Disparities in property insurance relief among socially vulnerable Texas communities after Winter Storm Uri.

Property insurance is an important tool for resiliency from the accelerating impacts of climate-intensified extreme weather events. However, disparities in property insurance payouts may reduce their potential protective effects. The objective of this study was to quantify disparities in insurance payouts by Texas' insurers after the 2021 Winter Storm Uri, and to understand if any socioeconomic factors were associated with higher rates of declined relief. We extracted data from the Texas Department of Insurance on rates of denied insurance claims by zip code and county at 1 month and 13 months into the recovery period. We then linked these data to community-level socioeconomic information. Finally, we produced separate linear regressions for each predictor and covariate. Across both time points, communities with a higher proportion of Hispanic people, primary Spanish speakers, people who did not graduate high school, and people living below the federal poverty line were significantly more likely to experience denied claims. Communities with higher social vulnerability scores also experienced more denied claims. While financial security is a critical social determinant of health, findings suggest that insurers may be engaging in structurally discriminatory practices and failing to provide relief for people from socially vulnerable communities in the wake of climate-intensified events.

Mapping regional cooperation of state actors for health research systems in Africa: A social network analysis.

Regional bodies can potentially play an important role in improving health research in Africa. This study analyses the network of African state-based regional organisations for health research and assesses their potential relationship with national health research performance metrics. After cataloguing organisations and their membership, we conducted a social network analysis to determine key network attributes of national governments' connections via regional organisations supporting functions of health research systems. This data was used to test the hypothesis that state actors with more connections to other actors via regional organisations would have higher levels of health research performance across indicators. With 21 unique regional organisations, the African continent is densely networked around health research systems issues. In general, the regional network for health research is inclusive. No single actor serves as a nexus. However, when statistics are grouped by African Union regions, influential poles emerge, with the most predominate spheres of influence in Eastern and Western Africa. Further, when connectivity data was analysed against national health research performance, there were no statistically significant relationships between increased connectivity and higher performance of key health research metrics. The inclusive and dense network dynamics of African regional organisations for health research strengthening present key opportunities for knowledge diffusion and cooperation to improve research capacity on the continent. Further reflection is needed on appropriate and meaningful ways to assess the role of regionalism and evaluate the influence of regional organisations in strengthening health research systems in Africa.

The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives.

BACKGROUND: Regional cooperation on health in Africa is not new. The institutional landscape of regional cooperation for health and health research, however, has seen important changes. Recent health emergencies have focussed regional bodies' attention on supporting aspects of national health preparedness and response. The state of national health research systems is a key element of capacity to plan and respond to health needs - raising questions about the roles African regional bodies can or should play in strengthening health research systems. METHODS: We mapped regional organisations involved in health research across Africa and conducted 18 interviews with informants from 15 regional organisations. We investigated the roles, challenges, and opportunities of these bodies in strengthening health research. We deductively coded interview data using themes from established pillars of health research systems - governance, creating resources, research production and use, and financing. We analysed organisations' relevant activities in these areas, how they do this work, and where they perceive impact. RESULTS: Regional organisations with technical foci on health or higher education (versus economic or political remits) were involved in all four areas. Most organisations reported activities in governance and research use. Involvement in governance centred mainly around agenda-setting and policy harmonisation. For organisations involved in creating resources, activities focused on strengthening human resources, but few reported developing research institutions, networks, or infrastructure. Organisations reported more involvement in disseminating than producing research. Generally, few have directly contributed to financing health research. Informants reported gaps in research coordination, infrastructure, and advocacy at regional level. Finally, we found regional bodies' mandates, authority, and collaborations influence their activities in supporting national health research systems. CONCLUSION: Continued strengthening of health research on the African continent requires strategic thinking about the roles, comparative advantages, and capability of regional organisations to facilitate capacity and growth of health research systems.