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Latest & greatest articles for inequality
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Coronary heart disease mortality among young adults in Scotland in relation to social inequalities: time trend study. To examine recent trends and social inequalities in age specific coronary heart disease mortality.Time trend analysis using joinpoint regression.Scotland, 1986-2006.Men and women aged 35 years and over.Age adjusted and age, sex, and deprivation specific coronary heart disease mortality.Persistent sixfold social differentials in coronary heart disease mortality were seen between (...) and women aged 45-54 showed similar flattening from about 2003. Rates in women aged 55-64 may also now be flattening. The flattening of coronary heart disease mortality in younger men and women was confined to the two most deprived fifths.Premature death from coronary heart disease remains a major contributor to social inequalities. Furthermore, the flattening of the decline in mortality for coronary heart disease among younger adults may represent an early warning sign. The observed trends were
Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment To map the health effects of interventions which aim to alter the psychosocial work environment, with a particular focus on differential impacts by socio-economic status, gender, ethnicity, or age.A systematic approach was used to identify, appraise and summarise existing systematic reviews (umbrella review) that examined the health (...) on health. Importantly, five reviews suggested that organisational level psychosocial workplace interventions may have the potential to reduce health inequalities amongst employees.Policy makers should consider organisational level changes to the psychosocial work environment when seeking to improve the health of the working age population.
Inequalities in reported use of breast and cervical screening in Great Britain: analysis of cross sectional survey data. To investigate the relation between women's reported use of breast and cervical screening and sociodemographic characteristics.Cross sectional multipurpose survey.Private households, Great Britain. Population 3185 women aged 40-74 interviewed in the National Statistics Omnibus Survey 2005-7.Ever had a mammogram, ever had a cervical smear, and, for each, timing of most recent (...) of cervical screening was greater among more educated women but was not significantly associated with cars, housing tenure, or region.Most (84%) eligible women report having had both breast and cervical screening, but 3% report never having had either. Some inequalities exist in the reported use of screening, which differ by screening type; indicators of wealth were important for breast screening and ethnicity for cervical screening. The routine collection within general practice of additional
Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidities. To describe on a national basis ethnic differences in severe maternal morbidity in the United Kingdom.National cohort study using the UK Obstetric Surveillance System (UKOSS).All hospitals with consultant led maternity units in the UK.686 women with severe maternal morbidity between February 2005 and February 2006.Rates, risk ratios, and odds ratios of severe maternal morbidity (...) . This highlights to clinicians and policy makers the importance of tailored maternity services and improved access to care for women from ethnic minorities. National information on the ethnicity of women giving birth in the UK is needed to enable ongoing accurate study of these inequalities.
Explaining educational inequalities in preterm birth: the generation r study Although a low socioeconomic status has consistently been associated with an increased risk of preterm birth, little is known about the pathways through which socioeconomic disadvantage influences preterm birth.To examine mechanisms that might underlie the association between the educational level of pregnant women as an indicator of socioeconomic status, and preterm birth.The study was nested in a population-based (...) , and lifestyle habits. Apparently, educational inequalities in preterm birth go together with an accumulation of multiple adverse circumstances among women with a low education. A number of explanatory mechanisms unravelled in the present study seem to be modifiable by intervention programmes.
Improving partnership working to reduce health inequalities Improving partnership working to reduce health inequalities | 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 Improving partnership working to reduce health inequalities This content relates to the following topics: Share this content Authors Tammy Boyce Professor David Hunter Working in partnership is central (...) to reducing health inequalities – one department acting alone cannot tackle an issue that does not respect organisational boundaries. But unfortunately, all too frequently, only lip service is paid to partnership working in place of real engagement with practicable and sustainable outcomes. The King's Fund, in partnership with the Strategic Review of Health Inequalities Post 2010 led by Professor Sir Michael Marmot, held a seminar to discuss how to improve partnership working and health inequalities.So
Strategic review of health inequalities in England post-2010 (Marmot Review) Strategic review of health inequalities in England post-2010 (Marmot Review) | 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 Strategic review of health inequalities in England post-2010 (Marmot Review) Consultation response This content relates to the following topics: Share this content (...) This paper is a response to the Marmot Review consultation. It provides a comprehensive analysis of the proposals to reduce health inequalities and a range of evidence to underpin future health policy and action. The Marmot Review helps to clarify the role of the Department of Health and the NHS in reducing health inequalities. This is welcome guidance as the role that the NHS can play in doing so is often vague. Related content You may also be interested in Quick links Connect with us Latest Tweet
Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions School-based cognitive-behavioural interventions: a systematic review of effects and inequalities 09 April 2019 Links Download report (pdf) Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions What do we want to know? Health inequalities are recognised as an important problem both (...) nationally and internationally. The research literature which demonstrates the complex interactions between the key axes of social differences in populations including class, education, occupation, income/assets, gender, ethnicity; in relation to health outcomes is yet to be matched by a strong body of evidence of what works to reduce health inequalities. Systematic reviewers wanting to examine how interventions impact upon gaps and gradients have been hampered by a lack of tested tools and methods
Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions Inequalities and the mental health of young people: a systematic review of secondary school-based cognitive behavioural interventions Kavanagh J, Oliver S, Caird J, Tucker H, Greaves A, Harden A, Oakley A, Lorenc T, Thomas J CRD (...) health educational programmes and explore the impact of these interventions on inequalities in young people's mental health. Searching MEDLINE, CINAHL, EMBASE, The Cochrane Library, PsycINFO, ERIC, Social Science Citation Index, ASSIA, Trials Register of Public Health Interventions (TROPHI), Database of Public Health Effectiveness Reviews (DOPHER), C2-SPECTR and PsiTri were searched for English-language articles published from 1996 onwards. Various websites were searched, references from relevant
