How local health departments work towards health equity

BackgroundHealth inequities are exacerbated when health promotion programs and resources do not reach selected populations. Local health departments (LHDs)¹ have the potential to address health equity via engaging priority populations in their work. However, we do not have an understanding of what local agencies are doing on this front.MethodsIn the summer of 2016, we collaborated with informants from thirteen LHDs across North Carolina. Via semi-structured interviews, the research team asked informants about their LHD’s understanding of health equity and engaging priority populations in program planning, implementation, and evaluation.FindingsAll informants discussed that a key function of their LHD was to improve the health of all residents. LHDs with a more comprehensive understanding of health equity engaged members of priority populations in their organizations’ efforts to a greater extent than LHDs with a more limited understanding. Additionally, while all LHDs identified similar barriers to engaging priority populations, LHDs that identified facilitators more comprehensively engaged members of the priority population in program planning, implementation, and evaluation.ConclusionsLHDs are ideally situated between the research and practice worlds to address health equity locally. To promote this work, we should ensure LHDs hold an understanding of health equity, have the means to realize facilitators of health equity work, and recognize the complex context in which health equity work exists.     

Planning minority health programs to eliminate health status disparity

The purpose of this research is to determine program characteristics that are essential to address the problem of health status disparity between minority and nonminority populations. The respondent group consisted of a sample of 50 minority health organizations currently listed as participants in the Minority Health Resource Network in the United States Public Health Service Office of Minority Health. A three-round Delphi technique was used to reach consensus by collecting data and assessing agreement and disagreement on the issue of health status disparity from a widespread national group. Findings indicate that there is strong consensus among respondents that cultural awareness is the top priority area to address in order to eliminate health status disparities.     

Father involvement,child health and maternal health behavior

This paper uses data from the baseline Fragile Families and Child Well-being Study to examine the level and effects of father-involvement on child's birth weight and mother's health behavior during pregnancy (prenatal care, drinking, drug use and smoking). The findings indicate that most fathers, including unwed fathers, are involved with their children at birth and have intentions to remain involved. The effects of father involvement on health and health behavior depend, however, on how the construct is measured. When measured as parent's relationship status (married, cohabiting, romantic or non-romantic), the effects of marriage are beneficial for all but one outcome, the effects of cohabitation are positive for prenatal care only, and the effects of romantic involvement are negative for child's birth weight. When measured as paternity acknowledgement, contributions during pregnancy and intentions to contribute, unmarried father involvement has no effect on child's birth weight, a strong effect on early prenatal care and a variable but overall positive effect on mother's health behaviors. Furthermore, the effects of father involvement do not vary systematically by fathers' earnings potential and psychosocial attributes. While these results support the notion that fathers can influence mothers to maintain or adopt healthy pregnancy behaviors, they do not indicate that father-involvement improves birth outcomes.     

The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

Tribal health programme

In June 1978, the Department of Social Welfare, Government of Maharashtra, commissioned the Centre for Development Studies and Activities (CDSA), Pune, to prepare an Action Programme for the Improvement of Health in the Tribal Areas of Maharashtra. The following is the brief report submitted by CDSA.     

Migration and health

Investigation of migration and health often forces us to acknowledge that the types of migration (international, internal, and residential) interact with each other as well as other population parameters such as the age/sex structure, sexual activity, fertility, mortality, and family structure. Research on migration is often obscured by these interactions. In fact, the adoption of a health perspective in the design of migration research represents a substantial improvement over traditional approaches that are based on distinctions among the various types of population movement. This is because a health perspective treats population movement as a dynamic process by which individuals are related to specific locations by reason of their participation in human networks. In other words, migration is regarded as a human process rather than a discrete event, and accordingly, it becomes less important to describe the individual's involvement with human networks and the institutions sustaining them. The use of a health perspective in migration research often calls our attention to the ways in which the types of migration are interconnected. For example, a migrant from Mexico might exhibit considerable internal mobility and may circulate between Mexico might exhibit considerable internal mobility and may circulate between Mexico and the US over several years until he develops enough contacts in the US to settle in a particular community in which his personal contact with human networks and place-specific institutions are conducive to settlement. Through him, family members may attach to the community. In the process, they all encounter health risks, make demands on the health care system, change the demographic/health characteristics of both sending and receiving places, sometimes act as transmitting agents of disease to those with whom they interact and, undergo changes in their levels of personal development and well-being. A research perspective that investigates these processes will consider all of the types of movement and characterize them as dynamic processes rather than as discrete events. The articles in this issue all touch on the ways in which migration can affect the health of migrants, and show the circle range of ways migration and health are interrelated. A special introductory note also suggests Acquired Immunodeficiency Syndrome (AIDS) should receive special attention in the study of this interrelationship. The uneven distribution of AIDS is heightening concern about the health implications for receiving countries.     

