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Latest & greatest articles for inequality
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Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016 This study describes key population health concepts and examines major empirical trends in US health and healthcare inequalities from 1935 to 2016 according to important social determinants such as race/ethnicity, education, income, poverty, area deprivation, unemployment, housing, rural-urban residence, and geographic location.Long-term trend data from the National Vital (...) Statistics System, National Health Interview Survey, National Survey of Children's Health, American Community Survey, and Behavioral Risk Factor Surveillance System were used to examine racial/ethnic, socioeconomic, rural-urban, and geographic inequalities in health and health care. Life tables, age-adjusted rates, prevalence, and risk ratios were used to examine health differentials, which were tested for statistical significance at the 0.05 level.Life expectancy of Americans increased from 69.7 years
Social determinants of health inequalities. The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status
Socioeconomic inequality in morbid obesity with body mass index more than 40Â kg/m2 in the United States and England This study evaluated socioeconomic inequality in morbid obesity (body mass index, BMI ≥40 kg/m2) through an analysis of population health survey data in the United States (US) and England (UK).We analysed data for the National Health and Nutrition Examination Survey and the Health Survey for England for 2011 to 2014. Age-adjusted odds ratios (AOR) were used to evaluate income (...) - and education-inequality.There were 26,898 eligible UK and 10,628 US participants. Morbid obesity was more frequent in women than men, and higher in the US than the UK (men: US, 4.8%; UK, 1.7%; women US, 9.6%; UK, 3.7%). In the UK, morbid obesity showed graded income-inequality in both genders (AOR, for lowest income quintile: men, 1.83, 95% confidence interval 1.16 to 2.88; women, 2.18, 1.55 to 3.07), as well as education-inequality (AOR for no school qualifications, men 2.57, 1.64 to 4.02; women, 2.18
Consideration of health inequalities in systematic reviews: a mapping review of guidance. Given that we know that interventions shown to be effective in improving the health of a population may actually widen the health inequalities gap while others reduce it, it is imperative that all systematic reviewers consider how the findings of their reviews may impact (reduce or increase) on the health inequality gap. This study reviewed existing guidance on incorporating considerations of health (...) inequalities in systematic reviews in order to examine the extent to which they can help reviewers to incorporate such issues.A mapping review was undertaken to identify guidance documents that purported to inform reviewers on whether and how to incorporate considerations of health inequalities. Searches were undertaken in Medline, CINAHL and The Cochrane Library Methodology Register. Review guidance manuals prepared by international organisations engaged in undertaking systematic reviews
Explaining racial and ethnic inequalities in postpartum allostatic load: Results from a multisite study of low to middle income woment Racial and ethnic inequalities in women's health are widely documented, but not for the postpartum period, and few studies examine whether neighborhood, psychosocial, and biological factors explain these gaps in women's health.Using prospective longitudinal data collected from 1766 low to middle income women between 2008 and 2012 by the Community Child Health (...) for Latinas compared to Whites.Racial and ethnic inequalities in AL were accounted for largely by household poverty with additional contributions by psychological, economic, neighbourhood and medical variables. There remained a significant inequality between African American, and Latina women as compared to Whites even after adjustment for this set of variables. Future research into health inequalities among women should include a fuller consideration of the social determinants of health including
An agent-based simulation of persistent inequalities in health behavior: Understanding the interdependent roles of segregation, clustering, and social influence Health inequalities are conspicuously persistent through time and often durable even in spite of interventions. In this study, I use agent-based simulation models (ABMs) to understand how the complex interrelationships between residential segregation, social network formation, group-level preferences, and social influence may contribute (...) to this persistence. I use a more-stylized ABM, Bubblegum Village (BV), to understand how initial inequalities in bubblegum-chewing behaviors either endure, increase, or decrease over time given group-level differences in preferences, neighborhood-level barriers or facilitators of bubblegum chewing (e.g., access to bubblegum shops), and agents' preferences for segregation, homophily, and clustering (i.e., the 'tightness' of social networks). I further use BV to understand whether segregation and social network
