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Latest & greatest articles for inequality
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Resources for mental health: scarcity, inequity, and inefficiency. Resources for mental health include policy and infrastructure within countries, mental health services, community resources, human resources, and funding. We discuss here the general availability of these resources, especially in low-income and middle-income countries. Government spending on mental health in most of the relevant countries is far lower than is needed, based on the proportionate burden of mental disorders (...) inefficiencies in financing mechanisms and interventions, and an overconcentration of resources in large institutions. Scarcity of available resources, inequities in their distribution, and inefficiencies in their use pose the three main obstacles to better mental health, especially in low-income and middle-income countries.
Social inequalities in self reported health in early old age: follow-up of prospective cohort study. To describe differences in trajectories of self reported health in an ageing cohort according to occupational grade.Prospective cohort study of office based British civil servants (1985-2004).10 308 men and women aged 35-55 at baseline, employed in 20 London civil service departments (the Whitehall II study); follow-up was an average of 18 years.Physical component and mental component scores (...) was only 4.5 years. Although mental health improved with age, the rate of improvement is slower for men and women in the lower grades.Social inequalities in self reported health increase in early old age. People from lower occupational grades age faster in terms of a quicker deterioration in physical health compared with people from higher grades. This widening gap suggests that health inequalities will become an increasingly important public health issue, especially as the population ages.
Reductions in child mortality levels and inequalities in Thailand: analysis of two censuses. Thailand's progress in reducing the under-five mortality rate (U5MR) puts the country on track to achieve the fourth Millennium Development Goal (MDG). Whether this success has been accompanied by a widening or narrowing of the child mortality gap between the poorest and richest populations is unknown. We aimed to measure changes in child-mortality inequalities by household-level socioeconomic strata (...) of the Thai population between 1990 and 2000.We measured changes in the distribution of the U5MR by economic strata using data from the 1990 and 2000 censuses. Economic status was measured using household assets and characteristics. The U5MR was estimated using the Trussell version of the Brass indirect method.Average household economic status improved and inequalities declined between the two censuses. There were substantially larger reductions in U5MR in the poorer segments of the population. Excess
Systematic review addresses socioeconomic inequalities. 17272534 2007 02 22 2018 11 13 1756-1833 334 7587 2007 Feb 03 BMJ (Clinical research ed.) BMJ Systematic review addresses socioeconomic inequalities. 221 Brunton Ginny G Oakley Ann A Harden Angela A eng Comment Letter England BMJ 8900488 0959-8138 AIM IM BMJ. 2007 Jan 20;334(7585):133 17118950 Adolescent Choice Behavior Female Health Promotion Health Status Humans Pregnancy Pregnancy in Adolescence statistics & numerical data Review
Effect of insulating existing houses on health inequality: cluster randomised study in the community. To determine whether insulating existing houses increases indoor temperatures and improves occupants' health and wellbeing.Community based, cluster, single blinded randomised study.Seven low income communities in New Zealand.1350 households containing 4407 participants.Installation of a standard retrofit insulation package.Indoor temperature and relative humidity, energy consumption, self
Do area-based interventions to reduce health inequalities work: a systematic review of evidence Do area-based interventions to reduce health inequalities work: a systematic review of evidence Do area-based interventions to reduce health inequalities work: a systematic review of evidence O'Dwyer LA, Baum F, Kavanagh A, Macdougall C CRD summary This review assessed whether area-based interventions reduced health inequalities with the finding that there was some evidence that area-based (...) interventions reduced inequalities. The authors' conclusions are suitably cautious in reflecting the available evidence and their recommendations for further research are likely to be reliable. Authors' objectives To assess whether area-based interventions reduce health inequalities. Searching More than 20 electronic databases and selected websites were searched (dates not reported). Reference lists of retrieved studies were screened. National and international organisations and individuals were contacted
