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Social Determinants of Health

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

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 32846

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Special Issue Editors

Dr. Roland J. Thorpe, Jr.

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Guest Editor

Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Ste 708, Baltimore, MD 21205, USA
Interests: social epidemiology and gerontology; influence of social determinants of health in understanding the etiology of race-related disparities in functional and health status of community-dwelling adults
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Dr. Paul Archibald

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Guest Editor

1. College of Staten Island, City University of New York, Staten Island, NY 10314, USA
2. Johns Hopkins University Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD 21205, USA
Interests: public health social work clinical practice and training; prevention and treatment of mental and physical health outcomes among persons exposed to chronic stressors—especially those exposed to the criminal justice system; impact of social determinants of health on stress-related health disparities
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Dr. Marino A. Bruce

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Guest Editor

Department of Behavioral and Social Sciences, College of Medicine, University of Houston, Houston, TX 77004, USA
Interests: social and behavioral science; faith implications for biopsychosocial pathways linking stress to disease risk and progression among African American men
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Dr. Haley Barge

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Guest Editor

School of Public Health, Franklin & Marshall College, 637 College Ave, Lancaster, PA 17603, USA
Interests: obesity and allostatic load; influence of social determinants of health on race-related disparities among women's health
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Special Issue Information

Dear Colleagues,

The effort to eliminate health disparities has achieved modest progress over the past three decades. Over this period, health disparities research has documented differences between groups; however, explanations for these observed disparities remain elusive. Data from this line of research suggest that health outcomes at the individual or population -level are influenced by cultural, economic, political, and social factors that are classified as social determinants” Within the past decade, social determinants of health have been posited as a plausible explanation for most health disparities. Yet, little attention has been paid to the understanding how social determinants of health impact health disparities or minority health.

We invite investigators to contribute original research (empirical and theoretical) and systematic reviews that will further broaden our understanding of the cultural, economic, political, and social factors that contribute to, or may decrease, health disparities. Papers that include qualitative, quantitative, or mixed methods are welcome, as are papers that discuss the design, implementation, and evaluation of behavioral and policy interventions. An important aspect of every manuscript selected for inclusion in the Special Issue will be a focus on social determinants of health disparities and/or applications of research findings reducing health disparities. Potential topics include, but are not limited to:

Papers that discuss, refine, or test theoretical models specifying the relationship between social determinants and health disparities.
Papers that emphasize an intersectional approach (e.g., race, gender, and social class) in advancing our understanding of social determinants and health disparities.
Papers that highlight how social determinants have implications for individual- (e.g., discrimination), place- (e.g., urbanicity), and community-oriented (e.g., segregation) factors and their contribution to health disparities.
Descriptions of epidemiological studies explicitly examining social determinants and its association with health disparities.
Descriptions of intervention studies that consider how social determinants of health affect health disparities.

Dr. Roland J. Thorpe, Jr.
Dr. Paul Archibald
Dr. Marino A. Bruce
Ms. Haley Barge

Guest Editors

Manuscript Submission Information

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

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

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

social determinants
health disparities
race, gender and social disparities
discrimination
urban and rural environment
community factors

Published Papers (10 papers)

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Research

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12 pages, 325 KiB

Open AccessArticle

Rural–Urban Differences in Behavioral Outcomes among Adults with Lifetime History of Traumatic Brain Injury with Loss of Consciousness: 2016–2019 Ohio BRFSS

by Robyn Feiss, John D. Corrigan, Kele Ding, Cynthia L. Beaulieu, Jennifer Bogner and Jingzhen Yang

Int. J. Environ. Res. Public Health 2022, 19(3), 1678; https://doi.org/10.3390/ijerph19031678 - 01 Feb 2022

Cited by 1 | Viewed by 1549

Abstract

This study examined if the associations between lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) and unhealthy alcohol use or mental health problems differ by location of living (rural vs. urban). The lifetime history data of TBI with LOC, location of living, unhealthy alcohol use (binge drinking, heavy drinking), and mental health problems (depression diagnosis, number of poor mental health days) were sourced from the 2016, 2017, 2018, and 2019 Ohio Behavioral Risk Factory Surveillance Surveys, and the final sample included 16,941 respondents. We conducted multivariable logistic regressions to determine the odds ratios for each of the five outcomes between individuals living in rural vs. urban areas and between individuals with vs. without a lifetime history of TBI with LOC. No interaction between location of living and lifetime history of TBI with LOC was observed for any outcomes, indicating rurality did not modify these relationships. Living in a rural area was associated with decreased binge drinking or heavy drinking but not mental health outcomes. Lifetime history of TBI with LOC was associated with an increased risk of binge drinking, heavy drinking, depression diagnoses, and poor general mental health, regardless of location of living. Our findings support the need for TBI screenings as part of mental health intake evaluations and behavioral health screenings. Though rurality was not associated with mental health outcomes, rural areas may have limited access to quality mental health care. Therefore, future research should address access to mental health services following TBI among rural residents. Full article

