c/o SDOH list "Liberal/Individualized Versus Materialist/Structuralist Approaches"

Abstract

Background: While consensus exists that the sources of health inequalities are social inequalities brought on by the experience of qualitatively different living and working conditions, means of addressing these conditions continue to be the subject of dispute. Whether to emphasis education or income as a social determinant of health is one such example of differing views on the sources of these inequalities and the means of addressing them. These different emphases are often justified through the narrow examination of the magnitude of statistical relationships between educational attainment and income with health outcomes.

Purpose: We offer a broader view, seeing these differing emphases as indicative of contrasting views of the nature of society and means of responding to these inequalities with emphasis on education representing a liberal reformist view of the issue while an emphasis on income representing a materialist structuralist view.

Research design and study sample: We examine, the validity of this hypothesis through an analysis of content of five representative publications that consider educational attainment as a social determinant of health and five that do so for income.

Analysis and results: We find that the emphasis on education as a social determinant of health focuses on the attributes of the individual and is generally accepting of the structures and processes of the existing economic and political order. In contrast, an emphasis on income – when placed within a materialist analysis – views existing systems as inequitably distributing income and other resources thereby requiring their reform or transformation.

Conclusion: Considering evidence of deteriorating living and working conditions for many in Canada and elsewhere, we see the latter emphasis as more useful for understanding and addressing these disturbing developments.

Ervin A, Raphael D. Liberal/Individualized Versus Materialist/Structuralist Approaches to Addressing Social and Health Inequalities: Education and Income as Social Determinants of Health. Community Health Equity Research & Policy. 2025;0(0). doi:10.1177/2752535X251316086

At present differentiating and conceptualising the individual and the collective (society) is ongoing. Ervin and Raphael's paper is helpful then:

'Grabb’s definition of social inequality leaves room for the importance of individuals’ attributes such as educational attainment and income – while Crossman’s definition directs explicit attention to the structures and processes of society9,10:'

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

'Social inequality can refer to any of the differences between people (or the socially defined positions they occupy) that are consequential for the lives they lead, most particularly for the rights or opportunities they exercise and the rewards or privileges they enjoy.9, p.1'	Physical processes Physical structures Infrastructures
'Social inequality is characterized by the existence of unequal opportunities and rewards for different social positions or statuses within a group or society. It contains structured and recurrent patterns of unequal distributions of goods, wealth, opportunities, rewards, and punishments.10'	Political processes  (bureaucracy) Political structures (inc. Institutional) Power

In Ervin and Rapahael (2025) there are also two tables:

Table 1. Four Primary Aspects of How Educational Attainment Comes to be a Social Determinant of Health.

Table 2. Five Primary Means of Conceptualizing How Income Comes to be a Social Determinant of Health.

- the main headings of which I have mapped to Hodges' model below.

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Personal cognitive and decision-making skills (Cognitive) Access - Literacies	(Physical) Access to healthcare
Behavioural risk factors SOCIO-	Life Chances - Health Career -ECONOMIC status

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Commentary: Global health journals need to address equity, diversity and inclusion c/o BMJ Global Health

HICs: high-income countries
LMICs: low-income and middle-income countries


individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

Individual experience & values Leader	Task - EDITING - Process < PARACHUTE > ---------------- RESEARCH LOCATION  global south
Leadership Roles INCLUSION - DIVERSITY Community of Practice Collective Values Values LMIC - expertise HIC Colonialism	Figure 1 Global health editors and editorial board members according to location, gender and group. Group 1 included editors-in-chief, or those in leadership roles; group 2 included senior, deputy or associate editors; and group 3 included editorial board or advisory board members. HICs, high-income countries; LMICs, low-income and middle-income countries.

Nafade V, Sen P, Pai M. Global health journals need to address equity, diversity and inclusion. BMJ Global Health 2019;4:e002018

World Justice Report: a Plan for Equality and Prosperity Within Planetary Boundaries

Box 1: Combining Global Equality and Planetary Habitability

The Global Justice Report describes desirable future scenarios combining two key goals: socioeconomic equality (including full equality between countries, full gender equality in labour hours and pay, sharp compression of within country income and wealth scales, combined with fair access to education, health and political voice), and planetary habitability (aligning global resource use within ecological boundaries, including a limitation of global temperature rise below 2°C). 

