Differential impacts of health systems and sociocultural environment on vulnerable populations during the COVID-19 pandemic: lessons from four Asia-Pacific countries.

Autor: Lee J; Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.; Hyo-tree nursing home, Incheon, Republic of Korea., Park S; Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.; Seoul National University, Seoul, Republic of Korea., Jang SN; Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea. sjang@cau.ac.kr.; Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea. sjang@cau.ac.kr., Reyes KA; Alliance for Improving Health Outcomes, Quezon City, Philippines., Garcia F Jr; College of Public Health, University of the Philippines Manila, Manila, Philippines., Canila C; College of Public Health, University of the Philippines Manila, Manila, Philippines., Oraño J; Alliance for Improving Health Outcomes, Quezon City, Philippines., Ballesteros AJ; Alliance for Improving Health Outcomes, Quezon City, Philippines., Muhartini T; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia., Frans S; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia., Marthias T; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia., Putri LP; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia., Mahendradhata Y; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia., De Foo C; NUS Saw Swee Hock School of Public Health and National University Health System, Singapore, Singapore.; Duke NUS Graduate Medical School, Singapore, Singapore.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Jun 05; Vol. 24 (1), pp. 1501. Date of Electronic Publication: 2024 Jun 05.
DOI: 10.1186/s12889-024-18949-1
Abstrakt: Background: This study aims to evaluate healthcare systems and pandemic responses in relation to marginalized and vulnerable groups, identify populations requiring urgent care, and assess the differential impacts on their health during the pandemic.
Methods: Data were collected by the Asia-Pacific Observatory on Health Systems and Policies (APO)-National University of Singapore and APO-International Health Policy Program consortium members: Korea, Indonesia, Philippines, and Singapore. Data were collected through a combination of semi-structured interviews, policy document reviews, and analysis of secondary data.
Results: Our findings reveal that the pandemic exacerbated existing health disparities, particularly affecting older adults, women, and children. Additionally, the study identified LGBTI individuals, healthcare workers, slum dwellers, and migrant workers as groups that faced particularly severe challenges during the pandemic. LGBTI individuals encountered heightened discrimination and limited access to health services tailored to their needs. Healthcare workers suffered from immense stress and risk due to prolonged exposure to the virus and critical working conditions. Slum dwellers struggled with healthcare access and social distancing due to high population density and inadequate sanitation. Migrant workers were particularly hard hit by high risks of virus transmission and stringent, often discriminatory, isolation measures that compounded their vulnerability. The study highlights the variation in the extent and nature of vulnerabilities, which were influenced by each country's specific social environment and healthcare infrastructure. It was observed that public health interventions often lacked the specificity required to effectively address the needs of all vulnerable groups, suggesting a gap in policy and implementation.
Conclusions: The study underscores that vulnerabilities vary greatly depending on the social environment and context of each country, affecting the degree and types of vulnerable groups. It is critical that measures to ensure universal health coverage and equal accessibility to healthcare are specifically designed to address the needs of the most vulnerable. Despite commonalities among groups across different societies, these interventions must be adapted to reflect the unique characteristics of each group within their specific social contexts to effectively mitigate the impact of health disparities.
(© 2024. The Author(s).)
Databáze: MEDLINE
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