(This article belongs to the Special Issue Social Determinants of Health)

10 pages, 318 KiB

Open AccessArticle

Food Insecurity Is Associated with Mental–Physical Comorbidities among U.S. Adults: NHANES 2013 to 2016

by LaToya J. O’Neal, Ara Jo, Lisa Scarton and Marino A. Bruce

Int. J. Environ. Res. Public Health 2022, 19(3), 1672; https://doi.org/10.3390/ijerph19031672 - 01 Feb 2022

Cited by 5 | Viewed by 2810

Abstract

The co-occurrence of mental and physical conditions has increased significantly during the last decade. However, research examining the influence of social factors such as food insecurity is limited. The purpose of this study was to examine the association between food insecurity and mental–physical comorbidity status among U.S. adults. Data for this analysis were drawn from the National Health and Nutrition Examination Survey (NHANES) for the years 2013–2016. Respondents ages 18 and older who reported at least one of three chronic conditions (i.e., type 2 diabetes mellitus, hypertension, and hyperlipidemia) and responded to a nine-item depression scale were included in the analytic sample. The prevalence of food insecurity among those with depression and a cardiometabolic condition was 34% compared to 13% among those with a cardiometabolic condition only. Findings from multinomial logistic regression models indicated that food insecurity was associated with higher risk of mental–physical comorbidity (OR: 3.6, 95% CI: 2.26–5.76). Respondents reporting poor diet and poor self-reported health had higher odds of comorbid depression and cardiometabolic conditions. Female respondents had increased odds of comorbid depression and cardiometabolic conditions. Food insecurity is associated with co-occurring depression and cardiometabolic disease and may have implications for disease management. Full article

(This article belongs to the Special Issue Social Determinants of Health)

21 pages, 1374 KiB

Open AccessArticle

Social Determinants of Remaining Life Expectancy at Age 60: A District-Level Analysis in Germany

by Achim Siegel, Jonas F. Schug and Monika A. Rieger

Int. J. Environ. Res. Public Health 2022, 19(3), 1530; https://doi.org/10.3390/ijerph19031530 - 29 Jan 2022

Cited by 4 | Viewed by 2901

Abstract

Remaining life expectancy at age 60 (in short: RLE) is an important indicator of the health status of a population’s elders. Until now, RLE has not been thoroughly investigated at the district level in Germany. In this study we analyzed, based on recent publicly available data (2015–2017), and for men and women separately, how large the RLE differences were in Germany across the 401 districts. Furthermore, we examined a wide range of potential social determinants in terms of their bivariate and multivariate (i.e., partial) impact on men’s and women’s RLE. Men’s district-level RLE ranged between 19.89 and 24.32 years, women’s district-level RLE between 23.67 and 27.16 years. The best single predictor both for men’s and women’s RLE at district level was ‘proportion of employees with academic degree’ with standardized partial regression coefficients of 0.42 (men) and 0.51 (women). Second and third in rank were classic economic predictors, such as ‘household income’ (men), ‘proportion of elder with financial elder support’ (women), and ‘unemployment’ (men and women). Indicators expressing the availability of medical services and staffing levels of nursing homes and services had at best a marginal partial impact. This study contributes to the growing body of evidence that a population’s educational level is a decisive determinant of population health resp. life expectancy in contemporary industrialized societies. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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14 pages, 9711 KiB

Open AccessArticle

Social Interaction in Public Spaces and Well-Being among Elderly Women: Towards Age-Friendly Urban Environments

by Yingyi Zhang, Ge Chen, Yue He, Xinyue Jiang and Caiying Xue

Int. J. Environ. Res. Public Health 2022, 19(2), 746; https://doi.org/10.3390/ijerph19020746 - 10 Jan 2022

