Search Results (1,450)

Urban public parks are vital for recreation, public health, environmental quality, and sustainable urban growth. Yet access to these parks remains uneven across many cities, disproportionately affecting low-income, marginalised, and spatially segregated communities. This study systematically examines socio-spatial disparities in park access and their implications for spatial justice. Using the PRISMA 2020 framework, 108 peer-reviewed articles published between 2000 and 2025 were analysed through thematic narrative synthesis. The results identify key factors shaping accessibility disparities, including socio-economic status, residential location, race and ethnicity, transport infrastructure, urban form, governance, and demographic vulnerability. The most common determinants were socio-economic status (24%), residential location and spatial distribution (20%), race and ethnicity (18%), and urban form and transport systems (17%). Limited park access exacerbates socio-economic inequality, worsens environmental injustice, contributes to health gaps, reinforces spatial segregation, hampers urban sustainability, and marginalises vulnerable populations. The review integrates Spatial Justice Theory, Environmental Justice Theory, and Urban Political Ecology into a comprehensive analytical framework and introduces a conceptual model linking accessibility factors to spatial justice outcomes. These findings underscore the importance of equitable green infrastructure planning, inclusive governance, and improved access in underserved urban areas. Full article

The United States is experiencing rapid population aging, making geriatric oral health an increasingly important public health and clinical concern. Older adults bear a disproportionate burden of oral diseases, including dental caries, periodontal disease, edentulism, xerostomia, and oral cancer, many of which are closely linked to chronic systemic conditions such as diabetes, cardiovascular disease, and cognitive impairment. This narrative review synthesizes current evidence on oral disease patterns and trends among older adults in the United States, with particular attention to the bidirectional relationships between oral and systemic health. It further examines the organization of oral health care delivery and financing for this population, including the roles of Medicare and Medicaid. Persistent inequities in access to preventive and restorative dental services are highlighted, especially among low-income individuals, racial and ethnic minorities, rural residents, and older adults with functional or cognitive limitations. Workforce shortages, fragmented care models, and limited integration of oral health into primary and geriatric care further exacerbate these disparities. Finally, this review identifies future directions to improve geriatric oral health, including policy reforms to expand dental coverage, integration of oral health into medical and long-term care settings, adoption of minimally invasive approaches, and strengthened interprofessional education and research. Addressing these challenges is essential to promoting healthy aging and reducing oral health disparities among older adults in the United States. Full article

Background/Objectives: Dental caries is socially patterned, but the magnitude of the inequality associated with social exclusion is difficult to quantify when populations are compared across different countries and health systems. This study estimated the oral health gap between socially vulnerable children attending escuelas singulares and a contemporaneous reference paediatric population attending university dental clinics within the same city and health-system context. Methods: A cross-sectional analytical study was conducted in 231 children aged 6–12 years in Valencia, Spain: 129 from two state-funded schools serving communities at high risk of social exclusion, hereafter referred to as escuelas singulares (Colegio Madre Petra, n = 64; Colegio Santiago Apóstol, n = 65), and 102 reference children examined at the University Dental Clinics of the Catholic University of Valencia. Caries experience (DMFT/dmft-derived global score), the Simplified Oral Hygiene Index (OHI-S), toothbrushing frequency and sugar consumption were recorded under standardised conditions. The groups were compared with non-parametric tests, and multivariable logistic and modified Poisson regression models estimated the independent association (adjusted OR and adjusted prevalence ratio, respectively) between school context and the presence of caries, adjusting for age, sex and behaviours. Results: Caries experience was markedly higher in vulnerable children (global caries score 4.07 ± 3.44 vs. 0.61 ± 1.96; p < 0.001), with a caries prevalence of 76.0% vs. 13.7% (a prevalence ratio of 5.5) and a 6.7-fold higher mean burden. Only 24.0% of vulnerable children were caries-free versus 86.3% of reference children. Vulnerable children also showed poorer oral hygiene (OHI-S 1.49 ± 0.84 vs. 0.19 ± 0.34; p < 0.001), less frequent brushing (50.4% vs. 79.4% brushing ≥ twice daily; p = 0.002) and higher sugar consumption (p < 0.001). After adjustment for age, sex, brushing and sugar, attendance at an escuela singular was associated with an adjusted prevalence ratio of 5.4 (95% CI 3.3–8.9; primary effect measure) and, in a secondary logistic model, with an adjusted OR of 20.5 (95% CI 9.6–43.8). Conclusions: Within a single high-income setting with formally universal health coverage, social exclusion was associated with a very large, graded excess of childhood caries that the measured behavioural differences alone were unlikely to explain, underscoring the role of social and structural determinants beyond individual behaviours. These cross-sectional findings are consistent with proportionate-universalism strategies (targeted, school-based preventive and restorative care embedded within the universal system), since formal coverage alone may be insufficient to achieve oral health equity. Full article

