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Latest & greatest articles for inequality
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Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective Could scale-up of parenting programmes improve child (...) disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective Gardner F, Leijten P, Mann J, Landau S, Harris V, Beecham J, Bonin E, Hutchings J & Scott S Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Gardner F, Leijten P, Mann J, Landau S
Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries. To provide an update on economic related inequalities in caesarean section rates within countries.Secondary analysis of demographic and health surveys and multiple indicator cluster surveys.72 low and middle income countries with a survey conducted between 2010 and 2014 for analysis of the latest situation of inequality, and 28 countries with a survey also conducted between 2000 (...) and 2004 for analysis of the change in inequality over time.Women aged 15-49 years with a live birth during the two or three years preceding the survey.Data on caesarean section were disaggregated by asset based household wealth status and presented separately for five subgroups, ranging from the poorest to the richest fifth. Absolute and relative inequalities were measured using difference and ratio measures. The pace of change in the poorest and richest fifths was compared using a measure of excess
Wealth inequality as a predictor of HIV-related knowledge in Nigeria Considering the high state-level heterogeneity of HIV prevalence and socioeconomic characteristics in Nigeria, it is a relevant setting for studies into the socioeconomic correlates of HIV-related knowledge. Although the relationship between absolute poverty and HIV transmission has been studied, the role of wealth inequality in the dynamics of the HIV epidemic has yet to be investigated in Nigeria. The current study (...) , therefore, investigates wealth inequality and other sociodemographic covariates as predictors of HIV-related knowledge, in order to identify subgroups of the Nigerian population that would benefit from HIV preventive interventions.This study used the nationally representative 2013 Nigerian Demographic and Health Survey (NDHS). HIV-related knowledge was computed as a total score based on HIV-related knowledge indicators in the NDHS, dichotomised using the sample median as the cut-off. Wealth inequality
The King’s Fund response to the Mayor of London’s draft health inequalities strategy The King’s Fund response to the Mayor of London’s draft health inequalities strategy | The King's Fund Main navigation Health and care services Leadership, systems and organisations Patients, people and society Policy, finance and performance Search term Apply The King’s Fund response to the Mayor of London’s draft health inequalities strategy This content relates to the following topics: Share this content (...) The King’s Fund is an independent health charity whose stipulates our work should include the promotion of health and alleviation of sickness, to confer benefit, whether directly or indirectly, for the health of Londoners. We interpret this broadly, and our national work has relevance to London, but we also undertake work and seek to influence in ways issues that will directly benefit Londoners’ health. As such we welcome the Mayor’s consultation on his future health inequalities strategy
Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective Journals Library An error occurred retrieving content
Is governance, gross domestic product, inequality, population size or country surface area associated with coverage and equity of health interventions? Ecological analyses of cross-sectional surveys from 80 countries To assess associations between national characteristics, including governance indicators, with a proxy for universal health coverage in reproductive, maternal, newborn and child health (RMNCH).Ecological analysis based on data from national standardised cross-sectional surveys.Low (...) -income and middle-income countries with a Demographic and Health Survey or a Multiple Indicator Cluster Survey since 2005.1 246 710 mothers and 2 129 212 children from 80 national surveys.Gross domestic product (GDP), country surface area, population, Gini index and six governance indicators (control of corruption, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and voice and accountability).Levels and inequality in the composite coverage index
Key policies for addressing the social determinants of health and health inequities Matthew Saunders | Ben Barr | Phil McHale | Christoph Hamelmann HEALTH EVIDENCE NETWORK SYNTHESIS REPORT 52 Key policies for addressing the social determinants of health and health inequitiesThe Health Evidence Network HEN – the Health Evidence Network – is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional (...) in 2003 through a Memorandum of Agreement between the Government of Italy, the Veneto Region and the WHO Regional Office for Europe. Health Evidence Network synthesis report 52 Key policies for addressing the social determinants of health and health inequities Matthew Saunders | Ben Barr | Phil McHale | Christoph HamelmannAbstract Evidence indicates that actions within four main themes (early child development, fair employment and decent work, social protection, and the living environment) are likely
How Social-Class Stereotypes Maintain Inequality Social class stereotypes support inequality through various routes: ambivalent content, early appearance in children, achievement consequences, institutionalization in education, appearance in cross-class social encounters, and prevalence in the most unequal societies. Class-stereotype content is ambivalent, describing lower-SES people both negatively (less competent, less human, more objectified), and sometimes positively, perhaps warmer than (...) upper-SES people. Children acquire the wealth aspects of class stereotypes early, which become more nuanced with development. In school, class stereotypes advantage higher-SES students, and educational contexts institutionalize social-class distinctions. Beyond school, well-intentioned face-to-face encounters ironically draw on stereotypes to reinforce the alleged competence of higher-status people and sometimes the alleged warmth of lower-status people. Countries with more inequality show more
Investigating the impact of the English health inequalities strategy: time trend analysis. Objective To investigate whether the English health inequalities strategy was associated with a decline in geographical health inequalities, compared with trends before and after the strategy.Design Time trend analysis.Setting Two groups of lower tier local authorities in England. The most deprived, bottom fifth and the rest of England.Intervention The English health inequalities strategy-a cross (...) government strategy implemented between 1997 and 2010 to reduce health inequalities in England. Trends in geographical health inequalities were assessed before (1983-2003), during (2004-12), and after (2013-15) the strategy using segmented linear regression.Main outcome measure Geographical health inequalities measured as the relative and absolute differences in male and female life expectancy at birth between the most deprived local authorities in England and the rest of the country.Results Before
