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1.
Oncol Rep ; 47(1)2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34779496

RESUMEN

The devastating complications of coronavirus disease 2019 (COVID­19) result from the dysfunctional immune response of an individual following the initial severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS­CoV­2 exploits the dysfunctional immune system to trigger a chain of events, ultimately leading to COVID­19. The authors have previously identified a number of contributing factors (CFs) common to myriad chronic diseases. Based on these observations, it was hypothesized that there may be a significant overlap between CFs associated with COVID­19 and gastrointestinal cancer (GIC). Thus, in the present study, a streamlined dot­product approach was used initially to identify potential CFs that affect COVID­19 and GIC directly (i.e., the simultaneous occurrence of CFs and disease in the same article). The nascent character of the COVID­19 core literature (~1­year­old) did not allow sufficient time for the direct effects of numerous CFs on COVID­19 to emerge from laboratory experiments and epidemiological studies. Therefore, a literature­related discovery approach was used to augment the COVID­19 core literature­based 'direct impact' CFs with discovery­based 'indirect impact' CFs [CFs were identified in the non­COVID­19 biomedical literature that had the same biomarker impact pattern (e.g., hyperinflammation, hypercoagulation, hypoxia, etc.) as was shown in the COVID­19 literature]. Approximately 2,250 candidate direct impact CFs in common between GIC and COVID­19 were identified, albeit some being variants of the same concept. As commonality proof of concept, 75 potential CFs that appeared promising were selected, and 63 overlapping COVID­19/GIC potential/candidate CFs were validated with biological plausibility. In total, 42 of the 63 were overlapping direct impact COVID­19/GIC CFs, and the remaining 21 were candidate GIC CFs that overlapped with indirect impact COVID­19 CFs. On the whole, the present study demonstrates that COVID­19 and GIC share a number of common risk/CFs, including behaviors and toxic exposures, that impair immune function. A key component of immune system health is the removal of those factors that contribute to immune system dysfunction in the first place. This requires a paradigm shift from traditional Western medicine, which often focuses on treatment, rather than prevention.


Asunto(s)
COVID-19/epidemiología , Neoplasias Gastrointestinales/epidemiología , COVID-19/etiología , COVID-19/inmunología , Neoplasias Gastrointestinales/etiología , Neoplasias Gastrointestinales/inmunología , Humanos , Factores de Riesgo , SARS-CoV-2/fisiología , Factores Socioeconómicos
2.
Sci Total Environ ; 804: 150124, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-34517315

RESUMEN

Information about the long-term trends of wet mercury (Hg) deposition is important for assessing the impact of atmospheric pollution on environmental health. As the most populated and capital city of Tibet, Lhasa is isolated far away from the heavily-polluted urban clusters in China. In this study, a 10-year observation was conducted in Lhasa to establish the long-term trend of wet Hg deposition and investigate the possible causes of this variation trend. Our study showed no significant increase in wet Hg deposition while Lhasa has achieved rapid population and economic growth during the study period. The contrasting changes in long-term wet Hg deposition and socioeconomic development (e.g., GDP growth) could be greatly attributed to the efforts in preventing and controlling air pollution at regional and local levels. This trend in Lhasa differs greatly from those observed by a rapid increase of Hg trend in the remote areas of the Tibetan Plateau. Our findings indicate that the remote cryospheric areas over the Tibetan Plateau are prone to be affected by transboundary Hg pollution, and more attention should be paid to its environmental and health effects for future study.