To avoid climate catastrophes, we show that sufficiency is required: a structural transformation of the economy involving shorter working hours, a lower material footprint, a shift from material-intensive sectors toward relatively immaterial sectors such as education and health, and major changes in food systems and land use. Rapid decarbonization of energy systems is also necessary, as is the sharp compression of income and wealth inequality. This compression is both a social justice objective and a condition for financing necessary climate investment and human capital expenditure and for sustaining political support from bottom- and middle-income classes in both the North and the South. 

Box 2: Material and Monetary Accounting for Democratic Debate

Economy and ecology cannot be debated apart: every economic activity has a material footprint, every ecological policy shapes incomes and wealth. To make these links visible, the Global Justice Report uses multidimensional social progress indicators. We set quantitative targets for global socioeconomic justice by combining two complementary languages: material accounting (work hours, sectoral shares, education and health, energy systems, GHG emissions, land use, forest cover, temperature levels) and monetary accounting (income and wealth scales between and within countries, progressive tax rates). The report draws on two centuries of historical data on global inequality and resource use, and on the recent literature on social progress, climate and colonial reparations. 

The Global Justice Report proposes a quantitatively and institutionally grounded step toward global justice. It does not seek to close the debate: it offers a transparent basis on which citizens, unions, parliaments, and international bodies can debate, contest, and decide the course of the coming decades.

...

Chancel, L., Dietrich, J., Mohren, C., Moshrif, R., Odersky, M., Piketty, T., Somanchi, A., et al. (2026), The Global Justice Report: A Plan for Equality & Prosperity Within Planetary Boundaries, World Inequality Lab (gjp.wid.world).

individual

|
INTERPERSONAL : SCIENCES             

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

group 

SOCIAL JUSTICE

Previously: 'wealth' : 'poverty' : 'social justice'

 My source: BBC Radio 4 World at One.

 

 

FINAL CALL: Have your say about evidence-based implementation! c/o HIFA

PARTICIPATE TO WIN PRIZES

View this email in your browser <https://mailchi.mp/nest360/improve-health-worldwide-complete-this-short-survey-10147215?e=f1722a9293>

LAST CHANCE TO INPUT - CLOSING ON 27TH JUNE!

Do you work on improving health and equity in low-and middle-income countries (LMICs)?

Have YOUR chance to: -Democratise research and evidence for implementation! -Ensure your setting is represented! -Win a £50 voucher in the prize draw!

Palestine, Uganda, and Peru shared the most replies so far!

BETTER HEALTH WORLDWIDE!

Complete this 10 minute survey about evidence-based implementation

You could win a £50 voucher!

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[content removed as not supported by HIFA]

English Do you work on improving health outcomes around the world?

Have your say! Why? To accelerate evidence-based implementation, with equity, for better health worldwide.

Who? People involved in any aspect of health service implementation and strengthening at any level of the system (e.g. health care provider, data analyst, policy maker).

How? Click here<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=a29ce2fd65&e=f1722a9293> to have your say!

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Evidence-based Implementation: Many life-saving interventions are not implemented effectively, with wide gaps between what is known and what is done, especially in low- and middle-income countries.

We are keen to hear perspectives and realities from implementers in all low- and middle-income contexts. 

We are seeking your insights to help close the gap from evidence to implementation!

We hope you will take a few minutes to complete this brief survey.<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=422f1a8283&e=f1722a9293>

Answers can be anonymous and there is no requirement to provide identifying information.

This survey is being conducted as part of the Lancet Commission on Evidence-Based Implementation in Global Health<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=ef480cd254&e=f1722a9293>. This study was funded by the Children’s Investment Fund Foundation.

A member of the study team can be contacted via ImplementersVoices AT gmail.com

Please share across your networks!! Let’s begin, click here!<https://newborntoolkit.us5.list-manage.com/track/click?u=7a4ba8643fabeb1b06801b973&id=63a8e4c758&e=f1722a9293>

[content removed as not supported by HIFA - and my source.]

From Harriet Ruysen - Harriet.Ruysen AT lshtm.ac.uk

NIHR Global Health Research - collecting diversity data

NIHR invites you to help shape their approach to diversity and inclusivity within NIHR Global Health Research (GHR) funding.

NIHR wants to make sure that their approach to collecting diversity data from applicants, award holders, and committee members is effective, appropriate, and reflects the settings where global health research takes place.

Please complete NIHR’s survey on the collection of diversity data in Global Health Research to be part of informing our approach. The value of your insights and your time are greatly appreciated.