Increasing inequality in age of death at shared levels of life expectancy: A comparative study of Scotland and England and Wales There is a strong negative correlation between increasing life expectancy and decreasing lifespan variation, a measure of inequality. Previous research suggests that countries achieving a high level of life expectancy later in time generally do so with lower lifespan variation than forerunner countries. This may be because they are able to capitalise on lessons (...) already learnt. However, a few countries achieve a high level of life expectancy later in time with higher inequality. Scotland appears to be such a country and presents an interesting case study because it previously experienced lower inequality when reaching the same level of life expectancy as its closest comparator England and Wales. We calculated life expectancy and lifespan variation for Scotland and England and Wales for the years 1950 to 2012, comparing Scotland to England and Wales when
Inter-individual inequality in BMI: An analysis of Indonesian Family Life Surveys (1993â€“2007) Widening inequalities in mean Body Mass Index (BMI) between social and economic groups are well documented. However, whether changes in mean BMI are followed by changes in dispersion (or variance) and whether these inequalities are also occurring within social groups or across individuals remain understudied. In addition, a substantial body of literature exists on the global increase in mean BMI (...) and prevalence of overweight and obesity. However, whether this weight gain is shared proportionately across the whole spectrum of BMI distribution, also remains understudied. We examined changes in the distribution of BMI at the population level over time to understand how changes in the dispersion reflect between-group compared to within-group inequalities in weight gain. Moreover, we investigated the entire distribution of BMI to determine in which percentiles the most weight gain is occurring over time
Trends in socioeconomic inequalities in self-rated health, smoking, and physical activity of Japanese adults from 2000 to 2010 Health disparities in Japan are attracting increasing attention. Temporal trends in health disparities should be continuously monitored using multiple indices of socioeconomic status (SES) and health-related outcomes. We explored changes in socioeconomic differences in the health of Japanese adults during 2000-2010. The data was taken from the Japanese General Social (...) Surveys, the cross-sectional surveys for nationally representative samples of Japanese adults. We used 14,193 samples (individuals of 20-64 years of age) in our analysis. We estimated age-adjusted prevalence ratios of the lowest SES group in comparison with the highest SES group using Poisson regression models with robust error variance. Relative index of inequality (RII) and slope index of inequality (SII) were also calculated. We examined the changes in the association between health-related
What is the evidence on the reduction of inequalities in accessibility and quality of maternal health care delivery for migrants? A review of the existing evidence in the WHO European Region What is the evidence on the reduction of inequalities in accessibility and quality of maternal health care delivery for migrants? A review of the existing evidence in the WHO European Region HEALTH EVIDENCE NETWORK SYNTHESIS REPORT 45 Ines Keygnaert | Olena Ivanova | Aurore Guieu | An-Sofie Van Parys | Els (...) is the evidence on the reduction of inequalities in accessibility and quality of maternal health care delivery for migrants? A review of the existing evidence in the WHO European Region Ines Keygnaert | Olena Ivanova | Aurore Guieu | An-Sofie Van Parys | Els Leye | Kristien RoelensAbstract The number of female migrants of childbearing age is rapidly increasing, which poses specific maternal health needs. Via a systematic academic literature review and a critical interpretive synthesis of policy frameworks
Explaining inequalities in women's mortality between U.S. States Inequalities in women's mortality between U.S. states are large and growing. It is unknown whether they reflect differences between states in their population characteristics, contextual characteristics, or both. This study systematically examines the large inequalities in women's mortality between U.S. states using a multilevel approach. It focuses on "fundamental" social determinants of mortality at the individual and state (...) stronger and more pernicious consequences for women than men. Taken together, the findings underscore the importance of 'bringing context back in' and taking a multilevel approach when investigating geographic inequalities in U.S. mortality.