Cited by 12 | Viewed by 5024

Abstract

The world’s population is aging and becoming more urbanized. Public space in urban areas is vital for improving the health of the elderly by stimulating social interaction. Many urban design projects are advertised as age-friendly but ignore the real needs of the elderly, especially elderly women, for social interaction in urban public spaces. Insufficient attention is paid to the physical and psychological characteristics of elderly women when shaping public space. This analysis addresses the question: What are the qualities of urban spaces which facilitate health-improving social interaction for elderly women? Methods include a case study in Beijing, field investigation, mapping, and qualitative and quantitative analysis. The survey was carried out in April 2021, and concerned 240 women aged 55–75 years. Results indicate that the social interactions of older women relate to both their physical and psychological situations. Public spaces can positively impact the psychological well-being and social participation of elderly women. Conclusions include insights regarding the relationship between social interaction and well-being among elderly women, as well as proposing a series of principles for shaping public spaces for an age-friendly urban environment. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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22 pages, 1989 KiB

Open AccessArticle

The Effect of High-Density Built Environments on Elderly Individuals’ Physical Health: A Cross-Sectional Study in Guangzhou, China

by Rongrong Zhang, Song Liu, Ming Li, Xiong He and Chunshan Zhou

Int. J. Environ. Res. Public Health 2021, 18(19), 10250; https://doi.org/10.3390/ijerph181910250 - 29 Sep 2021

Cited by 13 | Viewed by 2773

Abstract

The built environment refers to the objective material environment built by humans in cities for living and production activities. Existing studies have proven that the built environment plays a significant role in human health, but little attention is paid to the elderly in this regard. At the same time, existing studies are mainly concentrated in Western developed countries, and there are few empirical studies in developing countries such as China. Based on POI (point of interest) data and 882 questionnaires collected from 20 neighborhoods in Guangzhou, we employ multilevel linear regression modeling, mediating effect modeling, to explore the path and mechanism of the impact of the built environment on elderly individuals’ physical health, especially the mediating effects of physical and social interaction activity. The results show that the number of POIs, the distance to the nearest park and square, and the number of parks and squares are significantly positively correlated with the physical health of the elderly, while the number of bus and subway stations and the distance to the nearest station are significantly negatively correlated. Secondly, physical activity and social networks play a separate role in mediating the effect of the built environment on elderly individuals’ physical health. The results enrich the research on the built environment and elderly individuals’ health in the context of high-density cities in China and provide some reference basis for actively promoting spatial intervention and cultivating a healthy aging society. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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8 pages, 292 KiB

Open AccessArticle

Relationships of Educational Attainment and Household Food Insecurity with Obesity: Findings from the 2007–2016 National Health and Nutrition Examination Survey

by M. Monique McMillian and Roland J. Thorpe, Jr.

Int. J. Environ. Res. Public Health 2021, 18(15), 7820; https://doi.org/10.3390/ijerph18157820 - 23 Jul 2021

Viewed by 2941

Abstract

This study aimed to determine whether 1882 Black young adults’ educational attainment was associated with their obesity ([BMI] ≥ 30) and whether this association varied with household food insecurity. Data from interviews with Black young adults and a medical examination from the 2007–2016 National Health and Nutrition Examination Survey were analyzed. Modified Poisson regressions with robust standard errors were used. Educational attainment was not associated with obesity (prevalence ratio [PR] = 1.05, 95% confidence interval [CI]: 0.85, 1.30) after adjusting for age, sex, marital status, smoking status, drinking status, income, health insurance status, physical activity level, and household food insecurity. The interaction between educational attainment and household food insecurity was also not significant (PR = 1.11, 95% CI: 0.56, 2.19) after adjusting for the same covariates. These findings indicated that college graduates were as likely to be obese as those with less education, and the relationship between educational attainment and obesity did not vary with household food insecurity. Future studies should conduct longitudinal analyses of these relationships. There is a need to identify the roles that education, household food insecurity, and other measures of socioeconomic status play in Black young adults’ obesity. Full article

(This article belongs to the Special Issue Social Determinants of Health)

10 pages, 273 KiB

Open AccessArticle

Racial Disparities in Hypertension Prevalence within US Gentrifying Neighborhoods

by Genee S. Smith, Rachael R. McCleary and Roland J. Thorpe, Jr.

Int. J. Environ. Res. Public Health 2020, 17(21), 7889; https://doi.org/10.3390/ijerph17217889 - 28 Oct 2020

Cited by 10 | Viewed by 2531

Abstract

Racial disparities in hypertension remain a persistent public health concern in the US. While several studies report Black–White differences in the health impacts of gentrification, little is known concerning the impact of living in a gentrifying neighborhood on hypertension disparities. Data from the American Community Survey were used to identify gentrifying neighborhoods across the US from 2006 to 2017. Health and demographic data were obtained for non-Hispanic Black and White respondents of the 2014 Medical Expenditure Panel Survey (MEPS) residing in gentrifying neighborhoods. Modified Poisson models were used to determine whether there is a difference in the prevalence of hypertension of individuals by their race/ethnicity for those that live in gentrifying neighborhoods across the US. When compared to Whites living within gentrifying neighborhoods, Blacks living within gentrifying neighborhoods had a similar prevalence of hypertension. The non-existence of Black–White hypertension disparities within US gentrifying neighborhoods underscores the impact of neighborhood environment on race differences in hypertension. Full article