Asunto(s)
Contaminantes Atmosféricos , Mercurio , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente , Mercurio/análisis , Factores Socioeconómicos , Tibet
3.
Braz. j. oral sci ; 20: e219638, jan.-dez. 2021. tab
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254752

RESUMEN

Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson's, chi-square test and, Student's t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary


Asunto(s)
Factores Socioeconómicos , Neoplasias de la Boca/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Registros Médicos
4.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 1404-1407, 2021 Aug.
Artículo en Ruso | MEDLINE | ID: mdl-34792897

RESUMEN

The article deals with topical issues of changing the socio-economic state of citizens under the influence of the situation with the spread of a new coronavirus infection that swept the entire world at the beginning of this year. Currently, society is asking whether people's attitudes to each other will change, how the economic situation in general and the financial situation of citizens will develop, in particular, in the conditions of active use of remote technologies, the development of Internet resources and the transition to digitalization, which are gaining popularity in conditions of self-isolation and restrictions on mass events. The article uses the results of a survey of the research project «Self-organization and mutual assistance in countering the spread of coronavirus infection¼, conducted by the center for research of civil society and the non-profit sector of the Higher School of Economics. The responses of respondents regarding the introduction of digitalization, increasing online opportunities, both in terms of work, training, and entertainment and communication, converge and confirm the prospects for development. However, while volunteers are optimistic about digitalization, representatives of the civilian population are more concerned about strengthening the digital control of the state over the lives of citizens.


Asunto(s)
COVID-19 , Pandemias , Humanos , SARS-CoV-2 , Autoevaluación (Psicología) , Factores Socioeconómicos
6.
Artículo en Inglés | MEDLINE | ID: mdl-34733129

RESUMEN

Drawing on life course theory and research, we explored how socioeconomic circumstances during childhood and adulthood shape self-reported health trajectories among older Mexican adults. We used data from the Mexican Health and Aging Study panel survey (2001-2015) and used sequence analysis to estimate types of self-reported health trajectories in older adulthood. We then explored the association between those health trajectories and socioeconomic determinants at different life stages, including education, occupation, employment, economic status, parental education, and adverse living conditions and illnesses during childhood. Our contributions are threefold. First, we identified four types of health trajectories for men and eight for women, representing a more nuanced longitudinal health status profile than previously shown. Second, we found that childhood and adult socioeconomic circumstances influence self-reported health trajectories at older age. Third, our results suggest there is no simple monotonic relationship between life course circumstances and self-reported health trajectories.


Asunto(s)
Empleo , Estado de Salud , Adulto , Anciano , Envejecimiento , Escolaridad , Femenino , Humanos , Masculino , Factores Socioeconómicos
7.
Maturitas ; 154: 20-24, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34736576

RESUMEN

OBJECTIVES: To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52-56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT). STUDY DESIGN: Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988). MAIN OUTCOME MEASURES: The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms. RESULTS: Women aged 52-56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates. CONCLUSIONS: The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.


Asunto(s)
Climaterio/efectos de los fármacos , Terapia de Reemplazo de Estrógeno , Terapia de Reemplazo de Hormonas , Menopausia/efectos de los fármacos , Efecto de Cohortes , Femenino , Finlandia/epidemiología , Promoción de la Salud , Humanos , Menopausia/fisiología , Persona de Mediana Edad , Factores Socioeconómicos
8.
Maturitas ; 154: 7-12, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34736580

RESUMEN

OBJECTIVE: Menopausal symptoms may differ by geography and ethnicity, but the impact of socioeconomic factors is less clear. The purpose of this study was to compare menopausal symptoms in women from areas of Arizona with different socioeconomic resources. STUDY DESIGN: Women aged 40-65 years in two cohorts were surveyed: (1) Phoenix women attending either a clinic for patients who are uninsured or a clinic for people experiencing homelessness; and (2) Scottsdale women living in zip codes with higher average income and neighborhood advantage (surveyed by mail). Surveys included the Greene Climacteric Scale (GCS) and demographic questions. MAIN OUTCOME MEASURES: GCS score by domain and subdomain, corrected for age, race, menopause stage and menopausal hormone therapy (HT). RESULTS: Phoenix participants (N = 104) were 51.2 years old (SD 6.45), Hispanic (54.4%), White (28.2%) or African American (8.7%), and uninsured (53.0%). Scottsdale participants (N = 151) were 52.6 years old (SD 5.52), mostly White (94.7%) and insured (100%). Three percent of Phoenix women were on HT vs. 23.3% in Scottsdale (p < 0.001). Multivariate analysis revealed higher total GCS scores in the Phoenix vs. Scottsdale cohort (39.13 vs 30.14, p < 0.001), which was also seen in the psychological and somatic domains, as well as the anxiety and depression subdomains. No statistically significant differences were seen in the vasomotor or sexual dysfunction domains. CONCLUSION: In a group of women living in Arizona from distinct socioeconomic areas, significant differences were demonstrated in menopausal symptom bother specifically with higher psychological and somatic symptoms in women who were uninsured or experiencing homelessness independent of age, race, menopause stage and HT use. Future studies controlling for co-morbidities associated with lower socioeconomic status such as depression would provide further insight into this population of midlife women.