Please note: this survey is not about collecting data from research participants (research volunteers or subjects). Please answer the questions thinking about collecting data from those who apply or receive research funding and those who take part in our committees. 

More details & background from survey page:

Diversity data of global health stakeholders

The National Institute for Health Research (NIHR) is committed to promoting equality, diversity and inclusion and addressing inequalities. One key theme of our Research Inclusion strategy is to develop an evidence-led approach to our equalities and inclusion work.

One of the most important ways to make progress in this work is to collect diversity data and evidence. Only by collecting and analysing our diversity data can we identify the bias and under representation in our systems, and set priorities for future work. 

Diversity means being reflective of the wider community. Having a diverse community, with people from a broad range of backgrounds represented in all areas and at all levels. Diversity data is data collected directly from individuals that allows them to self describe aspects of their identity. 

Understanding of the concepts of equality, diversity and inclusion may differ between the UK and other countries. We want to improve the way we ask our applicants, award holders, and committee members about their diversity data.

Please note: this survey is not about collecting data from research participants (research volunteers or subjects). Please answer the questions thinking about collecting data from those who apply or receive research funding and those who take part in our committees. [Repeated above PJ].

This is your chance to shape what data we collect about you and how we categorise it.  

Please complete by the 30th April 2025.

A note on language:
Throughout this document we will be referring to Low and Middle Income Countries. Every three years, the Organisation for Economic Cooperation and Development’s Development Assistance Committee updates its list of countries eligible for overseas development assistance. We refer to these countries as Low and Middle Income Countries (LMICs). ... continued on survey page...

---

The link to the survey is embedded in the above text, but, in case helpful, the full link is

https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fnihr.us14.list-manage.com%2Ftrack%2Fclick%3Fu%3D299dc02111e8a68172029095f%26id%3D662b9becdb%26e%3D62ea777216&data=05%7C02%7Ct.a.beare%40soton.ac.uk%7C8d81ac29e6874c273dfd08dd580f5e35%7C4a5378f929f44d3ebe89669d03ada9d8%7C0%7C0%7C638763545225554700%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=%2FvfF7r285V4z0imxcHqDV9KsvYwjGA22On2RIF2zl1w%3D&reserved=0

Many thanks in advance.

Kind regards,

Tom

Thomas Beare  He/Him Research Manager, Global Health Research | NIHR Coordinating Centre

 e. thomas.beare AT nihr.ac.uk
 a. National Institute for Health and Care Research
Evaluation, Trials and Studies Coordinating Centre, Alpha House, Enterprise Road, Chilworth, Southampton SO16 7NS

My source: HIFA

Open access: everyone has the right to knowledge

SOURCE: The Conversation

By Alessandro Demaio, University of Copenhagen; Bertil Dorch, University of Copenhagen, and Fred Hersch, University of Sydney

This week, we celebrate open access week – an event aimed at bringing attention to this rapidly emerging form of scientific publication and its ethical imperatives.

Traditionally, knowledge breakthroughs and scientific discoveries are shared through publication in academic journals. Peer-reviewed and highly competitive, careers are made and broken on the number and impact of these publications.

With the complex, long-standing hierarchy of journal ranking, scientific publishing is big business. From a distance, one might assume that scientific publications aim to maximise the dissemination of ideas, break down barriers to science and make knowledge accessible to the masses – but this is not actually the case.

The publication process

When a scientist, whether in the field, the laboratory or the hospital, makes a discovery, she puts her ideas into an academic paper and submits it to a journal. The journal’s editors decide whether it’s relevant to the scope of the publication, and if it is, they (usually) send it on to a small group of the researcher’s peers.

These are other specialists in the field who will read and give feedback on the paper. If they think the work is worthwhile, and they have no changes to suggest (which is seldom), then the paper will be published in a future issue of that journal.

At this point, no one has paid for anything. The authors don’t pay to submit the article, the journal doesn’t pay for the scientists’ work and the peer reviewers are voluntary. Even the editors are often unpaid, unless they can integrate this service into their professional work.

Journals seek remuneration through subscriptions or once-off access fees by the user – often in the order of US$30 per paper. Those of us lucky enough to have an affiliation to a university, or live in Denmark where the government spends many millions on subscriptions for the entire population can access scientific knowledge free of charge.

Open access

Open access publication differs in one very important way from “traditional” academic publishing. Instead of the individual paying to access an article, or buying a subscription, researchers pay for the publication of their work, often out of their research funds.

