The Yale Journal of Biology and Medicine’s September 2021 issue on Health Equity has been published on PubMed Central. The YJBM September 2021 focus issue explores the breadth and complexity of health inequities research in the US and abroad.
Questions about health equity have garnered additional attention as the COVID-19 pandemic has demonstrated how devastating disparities in access to care and numerous other factors can be to the health of underprivileged communities. Although COVID-19 has brought health equity front and center, health inequities are not a new problem, nor unique to the US. Articles include authors from the US, Indonesia, Singapore, Australia, and Iran.
Highlights of the issue include a perspectives piece by authors Isabel S. Bazan, Section of Pulmonary, Critical Care & Sleep Medicine, Yale School of Medicine, and Kathleen M. Akgün, Pulmonary, Critical Care, & Sleep Medicine, VA Connecticut Healthcare System, who approach the racial and ethnic health disparities among COVID-19 vaccination rates. Bazan and Akgün use evidence of racial and ethnic disparities in seasonal influenza vaccination rates to provide recommendations for improving COVID-19 vaccine uptake in Black, Indigenous, and Latinx communities.
The issue also includes original research by Paul C. Archibald, CUNY and Johns Hopkins University Program for Research on Men’s Health. Archibald observed that there are racial disparities in rates of work-related stress and post-traumatic stress disorder (PTSD) in the US, with Black adults experiencing higher rates of both. While work-related stress is a known risk factor for PTSD, through a cross-sectional analysis of nationally representative data, Archibald found that depression, alcohol use, and discrimination may mediate this relationship among Black adults. The author calls for culturally informed interventions and policies for Black adults to address the higher rates of work-related stress and PTSD in this population.
Another original research article by Erni Astutik et al., Department of Epidemiology, Biostatistics, Population Studies, and Health Promotion, Universitas Airlangga, East Java, Indonesia, further demonstrates how the risk factors for a given disease can differ by population, perhaps perpetuating inequities. In their study, Astutik et al. found a higher prevalence of hypertension among elderly women in urban areas compared to rural areas in East Java, Indonesia, but that the risk factors associated with hypertension were different in these two populations.
Health disparities are rarely driven by a single factor and untangling these complex webs often involves looking across the body of literature. The high prevalence of lung disease in Central Appalachia in the Eastern United States is predominantly attributed to occupational exposures and environmental exposures as a consequence of the centrality of coal mining in these communities. However, in a review of lung disease in Central Appalachia, Claire L. Debolt et al., Department of Medicine, University of Virginia, demonstrates how worse pulmonary health outcomes in this population is influenced by a number of other social and economic factors, such as educational disparities, poverty, and access to health care and how these factors are intertwined with the environmental exposures to produce health disparities. The variety of factors that contribute to COVID-19 health inequities may be better understood through the lens of historical inequities present among other viral infectious diseases.
Understanding and combating health inequities is not just the domain of health researchers and healthy systems – just as the factors that lead to health disparities are many and varied, so too must be the actors who contribute to achieving health equity. There is a role for many different fields – policy, government, education, etc. and at the Yale Journal of Biology and Medicine we believe that academic journals can also play a role. We hope through this focus issue as well as future issues of the journal to highlight important research being done to address health inequities both in the United States and abroad. We aim to address and reduce biases and inequities in our own publishing practices and promote equity in health research and beyond by making our articles available open-access, encouraging new researchers to publish, and prioritizing research that addresses the importance of health equity across scientific disciplines.
Read the entire YJBM archive for free on PubMed Central. The YJBM is open-access for all.
Deputy Editors of this issue and Co-Editors-in-Chief of YJBM: Kelsie Cassell and Mallory Ellingson, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT