Original Articles


Background: Child food insecurity (CFI) in Florida is 25% higher than the national average, however, no studies currently exist which investigate the association between CFI and population health or social determinants of health in the State. The goal of this study was to identify those variables in order to inform future policy addressing CFI in the state of Florida.


Methods: Data on CFI, child health, and social determinants of health were collected from the Florida Department of Health website for the years 2014-2018. Variables were selected based on previous studies on CFI conducted primarily in the United States. A correlation analysis was conducted to determine associations between the selected variables and CFI in Florida.


Results: CFI had a moderate positive association with emergency department visits among children aged 0-5 in the years 2017 and 2018. All other child health outcomes examined in this study did not have significant associations with CFI. Teenage mothers represented the strongest positive association with CFI whereas breastfeeding represented the strongest negative association. 


Conclusion: In Florida, CFI surprisingly had few correlations with population health outcomes that have known national associations. This indicates that the factors contributing to and resulting from CFI are different in Florida relative to those found nationally. Several social determinants of health were identified that could help identify individuals and communities at increased odds of having CFI.

Background: Frontline healthcare workers, a vital workforce in developing countries is often out of mainstream vision and their challenges and coping behaviors under stressful conditions remain unclear to stakeholders. This study was undertaken with the objective to explore the challenges faced by community surveillance workers and their coping strategies during COVID-19 pandemic.


Methods: A qualitative descriptive study with constructivism paradigm was undertaken for a period of one year by conducting eight focus group discussions and eight in-depth interviews among the health workers undertaking COVID-19 surveillance selected purposively from eight wards within three Boroughs of a Municipal Corporation using interview guide. Thematic analysis was used to compare and contrast the codes to generate themes inductively under two constructs.


Results: The first construct, factors influencing work related stress was categorized into four themes related to- work environment, community’s response towards pandemic surveillance, organizational support and personal factors. Main predisposing factors of work place stress were risk of self-infection, concern for family safety, inadequate training, shortage of manpower and protective equipment etc. While a strong commitment towards work, assistance from local community influencers, administrative appreciation and supportive supervision were protective factors against stress. Second construct on coping strategies was categorized into managing stress by problem-focused strategies like adapting with experience, gathering information and sharing experiences, adopting self-care practices; while emotion-based coping strategies included denial, venting out, or turning to religion etc.


Conclusion: Community surveillance workers faced considerable and variable stress during pandemics due to various underlying work stressors, managed innovatively, using self-coping strategies.

Determinants of real stock return of pharmaceutical products and materials companies

Hojjatollah Marzban , Reza Sotudeh, Habib Piri

Social Determinants of Health, Vol. 9 (2023), , Page 1-12
https://doi.org/10.22037/sdh.v9i1.39590

Background: The present study aimed to investigate the factors that determine the actual efficiency of pharmaceutical companies.


Methods: This study was an applied and descriptive-correlation research. Using the financial information of 28 pharmaceutical materials and products companies of Tehran Stock Exchange during 2013-2016, modeling of multiple variables on the real returns of pharmaceutical companies was performed. Data entered to excel and were calculated and the relationship between independent and dependent variables was analyzed by performing multiple regression tests in Eviews software.


Results: There is a significance association between company size and real stock returns, but there was no relationship between assets and real stock returns and between equity returns and real stock returns. Between financial leverage and real stock returns, between price-to-earnings ratio and real stock returns; a significance association was observed between the ratio of book value to the market and the real stock return, and between the margin profit and the real stock return.


Conclusion: Considering the importance of the factors determining the real return of pharmaceutical products and materials companies, it is expected that the financial characteristics of pharmaceutical companies and Stock returns on the Tehran Stock Exchange should be used by planners as a guide for investors in Tehran Stock Exchange.

Background: This study was conducted with the intention of evaluating the prevalence of headache disorders in Tehran, assessing medical seeking behavior and costs endured by individuals affected, and compare them between men and women.