In the order of US$1,000-$2,500 per publication, this article processing fee is payable when and if the paper is accepted – and it’s routinely waived for researchers from low and middle-income nations.
This means that while the editorial and peer review process are the same as above, access to the published work is free forever and available openly (hence, open access) online.

The traditional publishing paradigm can be regressive and exclusive. Think for a moment how it works: I am a researcher, I do research in developing countries. What if I was to go there; take the time, resources, ideas or even blood samples from thousands of local people; take the information back to my university; access all the scientific knowledge I need in order to develop the work; and then publish my findings in journals for which there’s an access fee of one week’s wages for the people involved in my study.

Sure I might be able to send them a copy, but for the vast majority of people in that community, science remains out of reach. Now, these study participants may also have no internet access for open access sourcing, but many now do and at least the barrier to knowledge is not put up by the scientific community itself.

Similarly, in high-income nations, it’s still the wealthy, the highly educated or those at higher-education institutions who have greatest access to the vast majority of published science. How is this just?

And what happens when we add an additional layer of ethical consideration: that these researchers and their work is often is paid for by society, by taxpayers, through public funding. How can we then justify publishing it in academic media inaccessible to the vast majority who paid for it?

We can’t just blame researchers or the research community for this – and we’re not saying that because we’re researchers. Academic performance and assessment, in the large part, is determined by the amount and impact of one’s publications. The older “traditional” journals have greater histories and so researchers are almost coerced into publishing with these journals.

Some good news

The good news is that things are changing. In the first decade of the 21st century, we have seen an explosion in open access publications. During this time, we’ve observed a ten-fold increase in publications (almost 200,000 at 2011) and more than a six-fold increase in the number of open access journals, to almost 5,000.

Things are clearly moving in the right direction, but this impressive number still accounts for only around 20% of all publishing.

Simultaneously, global leaders have acknowledged the ethical dilemmas of our current system and backed open access. The European Union, for example, is currently piloting a project to encourage all EU-funded research to place their results in an open-access repository or publish them in open access journals.

And some nations, including the United Kingdom, Denmark and Australia, are either planning or implementing policies making publication of publicly-funded research in open access journals mandatory.

The call for change is being echoed by the academic community, which is asking for greater open access and the removal of economic barriers to science.

Research should be about furthering knowledge for all. And there’s no reason why open access publication shouldn’t be routine.

There are also strong economic arguments for investing in a knowledge economy. We are confident that with enough support, we will see more nations, companies and organisations mandating open access publication – a move that’s likely to bring social and economic benefits.

And who knows, maybe we’ll also begin to see the “traditional” academic journals change their business model and one day make knowledge open to all.

Dr Alessandro Demaio is PhD Fellow in Global Health with the Copenhagen School of Global Health at the University of Copenhagen. In addition, he is a Director of the Global Steering Committee for the Young Professional Chronic Disease Network and NCD Action. For The Conversation, Alessandro expresses his own views only.
Bertil F. Dorch is currently senior executive adviser to the university librarian at Copenhagen University Library Services (part of The Royal Library, Denmark), and have previously been Head of Center for Research Support Services as well as a research scientist at University of Copenhagen (The Niels Bohr Institute), within the field of astrophysics.
Fred Hersch does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.


This article was originally published at The Conversation. Read the original article.

Paper: Models of care for patients with hypertension and diabetes in humanitarian crises: a systematic review

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

"Implementing NCD care in humanitarian crises requires the development of a context-adapted approach or ‘model of care’. A model of care may be characterized as a conceptual and pragmatic framework that describes how services are delivered within a health system (Davidson et al., 2006; Agency for Clinical Innovation, 2013)." Models of care "We found that there was no single unifying model of care for HTN/DM care in humanitarian crises, and the variance in care models included in this review was highly dependent on context. In order to descriptively synthesize the diverse models presented in the included studies, we created a typology based on the type of crisis, region and integration with the health system, since these factors likely influenced model design"   patient’s expectations

hypertension and diabetes (HTN/DM) Crisis type and Region Natural: Hurricane, Flood, Earthquake Palestine, Lebanon, Jordan,  China, Pakistan,  India, Philippines, Syria, Iraq, Turkey, Nepal Camp, Non-Camp; Rural, Urban Location of services - Location of people in need, transport, travel time, distance Refugee population - Local population forced displacement, disruption of treatment and support, interrupted health services, movement and attrition of health care workers (HCWs), insecurity, destruction of infrastructure,  breakdown in supply chains and data processes "The domains of access — availability, affordability, accessibility, accommodation, and acceptability — were derived from previously described measures of coverage (Penchansky and Thomas, 1981; Hernández-Quevedo and Papnicolas, 2013; Levesque et al., 2013)."

