belén Díaz-Pulido

Int. J. Environ. Res. Public Health 2020, 17(24), 9311; https://doi.org/10.3390/ijerph17249311 - 12 Dec 2020

Cited by 5 | Viewed by 3012

Abstract

There is a great concern whether Physical Therapy students upon completion of their educational program are ready and equipped with the requisite skills to construct and implement a successful patient intervention with culturally diverse groups. The purpose of this study is to describe [...] Read more.

There is a great concern whether Physical Therapy students upon completion of their educational program are ready and equipped with the requisite skills to construct and implement a successful patient intervention with culturally diverse groups. The purpose of this study is to describe the professional and personal physical therapist development of Physical Therapy students after participating in Solidarity Activities in Collaboration with a Prisoner reinsertion program as a service-learning course. A qualitative approach was used. A convenience sample of twenty physical therapy students doing service learning and one teaching professor were included. Student diaries were analyzed. Semi-structured interviews were done to explore five students’ and the professor’s judgements. Internal and external observations and filling out structure field-notes were also used as data triangulation in order to build the conceptual model. The main findings include that the application of knowledge and practice of skills in different environments are the most important skills attained with this service learning. Five key themes emerged from the data analysis, namely: application of knowledge, adaptation to different environments, improving communication with patients, assisting people and providing treatment with self-confidence. A recommendation is that Physical Therapy programs include workplace practice in different environments to enhance the development of professionalism among students. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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12 pages, 334 KiB

Open AccessArticle

Impacts of Public Debates on Legalizing the Same-Sex Relationships on People’s Daily Lives and Their Related Factors in Taiwan

by Huang-Chi Lin, Yi-Lung Chen, Nai-Ying Ko, Yu-Ping Chang, Wei-Hsin Lu and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(22), 8606; https://doi.org/10.3390/ijerph17228606 - 19 Nov 2020

Cited by 5 | Viewed by 2728

Abstract

This study examined the proportion of the individuals who experienced negative impacts on daily lives resulted from public debates on the legalization of same-sex relationships and related factors in Taiwan. Data provided by 1370 participants recruited through a Facebook advertisement were analyzed. Participants [...] Read more.

This study examined the proportion of the individuals who experienced negative impacts on daily lives resulted from public debates on the legalization of same-sex relationships and related factors in Taiwan. Data provided by 1370 participants recruited through a Facebook advertisement were analyzed. Participants completed an online questionnaire assessing negative impact of public debates on daily lives, gender, age, sexual orientation, the number of lesbian, gay and bisexual (LGB) friends, and perceived population’s acceptance of homosexuality. The results showed that 39.5% of participants reported the negative impacts on their occupational or academic performance; 34.2% reported the negative impact on friendship; 37.7% reported the negative impact on family relationship; and 57.4% reported the negative impact on mood or sleep quality. Non-heterosexual participants were more likely to report negative impacts of public debates on all domains of daily lives than heterosexual ones. The number of LGB friends was positively associated with negative impacts of public debates on all domains of daily lives. Participants who were 20–29 years old were more likely to report negative impacts of public debates on the domains of family relationship and mood/sleep quality than those who were 40 or older. Participants who were 30–39 years old were more likely to report negative impacts of public debates on the domain of mood/sleep quality than those who were 40 or older. Males were less likely to report the negative impact on their mood/sleep quality than females. Perceiving population’s acceptance for homosexuality were negatively associated with negative impacts of public debates on the domains of occupational/academic performance, family relationship and mood/sleep quality. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

20 pages, 2623 KiB

Open AccessArticle

Exploring Daily Activity Patterns on the Typical Day of Older Adults for Supporting Aging-in-Place in China’s Rural Environment

by Ziqi Zhang and Zhi Qiu

Int. J. Environ. Res. Public Health 2020, 17(22), 8416; https://doi.org/10.3390/ijerph17228416 - 13 Nov 2020

Cited by 6 | Viewed by 3439

Abstract

Severe aging in rural China is prompting communities to promote support for older people to age in place. The study of the daily life of older adults in rural areas is conducive to understanding their real life and demands, as well as the [...] Read more.

