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1.
Artigo em Inglês | MEDLINE | ID: mdl-34199895

RESUMO

While men and women make up a similar number of COVID-19 cases, and are equally likely to know someone who has become ill due to the virus, the gendered and systemic implications of immigration during public health emergencies among minority groups in the United States are empirically underexplored. Using the SOMOS COVID-19 Crisis National Latino Survey, we conduct a series of intersectional analyses to understand the extent to which personal experiences with COVID-19, gendered structural factors, and spillover effects of US immigration policies impact the mental health of US Latina/os during a public health emergency. The results show that among Latinas, knowing an undocumented immigrant and someone ill with COVID-19 increases the probability of reporting worse mental outcomes by 52 percent. Furthermore, being a woman increases the probability of reporting the highest level of mental health problems by 30 percent among Hispanic people who know someone with COVID-19 and an undocumented immigrant. These findings indicate that the effects of the COVID-19 outbreak among US Latinas and Latinos are entrenched in gendered and systemic inequalities.


Assuntos
COVID-19 , Emigração e Imigração , Surtos de Doenças , Feminino , Hispano-Americanos , Humanos , Masculino , Saúde Mental , SARS-CoV-2 , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
2.
Afr J Prim Health Care Fam Med ; 13(1): e1-e7, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34212744

RESUMO

BACKGROUND: Hypertension is a public health threat of global concern with increasing prevalence in many countries, including Nigeria. AIM: The aim of the study was to determine the prevalence and determinants of hypertension in a rural agrarian community in Edo North, Nigeria. SETTING: The study was carried out in Ayua, a community in Edo North, southern Nigeria. METHODS: This cross-sectional descriptive study involved the use of a structured interviewer-administered questionnaire to obtain relevant data. Body mass index (BMI), blood pressure and glucose were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. RESULTS: Two hundred and nineteen participants aged 15 years completed the study with a mean age of 54.03 ± 16.61 years and females comprising 159 (72.6%) of the total. The prevalence of hypertension was 27.9% (in 61 participants). Twenty-one (9.8%) respondents gave a family history of hypertension. The mean BMI amongst respondents was 27.10 ± 6.61 kg/m2. Obesity and pre-obesity were found in 58 (26.5%) and 71(32.4%) respondents, respectively. The determinants of hypertension were age and BMI. Compared with those who were less than 40 years old, those aged 40-65 years and 65 years had 1.9 and 4.2 times increased odds of developing hypertension, respectively. Similarly, compared with the non-obese, obese participants had 2.3 times increased odd of having hypertension. CONCLUSION: Hypertension was highly prevalent in this rural community. Health sensitisation and intervention programmes are recommended in rural communities for early detection and management of hypertension, especially amongst older and obese adults.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Determinantes Sociais da Saúde , Adulto , Idoso , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Hipertensão/etnologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/complicações , Obesidade/etnologia , Obesidade/psicologia , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34204018

RESUMO

Despite near universal health insurance coverage in China, populations with low incomes may still face barriers in access and utilization of affordable health care. We aimed to identify the likelihood of forgone medical care due to cost by surveying individuals from the community to assess: (1) The percent with forgone medical care due to cost; and (2) Factors associated with forgone medical care due to cost. Surveys conducted (2016-2017) in Mandarin included demographic and medical care utilization-related items. Theoretically-informed, fully-adjusted analyses were employed. Approximately 94% of respondents had health insurance, which is somewhat similar to national estimates. Overall, 24% of respondents resided in rural areas, with 18% having less than a high school education, and 49% being male. More than 36% reported forgone medical care due to cost in the past 12 months. In fully-adjusted analyses, having lower education, generally not being satisfied with the commute to the hospital, and being a resident of a province with a lower density of physicians were associated with forgone medical care. Cost-related disparities in the access and utilization of needed medical care persist, even with near universal health insurance, which may be due to one's satisfaction with travel time to healthcare and other community assets.