Background: Autism spectrum disorder (ASD) affects not only diagnosed individuals but also their families, who often experience long-term psychological and organizational burden. This study aimed to assess depression, anxiety, and stress among family members of individuals with ASD and to identify socio-demographic and family-related associated factors of psychological distress, with particular attention to high-risk groups, social inequalities, and the healthcare system context. Methods: A cross-sectional study was conducted in February 2025 among 310 family members of individuals with ASD. Data were collected using the Computer-Assisted Web Interview (CAWI) method via the Ariadna Nationwide Research Panel. Psychological distress was assessed using the Depression Anxiety Stress Scales (DASS-21). Results: Respondents reported substantial levels of psychological distress. Severe or extremely severe symptoms were most common for anxiety (41.29%), followed by depression (35.48%) and stress (27.74%). Younger respondent age was consistently associated with higher depression, anxiety, and stress. Lower income was associated with higher depression and anxiety, indicating the importance of socio-economic inequalities. Conclusions: The findings highlight the need to identify high-risk groups and develop family-centered, coordinated support within the healthcare system, with particular attention to social inequalities, continuity of care, and access to psychological and therapeutic services. Full article

Place attachment contributes to urban resilience, identity, and well-being by fostering a sense of belonging and emotional connection to place. In contexts of urban transformation and socio-spatial inequality, understanding its determinants is essential for improving urban livability and inclusive urban environments. This study examines how women’s place attachment is influenced by individual, social, and built-environment factors in middle-income central and peri-central neighborhoods of Santiago, Chile. A key contribution is the inclusion of personal values in explaining place attachment, extending previous socio-spatial research. Data were collected through simple random sampling from 586 women residing in six middle-income neighborhoods of Santiago. Structural equation modeling was applied to analyze relationships between individual characteristics, personal values, social cohesion, accessibility, and subjective and objective built-environment conditions. Results show that working outside the home, length of residence, personal values, social cohesion, accessibility, aesthetic quality, and perceived comfort and insecurity significantly influence women’s place attachment. Built-environment characteristics related to accessibility and comfort emerge as key mechanisms shaping emotional attachment to urban neighborhoods. Findings highlight the importance of improving accessibility while maintaining neighborhood residential structure in middle-income areas undergoing urban transformation. Overall, the study provides empirical evidence on socio-spatial processes shaping women’s place attachment and contributes to understanding spatial equity, urban well-being, and inclusive urban environments in a Latin American metropolis. Full article

Background/Objectives: Child social vulnerability is a multidimensional phenomenon influenced by poverty, material deprivation, inequality, and institutional protection. This study analysed child and adolescent social vulnerability in Europe between 2017 and 2023 and developed a Child Social Vulnerability Index (CSVI). Methods: A longitudinal ecological study was conducted using Eurostat country-year data from European countries. Indicators included severe child poverty, severe material deprivation, income inequality (Gini index), preventive healthcare expenditure, and social protection expenditure. Descriptive, longitudinal, principal component, and cluster analyses were performed. Results: The findings revealed substantial differences in child social vulnerability across European countries. Poverty, material deprivation, and inequality were strongly associated, supporting the multidimensional nature of vulnerability. Principal Component Analysis supported the internal structure of the child Social Vulnerability Index (CSVI), identifying two components that explained 76.35% of the variance. The CSVI showed a very high correlation with the first principal component (r = 0.97, p < 0.001) confirming its structural consistency. Longitudinal analyses revealed a significant decline in child social vulnerability between 2017 and 2023 with an additional reduction during the COVID-19/post-COVID period. Cluster analysis identified three distinct European vulnerability profiles based on the CSVI and institutional protection dimension. Conclusions: Child social vulnerability in Europe is shaped by the interaction of socioeconomic inequalities and institutional protection mechanisms. The CSVI provides a useful tool for monitoring vulnerability and informing policies to reduce inequalities and promote child and adolescent well-being. Full article