Asunto(s)
Climaterio , Menopausia/etnología , Menopausia/fisiología , Mujeres/psicología , Afroamericanos/estadística & datos numéricos , Americanos Asiáticos/estadística & datos numéricos , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Pobreza , Características de la Residencia , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos/epidemiología
9.
Rural Remote Health ; 21(4): 6724, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34753291

RESUMEN

INTRODUCTION: Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. METHODS: The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. RESULTS: The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. CONCLUSION: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.


Asunto(s)
Inseguridad Alimentaria , Abastecimiento de Alimentos/estadística & datos numéricos , Hambre , Encuestas y Cuestionarios/normas , Bahamas , Humanos , Prevalencia , Reproducibilidad de los Resultados , Factores Socioeconómicos
10.
Hist Philos Life Sci ; 43(4): 116, 2021 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-34762181

RESUMEN

It has been claimed that the global pandemic is a 'great equaliser' that creates a sense of cohesion, however, this is problematic since COVID-19 has revealed the stark divisions in our societies. For instance, in the UK COVID-19 has hit northern cities particularly hard. Therefore, by focusing on the north of England, and Bradford especially, this paper offers suggestions which may help us see clearly through COVID-19, creating a future that is more equitable.


Asunto(s)
COVID-19 , Humanos , Pandemias , SARS-CoV-2 , Factores Socioeconómicos , Reino Unido
11.
BMC Med ; 19(1): 268, 2021 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-34736475

RESUMEN

BACKGROUND: Individuals with low socioeconomic status (SES) experience a higher risk of mortality, in general, and alcohol-attributable mortality in particular. However, a knowledge gap exists concerning the dose-response relationships between the level of socioeconomic deprivation and the alcohol-attributable mortality risk. METHODS: We conducted a systematic literature search in August of 2020 to update a previous systematic review that included studies published up until February of 2013. Quantitative studies reporting on socioeconomic inequality in alcohol-attributable mortality among the general adult population were included. We used random-effects dose-response meta-analyses to investigate the relationship between the level of socioeconomic deprivation and the relative alcohol-attributable risk (RR), by sex and indicator of SES (education, income, and occupation). RESULTS: We identified 25 eligible studies, comprising about 241 million women and 230 million men, among whom there were about 75,200 and 308,400 alcohol-attributable deaths, respectively. A dose-response relationship between the level of socioeconomic deprivation and the RR was found for all indicators of SES. The sharpest and non-linear increase in the RR of dying from an alcohol-attributable cause of death with increasing levels of socioeconomic deprivation was observed for education, where, compared to the most educated individuals, individuals at percentiles with decreasing education had the following RR of dying: women: 25th: 2.09 [95% CI 1.70-2.59], 50th: 3.43 [2.67-4.49], 75th: 4.43 [3.62-5.50], 100th: 4.50 [3.26-6.40]; men: 25th: 2.34 [1.98-2.76], 50th: 4.22 [3.38-5.24], 75th: 5.87 [4.75-7.10], 100th: 6.28 [4.89-8.07]. CONCLUSIONS: The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.