Severe aging in rural China is prompting communities to promote support for older people to age in place. The study of the daily life of older adults in rural areas is conducive to understanding their real life and demands, as well as the way they interact with their environment, to develop feasible strategies. In this study, 171 older adults over 60 years old in two different types of villages in Northern Zhejiang Province were investigated and analyzed in terms of the temporal and spatial features of daily activities, as well as their relationship with population attributes, personal competence, and subjective demands. The results show that: (1) significant association can be seen between working hours and the demand for health services, housework hours and gender and age, as well as leisure hours and ADL and the demand for recreational services. (2) The older adults appear to have inter-group homogeneity in some aspects: basic living activities, leisure hours, the gender difference in housework hours, and recreational preference, while they have higher average paid work hours and fewer leisure alternatives than their urban counterparts. Their definitions of paid work, housework, and leisure activities are vague. (3) The definition of home by the older adults in rural places sometimes seems to go beyond the scope of their own house, and the extensive definition of home may change their recognitions of some activities. They also inclined to assign meaning to a place through frequent use rather than through external definitions. (4) The weak consciousness on buying services and deteriorated financial situation hinders the older adults in rural communities from expressing their real demands. Unspoken demands include economic security, recreational choices, and assistance in housework. The results will help to provide references for the improvement of eldercare services and the community environment. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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16 pages, 347 KiB

Open AccessFeature PaperArticle

Air Pollution-Related Health Impacts on Individuals Experiencing Homelessness: Environmental Justice and Health Vulnerability in Salt Lake County, Utah

by Angelina L. DeMarco, Rebecca Hardenbrook, Jeff Rose and Daniel L. Mendoza

Int. J. Environ. Res. Public Health 2020, 17(22), 8413; https://doi.org/10.3390/ijerph17228413 - 13 Nov 2020

Cited by 13 | Viewed by 10324

Abstract

Experiences of homelessness, although widely varied, are characterized by extensive time in public spaces, often outdoors. However, there has been little empirical research about the ways in which environmental factors affect individuals experiencing homelessness (IEHs). Therefore, the purpose of this study was to [...] Read more.

Experiences of homelessness, although widely varied, are characterized by extensive time in public spaces, often outdoors. However, there has been little empirical research about the ways in which environmental factors affect individuals experiencing homelessness (IEHs). Therefore, the purpose of this study was to use an environmental justice approach to understand how cardiopulmonary health of IEHs is affected by episodic poor air quality in Salt Lake County. It was hypothesized that people who had experienced unsheltered homelessness and those who had been experiencing homelessness for longer periods of time would report greater health difficulties from poor air quality exposure. Through a combination of in-person semistructured interviews with IEHs (n = 138) and access to corresponding state-based service provider databases, researchers examined both overall descriptives of and relationships between types (sheltered and unsheltered) and duration (chronic and nonchronic) of homelessness. More than 61% of IEHs reported physical reactions to air pollution, 37% reported air pollution-related emotional stress, and more than 89% had sought medical attention for a condition related to air pollution. Findings indicate that while IEHs report a number of health effects related to poor air quality, there were no significant differences between individuals based on either sheltered status or duration of their experiences of homelessness. This study provides an initial empirical inquiry to understand how environmental disamenities negatively influence IEHs, as well as noting that sheltered status and duration of homelessness are less impactful than originally hypothesized. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

18 pages, 674 KiB

Open AccessArticle

Healthcare and Health Problems from the Perspective of Indigenous Population of the Peruvian Amazon: A Qualitative Study

by Bárbara Badanta, Giancarlo Lucchetti, Sergio Barrientos-Trigo, Elena Fernández-García, Lorena Tarriño-Concejero, Juan Vega-Escaño and Rocío de Diego-Cordero

Int. J. Environ. Res. Public Health 2020, 17(21), 7728; https://doi.org/10.3390/ijerph17217728 - 22 Oct 2020

Cited by 12 | Viewed by 6605

Abstract

Indigenous communities usually experience higher levels of mortality and poorer access to healthcare services compared to non-indigenous communities. This study aims to understand the most prevalent health problems and their treatment in the Asháninka indigenous communities of the Peruvian Amazon. We conducted an [...] Read more.