Assuntos
Acesso aos Serviços de Saúde , Determinantes Sociais da Saúde , China , Feminino , Hospitais , Humanos , Seguro Saúde , Masculino , Pobreza , Fatores Socioeconômicos
4.
Artigo em Inglês | MEDLINE | ID: covidwho-1259482

RESUMO

While men and women make up a similar number of COVID-19 cases, and are equally likely to know someone who has become ill due to the virus, the gendered and systemic implications of immigration during public health emergencies among minority groups in the United States are empirically underexplored. Using the SOMOS COVID-19 Crisis National Latino Survey, we conduct a series of intersectional analyses to understand the extent to which personal experiences with COVID-19, gendered structural factors, and spillover effects of US immigration policies impact the mental health of US Latina/os during a public health emergency. The results show that among Latinas, knowing an undocumented immigrant and someone ill with COVID-19 increases the probability of reporting worse mental outcomes by 52 percent. Furthermore, being a woman increases the probability of reporting the highest level of mental health problems by 30 percent among Hispanic people who know someone with COVID-19 and an undocumented immigrant. These findings indicate that the effects of the COVID-19 outbreak among US Latinas and Latinos are entrenched in gendered and systemic inequalities.


Assuntos
COVID-19 , Emigração e Imigração , Surtos de Doenças , Feminino , Hispano-Americanos , Humanos , Masculino , Saúde Mental , SARS-CoV-2 , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
6.
S Afr Fam Pract (2004) ; 63(1): e1-e3, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34212751

RESUMO

In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the links between poor hygiene, unclean environments and human health cannot be overemphasised, particularly in South Africa with its high incidence of infectious diseases and overburdened health system. One very controllable factor that is often overlooked is the poor disposal of litter and waste management and its adverse effects on public health. By wearing masks, regular handwashing and sanitising, as well as making sure that neighbourhoods and public spaces are clean and safe, the spread of COVID-19 and other diseases can be prevented.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Saúde Ambiental/organização & administração , Recuperação e Remediação Ambiental , Saúde Pública/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Higiene/normas , Condições Sociais , Determinantes Sociais da Saúde , África do Sul/epidemiologia
7.
Ann Ig ; 33(5): 521-523, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34223866

RESUMO

Abstract: The differences of the epidemiology (incidence, case-to-death rate, mortality, etc) of COVID-19 between USA and Italy are analyzed taking into account the social, economic and sanitary characteristics of the two countries, both severely hit be the pandemic; and the causes of the so many different behaviors of the disease in each of them are discussed and explained.


Assuntos
COVID-19/mortalidade , Pandemias/estatística & dados numéricos , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/terapia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Comorbidade , Europa (Continente)/epidemiologia , Política de Saúde , Recursos em Saúde/provisão & distribuição , Humanos , Imunização Passiva , Itália/epidemiologia , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
8.
BMJ Open ; 11(7): e048995, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226230

RESUMO

INTRODUCTION: Infectious disease models are important tools to inform public health policy decisions. These models are primarily based on an average population approach and often ignore the role of social determinants in predicting the course of a pandemic and the impact of policy interventions. Ignoring social determinants in models may cause or exacerbate inequalities. This limitation has not been previously explored in the context of the current pandemic, where COVID-19 has been found to disproportionately affect marginalised racial, ethnic and socioeconomic groups. Therefore, our primary goal is to identify the extent to which COVID-19 models incorporate the social determinants of health in predicting outcomes of the pandemic. METHODS AND ANALYSIS: We will search MEDLINE, EMBASE, Cochrane Library and Web of Science databases from December 2019 to August 2020. We will assess all infectious disease modelling studies for inclusion of social factors that meet the following criteria: (a) focused on human spread of SARS-CoV-2; (b) modelling studies; (c) interventional or non-interventional studies; and (d) focused on one of the following outcomes: COVID-19-related outcomes (eg, cases, deaths), non-COVID-19-related outcomes (ie, impacts of the pandemic or control policies on other health conditions or health services), or impact of the pandemic or control policies on economic outcomes. Data will only be extracted from models incorporating social factors. We will report the percentage of models that considered social factors, indicate which social factors were considered, and describe how social factors were incorporated into the conceptualisation and implementation of the infectious disease models. The extracted data will also be used to create a narrative synthesis of the results. ETHICS AND DISSEMINATION: Ethics approval is not required as only secondary data will be collected. The results of this systematic review will be disseminated through peer-reviewed publication and conference proceedings. PROSPERO REGISTRATION NUMBER: CRD42020207706.