[The state of research into inequalities in the incidence, death, prevention and healthcare in cancer in Spain. A bibliometric study and literature review.] Investigacion en Espana sobre desigualdades en la incidencia, mortalidad, prevencion y atencion del cancer. Estudio bibliometrico y de revision de la literatura. [The state of research into inequalities in the incidence, death, prevention and healthcare in cancer in Spain. A bibliometric study and literature review.] Investigacion en Espana (...) sobre desigualdades en la incidencia, mortalidad, prevencion y atencion del cancer. Estudio bibliometrico y de revision de la literatura. [The state of research into inequalities in the incidence, death, prevention and healthcare in cancer in Spain. A bibliometric study and literature review.] Aguado Romeo MJ, Marquez Calderon S, Rohlfs I, Sarmiento Gonzalez-Nieto V. Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation
Health promotion, inequalities and young people's health: a systematic review or research Health promotion, inequalities and young people 10 April 2019 Links Download report (pdf) Health promotion, inequalities and young people's health: a systematic review of research What do we want to know? Health inequalities are recognised as an important problem nationally and internationally. There is policy interest in improving the health of the most disadvantaged, reducing the gap between the most (...) and least disadvantaged, and reducing gradients across the whole population. Health inequalities arise from variations in social, economic and environmental influences along the life course. Health promotion, particularly when it uses social and structural interventions developed by multi-disciplinary teams working with young people, not merely for them, has the potential to reduce health inequalities among young people immediately, and in their later lives. This study describes how much health
Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. Although life expectancy in the European Union (EU) is increasing, whether most of these extra years are spent in good health is unclear. This information would be crucial to both contain health-care costs and increase labour-force participation for older people. We investigated inequalities in life expectancies and healthy life years (HLYs) at 50 years of age (...) years in men and women (p<0.039 for both indicators and sexes); however, in men alone, long-term unemployment was negatively associated (p=0.023) and life-long learning positively associated (p=0.021) with HLYs at 50 years of age.Substantial inequalities in HLYs at 50 years exist within EU countries. Our findings suggest that, without major improvements in population health, the target of increasing participation of older people into the labour force will be difficult to meet in all 25 EU
Best-practice interventions to reduce socioeconomic inequalities of coronary heart disease mortality in UK: a prospective occupational cohort study. How much the successful implementation of the most effective (ie, best-practice) interventions could reduce socioeconomic inequalities of coronary heart disease mortality is not known. We assessed this issue in an occupational cohort study comparing low with high socioeconomic groups.We undertook a prospective cohort study on 17 186 male civil
Effect of exposure to natural environment on health inequalities: an observational population study. Studies have shown that exposure to the natural environment, or so-called green space, has an independent effect on health and health-related behaviours. We postulated that income-related inequality in health would be less pronounced in populations with greater exposure to green space, since access to such areas can modify pathways through which low socioeconomic position can lead to disease.We (...) stratified models to identify the nature of this variation.The association between income deprivation and mortality differed significantly across the groups of exposure to green space for mortality from all causes (p<0.0001) and circulatory disease (p=0.0212), but not from lung cancer or intentional self-harm. Health inequalities related to income deprivation in all-cause mortality and mortality from circulatory diseases were lower in populations living in the greenest areas. The incidence rate ratio
Addressing social determinants of health inequities: what can the state and civil society do? In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provider or guarantor of human rights and essential services (...) and civil society can have important positive roles in addressing health inequity if political will exists.
Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes framework. The quality and outcomes framework is a financial incentive scheme that remunerates general practices in the UK for their performance against a set of quality indicators. Incentive schemes can increase inequalities in the delivery of care if practices in affluent areas are more able to respond to the incentives than (...) are those in deprived areas. We examined the relation between socioeconomic inequalities and delivered quality of clinical care in the first 3 years of this scheme.We analysed data extracted automatically from clinical computing systems for 7637 general practices in England, data from the UK census, and data for characteristics of practices and patients from the 2006 general medical statistics database. Practices were grouped into equal-sized quintiles on the basis of area deprivation in their locality
Socioeconomic inequalities in health in 22 European countries. Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe.We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes (...) , such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes.In almost all countries, the rates of death
The contribution of job characteristics to socioeconomic inequalities in incidence of myocardial infarction The current study estimated the contribution of job characteristics to socioeconomic inequalities in incidence of myocardial infarction (MI) during a 12-year follow-up period. Data were from the working population (aged 25-64 years) in the Netherlands longitudinal GLOBE study (N=5757). Self-reported information was available from baseline measurement (in 1991) for education, occupation
Inequity of access to investigation and effect on clinical outcomes: prognostic study of coronary angiography for suspected stable angina pectoris. To determine whether coronary angiography for suspected stable angina pectoris is underused in older patients, women, south Asian patients, and those from socioeconomically deprived areas, and, if it is, whether this is associated with higher coronary event rates.Multicentre cohort with five year follow-up.Six ambulatory care clinics in England.1375
Inequalities in mortality during and after restructuring of the New Zealand economy: repeated cohort studies. To determine whether disparities between income and mortality changed during a period of major structural and macroeconomic reform and to estimate the changing contribution of different diseases to these disparities.Repeated cohort studies.1981, 1986, 1991, 1996, and 2001 censuses linked to mortality data. Population Total New Zealand population, ages 1-74 years.Mortality rates (...) standardised for age and ethnicity were calculated for each census cohort by level of household income. Standardised rate differences and rate ratios, and slope and relative indices of inequality (SII and RII), were calculated to measure disparities on both absolute and relative scales.All cause mortality rates declined over the 25 year study period in all groups stratified by sex, age, and income, except for 25-44 year olds of both sexes on low incomes among whom there was little change. In all age groups