Refugees and Host Communities Humanitarian crises "Responsiveness has been defined as the ability of health services meet a patient’s holistic needs; in this framework, it also encompassed a model of care’s ability to respond to changing patient needs in a volatile context (.Hernández-Quevedo and Papnicolas, 2013; Kruk et al., 2018). Integration described the linkage between different levels and sites of care, such as facility-based care and community-based support as well as coordination between providers and institutions, while continuity of care referred to uninterrupted care throughout the patient’s disease and life course."

Formal health system and community-based formal or informal systems Non-governmental organisations Crisis type and Region Political: Conflict, Disaster Affordability, income, worth of service Accommodation Person :: Service centrednesss

 

"Availability was defined as the volume and type of existing services and whether this was adequate for the volume and needs of service users. Affordability constituted the patient’s capacity to use financial resources to obtain care balanced against their income and the perceived worth of the service. Accessibility addressed the match between the location of services vs the location of people in need, including transport, travel time, distance, and cost. The accommodation was defined as the organization of service delivery, such as opening times and ability of service users to accommodate to this. Acceptability was considered as the relationship between the services and the patient’s expectations of appropriate care."

(My emphasis)

NCD  - Non-communicable disease

My source: HIFA list

CITATION: Models of care for patients with hypertension and diabetes in humanitarian crises: a systematic review, Michael S Jaung, Ruth Willis, Piyu Sharma, Sigiriya Aebischer Perone, Signe Frederiksen, Claudia Truppa, Bayard Roberts, Pablo Perel, Karl Blanchet, Éimhín Ansbro

Health Policy and Planning, https://doi.org/10.1093/heapol/czab007

Learning for quality health services: A new thematic discussion on HIFA

The WHO Global Learning Laboratory (GLL) for Quality UHC and Healthcare Information For All (HIFA.org) are delighted to announce a new thematic discussion on HIFA: Learning for quality health services. The discussion starts on 28 June and will continue through to 20 August.

Quality of health services is critical to achieving universal health coverage (UHC): Between 5.7 and 8.4 million deaths are attributed to poor quality care each year in low- and middle-income countries, accounting for up to 15% of overall deaths in these countries. Improving access to health services must go hand in hand with improving the quality of these services. There is an urgent need to place quality at the centre of national-, district- and facility-level actions in order to progress towards UHC.

The discussion will explore in depth the following questions:

- What does quality of care mean to you, in your particular context? Why is it important to make the case for quality of care?

- From your experience, what might work best to enhance national commitment to quality of care? Have you seen any practical solutions that should be shared wider?

- From your experience, what are the biggest challenges for district health managers in tackling quality of care issues? Have you seen any practical solutions that should be shared wider?

- From your experience, what are the biggest challenges for improving quality of care at the facility level? Have you seen any practical solutions that should be shared wider?

Please forward this message to your contacts and networks and invite everyone to join us!

https://www.hifa.org/news/learning-quality-health-services-new-thematic-discussion-hifa

www.hifa.org/joinhifa

We have more than 60 HIFA members volunteering for this project. Also, we are introducing for the first time the concept of HIFA Catalysts, whose role is to stimulate comment and debate. We look forward to a rich discussion!

HIFA profile: Neil Pakenham-Walsh, HIFA Coordinator, neil AT hifa.org www.hifa.org

 <>

Mapping some points to Hodges' model:

individual
|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

SAFETY cognitive access QUALITY of CARE quantity of CARE health literacy mental health	SAFETY faculty - facilities physical access QUANTITY of CARE quality of CARE distance rural : urban Between 5.7 and 8.4 million deaths are attributed to poor quality care each year ... accounting for up to 15% of overall deaths in these countries
PRACTICAL SOLUTIONS	low- and middle-income countries national commitment to quality of care Universal Health Coverage

Money and Mental Health [i] Impact of Mass Unemployment Events (MUEs)

This post was prompted by an infographic on twitter and an associated report that includes the infographics:

Davies AR, Homolova L, Grey C, Bellis MA (2017). Mass Unemployment Events (MUEs) – Prevention and Response from a Public Health Perspective. Public Health Wales, Cardiff ISBN 978-1-910768-42-6.