Assuntos
COVID-19 , Determinantes Sociais da Saúde , Humanos , Pandemias , SARS-CoV-2 , Revisões Sistemáticas como Assunto
9.
Artigo em Inglês | PAHO-IRIS | ID: phr-54424

RESUMO

[SUMMARY]. In order to achieve the Sustainable Development and Health Goals, it is essential to increase the technological capacity of the most disadvantaged populations. In the 21st century, the necessary technologies for this exist. The gap in technological capacity reflects the existence of a technological gradient between large- and small-scale production, due to an absence of incentives for innovation and a lack of technological dissemination in small businesses and communities. Technological change is central to development, but it is a public good that the market economy does not provide efficiently. Providing it requires the implementation of public policies aimed at technological innovation and dissemination. Reducing the technological gradient is therefore a major part of the United Nations 2030 Agenda for Sustainable Development and the Pan American Health Orga-nization’s 2018-2030 Sustainable Health Agenda for the Americas. This also applies to the development of health systems, which function as a redistribution mechanism to break poverty traps. In addition, experiences in these systems are relevant to the implementation of policies that increase technological capacities aimed at reducing poverty, improving social determinants of health, and thereby reducing the scale of the human development trap.


[RESUMEN]. Para lograr los objetivos de desarrollo y salud sostenibles, es esencial incrementar las capacidades tecnológicas de las poblaciones más desfavorecidas. Entrado el siglo XXI, existen las tecnologías necesarias para ello. El déficit en capacidades tecnológicas se debe a la existencia de un gradiente tecnológico entre la producción de gran y de pequeña escalas, debido a la falta de incentivos para la innovación y la difusión en empresas y comunidades pequeñas. En estos ámbitos el cambio tecnológico, punto medular del desarrollo, es un bien público que la economía de mercado no provee eficientemente. Su provisión requiere la aplicación de políticas públicas de innovación y difusión tecnológicas. La reducción del gradiente tecnológico constituye, pues, parte medular de la Agenda 2030 para el Desarrollo Sostenible, de las Naciones Unidas, y la Agenda de Salud Sostenible para las Américas 2018-2030, de la Organización Panamericana de la Salud. Esto es aplicable, así mismo, al desarrollo de los sistemas de salud, que funcionan también como mecanismos de redistribución para romper las trampas de pobreza. Asimismo, las experiencias en esos sistemas tienen relevancia para aplicar políticas de incremento de capacidades tecnológicas que disminuyan la pobreza, mejoren los determinantes sociales de la salud y, con ello, reduzcan la magnitud de la trampa de desarrollo humano.


[RESUMO]. Para alcançar os objetivos de desenvolvimento e saúde sustentáveis, é fundamental aumentar a capacidade tecnológica das populações mais desfavorecidas. Com a entrada do século XXI, há tecnologias necessárias para isso. O déficit em capacidade tecnológica decorre de um gradiente tecnológico entre a produção em pequena e larga escala pela falta de incentivos à inovação e difusão em empresas e comunidades pequenas. Nestas esferas, a evolução tecnológica, que é o eixo do desenvolvimento, é um bem público que não é provido de forma eficiente pela economia de mercado. Políticas públicas de inovação e difusão tecnológicas são necessárias. Diminuir o gradiente tecnológico constitui, portanto, a base da Agenda 2030 para o Desenvolvimento Sustentável, da Agenda das Nações Unidas e da Agenda de Saúde Sustentável para as Américas 2018-2030 da Organização Pan-Americana da Saúde. Requer também o desenvolvimento dos sistemas de saúde que servem como mecanismos de redistribuição para romper com as armadilhas da pobreza. Ademais, a experiência adquirida nesses sistemas é indispensável para instituir políticas de aumento da capacidade tecnológica que diminuam a pobreza, melhorem os determinantes sociais da saúde e, assim, reduzam a dimensão da armadilha do desenvolvimento humano.