Asunto(s)
Renta , Adulto , Femenino , Humanos , Masculino , Factores de Riesgo , Factores Socioeconómicos
12.
BMC Palliat Care ; 20(1): 179, 2021 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-34802450

RESUMEN

BACKGROUND: Efforts inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need, particularly in the UK, for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. METHODS: This is a mixed studies narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search, as well as grey literature sources, in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised. RESULTS: Searches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care. CONCLUSION: There is not a consistent or clear narrative regarding the relationship between socioeconomic position and receipt of palliative and end-of-life care in the UK. Attempts to address any inequities in access will require knowledge and action across many different areas. Key evidence gaps in the UK literature concern the relationship between socioeconomic position, organisational context, and assessing need for care.


Asunto(s)
Cuidados Paliativos al Final de la Vida , Cuidado Terminal , Humanos , Cuidados Paliativos , Factores Socioeconómicos , Reino Unido
13.
Washington, D.C.; OPAS; 2021-11-10. (OPAS/NMH/MH/21-0038).
en Portugués | PAHO-IRIS | ID: phr-55140

RESUMEN

Esta ficha apresenta fatos sobre a epidemiologia do álcool divididos por população total, entre os bebedores e entre homens e mulheres na Região das Américas. Ela inclui estatísticas relacionadas ao uso de álcool, morbidade e mortalidade. A ficha informativa prossegue para destacar o indicador de consumo per capita de álcool e fornece informações ao público sobre o que este indicador nos diz em termos de bebidas consumidas por ano e por dia. Ela conclui com algumas recomendações e inclui um pequeno elenco de referências utilizadas para desenvolver o conteúdo.


Asunto(s)
Bebidas Alcohólicas , Consumo de Bebidas Alcohólicas , Industria del Alcohol , Análisis de Datos , Epidemiología Analítica , Factores Socioeconómicos , Estadística , Factores de Riesgo , Mortalidad , Morbilidad
14.
Washington, D.C.; PAHO; 2021-11-10. (PAHONMHMH21-0038).
en Inglés | PAHO-IRIS | ID: phr-55139

RESUMEN

This fact sheet presents facts about alcohol epidemiology broken down by total population, among drinkers, and between males and females in the Region of the Americas. It includes statistics related to alcohol use, morbidity, and mortality. The fact sheet goes on to highlight the indicator alcohol per capita consumption, and provides information to the public about what this indicator tells us in terms of drinks consumed per year and per day. It concludes with some recommendations and includes a short list of references used to develop the content.


Asunto(s)
Bebidas Alcohólicas , Consumo de Bebidas Alcohólicas , Industria del Alcohol , Estadística , Morbilidad , Mortalidad , Indicadores de Morbimortalidad , Epidemiología Analítica , Factores de Riesgo , Factores Socioeconómicos , Análisis de Datos , Américas
15.
Washington, D.C.; OPS; 2021-11-10. (OPS/NMH/MH/21-0037).
en Español | PAHO-IRIS | ID: phr-55136

RESUMEN

Esta hoja informativa presenta datos sobre la epidemiología del alcohol desglosados por población total, según consumo per cápita y sexo en la Región de las Américas. Incluye estadísticas relacionadas con el consumo de alcohol, la morbilidad y la mortalidad; así como el indicador de consumo de alcohol per cápita, con información sobre las bebidas consumidas por año y por día. Concluye con algunas recomendaciones e incorpora una breve lista de referencias utilizadas para elaborar el contenido.


Asunto(s)
Consumo de Bebidas Alcohólicas , Factores de Riesgo , Factores Socioeconómicos , Epidemiología Analítica , Análisis de Datos , Américas , Bebidas Alcohólicas , Estadística , Mortalidad , Morbilidad , Industria del Alcohol
16.
Caracas; OPS; 2021-11-11. (OPS/VEN/21-0001).
No convencional en Español | PAHO-IRIS | ID: phr2-55174

RESUMEN

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Asunto(s)
Cooperación Técnica , Prioridades en Salud , Políticas, Planificación y Administración en Salud , Programas Nacionales de Salud , Enfermedades no Transmisibles , Enfermedades Transmisibles , Sistemas de Salud , Sistemas de Información en Salud , Sistemas Nacionales de Salud , Cobertura de los Servicios de Salud , Cobertura Universal de Salud , Salud Mental , Factores de Riesgo , Factores Socioeconómicos , Administración en Salud Pública , América del Sur , Venezuela
17.
Health Aff (Millwood) ; 40(11): 1784-1791, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34724418

