International journal for equity in health
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Int J Equity Health · Feb 2019
The health equity measurement framework: a comprehensive model to measure social inequities in health.
Despite the wealth of frameworks on social determinants of health (SDOH), two current limitations include the relative superficial description of factors affecting health and a lack of focus on measuring health equity. The Health Equity Measurement Framework (HEMF) addresses these gaps by providing a more encompassing view of the multitude of SDOH and drivers of health service utilisation and by guiding quantitative analysis for public health surveillance and policy development. The objective of this paper is to present the HEMF, which was specifically designed to measure the direct and indirect effects of SDOH to support improved statistical modelling and measurement of health equity. ⋯ The HEMF highlights intervention areas to be influenced by strategic public policy for any organisation whose purview has an effect on health, including helping non-health sectors (such as education and labour) to better understand how their policies influence population health and perceive their role in health equity promotion. The HEMF recognises the complexity surrounding the SDOH and provides a clear, overarching direction for empirical work on health equity.
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Int J Equity Health · Jan 2019
Applying an intersectionality lens to examine health for vulnerable individuals following devolution in Kenya.
Power imbalances are a key driver of avoidable, unfair and unjust differences in health. Devolution shifts the balance of power in health systems. Intersectionality approaches can provide a 'lens' for analysing how power relations contribute to complex and multiple forms of health advantage and disadvantage. These approaches have not to date been widely used to analyse health systems reforms. While the stated objectives of devolution often include improved equity, efficiency and community participation, past evidence demonstrates that that there is a need to create space and capacity for people to transform existing power relations these within specific contexts. ⋯ If key actors in devolved decision-making structures are to ensure progress towards universal health coverage, there is need for intersectoral policy action to address social determinants, promote equity and identify ways to challenge and shift power imbalances in priority-setting processes.
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Int J Equity Health · Jan 2019
Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study.
Low back pain is an important public health issue across the world. However, it is unclear whether socioeconomic status (SES) is associated with low back pain. This study determines an association between SES and low back pain among older people. ⋯ Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.
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Int J Equity Health · Jan 2019
The impact of policy on the intangible service efficiency of the primary health care institution- based on China's health care reform policy in 2009.
Analyzing the impact of the China's health care reform policy in 2009 on the intangible service efficiency of PHCI and exploring the way to improve the service efficiency of PHCI. ⋯ The growth of intangible service efficiency in China's PHCI still belongs to input growth rather than efficiency growth. In the future, the technical progress and improvement in the management level are the key measures to promote the intangible service efficiency of PHCI.
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Int J Equity Health · Dec 2018
Tuberculosis incidence inequalities and its social determinants in Manaus from 2007 to 2016.
Brazil is among the 30 countries with high-burden of tuberculosis worldwide, and Manaus is the capital with the highest tuberculosis incidence. The accelerated economic and population growth in Manaus in the last 30 years has strengthened the process of social stratification that may result in population groups that are less favored in terms of healthcare and are vulnerable to infection and illness due to tuberculosis. This study aimed to characterize inequalities associated with tuberculosis incidence in relation to the socioeconomic and demographic characteristics of the resident population of Manaus and to identify their determinants from 2007 to 2016. ⋯ Disparities in tuberculosis incidence in the resident population in neighborhoods can be explained by the sociodemographic and economic heterogeneity. Our findings recommend that public policies and tuberculosis control strategies consider differences in the determinants of tuberculosis inequality for the development of specific actions for each population group.