Indigenous communities usually experience higher levels of mortality and poorer access to healthcare services compared to non-indigenous communities. This study aims to understand the most prevalent health problems and their treatment in the Asháninka indigenous communities of the Peruvian Amazon. We conducted an ethnographic study in order to explore the perceived health problems, the use of traditional medicine and the resources offered by the official Peruvian healthcare system. Field notes and semi-structured interviews were used. A total of 16 indigenous and four non-indigenous people were interviewed, and interpretative analysis was used to identify themes. The Asháninka community is an overlooked population, which, due to distance restrictions, misconceptions and ethnical disparities, is far away from an appropriate healthcare system and is subjected to acute medical conditions such as infections and gastrointestinal problems. This group tends to seek traditional medicine, mostly herbal medications and traditional healers. The use of a health professional is seen as a last resort. Although the official Peruvian health system incorporates community participation strategies to improve the healthcare of indigenous people, the shortage of material, human resources and cultural sensitivity makes this difficult. Healthcare strategies should be devised and implemented in order to minimize health inequality in this population. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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15 pages, 361 KiB

Open AccessArticle

Embodying Transgender: An Analysis of Trans Women in Online Forums

by Pranee Liamputtong, Kyja Noack-Lundberg, Tinashe Dune, Brahmaputra Marjadi, Virginia Schmied, Jane Ussher, Janette Perz, Alexandra Hawkey, Jessica Sekar and Eloise Brook

Int. J. Environ. Res. Public Health 2020, 17(18), 6571; https://doi.org/10.3390/ijerph17186571 - 9 Sep 2020

Cited by 5 | Viewed by 4928

Abstract

This paper discusses the way that trans women embody their transgender identity, focusing on identity questioning, gender dysphoria, clinical gatekeeping and medicalized narratives. Situated within the hermeneutics methodological approach, we adopted the unobtrusive research as our research method, where data was derived from [...] Read more.

This paper discusses the way that trans women embody their transgender identity, focusing on identity questioning, gender dysphoria, clinical gatekeeping and medicalized narratives. Situated within the hermeneutics methodological approach, we adopted the unobtrusive research as our research method, where data was derived from online forums where trans women posted content about their perspectives and experiences of gender and gender transitioning. Thematic analysis method was used for data analysis. Our findings suggest that gender identity is embodied and socially negotiated. Many trans women were initially ambivalent about their transgender identity and some continued to question their desired identity throughout adulthood. When presenting to healthcare professionals many trans women reported being expected to adopt a ‘wrong body’ narrative in order to gain access to treatment and surgery for gender transitioning and affirmation. In doing so, trans women interact with significant others and health care providers, and face many challenges. These challenges must be understood so that trans women can perform self-determination practices as a way to achieve gender autonomy. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

22 pages, 398 KiB

Open AccessArticle

Inequality in Health Services for Internal Migrants in China: A National Cross-Sectional Study on the Role of Fund Location of Social Health Insurance

by Qiang Yao, Chaojie Liu and Ju Sun

Int. J. Environ. Res. Public Health 2020, 17(17), 6327; https://doi.org/10.3390/ijerph17176327 - 31 Aug 2020

Cited by 16 | Viewed by 3583

Abstract

On-the-spot settlements of medical bills for internal migrants enrolled with a social health insurance program outside of their residential location have been encouraged by the Chinese government, with the intention to improve equality in healthcare services. This study compared the use of health [...] Read more.