RESUMEN

Racial health inequities exemplified during the COVID-19 crisis have awakened a sense of urgency among public health and policy experts to examine contributing factors. One potential factor includes the socioeconomic disadvantage of racially segregated neighborhoods. This study quantified associations of neighborhood socioeconomic disadvantage in Chicago, Illinois, as measured by the Area Deprivation Index (ADI), with racial disparities in COVID-19 positivity. A retrospective cohort included 16,684 patients tested for COVID-19 at an academic medical center and five community-based testing sites during Chicago's "first wave" (March 12, 2020-June 25, 2020). Patients living in Black majority neighborhoods had two times higher odds of COVID-19 positivity relative to those in White majority neighborhoods. The ADI accounted for 20 percent of the racial disparity; however, COVID-19 positivity remained substantially higher at every decile of the ADI in Black relative to White neighborhoods. The remaining disparities (80 percent) suggest a large, cumulative effect of other structural disadvantages in urban communities of color.


Asunto(s)
COVID-19 , Chicago/epidemiología , Grupos de Población Continentales , Humanos , Características de la Residencia , Estudios Retrospectivos , SARS-CoV-2 , Factores Socioeconómicos
18.
Acad Pediatr ; 21(8S): S126-S133, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34740419

RESUMEN

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. Rural children experience decreased availability and accessibility of primary care and specialty care (especially mental health care) due to a decreased number of health care providers as well as geographical and transportation-related barriers. Other geographic and socioeconomic determinants, especially concerning poverty and substandard housing conditions, are likely important contributors to the observed health disparities. Increased funding for research focused on rural populations is needed to provide innovative solutions for the unique health needs of rural children. Policy changes positioned to correct the trajectory of poor health among children should consider the needs of rural children as an under-researched and under-resourced vulnerable population.


Asunto(s)
Pobreza , Población Rural , Niño , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Humanos , Factores Socioeconómicos , Estados Unidos/epidemiología , Población Urbana , Poblaciones Vulnerables
19.
Pediatr Clin North Am ; 68(6): 1147-1155, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34736581

RESUMEN

Social determinants of health (SDH) as outlined by Healthy People 2020 encompasses 5 key domains: economic, education, social and community context, health and health care, and neighborhood and built environment. This article emphasizes pediatric populations and some of the existing SDH and health care disparities seen in pediatric gastroenterology. We specifically review inflammatory bowel disease, endoscopy, bariatric surgery, and liver transplantation. We also examine the burgeoning role of telehealth that has become commonplace since the coronavirus disease 2019 era.


Asunto(s)
Protección a la Infancia/estadística & datos numéricos , Gastroenterología/organización & administración , Equidad en Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Determinantes Sociales de la Salud , Niño , Accesibilidad a los Servicios de Salud/organización & administración , Disparidades en el Estado de Salud , Humanos , Factores Socioeconómicos , Estados Unidos
20.
Pediatr Clin North Am ; 68(6): 1157-1169, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34736582

RESUMEN

Pediatric gastroenterologists took on a variety of challenges during the coronavirus disease 2019 pandemic, including learning about a new disease and how to recognize and manage it, prevent its spread among their patients and health professions colleagues, and make decisions about managing patients with chronic gastrointestinal and liver problems in light of the threat. They adapted their practice to accommodate drastically decreased numbers of in-person visits, adopting telehealth technologies, and instituting new protocols to perform endoscopies safely. The workforce pipeline was also affected by the impact of the pandemic on trainee education, clinical experience, research, and job searches.


Asunto(s)
COVID-19/epidemiología , Protección a la Infancia/estadística & datos numéricos , Gastroenterología/organización & administración , Equidad en Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Determinantes Sociales de la Salud , Niño , Accesibilidad a los Servicios de Salud/organización & administración , Disparidades en el Estado de Salud , Humanos , Factores Socioeconómicos , Estados Unidos
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