BackgroundVaccination against influenza is considered the most important public health intervention to prevent unnecessary hospitalizations and premature deaths related to influenza in the elderly, though there are significant inequities among global influenza vaccine resources, capacities, and policies. The objective of this study was to assess the social determinants of health preventing adults ≥65 years old from accessing and accepting seasonal influenza vaccination.MethodsA systematic search was performed in January 2011 using MEDLINE, ISI – Web of Science, PsycINFO, and CINAHL (1980–2011). Reference lists of articles were also examined. Selection criteria included qualitative and quantitative studies written in English that examined social determinants of and barriers against seasonal influenza vaccination among adults≥65 years. Two authors performed the quality assessment and data extraction. Thematic analysis was the main approach for joint synthesis, using identification and juxtaposition of themes associated with vaccination.ResultsOverall, 58 studies were analyzed. Structural social determinants such as age, gender, marital status, education, ethnicity, socio-economic status, social and cultural values, as well as intermediary determinants including housing-place of residence, behavioral beliefs, social influences, previous vaccine experiences, perceived susceptibility, sources of information, and perceived health status influenced seasonal influenza vaccination. Healthcare system related factors including accessibility, affordability, knowledge and attitudes about vaccination, and physicians’ advice were also important determinants of vaccination.ConclusionsOur results demonstrate that the ability of adults ≥65 years to receive seasonal influenza vaccine is influenced by structural, intermediate, and healthcare-related social determinants which have an impact at the health system, provider, and individual levels.

Improved tuberculosis (TB) diagnosis and treatment through the DOTS and Stop TB strategies have saved millions of lives; however, their impact on TB incidence has been disappointing and the scale of the epidemic remains overwhelming. To reduce the incidence of TB, the drivers of the epidemic and social determinants of TB need to be addressed. These include co-morbidities and substance use and, moreover, the social and economic conditions that determine both the course of the TB epidemic and exposure to these risk factors. Doing so builds on the history of TB prevention and treatment during the public health revolution that resulted in a dramatic reduction in incidence in many countries. Addressing the social determinants is also imperative to address pervasive inequities in the incidence, mortality and morbidity of TB between different population groups, including in the performance of health systems in delivering diagnostic and treatment interventions, and in the financial consequences of people seeking care. Action on the social determinants can be categorised in terms of health-sector interventions, intersectoral policies impacting across society, and measurement and research to better understand inequities and links between TB and other factors. TB programmes cannot carry out these actions alone; however, they can make important contributions in the delivery of interventions and in advocating and negotiating for intersectoral efforts. The considerable progress seen in the clinical care of TB needs to be sustained; however, the attainment of TB targets, including elimination by 2050, will require expansion of the lens of TB control efforts beyond 'business as usual' to address the social determinants of the disease.

Background and Objectives: Excessive use of smartphones and computers among adolescents together with less physical activity is a major public health concern as it has shown to produce attention difficulties, decreased academic performance and various health issues. This study aims to identify the relationship among screen time, physical activity and cognitive function of adolescents. Materials & Methods:This was a cross sectional study done on students between the age of 10 and 14years of one government and one private school in Trivandrum corporation Kerala.Information processing speed was assessed using Digit Letter Substitution Tests (DLST).Physical Activity was measured using the Youth Physical Activity Questionnaire (YPAQ). Screen time in the study included watching television, playing video games, and using smartphones, tablet devices, desktop, and laptop. Results:147 students participated in the study. Screen time was high across all groups in the study, only 9.5 % of the study group had optimum screen time of 2 hours as recommended by WHO but this group had significantly higher information processing speed.57.1% of adolescents in the study group had adequate physical activity and this group of students had significantly higher DLST score compared to those with low physical activity. Interpretation & Conclusions: The findings of the study could serve as a reliable indicator on the harmfulness of screen time and sedentary lifestyle on cognitive function of young adolescents. This can also help to implement a school-based monitoring on unhealthy life styles and interventions for intellectual development of adolescents in Kerala.

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