College health professionals and academic librarians: collaboration for student health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. OBJECTIVE: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. PARTICIPANTS AND METHODS: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. RESULTS: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. CONCLUSIONS: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.     

Sexuality and health challenges: responding to a public health imperative

Sexuality is associated with a number of public health imperatives to prevent disease or disability or, if prevention is not possible, to treat and reduce the burden of disease as expeditiously as possible. With the advent of modern testing technology and better sampling of populations, the burden of sexually transmissible infections, sexual assault, and sexual disability have become more apparent. Presented here are U.S. data on the public health dimensions of human sexuality and the evidence for the urgent need to address the magnitude of sexually related public health problems.     

Health technology assessment between our health care system and our health

In this contribution, I wish to explore the potential of health technology assessment and ethics for increasing our capacity to pre-empt the shortcomings and undesired consequences of modern health care while maintaining its benefits. Central is the presumption that in case of some health problems this cannot be done unless we explicitly reconsider some features of the modern health care system, especially those related to its strong reliance on scientific rationality and the strong role played by medical professionals. So as to both maintain the benefits of advanced health care and ensure that it produces less reason for concern, we need to reconsider our approach to rationality—and maybe even the way in which we build our health care system around that rationality. That is, we need to introduce an element of reflexivity. Two types of circumstances are being explored in which such reflexivity may prove worthwhile: controversies on side effects, and persistent problems encountered in optimising health care. Drawing on brief discussions of typical cases, we explore the potential of reflexive HTA and its methodical prerequisites. We conclude that ethicists may contribute to reflexive HTA, if they combine a hermeneutic—and often also participative—methodology with a solid understanding of the relation between the health problem under scrutiny and more general critique of the health care system. Insights from the areas of science and technology studies, as well as from social philosophy may be critical items in their tool kit.     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

Parental health and child behavior: evidence from parental health shocks

This study examines the importance of parental health in the development of child behavior during early childhood. Our analysis is based on child psychometric measures from a longitudinal German dataset, which tracks mothers and their newborns up to age six. We identify major changes in parental health (shocks) and control for a variety of initial characteristics of the child including prenatal conditions. The results are robust to placebo regressions of health shocks that occur after the outcomes are measured. Our findings point to negative effects of maternal health shocks on children’s emotional symptoms, conduct problems and hyperactivity. We estimate that maternal health shocks worsen outcomes by as much as 0.9 standard deviations. In contrast, paternal health seems to be less relevant to children’s behavioral skills.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

Everyday health and identity management among older women with chronic health conditions

The majority of older women have at least one chronic health problem and coping with multiple conditions is common with advancing old age. In this longitudinal, qualitative study we explored the health perceptions of older women (N = 36) with multiple chronic conditions. Guided by a symbolic interactionist perspective, our research questions asked: (a) how do older women with chronic health conditions interpret their own health in their everyday lives and (b) how do they talk about their health with others. We found that women depended on their embodied self, or signs from the body, to interpret their everyday health. The women engage in identity management to make sense of limitations caused by their chronic health conditions. They regulated how much and with whom they were willing to share issues related to their everyday health. Findings suggest that everyday health is important in identity construction among older adults.