UNASSIGNED: To analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL).
UNASSIGNED: 5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics.
UNASSIGNED: The average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = -0.16, 95% CI: -0.23, -0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants.
UNASSIGNED: This analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL.
UNASSIGNED: Our findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.

New long-acting HIV treatment products have the potential to change the HIV epidemic in the United States and globally. Phase 3 clinical trials of HIV treatments tend to underrepresent populations bearing a disproportionate burden of the HIV epidemic-including women, racial minorities, trans and gender-diverse people, older adults, the unhoused, people who inject drugs, those in rural areas, individuals with mental illness, and other marginalized groups. These populations commonly face significant challenges in adhering to daily HIV treatment regimens. Conducting clinical trials of long-acting treatment targeting specific unmet medical needs of these populations can improve understanding of optimal care approaches, broaden the indication for use of long-acting products, and inform treatment guidelines, all of which can influence reimbursement and access policies. Innovative trial designs and programmatic implementation can improve inclusivity for long-acting therapy. This article summarizes discussions of a multistakeholder workshop on study designs for long-acting HIV treatments.

As we learn to co-exist with COVID-19, this Research Topic highlights significant research contributions that examine the interaction of COVID-19 and the social determinants of health. To emphasize the impactful research in this area, this Research Topic features scholarly contributions in the fields of Epidemiology, specifically Aging and Life-course Epidemiology, and Public Health, specifically Public Health Policy. This theme is intentionally broad in scope, and our editorial provides an overview of the key findings of the papers published in the Research Topic on COVID-19 pandemic and the social determinants of health. The types of articles received in response to this Research Topic are summarized below.

暂无摘要。

暂无摘要。

UNASSIGNED: Marginalized communities are exposed to higher levels of traffic-related air pollution (TRAP) than the general population. TRAP exposure is linked to pulmonary toxicity, neurotoxicity, and cardiovascular toxicity often through mechanisms of inflammation and oxidative stress. Early life exposure to TRAP is also implicated in higher rates of asthma in these same communities. There is a critical need for additional epidemiological, in vivo, and in vitro studies to define the health risks of TRAP exposure affecting the most vulnerable groups to set strict, protective air pollution standards in these communities.
UNASSIGNED: A literature review was conducted to summarize recent findings (2010-2024) concerning TRAP exposure and toxic mechanisms that are relevant to the most affected underserved communities.
UNASSIGNED: Guided by the perspectives of NYC community scientists, this contemporary review of toxicological and epidemiological studies considers how the exposome could lead to disproportionate exposures and health effects in underserved populations.

BACKGROUND: Telemedicine offers the opportunity to provide clinical services remotely, thereby bridging geographic distances for people engaged in the medical system. Following the COVID-19 pandemic, the widespread adoption of telemedicine in clinical practices has persisted, highlighting its continued relevance for post-pandemic healthcare. Little is known about telemedicine use among people from socially marginalized groups.
METHODS: The No One Waits (NOW) Study is a single-arm clinical trial measuring the acceptability, feasibility, and safety of an urban point-of-diagnosis hepatitis C (HCV) treatment initiation model delivered in a non-clinical community setting. Participants enrolled in the NOW Study are recruited via street outreach targeting people experiencing homelessness and injecting drugs. Throughout the NOW Study, clinical care is delivered through a novel staff-facilitated telemedicine model that not only addresses geographic and transportation barriers, but also technology and medical mistrust, barriers often unique to this population. While clinicians provide high-quality specialty practice-based care via telemedicine, on-site staff provide technical support, aid in communication and rapport, and review the clinicians\' instructions and next steps with participants following the visits. Research questionnaires collect information on participants\' experience with and perceptions of telemedicine (a) prior to treatment initiation and (b) at treatment completion.
CONCLUSIONS: For people from socially marginalized groups with HCV infection, creative person-centered care approaches are necessary to diagnose, treat, and cure HCV. Although non-clinical, community-based staff-facilitated telemedicine requires additional resources compared to standard-of-care telemedicine, it could expand the reach and offer a valuable entrance into technology-delivered care for socially marginalized groups.
BACKGROUND: NCT03987503.

UNASSIGNED: Exiting sex work is a complex process which can be facilitated by integrated action on health and its social determinants such as housing and employment. Few programs offer such coordinated support, and even fewer have been evaluated. We assessed if and how Exit Doors Here, a program anchored in the Critical Time Intervention (CTI) model, facilitated women\'s progress towards their goals, and exit from sex work.
UNASSIGNED: We performed a contribution analysis by combining pre-post questionnaire and administrative data from 55 women enrolled in the program (2018-2021), yearly interviews with program staff and peer mentors, and literature reviews to assess program outcomes and mechanisms as described in the theory of change.
UNASSIGNED: We found evidence that the program contributed to participants progressing on their pre-employment, housing, income, and sex work exiting goals. We identified four \"key ingredients\" facilitating success: trust building, collaborative goal setting, connecting with community supports and weekly drop-in sessions.
UNASSIGNED: This rigorous theory-based evaluation provides much needed evidence on the process and effectiveness of an integrated sex work exiting program. Findings regarding key program ingredients can inform other interventions serving similarly marginalized populations.

This article calls for a closer examination of health equity regarding the disparities and inequities in health care among marginalized and vulnerable populations. A review of strategies to improve culturally responsive care to these populations will be examined. This examination includes a discussion of the need for structural competence and the ongoing debate around the concepts of cultural competence and cultural humility. Cultural competemility, a new paradigm of thought regarding the relationship between cultural competence and cultural humility, will be proposed. This article culminates with downstream, midstream, and upstream approaches reducing the magnitude of inequity among marginalized and vulnerable populations.

暂无摘要。