Method: A cross-sectional study was conducted including individuals aged 18 and older from general population of Tehran through stratified random sampling method. Information on demographic characteristics, headache features, medical help seeking behaviors, medications used, and economic cost endured were collected through a self-administered structured questionnaire. The characteristics of the study population were presented using descriptive analysis. Chi-squared test and Independent T test were performed to compare the variables between sexes.


Result: Data on 523 adult participants were analyzed. Main findings showed a prevalence of 96% for all headaches in adults, including 47.9 % (n = 241) women and 52.1% (n = 262) men. Mostly described their headache as a squeezing sensation (32.8 %) felt bilaterally (78%) with medium intensity (59%). About a third (31%) reported reduced productivity due to headache. The prevalence of self-treatment was 75% in study population and about two third reported using medications for acute treatment of headache. Mean± SD out of pocket payment of US$139 ± 114.6, and average monthly expenditure of US$4.1 ± 13.4 for headache management purposes were documented. No significant differences were found between the sexes in terms of headache features, treatment-seeking behaviors, and headache management expenditures.


Conclusion: Findings point to the importance of prioritizing headache disorders in future decision-making and resource allocation strategies.

The effective factors on empowerment of faculty members to launch start-ups

Zahra Hesari , Ramezan Jahanian, Mohammadali Hosseini

Social Determinants of Health, Vol. 9 (2023), , Page 1-11
https://doi.org/10.22037/sdh.v9i1.40067

Background: This study aimed to investigate the factors affecting the empowerment of faculty members to launch start-ups in the branches of the Islamic Azad University of Tehran.


Methods: This research was descriptive-analytical. Its statistical population included 27,000 faculty members working in the Islamic Azad University, Tehran branch. The sampling method was cluster random sampling. The sample size was 50 people in the qualitative part and 384 people in the quantitative part. The research tools were researcher-made questionnaires, with a Likert scale and semi-structured interviews. For statistical analysis, confirmatory factor analysis tests, t-tests, and multivariate regression were used by SPSS software version 23.


Results: The results showed that there is a significant difference in the components affecting empowerment, including marketing and commercialization of knowledge (β=0.354), attracting elites and from business (β=0.306), and knowledge sharing (β=0.265). financial risk analysis (β=0.143), formation of business support association (β=0.111), value design and use of new technologies (β=0.075), financial and legal support of the government (β=0.066), creating environmental changes (β=0.056), increasing value-creating activities (β=0.044), providing infrastructure (β=0.037), and discussing startups (β=0.024) in the order of priority. The partial regression showed the impact of discussion about startups and environmental changes on the empowerment of faculty members.


Conclusion: It is essential to consider human resources, knowledge commercialization, elite recruitment, knowledge sharing, financial risk analysis, financial and business support, use of new technologies, environmental change, value creation activities, providing infrastructure, about start-ups based on the transformational attitude of management.

Background: Many factors are effective in business development and experts have emphasized marketing and consider it one of the most important factors determining business survival. This study aimed to present a model of how small and medium companies enter regional markets with an entrepreneurial marketing approach.


Methods: This study was a mixed research type. In the qualitative part of this study, market entry strategies were investigated and identified using the method of literature review and existing texts. To design the questionnaire, the opinions of 15 business management experts were used by the snowball method to obtain suitable samples for the study, and then the model was approved by the experts using the meta-heuristic method.


Results: 100 people were present for the implementation of this study, 6.7% of the participants in the study had less than 10 years of work experience and 40% between 16 and 20 years, and 20% had more than 20 years of service. The proposed conceptual model of the research, which is obtained from the met heuristic process, shows that the initial conceptual model of the research consists of 4 categories of dimensions (entrepreneur orientation, market orientation, customer orientation, and innovation orientation) and 48 concepts and 182 codes (indicators).


ConclusionGiven the importance of socioeconomic factors on health outcomes, businesses should consider the market distribution network, knowledge infrastructure, business capability, product innovation, the risk of participation, competitors, market development, and strategies.

Letter to Editor