Assuntos
Ciência, Tecnologia e Sociedade , Desenvolvimento Sustentável , Equidade , Sistemas de Saúde , Política de Saúde , Determinantes Sociais da Saúde , Ciência, Tecnologia e Sociedade , Desenvolvimento Sustentável , Equidade , Sistemas de Saúde , Política de Saúde , Determinantes Sociais da Saúde , Ciência, Tecnologia e Sociedade , Desenvolvimento Sustentável , Equidade , Sistemas de Saúde , Política de Saúde , Determinantes Sociais da Saúde
10.
Artigo em Inglês | PAHO-IRIS | ID: phr-54418

RESUMO

[ABSTRACT]. The Health Equity Network of the Americas (HENA) is a multidisciplinary network that promotes knowledge sharing and intersectoral action for equity in health and human rights in the Americas. The objectives of HENA are: 1) to share successful experiences in the development of interventions, considering the social determinants and determination of health, to achieve participatory and community-based health responses; 2) to analyze the health, social, political, environmental and economic impacts of the COVID-19 pandemic; 3) to identify the effects of pandemic care on populations most at risk because of their age and pre-existing health conditions; 4) examine the situation at borders and population movements in the spread of the pan-demic and its effects on migrant populations; 5) propose strategies to ensure access to comprehensive care for pregnant women in order to reduce maternal and neonatal suffering, morbidity, and mortality; and 6) ana-lyze violations of human rights and the right to health of historically marginalized populations, including street dwellers and other communities that depend on public spaces and the street for survival. The analytical and intervention models for health equity at HENA are based on various approaches, including social medicine, social epidemiology, medical anthropology, human ecology, and One Health.


[RESUMEN]. La Red de las Américas para la Equidad en Salud (RAES) es una red multidisciplinaria que promueve el intercambio de conocimientos y la acción intersectorial para la equidad en salud y los derechos humanos en las Américas. Los objetivos de la RAES consisten en: 1) compartir experiencias exitosas en el desa rrollo de inter-venciones, considerando la determinación y los determinantes sociales, para lograr respuestas participativas y comunitarias en salud; 2) analizar los impactos sanitarios, sociales, políticos, ambientales y económicos de la pandemia de COVID-19; 3) identificar los efectos de la atención de la pandemia en las poblaciones de mayor riesgo por su edad y las condiciones de salud preexistentes; 4) examinar la situación de las fronteras y de los movimientos de población en la propagación de la pandemia y de sus efectos en las poblaciones migrantes; 5) proponer estrategias para asegurar el acceso a la atención integral de las mujeres gestantes, con el fin de reducir el sufrimiento, la morbilidad y la mortalidad materna y neonatal; y 6) analizar vulneraciones de derechos humanos y del derecho a la salud de poblaciones históricamente marginalizadas, incluyendo habitantes en situación de calle y otras comunidades que dependen de los espacios públicos y de la calle para sobrevivir. Los modelos analíticos y de intervención para la equidad en salud de la RAES se desarrollan desde varios enfoques, como la medicina social, la epidemiologia social, la antropología médica, la ecología humana y el de Una sola salud.


