-
Social Science & Medicine (1982) Dec 2019Housing is a major pathway through which health disparities emerge and are sustained over time. However, no existing unified conceptual model has comprehensively... (Review)
Review
Housing is a major pathway through which health disparities emerge and are sustained over time. However, no existing unified conceptual model has comprehensively elucidated the relationship between housing and health equity with attention to the full range of harmful exposures, their cumulative burden and their historical production. We synthesized literature from a diverse array of disciplines to explore the varied aspects of the relationship between housing and health and developed an original conceptual model highlighting these complexities. This holistic conceptual model of the impact of housing on health disparities illustrates how structural inequalities shape unequal distribution of access to health-promoting housing factors, which span four pillars: 1) cost (housing affordability); 2) conditions (housing quality); 3) consistency (residential stability); and 4) context (neighborhood opportunity). We further demonstrate that these four pillars can lead to cumulative burden by interacting with one another and with other structurally-rooted inequalities to produce and reify health disparities. We conclude by offering a comprehensive vision for healthy housing that situates housing's impact on health through a historical and social justice lens, which can help to better design policies and interventions that use housing to promote health equity.
Topics: Health Equity; Housing; Humans; Models, Theoretical; Residence Characteristics; Socioeconomic Factors; United States
PubMed: 31675514
DOI: 10.1016/j.socscimed.2019.112571 -
The New England Journal of Medicine Jun 2018
Topics: Health Status Disparities; Healthcare Disparities; Humans; Poverty Areas; Residence Characteristics; Socioeconomic Factors
PubMed: 29949490
DOI: 10.1056/NEJMp1802313 -
The Pan African Medical Journal 2014The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk... (Review)
Review
The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk factors and the dearth of community genetic services. To direct effective preventive, diagnostic and counseling services, collecting data on the incidence and prevalence of various congenital and genetic disorders and their risk factors is a pre-requisite for establishing genetic services at the community level and mainly at the primary health care setting. This brief review is meant to assess the available epidemiological data in Ethiopia pertaining to congenital and genetic disorders on which the future community genetic services could be built. Existing epidemiological data on congenital and genetic disorders in Ethiopia is limited, and the few studies conducted revealed that folate and iodine deficiencies are prevalent among women in the reproductive age. Pregnant women's infection with syphilis and rubella is prevailing. Based on available data, cleft lip and palate, congenital heart diseases, club-foot, and gastro-intestinal malformations are the most common birth defects in Ethiopia. Community based studies to accurately demonstrate the incidence and prevalence levels of these disorders are almost unavailable. To plan for organization and implementation of community genetic services at the primary health care level in Ethiopia, conducting standardized epidemiological studies is currently highly recommended.
Topics: Community Health Services; Congenital Abnormalities; Ethiopia; Family; Female; Genetic Counseling; Genetic Diseases, Inborn; Humans; Infant, Newborn; Male; Maternal Health Services; Pregnancy; Residence Characteristics
PubMed: 25404975
DOI: 10.11604/pamj.2014.18.115.3172 -
Social Science & Medicine (1982) Jan 2024Evidence suggests that being evicted harms health. Largely ignored in the existing literature is the possibility that evictions exert community-level health effects,... (Review)
Review
Evidence suggests that being evicted harms health. Largely ignored in the existing literature is the possibility that evictions exert community-level health effects, affecting evicted individuals' social networks and shaping broader community conditions. In this narrative review, we summarize evidence and lay out a theoretical model for eviction as a community health exposure, mediated through four paths: 1) shifting ecologies of infectious disease and health behaviors, 2) disruption of neighborhood social cohesion, 3) strain on social networks, and 4) increasing salience of eviction risk. We describe methods for parsing eviction's individual and contextual effects and discuss implications for causal inference. We conclude by addressing eviction's potentially multilevel consequences for policy advocacy and cost-benefit analyses.
Topics: Humans; Housing; Public Health; Residence Characteristics; Health Behavior
PubMed: 38091853
DOI: 10.1016/j.socscimed.2023.116496 -
The Journals of Gerontology. Series B,... Apr 2021While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in...
OBJECTIVES
While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition.
METHOD
This article uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults' cognitive health and the mechanisms responsible.
RESULTS
We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship.
DISCUSSION
This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults.
Topics: Aged; Cognition; Cognitive Dysfunction; Economic Recession; Female; Health Status Disparities; Housing; Humans; Male; Mental Health; Residence Characteristics; Socioeconomic Factors
PubMed: 32303760
DOI: 10.1093/geronb/gbaa047 -
BMC Public Health Sep 2015Expanded program on immunization is one of the most successful and cost effective public health interventions that protect children against vaccine preventable diseases....
BACKGROUND
Expanded program on immunization is one of the most successful and cost effective public health interventions that protect children against vaccine preventable diseases. The full childhood immunization coverage in many parts of Ethiopia is far from optimal. Hence, the main objective of this study was to assess factors associated with childhood full immunization in Ethiopia.