Tackling inequalities through the social determinants of health: Building the evidence base 1 Petticrew M., 1 Bambra C., 2 Gibson M., 3 Sowden A., 4 Whitehead M., 5 Wright K. 4 1. Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine 2. Centre for Public Policy & Health, Durham University 3. MRC Social and Public Health Sciences Unit, Glasgow 4. Centre for Reviews and Dissemination, University of York 5. Division of Public (...) . Conclusions 49 8. Dissemination/Outputs 54 Acknowledgements 54 References………………………………………………………….……………….56 Appendices………………………………………………………………………….57 3 Preface: What this study adds to knowledge We know already that there are few evaluations of “wider public health” interventions, such as policies which affect the social determinants of health and health inequalities. From this project we find some suggestive evidence that certain categories of intervention may impact positively on inequalities
Reducing inequalities from injuries in Europe. Injuries cause 9% of deaths and 14% of ill health in the WHO European Region. This problem is neglected; injuries are often seen as part of everyday life. However, although western Europe has good safety levels, death and disability from injury are rising in eastern Europe. People in low-to-middle-income countries in the Region are 3.6 times more likely to die from injuries than those in high-income countries. Economic and political change have led (...) to unemployment, income inequalities, increased traffic, reduced restrictions on alcohol, and loss of social support. Risks such as movement of vulnerable populations and transfer of lifestyles and products between countries also need attention. In many countries, the public-health response has been inadequate, yet the cost is devastating to individuals and health-service budgets. More than half a million lives could be saved annually in the Region if recent knowledge could be used to prevent injuries
Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America. There are substantial social inequalities in adult male mortality in many countries. Smoking is often more prevalent among men of lower social class, education, or income. The contribution of smoking to these social inequalities in mortality remains uncertain.The contribution of smoking to adult mortality in a population can (...) and bottom social strata involved differences in risks of being killed at age 35-69 years by smoking (England and Wales 4%vs 19%, USA 4%vs 15%, Canada 6%vs 13%, Poland 5%vs 22%: four-country mean 5%vs 17%, four-country mean absolute difference 12%). Smoking-attributed mortality accounted for nearly half of total male mortality in the lowest social stratum of each country.In these populations, most, but not all, of the substantial social inequalities in adult male mortality during the 1990s were due
What is the contribution of smoking and socioeconomic position to ethnic inequalities in mortality in New Zealand? Mortality rates for Māori are twice those for non-Māori in New Zealand. We have assessed the contribution of tobacco smoking and socioeconomic position to these inequalities in 45-74-year-old census respondents during 1981-84 and 1996-99 (2.3 and 2.7 million person-years, respectively).We used linked census and mortality cohort datasets with measures of socioeconomic position (...) . The corresponding reductions in men were 5% in 1996-99 and -1% in 1981-84. The apparent contribution of socioeconomic factors to mortality differences between Māori and non-Māori non-Pacific was greatest for men (39% in 1981-84 and 37% in 1996-99) and increased over time for women (from 23% in 1981-84 to 32% in 1996-99).Although small, the contribution of smoking to ethnic inequalities in mortality increased over time and might grow more during the next two decades if differences in smoking between ethnic
Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: cross-sectional study. Inequalities in health between different ethnic groups in New Zealand are most pronounced between Māori and Europeans. Our aim was to assess the effect of self-reported racial discrimination and deprivation on health inequalities in these two ethnic groups.We used data from the 2002/03 New Zealand Health Survey to assess prevalence of experiences of self (...) -reported racial discrimination in Māori (n=4108) and Europeans (n=6269) by analysing the responses to five questions about: verbal attacks, physical attacks, and unfair treatment by a health professional, at work, or when buying or renting housing. We did logistic regression analyses to assess the effect of adjustment for experience of racial discrimination and deprivation on ethnic inequalities for various health outcomes.Māori were more likely to report experiences of self-reported racial
Does IQ explain socioeconomic inequalities in health? Evidence from a population based cohort study in the west of Scotland. To test the hypothesis that IQ is a fundamental cause of socioeconomic inequalities in health.Cross sectional and prospective cohort study, in which indicators of IQ were assessed by written test and socioeconomic position by self report.West of Scotland.1347 people (739 women) aged 56 in 1987.Total mortality and coronary heart disease mortality (ascertained between 1987
[Social inequalities in perinatal health in the Basque Autonomous Community] Desigualdades sociales en la salud perinatal en la CAPV [Social inequalities in perinatal health in the Basque Autonomous Community] Desigualdades sociales en la salud perinatal en la CAPV [Social inequalities in perinatal health in the Basque Autonomous Community] Latorre PM, Aizpuru F, De Carlos Y, Echevarria J, Fernandez-Ruanova B, Lete I, Martinez-Astorquiza T,Martinez C, Paramo S Citation Latorre PM, Aizpuru F, De (...) Carlos Y, Echevarria J, Fernandez-Ruanova B, Lete I, Martinez-Astorquiza T,Martinez C, Paramo S. Desigualdades sociales en la salud perinatal en la CAPV. [Social inequalities in perinatal health in the Basque Autonomous Community] Vitoria-Gasteiz: Basque Office for Health Technology Assessment (OSTEBA). D-07-05. 2006 Authors' objectives