On-the-spot settlements of medical bills for internal migrants enrolled with a social health insurance program outside of their residential location have been encouraged by the Chinese government, with the intention to improve equality in healthcare services. This study compared the use of health services between the internal migrants who had local health insurance coverage and those who did not. Data (n = 144,956) were obtained from the 2017 China Migrants Dynamic Survey. Use of health services was assessed by two indicators: visits to physicians when needed and registration (shown as health records) for essential public health services. Multi-level logistic regression models were established to estimate the effect size of fund location on the use of health services after controlling for variations in other variables. The respondents who enrolled with a social health insurance scheme locally were more likely to visit physicians when needed (adjusted odds ratio (AOR) = 1.18, 95% CI = 1.06–1.30) and to have a health record (AOR = 1.47, 95% CI = 1.30–1.65) compared with those who enrolled outside of their residential location: a gap of 3.5 percentage points (95% CI: 1.3%–5.8%) and 6.1 percentage point (95% CI: 4.3%–7.8%), respectively. The gaps were larger in the rural-to-urban migrants than those in the urban-to-urban migrants (AOR = 1.17, 95% CI = 0.93–1.48 for visiting physicians when needed; AOR = 0.71, 95% CI = 0.54–0.93 for having a health record). The on-the-spot medical bill settlement system has yet to fully achieve its proposed potential as inequalities in both medical and public health services remain between the internal migrants with and without local health insurance coverage. Further studies are needed to investigate how on-the-spot settlements of medical bills are implemented through coordination across multiple insurance funds. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

12 pages, 296 KiB

Open AccessArticle

Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study

by Ju Young Kim, Dae In Kim, Hwa Yeon Park, Yuliya Pak, Phap Ngoc Hoang Tran, Truc Thanh Thai, Mai Thi Thanh Thuy and Do Van Dung

Int. J. Environ. Res. Public Health 2020, 17(17), 6320; https://doi.org/10.3390/ijerph17176320 - 31 Aug 2020

Cited by 11 | Viewed by 4320

Abstract

The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and the associated factors among people living in rural Vietnam. This cross-sectional study was conducted with 233 participants in a rural area. The methods included [...] Read more.

The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and the associated factors among people living in rural Vietnam. This cross-sectional study was conducted with 233 participants in a rural area. The methods included face-to-face interviews using a structured questionnaire, and anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs. Of the participants, 18% (n = 43) had unmet healthcare needs, for reasons like transportation (30%), a lack of available doctors or medicine (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that living in a rural area, having stage 2 hypertension, and having insurance were associated with unmet healthcare needs. To better meet the healthcare needs in rural or suburban areas of Vietnam, allocation of adequate healthcare resources should be distributed in rural areas and insurance coverage for personalized healthcare needs might be required. Efforts should focus on availability of medicine, improvement of transportation systems, and communication skills of healthcare providers to improve access to healthcare services. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

13 pages, 617 KiB

Open AccessArticle

The Relationship between Masculinity and Internalized Homophobia amongst Australian Gay Men

by Jack Thepsourinthone, Tinashe Dune, Pranee Liamputtong and Amit Arora

Int. J. Environ. Res. Public Health 2020, 17(15), 5475; https://doi.org/10.3390/ijerph17155475 - 29 Jul 2020

Cited by 23 | Viewed by 15985

Abstract

Due to the heterosexist ideals associated with gender norms, gay men often experience negative attitudes towards their own sexuality—internalized homophobia. As a result, gay men often feel compelled to compensate for their perceived lack of masculinity. The study aimed to investigate the relationship [...] Read more.

Due to the heterosexist ideals associated with gender norms, gay men often experience negative attitudes towards their own sexuality—internalized homophobia. As a result, gay men often feel compelled to compensate for their perceived lack of masculinity. The study aimed to investigate the relationship and predictive power of masculinity on gay men’s experiences of internalized homophobia. A sample of 489 self-identified Australian gay men 18–72 years old participated in an online survey on masculinity and homosexuality. Descriptive statistics, bivariate correlations, and sequential multiple regressions were used to test the study’s aims. Sequential multiple regressions revealed that conformity to masculine norms and threats to masculinity contingency were stronger predictors of internalized homophobia over and above demographic and other factors. Given the already known psychological risks associated with social isolation, internalized homophobia, and the poor mental health outcomes associated with sexual minority groups, it is suggested that gay men who are experiencing high degrees of internalized homophobia should not be distancing themselves from other gay men but, conversely, seek a strong relationship with the LGBTI community. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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14 pages, 638 KiB

Open AccessArticle

Determinants of Full Breastfeeding at 6 Months and Any Breastfeeding at 12 and 24 Months among Women in Sydney: Findings from the HSHK Birth Cohort Study

by Ritesh Chimoriya, Jane Anne Scott, James Rufus John, Sameer Bhole, Andrew Hayen, Gregory S. Kolt and Amit Arora

Int. J. Environ. Res. Public Health 2020, 17(15), 5384; https://doi.org/10.3390/ijerph17155384 - 27 Jul 2020

Cited by 30 | Viewed by 6469

Abstract

The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), [...] Read more.