Inflation has become a major global economic issue, affecting household welfare and poverty reduction efforts, especially in developing countries. Despite growing scholarly attention, understanding of its conceptual foundations, emerging themes, and future research directions remains limited. This review analyzes international studies on inflation and household poverty from 2015 to 2025. Following PRISMA 2020 guidelines, 147 peer-reviewed English-language articles were selected from an initial pool of 659 records in the Scopus database and analyzed using the Biblioshiny package in R for performance metrics and science mapping. The findings reveal a rapidly growing and diverse research area, with an average annual growth rate of 20.77%, involving 362 authors across 147 journals. Most research focuses on high-income nations such as the United States, China, and the UK, while regions heavily affected by inflation-driven poverty, such as Sub-Saharan Africa and Central Asia, are less represented. Thematic analysis identifies five key areas: macroeconomic instability and inequality; household well-being and food security; energy poverty and commodity prices; COVID-19 and external economic threats; and multidimensional poverty combined with social policies. Around 30% of the publications feature international collaboration, reflecting increased global cooperation. Life-cycle analysis indicates the field is in a growth phase and may reach maturity around 2036. Overall, this review provides a detailed overview of the development and structure of research on inflation and household poverty, highlights notable geographic and thematic gaps, and offers valuable insights for future studies and policies aimed at reducing inflation’s adverse effects on vulnerable economies. Full article

Hepatitis B virus (HBV) infection remains a major public-health challenge in Peru, particularly in historically hyperendemic Amazonian and Andean regions; however, the structure, evolution, and equity of national HBV research have not been systematically evaluated. We conducted a PRISMA-informed bibliometric analysis of all peer-reviewed and theses on HBV in Peru published between 1988 and 2023 using Scopus, Google Scholar, and the Peruvian National Repository (RENATI). Bibliometric indicators, collaboration networks, thematic structure, and temporal thematic evolution were analyzed in R using bibliometrix- and network-based approaches. The final corpus comprised 232 documents, with a marked increase in production after 2005 and a publication peak in 2018. Scientific output was strongly concentrated in Lima-based institutions, while several departments historically associated with HBV endemicity exhibited minimal or absent research production. Nearly half of the corpus corresponded to undergraduate and postgraduate theses. Thematic analyses revealed persistent predominance of epidemiology, seroprevalence, and vaccination-related research, whereas molecular virology, therapeutics, and translational research remained peripheral or poorly represented. International collaboration was markedly limited. Overall, Peruvian HBV research has expanded quantitatively but remains geographically centralized and shows only limited correspondence with the contemporary geographic distribution of HBV incidence, while also remaining only partially aligned with the contemporary global HBV research frontier. These findings provide an evidence-based framework to guide research-priority setting, territorial equity policies, and strategic investment in infectious disease research capacity in Peru. Moreover, the weak association observed between scientific production and departmental HBV incidence suggests that factors beyond contemporary epidemiological burden contribute to the current distribution of research activity in Peru, highlighting a critical but often overlooked dimension of health inequity in low- and middle-income countries (LMIC) research systems. Full article

Palliative care evolved through recognition of subjectively experienced suffering, yet its availability depends on how societies recognize, prioritize and act. This paper presents a narrative, conceptually oriented synthesis of interdisciplinary literature from social science, bioethics and global health policy to examine how concepts of consciousness and suffering shape the governance and distribution of palliative care within health systems, particularly between high-income and low- and middle-income countries. These disparities are mediated by resources, as well as regulatory regimes, financing structures, workforce authority, and political prioritization. Relieving suffering is a health system responsibility that requires policy coherence, proportionate regulation and accountability in addressing global inequities. Full article

