UNASSIGNED: Practice variation in newborn toxicology testing during the birth hospitalization exists across institutions and legal jurisdictions. While testing can provide benefits, indiscriminate testing has been shown to perpetuate health care inequities. In the backdrop of an opioid epidemic and a charged medicolegal landscape, this workshop guides participants to reexamine newborn toxicology testing through a shared ethical lens.
UNASSIGNED: We conducted a live, 90-minute workshop in English at an international pediatric conference. Physicians, residents, and fellows participated in large- and small-group breakout sessions to learn relevant clinical and bioethical frameworks, share their own local context and expertise, and explore ethical applications through case-based discussions. We administered two anonymous online follow-up surveys to assess self-perceived impact on participant knowledge, behavior, and clinical practice.
UNASSIGNED: Seven facilitators and 45 individuals participated in the workshop. Eighteen participants completed survey 1 immediately following workshop conclusion, and six participants completed survey 2 after 3 months had elapsed. Immediately following the workshop, 94% of respondents reported that they had been introduced to a new idea, and 82% were considering practice change. A low response rate to survey 2 limited interpretation, but some respondents reported self-perceived change following workshop attendance.
UNASSIGNED: This workshop facilitated conversation between physician participants on a complex pediatric health care inequity issue using an ethical framework.

OBJECTIVE: There is an urgent need to investigate innovative and creative approaches in health promotion that support work towards health equity. In response, this study explores the potential for arts, and community music specifically, to strengthen individual and collective well-being.
METHODS: This study used a qualitative case study methodology that involved interviews, focus groups and ethnographic observation with participants (N = 13), facilitator (N = 1) and support staff (N = 2) of an established community music initiative conducted in an urban community. Data collection was conducted across 2023 and data analysis drew on a socioecological framework to explore potential individual and collective outcomes from the perspective of those involved in the initiative.
RESULTS: Findings point to outcomes across socioecological levels with researchers identifying positive health and well-being implications for participants including joy, healing and a sense of purpose, creative self-expression, confidence, social connection and contribution. Positive outcomes for the wider community were also identified including developing community ties, promoting safety and shaping and sharing of collective identity. Findings suggest community-led opportunities for engagement can support healing and empowerment for people who are marginalised, and this can enable active community participation related to challenging the status quo and developing a shared set of values. Potential implications of these outcomes in relation to broader societal transformations are discussed.
CONCLUSIONS: This study highlights how community music, and the arts more broadly are working in communities in ways that support potential personal, community and societal transformations towards health equity. SO WHAT?: By developing coalitions and collaborating with diverse sectors, including the arts and social sectors, health promotion practitioners and researchers can harness the creative strengths and resources that exist within a community to support positive individual and collective well-being.

Adolescence is a high-risk life stage for obesity. Digital strategies are needed to prevent and manage obesity among adolescents. We assessed if digital health interventions are contributing to disparities in obesity outcomes and assessed the adequacy of reporting of digital health equity criteria across four levels of influence within the digital environment. The systematic search was conducted on 10 major electronic databases and limited to randomized controlled trials (RCTs) or cluster-RCTs for prevention or management of obesity among 10-19 year olds. Primary outcome was mean body mass index (BMI), or BMI z-score change. The Adapted Digital Health Equity Assessment Framework was applied to all studies. Thirty-three articles (27 unique studies with 8483 participants) were identified, with only eight studies targeting adolescents from disadvantaged populations. Post-intervention, only three studies reported significantly lower BMI outcomes in the intervention compared to control. Of the 432 digital health equity criteria assessed across 27 studies, 82% of criteria were \"not addressed.\" Studies are not addressing digital health equity criteria or inadequately reporting information to assess if digital health interventions are contributing to disparities in obesity outcomes. Enhanced reporting is needed to inform decision-makers and support the development of equitable interventions to prevent and manage obesity among adolescents.