The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), Australia. Mother–infant dyads (n = 1035) were recruited to the Healthy Smiles Healthy Kids birth cohort study. Study data were collected through telephone interviews at 2, 4, 8, 12, and 24 months postpartum. Cox proportional hazards models were used to determine factors associated with the risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. The majority of mothers (92.3%) had initiated breastfeeding. At six months, 13.5% of infants were fully breastfed, while 49.9% received some breast milk. Only 25.5% and 2.9% of infants received some breast milk at 12 and 24 months, respectively. Lower maternal education level, lower socioeconomic status, full-time employment, maternal smoking during pregnancy, and caesarean delivery were associated with increased risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. Older maternal age and partner’s preference for breastfeeding were associated with an increased likelihood of continuing any breastfeeding at 12 and 24 months. These findings present a number of opportunities for prolonging breastfeeding duration in disadvantaged communities in NSW. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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Review

Jump to: Research, Other

21 pages, 931 KiB

Open AccessReview

Review of Use Prevalence, Susceptibility, Advertisement Exposure, and Access to Electronic Nicotine Delivery Systems among Minorities and Low-Income Populations in the United States

by Susana Addo Ntim, Bria Martin and Yasmin Termeh-Zonoozi

Int. J. Environ. Res. Public Health 2022, 19(20), 13585; https://doi.org/10.3390/ijerph192013585 - 20 Oct 2022

Cited by 4 | Viewed by 2855

Abstract

Increased use of electronic nicotine delivery systems (ENDS) and improper disposal after use pose a public health and an environmental justice (EJ) concern if use prevalence is disproportionately high among minorities and people of low socioeconomic status (SES) (broadly termed “EJ populations” for [...] Read more.

Increased use of electronic nicotine delivery systems (ENDS) and improper disposal after use pose a public health and an environmental justice (EJ) concern if use prevalence is disproportionately high among minorities and people of low socioeconomic status (SES) (broadly termed “EJ populations” for the purposes of this review). This review synthesizes literature on demographic patterns of use prevalence, susceptibility, advertisement exposure, and access to ENDS, and extrapolates environmental tobacco exposure (ETE) from ENDS among EJ populations. Seven electronic databases were searched using ENDS-related terms. We included studies published between 2017 and May 2020 that described ENDS use prevalence, susceptibility to ENDS use, advertisement exposure, and access to ENDS by race, ethnicity, or SES. Data synthesis was based on the assumptions that ETE increases with high use prevalence, susceptibility may influence future use, and advertisement exposure and access may impact demographic differences in use. We identified 32 studies describing use prevalence, susceptibility, advertisement exposure, or access to vape shops and other tobacco retail outlets by race/ethnicity or SES. We found higher prevalence of ENDS use among non-Hispanic Whites and inconclusive use patterns by SES. Patterns of susceptibility to use, advertisement exposure, and access were also mixed, with slightly higher outcomes observed among low SES youth. However, the evidence base on advertisement exposure was limited, with limited generalizability. Our findings indicate low prevalence of ENDS use among EJ populations. While this suggests low potential ETE among these groups, mixed outcomes on susceptibility, advertisement exposure, and access to ENDS among low SES groups may affect future ENDS use and ETE. Educational campaigns that discourage ENDS uptake should target EJ youth. Initiatives aimed at managing vape shop presence in EJ communities and monitoring targeted advertisement are also needed. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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16 pages, 506 KiB

Open AccessReview

“Lived the Pandemic Twice”: A Scoping Review of the Unequal Impact of the COVID-19 Pandemic on Asylum Seekers and Undocumented Migrants

by Zelalem Mengesha, Esther Alloun, Danielle Weber, Mitchell Smith and Patrick Harris

Int. J. Environ. Res. Public Health 2022, 19(11), 6624; https://doi.org/10.3390/ijerph19116624 - 29 May 2022

Cited by 51 | Viewed by 6252

Abstract

Background: Emerging evidence suggests that the COVID-19 pandemic is widening pre-pandemic health, social, and economic inequalities between refugees, migrants, and asylum seekers and the general population. This global scoping review examined the impact of the pandemic on community-based asylum seekers and undocumented migrants [...] Read more.