Assuntos
Equidade em Saúde , Saúde Única , Colaboração Intersetorial , Determinantes Sociais da Saúde , América , Equidade em Saúde , Saúde Única , Colaboração Intersetorial , Determinantes Sociais da Saúde
11.
Artigo em Inglês | PAHO-IRIS | ID: phr-54413

RESUMO

[ABSTRACT]. Objective. Characterize the relationship between ethnic-racial inequity and type of health insurance in Colombia. Methods. Cross-sectional study based on data from the 2019 Quality of Life Survey. We analyzed the type of health insurance (contributory, subsidized, or none) and its relationship to ethnic-racial status and predisposing variables (sex, age, marital status), demographic variables (area and region of residence), and socioeconomic variables (education, type of employment, income, and unmet basic needs) through simple and multivariate regression analyses. The association between ethnic-racial status and type of health insurance was estimated using odds ratios (OR) and their 95% confidence intervals, through a multinomial logistic model. Results. A statistically significant association was found between ethnic-racial status and type of health insurance. In comparison with the contributory system, the probabilities of being a member of the subsidized system were 1.8 and 1.4 times greater in the indigenous population (OR x 1.891; 95%CI: 1.600-2.236) and people of African descent (OR = 1.415; 95%CI: 1.236-1.620), respectively (p <0.01) than in the population group that did not identify as belonging to one of those ethnic-racial groups. Conclusions. There is an association between ethnic-racial status and type of insurance in the contributory and subsidized health systems in Colombia. Ethnic-racial status is a structural component of inequity in access to health services and heightens the disadvantages of people and population groups with low socioeconomic status.


[RESUMEN]. Objetivo. Caracterizar la relación entre la inequidad por la condición étnico-racial y el tipo de aseguramiento de salud en Colombia.Métodos. Estudio de corte transversal basado en datos de la Encuesta de Calidad de Vida 2019. Se analizó el tipo de aseguramiento de salud (contributivo, subsidiado o ninguno) y su relación con la condición étnico- racial y variables predisponentes (sexo, edad, estado civil), demográficas (zona y región de residencia) y socioeconómicas (educación, tipo de empleo, ingresos y necesidades básicas insatisfechas) mediante análisis de regresión simple y multifactorial. La asociación entre la condición étnico-racial y el tipo de asegur-amiento de salud fue estimada utilizando razones de posibilidades (OR) y sus intervalos de confianza de 95%, mediante un modelo logístico multinomial.Resultados. Se encontró asociación estadísticamente significativa entre la condición étnico-racial y el tipo de aseguramiento de salud. En comparación con el régimen contributivo, las probabilidades de estar afiliado al régimen subsidiado fueron 1,8 y 1,4 veces mayores en los indígenas (OR = 1,891; IC95%: 1,600-2,236) y afrodescendientes (OR = 1,415; IC95%: 1,236-1,620), respectivamente (p < 0,01), que el grupo de la población que no se reconoció como perteneciente a uno de esos grupos étnico-raciales.Conclusiones. Existe una asociación entre la condición étnico-racial y el tipo de aseguramiento en el régimen contributivo y subsidiado de salud en Colombia. La condición étnico-racial se manifiesta como un compo-nente estructural de la inequidad en el acceso a los servicios de salud y profundiza las desventajas de las personas y grupos poblacionales con un bajo estatus socioeconómico.


[RESUMO]. Objetivo. Caracterizar a relação entre as iniquidades étnico-raciais e o tipo de seguro de saúde na Colômbia.Métodos. Estudo transversal realizado com dados da Pesquisa de Qualidade de Vida 2019. Analisou-se o tipo de seguro de saúde (contributivo, subsidiado ou inexistente) e sua relação entre a condição étnico- racial e variáveis predisponentes (gênero, idade, estado civil), demográficas (zona e região de residência) e socioeconômicas (nível de escolaridade, tipo de emprego, renda e necessidades básicas não atendidas) por regressão simples e multifatorial. Estimou-se a associação entre a condição étnico-racial e o tipo de seguro de saúde em um modelo de regressão logística multinomial com razão de possibilidades (OR) e os respecti-vos intervalos de confiança de 95%.Resultados. Observou-se uma associação estatisticamente significativa entre a condição étnico-racial e o tipo de seguro de saúde. Em comparação ao esquema contributivo, a probabilidade de um indivíduo ser associado ao esquema subsidiado foi 1,8 e 1,4 vez maior entre indígenas (OR = 1,891; IC95%: 1,600-2,236) e afrodescendentes (OR = 1,415; IC95%: 1,236-1,620), respectivamente (p < 0,01) que no grupo populacional que não se declarou pertencer a um destes grupos étnicos-raciais.Conclusões. Existe uma associação entre a condição étnico-racial e o tipo de seguro de saúde nos esque-mas contributivo e subsidiado na Colômbia. A condição étnico-racial constitui um componente estrutural da iniquidade no acesso aos serviços de saúde aprofundando as desvantagens das pessoas e grupos popula-cionais com nível socioeconômico baixo.


