Social prescribing is growing rapidly globally as a way to tackle social determinants of health. However, whom it is reaching and how effectively it is being implemented remains unclear.

To gain a comprehensive picture of social prescribing in the UK, from referral routes, reasons, to contacts with link workers and prescribed interventions.

This study undertook the first analyses of a large database of administrative data from over 160 000 individuals referred to social prescribing across the UK. Data were analysed using descriptive analyses and regression modelling, including logistic regression for binary outcomes and negative binomial regression for count variables.

Mental health was the most common referral reason and mental health interventions were the most common interventions prescribed. Between 72% and 85% of social prescribing referrals were from medical routes (primary or secondary healthcare). Although these referrals demonstrated equality in reaching across sociodemographic groups, individuals from more deprived areas, younger adults, men, and ethnic minority groups were reached more equitably via non-medical routes (e.g. self-referral, school, charity). Despite 90% of referrals leading to contact with a link worker, only 38% resulted in any intervention being received. A shortage of provision of community activities – especially ones relevant to mental health, practical support and social relationships – was evident. There was also substantial heterogeneity in how social prescribing is implemented across UK nations.

Mental health is the leading reason for social prescribing referrals, demonstrating its relevance to psychiatrists. But there are inequalities in referrals. Non-medical referral routes could play an important role in addressing inequality in accessing social prescribing and therefore should be prioritised. Additionally, more financial and infrastructural resource and strategic planning are needed to address low intervention rates. Further investment into large-scale data platforms and staff training are needed to continue monitoring the development and distribution of social prescribing.

Adolescent girls are at risk of anaemia due to increased nutrient demands because of growth, menstrual blood loss and possible pregnancies. Sociocultural and household conditions influence their anaemia risk. We aimed to identify the sociocultural and economic factors associated with anaemia among adolescent girls in Nepal.

The Nepal Demographic and Health Surveys (NDHS) conducted in 2006, 2011 and 2016 were pooled for secondary analysis. We used data on haemoglobin measurements for anaemia and conducted bivariate and multivariable logistic regression analyses to identify factors associated with anaemia.

Nationally representative NDHS households with adolescent girls 15–19 years of age.

Non-pregnant adolescent girls 15–19 years, with a haemoglobin measurement (n = 3731).

The overall prevalence of anaemia among adolescent girls was 39·6 %. Adolescents from socially disadvantaged caste/ethnicity groups were 1·42 times (95 % CI: 1·13, 1·78) more likely to have anaemia compared with those from Brahmin/Chhetri households. We found a counter-intuitive association between socio-economic status and anaemia where adolescents from the middle (adjusted OR (aOR) 1·37, 95 % CI: 1·01, 1·85) and highest (aOR 1·74, 95 % CI: 1·18, 2·56) quintiles were at increased odds of anaemia. Relative geographical inequality was observed where adolescents from the Terai region had 3·5 times (95 % CI: 2·32, 5·33) higher odds of anaemia.

The disparities in the distribution of anaemia among adolescents by caste/ethnicity groups, wealth quintiles and geographical regions are evident. Reducing the anaemia burden will require addressing the social determinants of anaemia by allocating resources and expanding anaemia prevention programmes to target adolescents at higher risk.

This study aims to determine health-related quality of life (QoL) and the related factors from the perspective of social determinants of health among children.

Childhood is the most intense period of life, and environmental factors surrounding children, as well as individual lifestyle factors, are related to the child’s physical and mental well-being. To our knowledge, there is a lack of studies evaluating the relationship between determinants of health and the QoL of healthy children in general.

This cross-sectional study was executed in the Bayrakli district of Izmir city. Stratified clustered sampling was used including 24 schools and 3367 7th-grade children, and 1284 students were targeted (50% prevalence, 95% CI, %5 margins of error, 2.25 design effect, and 20% replacement). The response rate was 84.9% (n = 1090). The Turkish KID-KINDL Health-Related Quality of Life Questionnaire for Children was used to assess QoL. Independent variables were examined in four layers using Dahlgren’s Determinants of Health Model: basic characteristics, lifestyle factors, family characteristics, and life conditions.

The mean QoL score was 71.3 ± 12.6. Our study explained 31.7% of the variance in QoL. Higher QoL scores were associated with better health status, perceived academic achievement, normal/thin body perception, physical activity (PA), and adequate sleep duration. Living with both parents and having fewer siblings positively influenced QoL. Moreover, the presence of structural problems in the household and poorer health perceptions were associated with lower QoL scores (P < 0.05) This study highlighted the multifaceted nature of QoL in Turkish children, revealing the importance of various determinants of health. The results show that in order to improve the general well-being of this population, interventions and policies are required that concentrate on elements including health status, academic accomplishment, body perception, physical activity, family structure, and living situations.

The COVID-19 pandemic dramatically altered social determinants of health including work, education, social connections, movement, and perceived control; and loneliness was commonly experienced. This longitudinal study examined how social determinants at the personal (micro), community (meso), and societal (macro) levels predicted loneliness during the pandemic.

