Session

Disparities and Inequities in Global Health

Nithya Mani, MPH and Keren Herrán, B.S., Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, 1318 Quicksilver St, Round Rock, TX 78665-1118

APHA 2025 Annual Meeting and Expo

Abstract

Caste, oppression, and health care: Structural inequities and health disparities in India

Aditya Raj1 and Parth Lalakia, PhDc, MPH2
(1)Jawaharlal Nehru Medical College, KLE University, Belagavi, India, (2)Thomas Jefferson University, Philadelphia, PA

APHA 2025 Annual Meeting and Expo

Introduction: Caste-based discrimination in India remains a pervasive social determinant of health, disproportionately affecting Dalits, Scheduled Castes (SCs), and Scheduled Tribes (STs). Identifiable with one’s last name, this identity has marginalized the underprivileged since centuries. Despite constitutional protections and affirmative action policies, these groups experience significant health inequities due to systemic barriers in healthcare access, economic deprivation, and institutional bias.

Methods: This study analyses data from the National Family Health Survey (NFHS-5), government reports, and peer-reviewed research to analyze caste-based health disparities. Metrics include maternal and child health indicators, healthcare utilization rates, and documented cases of discrimination within medical institutions.

Results: SC/ST populations have higher neonatal and under-five mortality rates, lower maternal healthcare utilization, and disproportionately poor mental health outcomes. Institutionalized discrimination in healthcare delivery, economic constraints, and lack of representation in medical professions further widen the gap. Disparities persist in access to prenatal and postnatal care, immunization rates, and non-communicable disease treatment, exacerbating intergenerational health disadvantages. Structural caste hierarchies remain embedded in public health policy, medical education, and healthcare workforce composition, reinforcing exclusion and inequity.

Conclusion: Addressing caste-based health disparities requires systemic policy interventions, including anti-discriminatory training for healthcare professionals, increased representation of marginalized communities in medical institutions, and targeted public health initiatives. A shift toward equity-focused policies, improved healthcare accessibility, and accountability measures is critical to dismantling caste-based barriers.

Advocacy for health and health education Diversity and culture Ethics, professional and legal requirements Public health or related public policy Public health or related research Social and behavioral sciences

Abstract

Progress and impacts of health equity projects implemented by the Atlantic Fellows for Health Equity

Lauren Muñoz, PhD, RN, FNP-BC1, Selam Bedada, MPH1, Tamara Tur, MA1, Beth Mechum, BA1, Janice Blanchard, MD, PhD1, Olivia Jefferson, MPH1, Kate Hilton, JD, MTS2, Khadidiatou Ndiaye, PhD1, Shadelle Yancey, BA1 and Guenevere Burke, MD, MBA1
(1)The George Washington University, Washington, DC, (2)Innovation Capital, Hanover, NH

APHA 2025 Annual Meeting and Expo

  • Context: Inequities persist in global health, but the Atlantic Fellows for Health Equity (AFHE) program is seeking to change that. Since 2017, the AFHE program has provided leadership and health equity training to a small group of early-to-mid-career individuals from across the globe who are conducting health equity work in their community. As part of the AFHE program, fellows implement a health equity project with guidance and support of the program faculty and curriculum. We sought to learn more about the progress and impacts of their health equity projects.
  • Methods: In January 2025, we surveyed all senior fellows (those who have graduated from the program; n = 107), and 74 (69.2%) responded. Respondents came from the following continents: 41 from North America (including Canada, the Caribbean, Mexico, and the U.S.), 12 from Asia, 11 from Africa, four from South America, and three from Europe.
  • Results: Almost half (n = 35, 47.3%) of AFHE senior fellows were continuing to work on their health equity projects. Of those who were not, 12 reported that their projects had been successfully completed, and two had handed their projects over to someone else. Other reasons for noncompletion included work role or job changes, shifting priorities at work, country instability, lack of funding, and difficulty with partners. A broad range of people were reached through senior fellows’ health equity projects: from 30 people to 9 million, with a total of over 25.5 million people impacted. Target populations for health equity projects included: women, LGBTQ+ individuals, those with physical disabilities, youth and children, veterans, rural dwellers, and others. Senior fellows’ project work comprised advocacy, mentorship, education and training, informing policy, community building, increasing access and resources for health services, app development, and creating their own health equity fellowships.
  • Conclusion and Discussion: The AFHE program is enabling emerging leaders to have enduring and widespread impact on initiatives that support vulnerable and underserved populations. However, some senior fellows have faced challenges in their health equity work due to multiple factors. Future training efforts that emphasize long-term partnerships and funding may be beneficial to promote sustainability after the fellowship experience.

Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs

Abstract

Health Conspiracy Theories in Public Health: Prevalence, Impact, and Strategic Responses

Adnan Kisa, PhD1 and Sezer Kisa, PhD2
(1)Kristiania University of Applied Sciences, Oslo, Norway, (2)Oslo Metropolitan University, Oslo, NORW

APHA 2025 Annual Meeting and Expo

Background: Health-related conspiracy theories pose a growing threat to public health by eroding trust in science, increasing vaccine hesitancy, and worsening health disparities. These beliefs, shaped by misinformation, historical injustices, and the rapid circulation of content on digital platforms, disproportionately affect marginalized communities. To develop effective responses, it is essential to understand the scope, impact, and underlying drivers of these theories. This study systematically maps and synthesizes existing research by identifying the most prevalent conspiracy theories in health, examining their influence on health behaviors and outcomes, exploring the factors contributing to their spread, and analyzing the strategies proposed or implemented to address them within healthcare settings.

Methods: A comprehensive synthesis of evidence was conducted by systematically reviewing studies retrieved from six databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, and Scopus) for empirical studies examining health conspiracy beliefs, their impacts, contributing factors, and interventions. Data were extracted and thematically analyzed.

Results: Conspiracy beliefs were found to be widespread across health domains such as HIV/AIDS, vaccination, mental health, and COVID-19. These beliefs contributed to reduced vaccine uptake, heightened anxiety, and diminished trust in public health institutions. In particular, vaccine intent decreased by up to 6% following exposure to misinformation. Drivers of conspiracy beliefs included political ideology, low institutional trust, limited health literacy, and the influence of social media. Interventions such as inoculation messages, science-based infographics, and media literacy training showed varied effectiveness, with limited evidence on their long-term impact. These effects were especially pronounced among marginalized populations.

Conclusions: Health-related conspiracy theories pose serious behavioral and psychological threats to public health. Effective strategies must combine community trust-building, culturally relevant education, and digital misinformation control. More comparative and longitudinal studies are needed. These findings highlight the urgent need for evidence-based public health strategies that address misinformation and rebuild trust among vulnerable populations.

Advocacy for health and health education Communication and informatics Diversity and culture Implementation of health education strategies, interventions and programs Public health or related research Social and behavioral sciences

Abstract

Disproportionate impacts of wildfire waste on Indigenous communities: An environmental justice perspective

Corrinne Joseph Tendo, MPH
New York University, New York, NY

APHA 2025 Annual Meeting and Expo

Background
As climate change accelerates the frequency and severity of wildfires, the resulting toxic waste—such as dioxins, heavy metals, and asbestos—poses growing threats to environmental and public health. These hazards disproportionately affect Indigenous communities, shaped by historical and ongoing structural inequities, including land dispossession, chronic underinvestment in health systems, and exclusion from emergency response and recovery planning. This study examines how wildfire waste intersects with environmental justice concerns and identifies Indigenous-led approaches as essential to equitable and culturally grounded recovery efforts.

Methods
A comparative, multi-country analysis was conducted using secondary literature, policy documents, and civil society reports from Canada, Australia, Brazil, and the United States. Thematic analysis revealed cross-cutting patterns of environmental exposure, barriers to remediation, cultural and ecological loss, and Indigenous strategies for resilience and adaptation.

Results
Findings demonstrate consistent delays in debris removal, limited access to recovery resources, and exclusion of Indigenous voices in formal recovery planning. In Canada, significant delays were recorded on Nlaka’pamux territory following the Lytton wildfire. In Australia, Aboriginal communities reported spiritual and cultural losses after the Black Summer fires, with minimal inclusion in post-fire planning. In Brazil, Indigenous Peoples in the Amazon face continued toxic exposure from fire-driven deforestation, alongside the criminalization of land defenders. In the United States, tribal nations in California have long advocated for recognizing cultural burning practices, which remain largely absent from state-managed fire strategies. The 2023 Maui wildfires further illustrated these systemic inequities, with Native Hawaiians experiencing displacement and limited access to land restoration support.

Conclusion
Wildfire waste is both an environmental hazard and a justice issue. Addressing its impacts requires disaster response frameworks that center on Indigenous sovereignty, integrate traditional ecological knowledge, and support culturally responsive recovery mechanisms. Indigenous-led and community-based strategies are vital for reducing harm and strengthening long-term climate resilience in wildfire-prone regions.

Diversity and culture Environmental health sciences Public health or related public policy Public health or related research