The report is very interesting, not just in it demonstrating the conceptual scope and application of Hodges' model, but in the real-world examples of people who have experienced this socioeconomic phenomena which impacts so heavily on the individual, spouses (partners) and communities. In addition the research is global across countries and industries. It is sobering to reflect also on the dynamic that is the workforce. Paradoxically, at present UK employment is at a high:

"The employment rate (the proportion of people aged from 16 to 64 who were in work) was 74.8%, the joint highest since comparable records began in 1971." (ONS June 2017).

The report does not mention the 'gig economy', but the rise of 'zero hours' a feature of the new economy is found on page 48. With demographers, forward thinking policy makers and media seers predicting the future of work as the robots not only find their feet, but walk, run and jump - you wonder where we are headed. Children will need to be educated in such a way that they are prepared to retrain, possibly several times in their working lives. Other avenues to ease the human pain are a basic universal income, and a reduced working week. You do wonder if another hidden and subtle MUE is underway? It is not so much massive, as yet, but it is happening in not so slow - slow motion ...?

What follows is drawn from section 4.

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

Effect on mental health and well-being loss of self-esteem, increased stress, anxiety, changes to perceived control, shame and loss of status, withdrawal experiencing a grieving process insomnia, depression, self-harm, attempted and completed suicide loneliness financial strain  Effect on pre-existing poor health behaviours -  helplessness, hopelessness loss of individual and collective* identity

physical health reduced freedom from disability back-pain mortality reduced life expectancy stroke, myocardial infarction weight gain relapse to smoking ... again - such as, increased alcohol consumption, tobacco smoking, illegal and prescription drug misuse, and being overweight "job for life" hidden morbidity

spousal mental health reduced household income change in family dynamics emasculation increased conflict and domestic violence, increased unplanned pregnancy, and reduced infant growth - child educational attainment Community impact: loss of cohesion and identity* the already unemployed social inequalities women seeking community mental health support as their (male) partners will not seek help having to work away from home intergenerational impact culture of worklessness, unemployability "job for life of a family"

hidden unemployed accumulation of debt jobs offered not local labour market competition housing market - affordability commuting costs reliance on food banks  increased expenditure on antidepressants  and related drugs financial hardship increased hospitalisation, out-patient attendance Community impact: labour market and economy Loss of industries youth move away -  no workers for new initiatives/industries loss to local economy of MUE reliance on welfare benefits

A future post will conduct a similar treatment of a publication by The Money and Mental Health Policy Institute.

WHO Mental Health Atlas 2011

Forwarded to the GANM from Ana Lucia Ruggiero at PAHO

WHO Mental Health Atlas 2011

Available online PDF [82.p] at: http://bit.ly/rocbFH

10 October 2011 – “…..New figures from the WHO Mental Health Atlas 2011 indicate that while the need for mental health care is large, with up to 25% of the population requiring it at some point in their lives, there is underinvestment in the sector.

The Atlas shows average global spending on mental health is still less than US$ 3 per capita per year and as little as US$ 0.25 per person per year in low-income countries.

It presents data from 184 WHO Member States, covering 98% of the world’s population. Facts and figures presented in Atlas indicate that resources for mental health remain inadequate.

The distribution of resources across regions and income groups is substantially uneven and in many countries resources are extremely scarce. Results from Atlas reinforce the urgent need to scale up resources and care for mental health within countries….”

Brochure: http://bit.ly/qvV9jN

My source: GANM (Global Alliance for Nursing and Midwifery)

Book review: "Leave No One Behind" i #LNOB

Leave No One Behind

This book is like a favourite CD or LP [that's vinyl ;-) ], every track - chapter - is an ace - no duds. I wanted to start this review with the final chapter, but I'll pick that up in due course (iv?).

The book is structured in three parts:

1. People
2. Problems
3. Places

I don't read horror specifically, so it is not often a book scares me from the get-go; but this one did. 

Chapter 1 gets specific on the statistics of LNOB and sustainable development. The numbers make for grim reading and had me wondering how much sense I could make of the book overall from the albeit COVID tainted comfort of Wigan Pier. What stood out was the way the intro chapter set out the stall. Obviously, that's the purpose and while depressed at what was follow from the initial graphs, the structure and cogency provided its own impetus to read. The text is clear and very readable, the data, graphs, notes all have bite. While the SDGs are Sisyphean in nature, the intro is like a snowball that starts from the upper peaks and grows chapter by chapter in  meaning and significance.