Assuntos
Acesso aos Serviços de Saúde , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Iniquidade Étnica , Colômbia , Acesso aos Serviços de Saúde , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Iniquidade Étnica , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Iniquidade Étnica , Acesso aos Serviços de Saúde , Colômbia
12.
Washington, D.C.; OPS; 2021-06-18. (OPAS/IMS/FPL/COVID-19/21-0011).
em Português | PAHO-IRIS | ID: phr-54331

RESUMO

Este documento aborda as consequências sociais, econômicas e referentes à saúde, das medidas adotadas para controlar a pandemia relacionadas ao fechamento das escolas, bem como os elementos que devem ser considerados para na reabertura e fechamento, com foco nas crianças e adolescentes em situação de vulnerabilidade. Fornece ainda considerações adicionais para que os planos de reabertura das escolas incluam medidas especialmente formuladas para beneficiar as crianças e os adolescentes com maior risco de terem resultados desfavoráveis em relação à educação e à saúde devido ao impacto negativo direto e indireto da pandemia de COVID-19.


Assuntos
COVID-19 , Coronavirus , Infecções por Coronavirus , Betacoronavirus , Promoção da Saúde , Determinantes Sociais da Saúde , Saúde Pública , Vulnerabilidade Social , Instituições Acadêmicas , Pandemias
13.
Health Educ Behav ; 48(3): 371-375, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34080477

RESUMO

Anti-Asian racism and violence dramatically increased during the COVID-19 pandemic. As a result, recent studies and reports are showing that the health and well-being of Asian Americans are negatively affected. To address this urgent problem, the field of health education and public health must be equipped with the critical frameworks and concepts to analyze racism and White supremacy and how it affects the health and well-being of Asian Americans. We argue that using an ethnic studies lens in health education can help educators, researchers, and practitioners teach and train health educators to address racism experienced by Asian Americans during COVID-19 in relation to their health. We will discuss the elements of ethnic studies and demonstrate how to use it as a lens in understanding health disparities in the Asian American population influenced and exacerbated by the COVID-19 pandemic.


Assuntos
Americanos Asiáticos/educação , COVID-19/etnologia , Competência Cultural , Educação em Saúde/organização & administração , Racismo/psicologia , Educação em Saúde/normas , Humanos , Pandemias , SARS-CoV-2 , Determinantes Sociais da Saúde/etnologia , Estados Unidos
14.
Rev Bras Enferm ; 74(suppl 4): e20200138, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133704

RESUMO

OBJECTIVE: to analyze the association of skin-to-skin contact and social determinants of health. METHODS: this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval. RESULTS: 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines. CONCLUSION: skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.


Assuntos
Cesárea , Mães , Brasil , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Gravidez , Determinantes Sociais da Saúde
16.
J Health Care Poor Underserved ; 32(2): 598-606, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34120960

RESUMO

In response to the COVID-19 pandemic, the Herbert Wertheim College of Medicine's Neighborhood Health Education Learning Program (NeighborhoodHELP) initiated a longitudinal assessment and mitigation of social and health care challenges for a population of approximately 850 underserved households. Here, we describe the needs assessment, ensuing interventions, and lessons learned during this pandemic.


