Introduction to Issue 54:2

In this Issue of the journal, a variety of papers on Social Determinants of Health, health inequalities and health services are presented. The section titled “Social Policy and Global Food Insecurity” initiates the discourse, with an article authored by Seth A. Berkowitz et al., titled “Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries”. ¹ In this paper, the authors analyze UN data from 19 countries to investigate the association between a country's social policy configuration, specifically its welfare state regime, and the risk of food insecurity. The study's findings suggest a significant association, indicating the potential efficacy of implementing social policy reforms in mitigating the risk of food insecurity, particularly in high-risk countries.

Following this is the new section on “Precarious Employment, Labour Markets and Health”, featuring an article by Elsa Underhill and Michael Quinlan entitled “The struggle to regulate precarious work arrangements to minimize their adverse effects on health and safety in Australia”. ² This paper reviews regulatory work-related interventions in Australia over the past two decades, focusing especially on industrial relations regulation, in order to build a deeper understanding of the underlying mechanisms that shape precarious work in Australia. It includes an analysis of the major – and controversial – regulations passed by the Australian Parliament in February 2024.

The subsequent section, labeled “Analyzing Policy Responses to Mental Health,” features two articles: the first, authored by Gojjam Limenih et al., is titled “Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse”. ³ This article scrutinizes the influence of international guidelines from entities such as the World Health Organization and the Global Mental Health Movement on the global discourse surrounding depression, particularly in low- and middle-income countries. It underscores the role of these guidelines in shaping knowledge-power dynamics, perpetuating biopolitical assumptions, exerting governmentality, and establishing ‘conditions of possibility.’ The article concludes by advocating for a reassessment of the treatment gap for common mental disorders and highlights forms of resistance within the discourse. The second article, ““What works” to support LGBTQ + young people's mental health: An intersectional youth rights approach,” ⁴ by Elizabeth McDermott et al., endeavors to develop an early intervention model for supporting LGBTQ + youth with emerging mental health issues. The analysis advocates for an intersectional youth rights approach comprising 13 principles aligned with recommendations by the UNCRC and WHO to deliver effective mental health services.

Section IV, titled “Determinants of Health Care in Europe: A Comparative Analysis,” presents a paper authored by Almudena Moreno et al., titled “Socioeconomic Patterns in the Frequency of Doctor Visits in Germany and Spain in Subjects With and Without Chronic Diseases.” ⁵ This study examines the relationship between socioeconomic factors (income and education) and the frequency of doctor's visits among individuals with and without chronic diseases in both Germany and Spain. The study reveals marginal significance in the ratio of medical consultations between lower and higher income groups for subjects with chronic conditions. Notably, lower income subjects with chronic conditions in Germany exhibit significantly more consultations than their higher-income counterparts.

In the following section on “The Struggle for Universal Healthcare in the United States”, a paper by Charlene Harrington et al., titled “United States’ Nursing Home Finances: Spending, Profitability, and Capital Structure”, ⁶ investigates the financial status of nursing homes in the United States. The study underscores the necessity for accurate and comprehensive cost report analyses, advocating for enhanced financial transparency and accountability, particularly in relation to government funding.

Section VI, titled “Social Determinants of Health in the Global South”, features two papers that delve into significant aspects of social determinants in the Occupied Palestinian Territories and Morocco. The first paper, “Barriers to Elderly Health Care in the Occupied Palestinian Territories” ⁷ by Carol El Jabari et al., analyzes the effects of social, political, and economic factors on the access to and utilization of primary healthcare services by the elderly in Palestine. The study reveals that while health insurance coverage is widespread, out-of-pocket expenses remain burdensome, which – along with other political, geographic, and economic factors – impedes access to healthcare services. The second paper, authored by Chaimae Moujahid et al., addresses the social determinants of maternal health in a rarely studied country. Titled “Scoping Review to Identify Social Determinants of Maternal Health in Morocco”, ⁸ the article identifies structural and intermediary factors influencing maternal health service utilization and outcomes, highlighting power dynamics across different socioeconomic categories.

Section VII, titled “Developing Research for Health Equity and Services”, includes two papers. The first, authored by Lucinda Cash-Gibson and Joan Benach, is titled “Understanding Health Inequalities Research Capacities: Insights and Recommendations From Comparing Two High Income Settings”, ⁹ and analyzes recent case studies to explore cities’ and countries’ capacities for generating research on health inequalities. This analysis may inform strategies to enhance research capacities and promote research production, particularly in settings with limited health inequalities research output. The second paper, by Toby Freeman et al., is titled “The Benefits of Cooperative Inquiry in Health Services Research: Lessons from an Australian Aboriginal and Torres Strait Islander Health Study.” ¹⁰ This paper employs a ‘cooperative inquiry method’ involving partner health services as co-researchers. It outlines the establishment of a multi-state Decolonising Practice research project in Australia, highlighting the indispensable role of cooperative inquiry in navigating uncertainty, ensuring research continuity, and deepening understanding of local contexts and operational methods, particularly in Indigenous health research.

In the final section, “Equity and the Pharmaceutical Industry”, a compelling paper is presented. This paper, “A European Salk Institute could ensure accessible and affordable medicine” ¹¹ by Wim De Ceukelaire and Tim Joye, proposes the establishment of a European institute dedicated to overseeing research in the pharmaceutical sector, aiming to promote accessibility and affordability of medicines for public benefit.