Obviously, Agenda 2030 looms large, but if you think in first reading of poverty, or to be more specific ultra-poor, income, education, Africa, development and finance you know the agenda to follow then for this community mental health nurse there are insights aplenty.

Chapter 2 combines two central issues in gender equality (by 2030) with 'Women on the Move'. The book draws significance to decade long issues that now constitute a specific SDG - #5 in this case. The book is up-to-date - oozing contemporaneity with #MeToo and background on the cussedness of the root causes of gender inequality. There's common sense too in the need for 'adaptable solutions that are fit for the complexity of the problem'. On first reading about the progress of feminist movements, but more recently experiencing resistance in access to and being able to inhabit civil spaces, this is more 'scary' than a horror story. Reflecting on the 'other' challenges and climate change especially and the role that feminism can play, this retrograde motion could be the stuff of nightmares. The chapter and book, as I will explain, drew my attention to the fact that while I tweet and post here on feminist issues: I am no feminist. The notes provide references and pointers to specific books on feminism. From this book I can see I should read one.

Organizations, such as, BRAC, Camfed, CARE Int. and Oxfam with authors clearly experts from academia and such key players in the field. The balances are not just financial, but a community program on women and girls can potentially prompt a backlash if men and boys and not engaged. I can see further relevance of being able to traverse individual-group, as Matthews and Nunn debate the merits and limitations of individual-based and need for social-based interventions. Yes, I can see how individual-based interventions can be apolitical (and how an axis can invoke several thresholds). To a text on feminism, I must add formal reading on intersectionality too, as the analysis called upon here (box 2.2) to make sense of social and income-based factors. 

Several chapters raise the problem of scale, the lack of data, especially what is and can be measured. Without due care, false proxies can be used for measures and more simple interventions may be pursued because they are more easily quantified. This may be insufficient to fully understand the complexity of gender equality. The book is 'dynamic' throughout; with project and service-based action for the individual progressing then to movement-based at the social change level (CARE, 2017, p.31. Gender Equality Framework -- through Individual, Group, Communities to deliver Social Change).

Although in this first review-post I refer to feminism, the treatment in the book is balanced and also essential. I usually equate 'hope' with the intra- interpersonal domain. Of the many sources in this to follow-up, is evidence on the "science of hope" with Coates and MacMillan in chapter 3.

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

hope	SCIENCE of HOPE

 

Homi Kharas, John W. McArthur and Izumi Ohno, (Eds.) 2020. Leave No One Behind: Time for Specifics on the Sustainable Development Goals, Washington D.C.: Brookings Institution Press.  

Targeting poverty (in Hodges' model) c/o The Economist

"Indian politicians are promising more cash for the poor. They should be less selective. "

[ by the quarter - make progress ...? ]


individual - self

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group- population

"Targeting welfare is costly and difficult in a country like India.

If it looks for signs such as straw roofs, it will almost certainly miss many poor people, especially in the cities.

How is the state supposed to identify the poorest 50m households in a country where income and spending are so hard to track?

The political economy of targeted schemes is also tricky. In countries with minimal welfare states, schemes with few beneficiaries also have few supporters, and therefore risk being quietly wound down or diminished by inflation. And any formula used to target the bottom 20% is likely to be so opaque that people will never know whether they should have been included or not, so cannot fight for their entitlements."

"Two years ago a government report suggested a bold new approach. Instead of a universal basic income - an idea doing the rounds in rich countries - create a nearly universal scheme from which you exclude the richest quarter of the population."

Source: Leaders. Welfare in India: The beauty of breadth. The Economist, April 6, 2019, p.14.
Print edition.
https://www.economist.com/leaders/2019/04/06/a-better-anti-poverty-plan-for-india

Blog Action Day 15 October: Poverty - Hodges' model

The table below indicates some of the main concepts and concerns that surround poverty presented using the four care domains of Hodges' model:

INTERPERSONAL : SCIENCES SOCIOLOGY : POLITICAL

Well-being, mental health, mood, hope, human spirit. Education - literacies: 3Rs, ICT, social, visual, spiritual, health.... human potential, premature death, personal choices & autonomy. ability to work, philanthropy, disability, gender, LEARNING - UNLEARNING, adversity, personal development, making a difference - Giving. Awareness of poverty. Attitudes, beliefs, sustainability.