Persistent urban–rural inequality remains a major challenge for sustainable regional development, especially in countries where rural communities still face limited access to markets, employment, and public services. This study examines whether rural road network density promotes inclusive regional growth in China. Using county-level panel data from 2013 to 2024, we construct an inclusive regional growth index that combines economic output, nighttime-light-measured economic activity, rural income, and the urban–rural income gap. rural road network density is measured by the length of county, township, and village roads per 100 square kilometers. Two-way fixed-effects models, mechanism tests, robustness checks, instrumental-variable estimation, and heterogeneity analysis are employed. The results show that rural road network density significantly improves inclusive regional growth. Dimensional analysis indicates that higher rural road network density increases real GDP per capita, strengthens nighttime-light-measured economic activity, raises rural income, and reduces the urban–rural income gap. Mechanism analysis shows that these effects operate through labor mobility, market access, and non-agricultural industrial development. The results remain robust to alternative road measures, lagged specifications, outlier treatment, sample restrictions, and instrumental-variable estimation. Heterogeneity analysis further shows that the effects are larger in central-western counties, low-accessibility counties, and less-developed counties. These findings suggest that rural road network density is not only a transport infrastructure indicator but also a key spatial condition for promoting sustainable and inclusive regional development. Full article

In the pursuit of sustainable development, it is crucial to examine whether technological innovation (TI) creates equitable economic distribution or widens income inequality (II). The study aims to investigate TI’s impact on II in BRICS-T and BRICS PLUS-T countries within the context of the technological Kuznets curve (TKC). Along with TI, financial development is a driving force for economic development, and the research explores FD’s influence on II. To analyze these relationships while accounting for globalization (G), the method of moments quantile regression (MMQR) is used. The study’s findings validate the U-shaped TKC, suggesting that TI, in the initial stage, reduces II. However, beyond a certain threshold, TI² significantly widens II in both country groups. We found that the impact of TI on II was more pronounced in BRICS-T countries than in BRICS-PLUS-T countries, and the inclusion of newly added countries did not significantly affect the U-shaped relationship. Additionally, by enhancing financial inclusion, FD had a substantial and negative effect on II. In contrast, G, which concentrates wealth, was associated with higher II in both groups. This study offers a significant contribution by introducing the TKC in the context of BRICS-T and BRICS PLUS-T countries. Furthermore, the research contributes to the literature by evaluating the influence of FD and G within the context of TKC and applying novel MMQR. The study highlights a pathway to achieving the Sustainable Development Goals (SDGs 1, 7, and 10) and provides a policy framework for strategically allocating funds to technological advancements to reduce II. Full article

Background: Child malnutrition is a major public health problem worldwide, but the pathways through which socioeconomic status (SES) affects nutritional outcomes differ markedly between economic and welfare regimes. Differentiating whether these impacts are direct or through behavioural and structural factors is key to focused policy intervention. Objective: This study aimed to investigate the effects of socioeconomic inequalities, maternal knowledge and feeding practices, and food insecurity on preschool undernutrition in Hungary and Indonesia. Methods: The study employs a cross-national comparative design. Respondents were households with children 36 to 59 months old; the sample comprised 128 households in Budapest, Hungary and 535 households in Surabaya, Indonesia. The instruments were designed to fit within a survey for data collection. Data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) with Multi-Group Analysis (MGA). Results: In Hungary, SES and food insecurity are positively associated with malnutrition, whereas in Indonesia, SES and biological factors drive malnutrition. Intermediate factors such as maternal feeding practices (Hungary) and health coverage (Indonesia) did not directly affect malnutrition. Although the model identified significant socioeconomic pathways, its very low explanatory and predictive power for child malnutrition in both urban Hungary (R² = 0.024) and Indonesia (R² = 0.062), and the predictive relevance (Q² Hungary: −0.009); (Q² Indonesia: 0.016), which remained close to zero or negative, indicate that these variables only partially capture the complex, multifactorial mechanisms driving nutritional status. Conclusions: These findings indicate that a more targeted approach to food insecurity and behavioural screening within the Hungarian welfare system would be necessary to address malnutrition effectively. Findings in Indonesia underline the potential benefits of prioritising equity in health coverage and income support. Full article

Sustainable development, challenged by the global climate crisis, environmental degradation, and income inequality, requires more than growth-oriented indicators. In this context, the impact of financial innovation (FinTech) on the economic, environmental, and social dimensions of sustainability in emerging economies has been debated. This study empirically identifies the multidimensional effects of FinTech on sustainability across 23 emerging economies from 2011 to 2023. Using 299 observations over a 13-year period, we apply the triple bottom line (TBL) framework. It also tests the moderating role of physical capital accumulation in the relationship between FinTech and economic sustainability using an economic model. Two-way fixed-effects models were constructed for economic, environmental, and social sustainability metrics. A FinTech index derived from Google Trends search frequencies related to artificial intelligence, blockchain, cloud computing, and data technologies, validated through factor analysis and reliability tests, was used as the primary independent variable. To address the identified issues of heteroscedasticity, autocorrelation, and cross-sectional dependence, robust estimates were obtained using Driscoll and Kraay’s standard errors. The results indicate that FinTech does not have a statistically significant direct effect on economic or environmental sustainability. However, FinTech is positively associated with social sustainability, and its contribution to economic sustainability becomes significant when sufficient physical capital accumulation is supported. Interaction analysis revealed that the contribution of FinTech to economic sustainability is conditional. The marginal effect is negative at low levels of physical capital accumulation but turns positive as physical capital accumulation increases. The findings indicate that FinTech acts as a lever to strengthen inclusivity under SDGs 1 and 10; however, it does not automatically generate economic or ecological gains for SDGs 7, 9, and 13 unless it is integrated with physical infrastructure investments, green/ESG regulations, green credit quotas, and renewable energy strategies. Full article

With the growing energy demand and concerns about environmental impacts, green hydrogen has become one of the main alternatives for a clean and reliable energy future. Brazil presents itself as one of the main potential suppliers of this renewable fuel, considering its resource abundance, such as solar irradiation. Therefore, the present study aims to evaluate in detail the hydrogen production potential of one of Brazil’s main states when it comes to solar power potential, Minas Gerais. The potential for each of the 853 municipalities of the region was assessed individually using three different methodologies, indicating that the state could produce 2365.2 TWh of electricity or 47.3 Mt_H2/year (with a maximum variation of 3.4% between the methodologies), nearly five times the EU’s projected 2030 hydrogen import demand. This estimation, however, was significantly reduced when only areas with a slope lower than 8% were considered, decreasing land availability by 40% and cutting hydrogen potential by 18.8 Mt/year. On the other hand, increasing power density from 4 to 15 MWh/km² almost tripled hydrogen production potential, while electrolyzer efficiency also presented a positive effect on hydrogen output. Finally, the comparison of hydrogen potential with Human Development Index (HDI) data indicates that the most productive mesoregions often coincide with lower human development levels, particularly in the “Norte de Minas” and “Jequitinhonha” mesoregions, highlighting the opportunity to align energy transition with regional development goals. Therefore, targeted investments in these regions could generate jobs, boost income, and reduce inequalities, reinforcing green hydrogen as both an environmental and social driver. Full article

Background: Spatial analysis methods, including model-based geostatistics (MBG), small-area estimation (SAE), and cluster detection, are increasingly used to map subnational immunisation coverage and identify geographic inequalities in low- and middle-income countries. However, the extent to which these methods capture the multidimensional determinants of immunisation uptake, and whether their outputs inform programme decisions in practice, remains unclear. Methods: We conducted a critical scoping review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, systematically searching PubMed and Google Scholar for studies applying spatial statistical methods to childhood immunisation coverage or equity. Findings were synthesised using a combination of descriptive summary and thematic and interpretive synthesis. Results: We included 50 studies from the 421 papers identified. Spatial methods have successfully revealed subnational coverage inequalities that national averages obscure, and studies developed in collaboration with national programme teams, integrating routine health system data alongside household surveys, produced the most operationally relevant outputs. However, most studies relied exclusively on survey data with a limited incorporation of supply-side determinants, and few discussed how uncertainty in estimates should constrain downstream use. Although a growing number of studies articulated clear implementation pathways, confirmed programmatic uptake of spatial outputs remained largely undocumented. The emergence of machine learning approaches (8 of 50 studies) offers predictive gains but introduces additional challenges around transparency and quality assurance for governance use. Conclusions: Spatial methods are becoming more frequently used for immunisation but are more likely to contribute to immunisation equity goals when co-produced with programme teams, matched to decision-relevant geographies, and accompanied by transparent documentation of model assumptions and limitations. Future research should prioritise quality frameworks for algorithm-assisted health estimates and systematic evaluation of whether spatial outputs improve decision-making relative to existing data sources. Full article