Rethinking gender-based violence during war: Is violence against civilian men a problem worth addressing?

Gender-based violence during conflict and post-conflict situations has received increased attention in research and in the work of development agencies. Viewed primarily as a form of violence against women, this commentary questions whether male civilians have also been victims of gender-based violence during conflict, invisible due to stereotypes surrounding masculinity and a culturally permissive approach towards violence perpetrated against men, especially at times of war. The experience of civilian males of violence, including sexual violence, during the war in Bosnia and Herzegovina and other contemporary wars, suggests that the discourse on gender-based violence and public health research should begin exploring the specific needs of men. Drawing on Nancy Krieger's (Krieger, N. (2003). Genders, sexes, and health: what are the connections--and why does it matter? International Journal of Epidemiology, 32, 652-657) analysis on the differential role of 'sex' and 'gender' on a given exposure-outcome association, this commentary suggests that the impact of gender-based violence on health during conflict may be different for men and women and may require distinct therapeutic approaches. Given that perpetrators are often male, an extra level of stigma is added when heterosexual men are sexually violated, which may lead to underreporting and reduced health-service seeking behavior. Further public health research is needed to guide the work of humanitarian agencies working with survivors of gender-based violence in conflict and post-conflict settings to ensure equal access to appropriate health services for men and women.Yugoslavia Armed conflict Gender-based violence Gender Sex

The influence of a school-based intervention programme regarding adherence to a healthy diet in children and adolescents from disadvantaged areas in Greece: The DIATROFI study

Background To evaluate the effects, via a cohort study, of a food aid and promotion of healthy nutrition programme, implemented in areas of low socioeconomic status (SES) in Greece, on students' diet quality. Methods From a total of 162 schools participating in the programme during the 2012-2013 school year, we collected 3941 individually linked questionnaires at baseline and at the end of the intervention, recording sociodemographic characteristics, lifestyle parameters and dietary habits of the students. For the assessment of diet quality, the KIDMED score was computed, along with food frequency consumption data regarding milk, fruits, vegetables and whole grain products. Pre-post intervention values were compared using non-parametric tests. Generalised estimating equations were used to explore the factors that influence changes in dietary habits. Results By the end of the intervention, favourable changes were observed regarding healthy eating; KIDMED increased statistically significantly in adolescent girls (p=0.042), while the consumption frequency of all foods promoted by the intervention, namely, milk, fruits, vegetables and whole grain products, increased for children and adolescents, boys and girls (p=0.002). Factors indicating lower SES, such as foreign country of birth, lower education level, no income source and high levels of food insecurity, were associated with lower diet quality. Conclusions As low SES groups tend to adopt unhealthier dietary choices, it is of the outmost importance to take action for the promotion of healthy eating, directed especially to these at risk populations. School-based nutritional programmes can be considered as an effective policy measure towards this direction

Structural racism and health inequities in the USA: evidence and interventions

Despite growing interest in understanding how social factors drive poor health outcomes, many academics, policy makers, scientists, elected officials, journalists, and others responsible for defining and responding to the public discourse remain reluctant to identify racism as a root cause of racial health inequities. In this conceptual report, the third in a Series on equity and equality in health in the USA, we use a contemporary and historical perspective to discuss research and interventions that grapple with the implications of what is known as structural racism on population health and health inequities. Structural racism refers to the totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice. These patterns and practices in turn reinforce discriminatory beliefs, values, and distribution of resources. We argue that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health