Physical health, nutrition, DIAGNOSES: infectious diseases - diarrhoeal illness, malaria, tuberculosis, HIV/AIDS. Infant / maternal mortality. Water. Natural resources, fuel, crops, disasters. Geography, global warming, climate change, gender, age. WHO regional-global reporting, ICD. Complexity. Research: Dimensions of Poverty - "The human development index (HDI) includes income, longevity and education. This paper contends that poverty extends beyond these domains. It explores dimensions of poverty that poor people value, but for which little or no data is available."

Shelter, housing, schools, local environment, social inclusion, work, social mobility, homelessness, stigma (poverty as a disease?), media, major - national & global fund-raising events. Access to information and communications technology. Dependency. Social justice. Social Impact Analysis (PSIA) Religion, humanitarianism, fatalism, leisure. http://www.poverty.com/

HUMAN RIGHTS, LAW, POLICY, U.N., FUNDING, GLOBAL ECONOMICS, MDG 2015. Governance. DEFINITIONS: Relative poverty, absolute poverty, exclusion. effects of globalisation, industrialisation, urbanisation, conflict, refugees, migration, loss of statehood, immigration, professional migration, corruption, economic costs, welfare, benefits, income thresholds, min. wage, inflation, poverty indicators, GDP, major philanthropic programmes, charities, NGOs. social exclusion, unemployment, 'knowledge' economy - learning disability, pension economics, micro lending. International Aid: Official Development Assistance 0.7% national targets.

Universal Basic [Income and Capital] c/o N. Berggruen

Individual

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

AI .. Pope Leo XIV - 'Distributional justice' Pope Leo XIII "Rerum Novarum" 1891?^    *Ethics - see below.	Baby bond schemes - Australia Superannuation programme USA MAGA accounts Proposed European Sovereignty Fund? UK? Globally? "We're in this together, remember"
UNIVERSAL BASIC INCOME UNIVERSAL BASIC CAPITAL    PREDISTRIBUTION not REDISTRIBUTION ^History: Impact of the industrial revolution	.. ECONOMY   Diminishing value of labour  Global wealth inequality  US: top 10% own 93% of all equities Europe: .. nearly 60% of all wealth. Bottom 50% owns just 5%

*The ecological and ethical impacts from the energy demands of AI still need to be addressed. Financial 'rewards' for the masses, must not become the 'cake' - the bribe for the public to enter into a conspiratorial dyad with technology. PJ

Source: N. Berggruen, Universal basic capital would create a fair AI economy, Opinion, FTWeekend, 1-2 November. 2025, p.13. https://berggruen.org/eu

https://www.ft.com/content/9b93e02a-c693-4070-9094-a2f532dfa929

See also: 'economics' : 'poverty' : 'AI' : 'inequality' : 'universal'

Universal Health Coverage Day c/o CHIC mailing list

Dear Peter,

Today, we recognize Universal Health Coverage Day and join partners around the world to advocate for #HealthForAll. How will we get there? Professional community health workers (CHWs) who are salaried, skilled, supervised, and supplied.

We have a long way to go. Millions of CHWs - 70% women - are not paid, supported, or supplied. And now, new evidence from the Coalition and collaborators spotlights the severity of stock-outs experienced by CHWs on the frontlines of care: CHWs are out of stock-out nearly ⅓ of the time, and the problem is getting worse.

This #UHCDay, we hope you'll join our #SupplyCHWs campaign to highlight the unacceptable frequency at which CHWs in low- and middle-income countries experience stock-outs and call for solutions to address this widespread issue.

Join the Campaign

In Solidarity,
The Coalition

 

READ: The first ever global estimate of the extent of stock outs among CHWs
SHARE: One-page summary with everything you need to know
ACT: Share the findings on social media and tag decision-makers to take action

Curious about the Coalition's other work? Read our latest update here and sign up to stay in the loop!)

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

My access to health care Cognitive / Conceptual My health literacy (and other literacies)	logistics, stock control, 'Just in Time' Systematic Literature Review 'Coverage'?
Universal Health Coverage/Care communities paraprofessionals - lay individuals	Funding, Workforce planning SDGs Professional community health workers (CHWs) who are salaried, skilled, supervised, and supplied.

Olaniran, A., Briggs, J., Pradhan, A. et al. Stock-outs of essential medicines among community health workers (CHWs) in low- and middle-income countries (LMICs): a systematic literature review of the extent, reasons, and consequences. Hum Resour Health 20, 58 (2022).
https://doi.org/10.1186/s12960-022-00755-8
https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00755-8