Participants were 2056 Australian adults surveyed up to three times over 18 months in 2020 and 2021. Multi-level mixed-effect regressions were conducted predicting loneliness from social determinants at baseline and two follow-ups.

Loneliness was associated with numerous micro determinants: male gender, lifetime diagnosis of a mental health disorder, experience of recent stressful event(s), low income, living alone or couples with children, living in housing with low natural light, noise, and major building defects. Lower resilience and perceived control over health and life were also associated with greater loneliness. At the meso level, reduced engagement with social groups, living in inner regional areas, and living in neighbourhoods with low levels of belongingness and collective resilience was associated with increased loneliness. At the macro level, increased loneliness was associated with State/Territory of residence.

Therapeutic initiatives must go beyond psychological intervention, and must recognise the social determinants of loneliness at the meso and macro levels.

To determine predictors of the association between being a Veteran and adult food security, as well as to examine the relation of potential covariates to this relationship.

Data collected during 2011–2012, 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey (NHANES) were pooled for analyses. Veterans (self-reported) were matched to non-Veterans on age, race/ethnicity, sex and education. Adjusted logistic regression was used to determine the odds of Veterans having high food security v. the combination of marginal, low and very low food security compared with non-Veterans.

2011–2012, 2013–2014 and 2015–2016 NHANES.

1227 Veterans; 2432 non-Veterans.

Veteran status had no effect on the proportion of food insecurities between Veterans and non-Veterans reporting high (Veterans v. non-Veteran: 79 % v. 80 %), marginal (9 % v. 8 %), low (5 % v. 6 %) and very low (8 % v. 6 %) food security (P = 0·11). However, after controlling for covariates, Veterans tended to be less likely to have high food security (OR: 0·82 (95 % CI 0·66, 1·02), P = 0·07). Further, non-Hispanic White Veterans (OR: 0·72 (95 % CI 0·55, 0·95), P = 0·02) and Veterans completing some college (OR: 0·71 (95 % CI 0·50, 0·99), P < 0·05) were significantly less likely to experience high food security compared with non-Veterans.

This study supports previous research findings that after controlling for covariates, Veterans tend to be less likely to have high food security. It also highlights ethnicity and level of education as important socio-economic determinates of food security status in Veterans.

Early-life socioeconomic status (SES) and adversity are associated with late-life cognition and risk of dementia. We examined the association between early-life SES and adversity and late-life cross-sectional cognitive outcomes as well as global cognitive decline, hypothesizing that adulthood SES would mediate these associations.

Our sample (N = 837) was a racially and ethnically diverse cohort of non-Hispanic/Latino White (48%), Black (27%), and Hispanic/Latino (19%) participants from Northern California. Participant addresses were geocoded to the level of the census tract, and US Census Tract 2010 variables (e.g., percent with high school diploma) were extracted and combined to create a neighborhood SES composite. We used multilevel latent variable models to estimate early-life (e.g., parental education, whether participant ever went hungry) and adult (participant’s education, main occupation) SES factors and their associations with cross-sectional and longitudinal cognitive outcomes of episodic memory, semantic memory, executive function, and spatial ability.

Child and adult factors were strongly related to domain-specific cognitive intercepts (0.20–0.48 SD per SD of SES factor); in contrast, SES factors were not related to global cognitive change (0.001–0.01 SD per year per SD of SES factor). Adulthood SES mediated a large percentage (68–75%) of the total early-life effect on cognition.

Early-life sociocontextual factors are more strongly associated with cross-sectional late-life cognitive performance compared to cognitive change; this effect is largely mediated through associations with adulthood SES.

Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults.

Secondary data analysis of the California Health Interview Survey (CHIS).

The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161).

Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables.

First generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers.

Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.

Displaced refugee children with a history of war exposure are at risk of developing complex and severe forms of post-traumatic stress disorder (PTSD).

Search for the most relevant causal predictors of complex PTSD in a prospective cohort of Syrian refugee children living in informal settlements in Lebanon (N=1007).

A latent class unsupervised analysis was carried out to determine clusters with complex PTSD presentation at the follow-up assessment. A new exploratory causal discovering modelling approach was applied using 97 multilevel psychosocial variables as predictors (Biazoli et al., 2021). Associations between discovered candidate causal factors assessed at baseline with a presumed diagnosis of complex PTSD one year later were calculated using a multiple logistic regression model.

Several putative causal factors emerged: perceived social coherence of the neighbourhood (Positive Predictive Value increase: 1.22); impulsivity (1.25), self-efficacy (1.23) and depressive symptoms (1.15) at the parental level; positive home experiences (1.16) at the family level; and child-level factors such as being forced to work (1.22), being a victim of verbal or physical bullying (1.19), loneliness (1.17) and well-being (1.18). In further confirmatory multiple logistic regression analysis and after correction for multiple comparisons, verbal or physical bullying victimization (p=.005) and caregiver depressive symptoms (p=.0004) at baseline were associated with complex PTSD presentations one year later.

Our results support the need for a multi-level psychosocial care model to prevent psychological distress and promote mental health in refugee children. Specifically, our results suggest that programs tackling caregiver’s mental health and children’s exposure to violence might effectively prevent complex PTSD.

No significant relationships.