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BACKGROUND: Socio-structural and socio-cultural change in Western societies is increasingly challenging healthcare institutions to take good care of people\'s health and dignity. Further and sustainable progress in health care is increasingly influenced by socio-cultural conditions. If these conditions are insufficiently taken into account, further medical progress is jeopardized.
OBJECTIVE: The aim of this paper is to elucidate the significance of social conditions of health over the life course and thus to shed more light on one of the four ethical principles in medicine, namely equity.
METHODS: The question is addressed by a literature review, whereby the literature was reviewed from a structural theory perspective.
RESULTS: If people feel discriminated against in terms of their age, gender, or migration background, this not only has an impact on their self-esteem, but also on their health and recovery from illness. Unfavorable economic living conditions have a negative impact on health behavior. Experiences of discrimination in the healthcare system can reduce satisfaction with treatment and contribute to non-compliance with treatment instructions.
CONCLUSIONS: The socio-cultural effects mentioned above can be influenced not only by individual changes in behavior but in particular by structural and institutional change processes. There is a need for \"habitus sensitivity\" in both clinical and private practice, i.e., it is also part of the responsibility of doctors in the healthcare system to eliminate discrimination.
UNASSIGNED: HINTERGRUND: Der soziostrukturelle und soziokulturelle Wandel in den westlichen Gesellschaften stellt die Gesundheitseinrichtungen zunehmend vor Herausforderungen, die Gesundheit und Würde der Menschen gut zu berücksichtigen. Weitere und nachhaltige Fortschritte in der Gesundheitsversorgung sind zunehmend von soziokulturellen Bedingungen beeinflusst. Werden diese Bedingungen unzureichend berücksichtigt, sind die weiteren medizinischen Fortschritte gefährdet.
UNASSIGNED: Das Ziel dieser Arbeit liegt darin, die Bedeutung sozialer Bedingungen der Gesundheit im Lebenslauf herauszuarbeiten und damit eines der vier ethischen Prinzipien in der Medizin, nämlich die Gerechtigkeit, genauer auszuleuchten.
METHODS: Bearbeitet wird die Fragestellung anhand sozialwissenschaftlicher Literatur, wobei die Literatur unter strukturtheoretischer Perspektive gesichtet wurde.
UNASSIGNED: Fühlen sich Menschen in Hinsicht auf Alter, Geschlecht oder Migrationshintergrund diskriminiert, dann hat das nicht nur Auswirkungen auf das Selbstwertgefühl, sondern auch auf die Gesundheit bzw. Rekonvaleszenz nach Erkrankungen. Ungünstige wirtschaftliche Lebensverhältnisse wirken sich auf das Gesundheitsverhalten negativ aus. Diskriminierungserfahrungen im Gesundheitswesen können die Zufriedenheit mit Behandlungen verringern und dazu beitragen, dass Behandlungsvorschriften nicht eingehalten werden.
UNASSIGNED: Beeinflusst werden können die angeführten soziokulturellen Effekte nicht nur über individuelle Verhaltensänderungen, sondern insbesondere auch über strukturelle bzw. institutionelle Wandlungsprozesse. Es braucht eine „Habitussensibilität“ sowohl im klinischen als auch im niedergelassenen Bereich, das heißt, die Verantwortung von Ärzt*innen im Gesundheitssystem liegt auch in der Beseitigung von Diskriminierung.

BACKGROUND: Local governments have a critical role to play in addressing health inequities. Health equity impact assessments are recommended to help governments apply an equity lens to the development and implementation of policies and programs. Despite evidence of equity-positive benefits of such tools, adoption remains limited, prompting calls for evaluations to assess their impact and identify factors that will promote uptake across various contexts.
METHODS: We conducted a mixed method study to evaluate the impact of an equity impact assessment (EIA) tool and process on policies and organisational capacity in a local government in Victoria, Australia, and identify factors that influenced this impact. We analysed 33 documents related to 18 EIAs, and conducted surveys (n = 40) and in-depth interviews (n = 17) with staff involved in EIAs.
RESULTS: Almost all (17 of 18) EIAs resulted in equity-positive changes to policies and programs, most frequently addressing individual-level factors, such as making community communications and consultations more accessible to under-represented or under-served groups. Structural-level recommendations from one EIA, such as increasing diversity in decision-making panels, were found to impact both the current policy and a broad range of future, related projects and services. Improvements in equity-centric organisational culture and capacity (including staff awareness, skills and confidence) and increased engagement with under-represented communities were also reported. Factors perceived to influence the impact of EIA\'s related to organisational commitment and capacity to prioritise equity, process-level factors related to the type and timing of EIAs, and extent of implementation support.
CONCLUSIONS: Our study supports wider uptake of health equity impact assessments in local government policies and programs. Legislation, leadership and resources from upper-tiers of government can help increase the adoption of equity tools to reduce disparities in population health.

OBJECTIVE: This article reports on UK sexual minority cisgender women\'s experiences of menopause health and healthcare, based on a data subset from a study exploring lesbian, gay, bisexual, and queer (LGBTQ+) menopause.
METHODS: An online survey was conducted with UK LGBTQ + individuals who went through/are going through the menopause. Quantitative data were analysed using simple descriptive statistics. Qualitative data were analysed using thematic analysis.
RESULTS: Cisgender respondents comprised 51 lesbian, gay, bisexual, pansexual, queer, and \'other\' women, aged between 17 and 89 years. They reported similar types and levels of menopause symptoms as heterosexual cisgender women in other studies, apart from higher levels of anxiety and depression, especially bisexual women. Dissatisfaction regarding menopause healthcare services related to access, information, and heteronormative/heterosexist provision.
CONCLUSIONS: Healthcare providers must ensure they provide inclusive menopause services to sexual minority cisgender women.

BACKGROUND: Differences in social and environmental factors contribute to disparities in fatal injury rates. This study assessed the relationship between social vulnerability and homicide and suicide rates across United States counties.
METHODS: County-level age-adjusted homicide and suicide rates for 2016-2020 were linked with data from the Centers for Disease Control and Prevention\'s 2020 Social Vulnerability Index (SVI), a dataset identifying socially vulnerable communities. We conducted negative binomial regressions to examine the association between SVI and homicide and suicide rates, overall and by Census region/division. We mapped county-level data for SVI and homicide and suicide rates in bivariate choropleth maps.
RESULTS: Overall SVI was associated with homicide rates across U.S. counties. While no association was found for overall SVI and suicide rates, Socioeconomic Status and Racial & Ethnic Minority Status domains were associated. The geographic distribution of SVI and homicide and suicide rates varied spatially; notably, counties in the South had the greatest levels of social vulnerability and greatest homicide rates.
CONCLUSIONS: Our findings demonstrate county-level social vulnerability is associated with homicide rates but may be more nuanced for suicide rates. A modified SVI for injury should include additional social and structural determinants and exclude variables not applicable to injuries.
CONCLUSIONS: This study combines the SVI with homicide and suicide data, enabling researchers to examine related social and environmental factors. Modifying the SVI to include relevant predictors could improve injury prevention strategies by prioritizing efforts in areas with high social vulnerability.

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