METHODS
The data source for this study was the 2011 Ethiopian Demographic and Health Survey. Multilevel regression analysis techniques were used to conduct the analysis. Accordingly a two level multilevel regression analysis model was built with individuals (level 1) nested with in communities (level 2).
RESULTS
A total of 4983 children aged 12-59 months nested within 520 clusters were included in the analysis. According to the analysis results, in the year 2011, 26 % of children less than 5 years old were fully immunized in Ethiopia. Being born at health institutions, higher level of maternal education, media exposure, region of residence and residing in communities possessing higher maternal antenatal care services utilization were positively associated with childhood full immunization. In contrary to this, the number children aged less than 5 years in the household was negatively associated with childhood full immunization. The random effect results indicated that 21 % of the variation among the communities was due to community level factors.
CONCLUSIONS
It was found that various individual and contextual factors were associated with childhood full immunization. In addition, significant community level variation remains after having controlled individual and community level factors which is an indicative of a need for further research on community level factors. Hence, utilizing multilevel modeling in determining the effect of both individual and contextual level factors simultaneously had brought an important output which may help planners, policy and decision makers to emphasize on both individuals and communities in which they live.
Topics: Child, Preschool; Ethiopia; Female; Health Surveys; Humans; Infant; Male; Mass Media; Multilevel Analysis; Prenatal Care; Residence Characteristics; Socioeconomic Factors; Vaccination
PubMed: 26415507
DOI: 10.1186/s12889-015-2315-z -
The Gerontologist Jan 2022Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance. Based on processes of belonging and agency, which suggest that...
BACKGROUND AND OBJECTIVES
Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance. Based on processes of belonging and agency, which suggest that person-environment interactions influence residents' evaluations and behaviors related to the environment, this study aims to examine the interrelationship between the availability of age-friendly features, perceived age-friendliness of community, and intention toward AIP.
RESEARCH DESIGN AND METHODS
This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the 8 domains specified by the World Health Organization's Age-Friendly Cities Guidelines. A series of regression and mediational analyses were conducted to test hypotheses.
RESULTS
Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3%-96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant.
DISCUSSION AND IMPLICATIONS
Findings suggest that a greater availability of age-friendly features influences older adults' perception on their community, leading to the development of a desire to age in place, supporting processes of belonging and agency. Domains of housing, outdoor spaces and buildings, and transportation may be the most important features in promoting age-friendliness of community and the key determinants of AIP. Policymakers and practitioners may need to prioritize promoting an age-friendly built environment before the social environment in building age-friendly communities.
Topics: Aged; Aging; Humans; Independent Living; Intention; Residence Characteristics; Social Environment
PubMed: 34043782
DOI: 10.1093/geront/gnab070 -
BMC Health Services Research Nov 2016Community capability is the combined influence of a community's social systems and collective resources that can address community problems and broaden community... (Review)
Review
BACKGROUND
Community capability is the combined influence of a community's social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs).
METHODS
We searched for journal articles published between 2000 and 2012 related to the concepts of "community", "capability/participation", "health systems research" and "LMIC." We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability.
RESULTS
When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality.
CONCLUSIONS
Strengthening community capability is critical to ensuring that community participation leads to genuine empowerment. Our simpler framework to define community capability may help researchers better recognize, support and assess it.
Topics: Community Participation; Delivery of Health Care; Female; Government Programs; Health Services Research; Humans; Leadership; Male; Medical Assistance; Peer Review; Power, Psychological; Research; Residence Characteristics
PubMed: 28185589
DOI: 10.1186/s12913-016-1860-1 -
American Journal of Public Health Jul 2013
Topics: Disasters; Humans; Public Health Practice; Residence Characteristics; Resilience, Psychological
PubMed: 23678934
DOI: 10.2105/AJPH.2013.301354 -
Alcohol Research : Current Reviews 2013Community indicators are used to assess the impact of alcohol on communities. This article reviews the main data sources for community indicators, discusses their... (Review)
Review
Community indicators are used to assess the impact of alcohol on communities. This article reviews the main data sources for community indicators, discusses their strengths and limitations, and discusses indicators used in reference to four main topics relating to alcohol use and problems at the community level: alcohol use, patterns, and problems; alcohol availability; alcohol-related health outcomes/trauma; and alcohol-related crime and enforcement. It also reviews the challenges associated with collecting community indicator data, along with important innovations in the field that have contributed to better knowledge of how to collect and analyze community-level data on the impact of alcohol.
Topics: Accidents, Traffic; Alcohol Drinking; Alcohol-Related Disorders; Cost of Illness; Crime; Data Collection; Ethanol; Health Status; Hospital Records; Humans; Residence Characteristics; Wounds and Injuries
PubMed: 24881322
DOI: No ID Found