Background: Emerging evidence suggests that the COVID-19 pandemic is widening pre-pandemic health, social, and economic inequalities between refugees, migrants, and asylum seekers and the general population. This global scoping review examined the impact of the pandemic on community-based asylum seekers and undocumented migrants in high- and upper-middle-income countries. Methods: We conducted a systematic search of peer-reviewed articles in PubMed, Scopus, Web of Science, and ProQuest Central. We applied Katikireddi’s framework of understanding and addressing inequalities to examine the differential impact of the pandemic across exposure, vulnerability to infection, disease consequences, social consequences, effectiveness of control measures, and adverse consequences of control measures. Results: We included 32 articles in the review. The analysis showed that asylum seekers and undocumented migrants experienced greater exposure to the COVID-19 virus and higher infection rates. They also experienced differential social consequences in the form of job loss and lost and/or reduced work hours. The effectiveness of pandemic response measures on asylum seekers and undocumented migrants was also affected by pre-pandemic social and economic marginalisation, exclusion from pandemic-induced policy measures, lack of appropriate pandemic communication, and variable trust in governments and authority. Pandemic control measures had greater adverse consequences on asylum seekers and undocumented migrants than the general population, with the majority of studies included in this review reporting worsened mental health and social isolation conditions and reduced access to health care. Conclusions: Asylum seekers and undocumented migrants experienced a disproportionate impact of the COVID-19 pandemic across the six thematic areas of comparison. Policies that reduce exposure and vulnerability to the infection, grant equitable access to health and social care, and build capacities and resilience, are critical to enable asylum seekers and undocumented migrants to cope with and recover from pre-pandemic and pandemic-induced inequalities. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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17 pages, 757 KiB

Open AccessReview

Are Services Inclusive? A Review of the Experiences of Older GSD Women in Accessing Health, Social and Aged Care Services

by Tinashe Dune, Jacqueline Ullman, Tania Ferfolja, Jack Thepsourinthone, Shirali Garga and Zelalem Mengesha

Int. J. Environ. Res. Public Health 2020, 17(11), 3861; https://doi.org/10.3390/ijerph17113861 - 29 May 2020

Cited by 7 | Viewed by 4713

Abstract

The review aimed to examine the views and experiences of ageing gender and sexually diverse (GSD) women—a triple minority in relation to their age, gender and sexual orientation—in accessing health, social and aged care services. Eighteen peer reviewed articles identified from seven electronic [...] Read more.

The review aimed to examine the views and experiences of ageing gender and sexually diverse (GSD) women—a triple minority in relation to their age, gender and sexual orientation—in accessing health, social and aged care services. Eighteen peer reviewed articles identified from seven electronic databases in health and social sciences were evaluated according to predefined criteria and a thematic review methodology drawing upon socio-ecological theory was used to analyse and interpret the findings. Four major themes were identified from the analysis: “The Dilemma of Disclosure”, “Belonging/Connection”, “Inclusiveness of Aged Care” and “Other Barriers to Access Care”. In the dilemma of disclosure, older GSD women consider factors such as previous experiences, relationship with the provider and anticipated duration of stay with the provider before disclosing their sexual identifies. The review also revealed that aged care services lack inclusiveness in their policies, advertising materials, aged care spaces and provider knowledge and attitude to provide sensitive and appropriate care to GSD women. Overall, older GSD women experience multiple and multilevel challenges when accessing health, aged and social services and interventions are needed at all levels of the socio-ecological arena to improve their access and quality of care. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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16 pages, 975 KiB

Open AccessSystematic Review

LGBTIQ CALD People’s Experiences of Intimate Partner Violence: A Systematic Literature Review

by Alex Workman, Erin Kruger, Sowbhagya Micheal and Tinashe Dune

Int. J. Environ. Res. Public Health 2022, 19(23), 15843; https://doi.org/10.3390/ijerph192315843 - 28 Nov 2022

Cited by 2 | Viewed by 3192

Abstract

Background: Experience of surviving intimate partner violence (IPV) is well documented in research, policing practices, newspapers, and awareness campaigns domestically and internationally. Arguably, those who have survived IPV and have their experiences reflected within society undergo a transformative experience of empowerment. As society [...] Read more.