Wealth, education and urbanâ€“rural inequality and maternal healthcare service usage in Malawi Malawi is among the 5 sub-Saharan African countries presenting with very high maternal mortality rates, which remain a challenge. This study aims to examine the impact of wealth inequality and area of residence (urban vs rural) and education on selected indicators of maternal healthcare services (MHS) usage in Malawi.This study was based on data from the 5th round of Multiple Indicator Cluster Surveys (...) appears to be reasonable, yet the high maternal mortality rate is disturbing and calls for analysing factors hindering the achievement of maternal health-related Sustainable Development Goals (SDGs). The findings of this study underscore the need to minimise the wealth inequality, urban-rural divide and the low level of education among mothers to improve the usage of MHS. An equity-based policy approach considering the sociodemographic inequity in terms of wealth index, education and urban-rural
Trends of geographic inequalities in the distribution of human resources in healthcare system: the case of Iran Considering the scarcity of skilled workers in the health sector, the appropriate distribution of human resources in this sector is very important for improving people's health. Having information about the degree of equality in the distribution of health human resources and their time trends is necessary for better planning and efficient use of these resources. The aim of this study (...) was to determine the trend of inequality in the allocation of human resources in the health sector in Tehran between 2007 and 2013.This cross-sectional study was conducted in Tehran Province in Iran. The inequality in the distribution of human resources (specialists, general practitioners, pharmacists, paramedics, dentists, nurses and community health workers (Behvarz)) in 10 cities in Tehran Province was investigated using the Gini coefficient and the dissimilarity index. The time trend of inequality
Theoretical basis and explanation for the relationship between area-level social inequalities and population oral health outcomes â€“ A scoping review This study was conducted to review the evidence on the association between area-level social inequalities and population oral health according to type and extent of social theories. A scoping review was conducted of studies, which assessed the association between area-level social inequality measures, and population oral health outcomes including (...) to their theoretical basis. A total of 2892 studies were identified with 16 included in the review. Seven types of social theories were used on 48 occasions within the selected studies including: psychosocial (n=13), behavioural (n=10), neo-material (n=10), social capital (n=6), social cohesion (n=4), material (n=3) and social support (n=2). Of the selected studies, four explicitly tested social theories as pathways from inequalities to population oral health outcomes, three used a theoretical construct, seven
The effects of Positive Youth Development interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes The effects of Positive Youth Development interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could
The effects of Positive Youth Development interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes The effects of Positive Youth Development interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes The effects of Positive Youth Development interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes (...) interventions on substance use, violence and inequalities: systematic review of theories of change, processes and outcomes. Public Health Research 2016; 4(5) Authors' objectives Positive Youth Development (PYD) delivered outside school aims to enable young people to develop positive assets such as relationships and confidence, rather than to merely address risk. Existing reviews of PYD effects on substance use or violence are old and unsystematic. The objective was to systematically review evidence
Inequalities in mental health and well-being in a time of austerity: Baseline findings from the Stockton-on-Tees cohort study Since 2010, the UK has pursued a policy of austerity characterised by public spending cuts and welfare changes. There has been speculation - but little actual research - about the effects of this policy on health inequalities. This paper reports on a case study of local health inequalities in the local authority of Stockton-on-Tees in the North East of England, an area (...) characterised by high spatial and socio-economic inequalities. The paper presents baseline findings from a prospective cohort study of inequalities in mental health and mental wellbeing between the most and least deprived areas of Stockton-on-Tees. This is the first quantitative study to explore local mental health inequalities during the current period of austerity and the first UK study to empirically examine the relative contributions of material, psychosocial and behavioural determinants in explaining
Inequalities in use of total hip arthroplasty for hip fracture: population based study. To determine whether the use of total hip arthroplasty (THA) among individuals with a displaced intracapsular fracture of the femoral neck is based on national guidelines or if there are systematic inequalities.Observational cohort study using the National Hip Fracture Database (NHFD).All hospitals that treat adults with hip fractures in England, Wales, and Northern Ireland.Patients within the national
Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States To compare the magnitude of, and contributors to, income-related inequalities in oral health outcomes within and between Canada and the United States over time.The concentration index was used to estimate income-related inequalities in three oral health outcomes from the Nutrition Canada National Survey 1970-1972, Canadian Health Measures Survey 2007 (...) -2009, Health and Nutrition Examination Survey I 1971-1974, and National Health and Nutrition Examination Survey 2007-2008. Concentration indices were decomposed to determine the contribution of demographic and socioeconomic factors to oral health inequalities.Our estimates show that over time in both countries, inequalities in decayed teeth and edentulism were concentrated among the poor and inequalities in filled teeth were concentrated among the rich. Over time, inequalities in decayed teeth