Assuntos
COVID-19/epidemiologia , Determinação de Necessidades de Cuidados de Saúde , Populações Vulneráveis , Adolescente , Adulto , Idoso , Criança , Serviços de Saúde Comunitária , Informação de Saúde ao Consumidor , Feminino , Florida/epidemiologia , Assistência Alimentar , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Pandemias , Determinantes Sociais da Saúde , Adulto Jovem
17.
BMJ Open ; 11(6): e046545, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34155074

RESUMO

OBJECTIVE: To examine the social determinants of influenza and pertussis vaccine uptake among pregnant women in England. DESIGN: Nationwide population-based cohort study. SETTING: The study used anonymised primary care data from the Clinical Practice Research Datalink and linked Hospital Episode Statistics secondary care data. PARTICIPANTS: Pregnant women eligible for pertussis (2012-2015, n=68 090) or influenza (2010/2011-2015/2016, n=152 132) vaccination in England. MAIN OUTCOME MEASURES: Influenza and pertussis vaccine uptake. RESULTS: Vaccine uptake was 67.3% for pertussis and 39.1% for influenza. Uptake of both vaccines varied by region, with the lowest uptakes in London and the North East. Lower vaccine uptake was associated with greater deprivation: almost 10% lower in the most deprived quintiles compared with the least deprived for influenza (34.5% vs 44.0%), and almost 20% lower for pertussis (57.7% vs 76.0%). Lower uptake for both vaccines was also associated with non-white ethnicity (lowest among women of black ethnicity), maternal age under 20 years and a greater number of children in the household. The associations between all social factors and vaccine uptake were broadly unchanged in fully adjusted models, suggesting the social determinants of uptake were largely independent of one another. Among 3111 women vaccinated against pertussis in their first eligible pregnancy and pregnant again, 1234 (40%) were not vaccinated in their second eligible pregnancy. CONCLUSIONS: Targeting promotional campaigns to pregnant women who are younger, of non-white ethnicity, with more children, living in areas of greater deprivation or the London or North East regions, has potential to reduce vaccine-preventable disease among infants and pregnant women, and to reduce health inequalities. Vaccination promotion needs to be sustained across successive pregnancies. Further research is needed into whether the effectiveness of vaccine promotion strategies may vary according to social factors.


Assuntos
Vacinas contra Influenza , Influenza Humana , Complicações Infecciosas na Gravidez , Coqueluche , Adulto , Criança , Estudos de Coortes , Registros Eletrônicos de Saúde , Inglaterra/epidemiologia , Feminino , Número de Gestações , Humanos , Influenza Humana/prevenção & controle , Londres , Vacina contra Coqueluche , Gravidez , Determinantes Sociais da Saúde , Vacinação , Coqueluche/prevenção & controle , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: covidwho-1224009

RESUMO

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical-community linkage that enhances overall population health. An exploratory roadmap is proposed.


Assuntos
Inteligência Artificial , COVID-19 , Humanos , Pandemias , Medicina de Precisão , SARS-CoV-2 , Determinantes Sociais da Saúde
20.
Nurs Adm Q ; 45(3): 219-225, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1249346

RESUMO

The COVID-19 pandemic has overwhelmed communities. Physical, emotional, and financial struggles have heightened, especially with our vulnerable populations. People have been afraid to return to their provider's office. For children, there has been an interruption of well-visits and immunizations. As the nation saw a decline in immunization uptake, a pilot nurse-led program was designed to increase vaccinations and address the social determinant needs during a global pandemic. The purpose of this article is to describe the planning and implementation of a curbside immunization event. The Logic model was used as a framework to ensure an efficient and replicable process. Initial observations showed an overall increase in immunization uptake and 97% of participants current with recommended vaccinations. Most parents (93%) would attend again and recommend it to others. They also felt that infection control precautions helped make the care delivered safe and efficient. Social determinants of health were assessed and addressed. This method of vaccine delivery is a viable model going into the future. Others may replicate this model, and it may also serve as a platform regarding flu or COVID-19 vaccine distribution.


Assuntos
Imunização/enfermagem , Modelos de Enfermagem , Determinantes Sociais da Saúde/estatística & dados numéricos , Humanos , Imunização/estatística & dados numéricos , Programas de Imunização/métodos , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Michigan , Projetos Piloto
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