(This article belongs to the Special Issue Social Determinants of Health)

15 pages, 621 KiB

Open AccessArticle

Timing of Entry into Paid Employment, Adverse Physical Work Exposures and Health: The Young Helsinki Health Study

by Tea Lallukka, Rahman Shiri, Olli Pietiläinen, Johanna Kausto, Hilla Sumanen, Jaana I. Halonen, Eero Lahelma, Ossi Rahkonen, Minna Mänty and Anne Kouvonen

Int. J. Environ. Res. Public Health 2020, 17(21), 7854; https://doi.org/10.3390/ijerph17217854 - 27 Oct 2020

Cited by 2 | Viewed by 2069

Abstract

It is not well known how the timing of entry into paid employment and physical work exposures contribute to different health outcomes in young employees. Thus, we determined the associations of age at entry into paid employment and physical work exposures with general and mental health in young employees and determined whether associations differ by behavior-related risk factors. Data were collected via online and mailed surveys in autumn 2017 from employees of the City of Helsinki aged 18–39 years (n = 5897; 4630 women and 1267 men, response rate 51.5%). Surveys comprised measures of age at entry into paid employment, seven working conditions, behavior-related risk factors and health outcomes (self-rated health [SRH] and common mental disorders [CMD] as generic indicators of physical and mental health). Logistic regression analysis was used. After full adjustment, age at entry was not associated with the health outcomes; however, in additional analyses, younger age at first employment was associated with smoking and obesity (OR 3.00, 95% CI 2.34–3.85 and 1.67, 95% CI 1.32–2.11 for those started working at age of ≤18 years, respectively). Of the working conditions, sitting and standing were positively associated with poor SRH and CMD and uncomfortable working postures with CMD. Working conditions were broadly similarly associated with health outcomes among those with and without behavior-related risk factors. Although we found little support for modification by behavior-related risk factors, overweight, obesity and smoking were associated with poor SRH and binge drinking and smoking with CMD. Additionally, moderate and high levels of leisure-time physical activity were inversely associated with poor SRH. In conclusion, early entry into paid employment appears not to associate to immediate poorer health in young employees, although it was associated with smoking and obesity even after full adjustment. Exposure to physically heavy work and uncomfortable working postures may increase the risk of adverse health outcomes. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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21 pages, 623 KiB

Open AccessArticle

Exploration of Influence of Socioeconomic Determinants on Mortality in the European Union

by Beata Gavurova, Samer Khouri, Viliam Kovac and Michaela Ferkova

Int. J. Environ. Res. Public Health 2020, 17(13), 4699; https://doi.org/10.3390/ijerph17134699 - 30 Jun 2020

Cited by 5 | Viewed by 1979

Abstract

Economic performance measured through the gross domestic product indicator and the poverty rate varies across the whole European Union, together with the considerable income inequalities in the long-term. Economic growth may not bring a reduction in the health inequalities in the individual countries themselves. In order to eliminate health inequalities, the different types of policies implemented in the health, social and economic systems need to be explored in more detail. Mortality is explored through an indicator of the standardised mortality rate for both sexes explained by the several socioeconomic determinants, among which variables such as the variations of the gross domestic product per capita, the healthcare expenditures, the unemployment rate, and the healthcare system financing. Almost in all the described cases, these dimensions have negative impact. All the influences are expressed in a relative way in order to be suitably interpretable. The analysis is not comprehensive; nevertheless, it contains 18 regression models to cover as many aspects as it is possible. The Discussion section offers an evaluation of the obtained results according to the outcome of the other studies. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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Review

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36 pages, 1228 KiB

Open AccessReview

Social Determinants of Health and Depression among African American Adults: A Scoping Review of Current Research

by Brooks Yelton, Daniela B. Friedman, Samuel Noblet, Matthew C. Lohman, Michelle A. Arent, Mark M. Macauda, Mayank Sakhuja and Katherine H. Leith

Int. J. Environ. Res. Public Health 2022, 19(3), 1498; https://doi.org/10.3390/ijerph19031498 - 28 Jan 2022

Cited by 17 | Viewed by 6025

Abstract

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities. Full article

(This article belongs to the Special Issue Social Determinants of Health)

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