"The aims we have proposed for this survey are as follows: 1) Increase our knowledge of the main factors that lead to social inequalities in perinatal health
Do urban regeneration programmes improve public health and reduce health inequalities: a synthesis of the evidence from UK policy and practice (1980-2004) Do urban regeneration programmes improve public health and reduce health inequalities: a synthesis of the evidence from UK policy and practice (1980-2004) Do urban regeneration programmes improve public health and reduce health inequalities: a synthesis of the evidence from UK policy and practice (1980-2004) Thomson H, Atkinson R, Petticrew M (...) on health, key socioeconomic determinants and health inequalities. Searching BIDS IBSS, COPAC, HMIC (from 1988), IDOX Information Service, Inside, MEDLINE, URBADISC/ACOMPLINE, Web of Knowledge were searched from 1980 to 2004; brief search terms were reported. Governmental departmental libraries, authors of national ABI evaluations and other identified experts were contacted, and the bibliographies of located documents and selected websites were screened. Study selection Study designs of evaluations
Is there a north-south divide in social class inequalities in health in Great Britain? Cross sectional study using data from the 2001 census. To examine individual social class inequalities in self rated general health within and between the constituent countries of Great Britain and the regions of England.Cross sectional study using data from the 2001 national census.Great Britain.Adults aged between 25 and 64 in Great Britain and enumerated in the 2001 population census (n = 25.6 million (...) ).European age standardised rates of self rated general health, for men and women classified by the government social class scheme.In each of the seven social classes, Wales and the North East and North West regions of England had high rates of poor health. There were large social class inequalities in self rated health, with rates of poor health generally increasing from class 1 (higher professional occupations) to class 7 (routine occupations). The size of the health divide varied between regions
Tackling socioeconomic inequalities in health: analysis of European experiences. Effective strategies must be developed to reduce socioeconomic inequalities in health. Most efforts take place in isolation, and only the UK experience has been discussed widely in international published work. We therefore analysed policy developments on health inequalities in different European countries between 1990 and 2001. We noted that countries are in widely different phases of awareness of, and willingness (...) to take action on, inequalities in health. We identified innovative approaches in five main areas: policy steering mechanisms; labour market and working conditions; consumption and health-related behaviour; health care; and territorial approaches. National advisory committees in the UK, the Netherlands, and Sweden have proposed comprehensive strategies to reduce health inequalities. Variations between these packages suggest that policymaking in this area still is largely intuitive and would benefit
Inequities among the very poor: health care for children in rural southern Tanzania. Few studies have been done to assess socioeconomic inequities in health in African countries. We sought evidence of inequities in health care by sex and socioeconomic status for young children living in a poor rural area of southern Tanzania.In a baseline household survey in Tanzania early in the implementation phase of integrated management of childhood illness (IMCI), we included cluster samples of 2006
Are inequalities in height underestimated by adult social position? Effects of changing social structure and height selection in a cohort study. To investigate whether changing social structure and social mobility related to height generate (inflate) inequalities in height.Longitudinal 1958 British birth cohort study.England, Scotland, and Wales.10 176 people born 3-9 March 1958 for whom data were available at age 33 years.Adult height and social class at age 33 years; class of origin (father's (...) occupation when participant was 7 years old).Adult height showed a social gradient with class at age 7 years and age 33 years. The difference in mean height between extreme groups was greater for class of origin than for adult class, reducing from 2.21 cm to 1.62 cm for men and from 2.18 cm to 1.74 cm for women. This narrowing inequality was due mainly to a decrease in mean height in classes I and II. This was because of the pattern of height related social mobility in which, for example, men moving
Consumer demand for caesarean sections in Brazil: informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods. To investigate why some women prefer caesarean sections and how decisions to medicalise birthing are influenced by patients, doctors, and the sociomedical environment.Population based birth cohort study, using ethnographic and epidemiological methods.Epidemiological study: women living