Strategies and governance to reduce health inequalities: evidences from a cross-European survey The main objective of the paper is to identify the governance system related to policies to reduce health inequalities in the European regions. Considering the Action Spectrum of inequalities and the check list of health equity governance, we developed a survey in the framework of the AIR Project - Addressing Inequalities Intervention in Regions - was an European project funded by the Executive (...) Agency of Health and Consumers.A web-based qualitative questionnaire was developed that collected information about practiced strategies to reduce health inequalities. In total 28 questionnaires from 28 different regions, related to 13countries, were suitable for the analysis.Progress in health equity strategies at the national and regional levels has been made by countries such as France, Portugal, Poland, and Germany. On the other hand, Spain, Italy, and Belgium have a variable situation depending
Inequalities in non-communicable diseases between the major population groups in Israel: achievements and challenges. Israel is a high-income country with an advanced health system and universal health-care insurance. Overall, the health status has improved steadily over recent decades. We examined differences in morbidity, mortality, and risk factors for selected non-communicable diseases (NCDs) between subpopulation groups. Between 1975 and 2014, life expectancy in Israel steadily increased (...) Arabs than Jews. Smoking prevalence is highest for Arab men and lowest for Arab women. Health inequalities are also evident by the indicators of socioeconomic position and in subpopulations, such as immigrants from the former Soviet Union, ultra-Orthodox Jews, and Bedouin Arabs. Despite universal health coverage and substantial improvements in the overall health of the Israeli population, substantial inequalities in NCDs persist. These differences might be explained, at least in part, by gaps
Trends in social inequality in physical inactivity among Danish adolescents 1991â€“2014 The aim of this study was to investigate social inequality in physical inactivity among adolescents from 1991 to 2014 and to describe any changes in inequality during this period. The analyses were based on data from the Danish part of the HBSC study, which consists of seven comparable cross-sectional studies of nationally representative samples of 11-15-year old adolescents. The available data consisted (...) of weekly time (hours) spent on vigorous physical activity and parental occupation from 30,974 participants. In summary, 8.0% of the adolescents reported to be physically inactive, i.e. spend zero hours of vigorous leisure time physical activity per week. The proportion of physically inactive adolescents was 5.4% in high social class and 7.8% and 10.8%, respectively, in middle and low social class. The absolute social inequality measured as prevalence difference between low and high social class did
Inequality and the health-care system in the USA. Widening economic inequality in the USA has been accompanied by increasing disparities in health outcomes. The life expectancy of the wealthiest Americans now exceeds that of the poorest by 10-15 years. This report, part of a Series on health and inequality in the USA, focuses on how the health-care system, which could reduce income-based disparities in health, instead often exacerbates them. Other articles in this Series address population (...) health inequalities, and the health effects of racism, mass incarceration, and the Affordable Care Act (ACA). Poor Americans have worse access to care than do wealthy Americans, partly because many remain uninsured despite coverage expansions since 2010 due to the ACA. For individuals with private insurance, rising premiums and cost sharing have undermined wage gains and driven many households into debt and even bankruptcy. Meanwhile, the share of health-care resources devoted to care of the wealthy
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
Mass incarceration, public health, and widening inequality in the USA. In this Series paper, we examine how mass incarceration shapes inequality in health. The USA is the world leader in incarceration, which disproportionately affects black populations. Nearly one in three black men will ever be imprisoned, and nearly half of black women currently have a family member or extended family member who is in prison. However, until recently the public health implications of mass incarceration were
Population health in an era of rising income inequality: USA, 1980-2015. Income inequality in the USA has increased over the past four decades. Socioeconomic gaps in survival have also increased. Life expectancy has risen among middle-income and high-income Americans whereas it has stagnated among poor Americans and even declined in some demographic groups. Although the increase in income inequality since 1980 has been driven largely by soaring top incomes, the widening of survival inequalities (...) has occurred lower in the distribution-ie, between the poor and upper-middle class. Growing survival gaps across income percentiles since 2001 reflect falling real incomes among poor Americans as well as an increasingly strong association between low income and poor health. Changes in individual risk factors such as smoking, obesity, and substance abuse play a part but do not fully explain the steeper gradient. Distal factors correlated with rising inequality including unequal access
Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study (...) , which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status
Family of origin and educational inequalities in mortality: Results from 1.7 million Swedish siblings Circumstances in the family of origin have short- and long-term consequences for people's health. Family background also influences educational achievements - achievements that are clearly linked to various health outcomes. Utilizing population register data, we compared Swedish siblings with different levels of education (1,732,119 individuals within 662,095 sibships) born between 1934 (...) and 1959 and followed their death records until the end of 2012 (167,932 deaths). The educational gradient in all-cause mortality was lower within sibships than in the population as a whole, an attenuation that was strongest at younger ages (< 50 years of age) and for those with a working class or farmer background. There was substantial variation across different causes of death with clear reductions in educational inequalities in, e.g., lung cancer and diabetes, when introducing shared family factors
The evolution of socioeconomic status-related inequalities in maternal health care utilization: evidence from Zimbabwe, 1994â€“2011 Inequalities in maternal health care are pervasive in the developing world, a fact that has led to questions about the extent of these disparities across socioeconomic groups. Despite a growing literature on maternal health across Sub-Saharan African countries, relatively little is known about the evolution of these inequalities over time for specific countries (...) measure inequalities in maternal health care use using the Erreygers corrected concentration index. A decomposition analysis was conducted to determine the underlying drivers of the measured disparities.The computed concentration indices for professional delivery assistance and prenatal care reveal a mostly pro-rich distribution of inequalities between 1994 and 2011. Particularly, the concentration index [95% confidence interval] for the receipt of prenatal care was 0.111 [0.056, 0.171] in 2005/06