Background: Experience of surviving intimate partner violence (IPV) is well documented in research, policing practices, newspapers, and awareness campaigns domestically and internationally. Arguably, those who have survived IPV and have their experiences reflected within society undergo a transformative experience of empowerment. As society recognises and validates their experience has occurred, and responds to it, accordingly, as some survivors have targeted services and interventions to assist in this transformation. However, for LGBTIQ-identifying peoples, experiences of IPV are poorly understood in contemporary society, which is further exacerbated for LGBTIQ-identifying CALD people as they continue to remain hidden. Aim and objective: The systematic literature review aims to explore the experiences of this group in their development of resilience following an abusive and violent relationship. Methods: Of the potential 230 identified studies, 5 studies met the eligibility criteria. In line with the eligibility criteria, these studies were first reviewed by title, then by abstract and then by full text. Of those studies which the research team deemed relevant for inclusion, their reference lists where also reviewed to determine if any further relevant studies could be identified using this strategy. As a result of the above process, five (5) studies met the eligibility criteria and were included in the study. Results: From data extraction, three major themes emerged: Intimate Partner Violence as Experienced by LGBTIQ survivors, Marginalised Identity and Types of Survivorship. While refined, these themes capture a more robust set of sub-themes that identify the diverse ways in which LGBTIQ survivors experience responses to their victimised status as experienced in IPV situations. Conclusions: Overall, the review found that resilient outcomes for LGBTIQ CALD survivors remain misunderstood and missing within the literature. There is a propensity to focus on negative coping strategies and an exclusive focus on LGBTIQ CALD vulnerabilities. Future research requires investigation into strategies and support that move beyond coping to include resilient outcomes and support systems that allow manifestations of resilience. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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18 pages, 496 KiB

Open AccessSystematic Review

Representations of Sexuality among Persons with Intellectual Disability, as Perceived by Professionals in Specialized Institutions: A Systematic Review

by Tamara Guenoun, Barbara Smaniotto, Christophe Clesse, Marion Mauran-Mignorat, Estelle Veyron-Lacroix, Albert Ciccone and Aziz Essadek

Int. J. Environ. Res. Public Health 2022, 19(8), 4771; https://doi.org/10.3390/ijerph19084771 - 14 Apr 2022

Cited by 5 | Viewed by 3292

Abstract

The objective of this systematic review is to make an inventory of the representations of the professionals of specialized institutions on the sexuality of persons with intellectual disabilities. The scientific studies were identified according to the PRISMA protocol using 18 databases, with keywords [...] Read more.

The objective of this systematic review is to make an inventory of the representations of the professionals of specialized institutions on the sexuality of persons with intellectual disabilities. The scientific studies were identified according to the PRISMA protocol using 18 databases, with keywords on sexuality and parenthood. Studies were reviewed through a methodological assessment and then a thematic analysis. Twenty-four studies were reviewed and three themes were identified: professionals’ representations of gender, sexuality, and consent; professionals’ perceptions of their role in supporting people’s sexual lives; and the ways in which professionals construct representations of people’s sexual lives. This corpus highlights deep paradoxes in the representations of professionals concerning the socio-affective needs and sexuality of people with intellectual disabilities, creating what we could define as a “system of incompatibility” and leading to difficulties in positioning. Support is still too random and subject to control logics in the name of protecting users, who are perceived as vulnerable. Training and new ways of teamwork appear to be central to supporting the evolution of the representations and practices of professionals. Future research anchored in practices and involving users as well as professionals is necessary to better understand the paradoxical aspects of professionals’ representations and to draw alternative ways of constructing these representations. Full article

(This article belongs to the Special Issue Addressing Public Health and Health Inequities in Marginalized and Hidden Populations)

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