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Socioeconomic Inequalities (socioeconomic + inequality)
Selected AbstractsIntellectual Disabilities and Socioeconomic Inequalities in Health: An Overview of ResearchJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2005Hilary Graham Background, There is an enduring association between socioeconomic position and health, both over time and across major causes of death. Children and adults with intellectual disabilities are disproportionately represented among the poorer and less healthy sections of the population. But research on health inequalities, and on the broader societal influences on health, has yet to be integrated into perspectives and policy for people with intellectual disabilities. Methods, The paper reviews evidence on the patterns and causes of socioeconomic inequalities in health. Results, It points to evidence that socioeconomic position is the fundamental determinant of health, drawing on longitudinal studies to highlight how it exerts its influence on health from before birth and across the lifecourse. The factors shaping an individual's socioeconomic position are also discussed. Conclusions, The paper concludes by identifying research and policy challenges. [source] Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2010A systematic review Abstract The major increase in the prevalence of diabetes mellitus (DM) has led to the study of social inequalities in health-care. The aim of this study is to establish the possible existence of social inequalities in the prevention, diagnosis, treatment, control and monitoring of diabetes in Organisation for Economic Co-operation and Development (OECD) countries which have universal healthcare systems. We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles published up to 15 December 2007. We included observational studies carried out in OECD countries with universal healthcare systems in place that investigate social inequalities in the provision of health-care to diabetes patients. Two independent reviewers carried out the critical assessment using the STROBE tool items considered most adequate for the evaluation of the methodological quality. We selected 41 articles from which we critically assessed 25 (18 cross-sectional, 6 cohorts, 1 case-control). Consistency among the article results was found regarding the existence of ethnic inequalities in treatment, metabolic control and use of healthcare services. Socioeconomic inequalities were also found in the diagnosis and control of the disease, but no evidence of any gender inequalities was found. In general, the methodological quality of the articles was moderate with insufficient information in the majority of cases to rule out bias. This review shows that even in countries with a significant level of economic development and which have universal healthcare systems in place which endeavour to provide medical care to the entire population, socioeconomic and ethnic inequalities can be identified in the provision of health-care to DM sufferers. However, higher quality and follow-up articles are needed to confirm these results. [source] Environmental justice and Roma communities in Central and Eastern EuropeENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2009Krista Harper Abstract Environmental injustice and the social exclusion of Roma communities in Central and Eastern Europe (CEE) has roots in historical patterns of ethnic exclusion and widening socioeconomic inequalities following the collapse of state socialism and the transition to multi-party parliamentary governments in 1989. In this article, we discuss some of the methodological considerations in environmental justice research, engage theoretical perspectives on environmental inequalities and social exclusion, discuss the dynamics of discrimination and environmental protection regarding the Roma in CEE, and summarize two case studies on environmental justice in Slovakia and Hungary. We argue that, when some landscapes and social groups are perceived as ,beyond the pale' of environmental regulation, public participation and civil rights, it creates local sites for externalizing environmental harms. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment. [source] What difference does the choice of SES make in health inequality measurement?HEALTH ECONOMICS, Issue 10 2003Adam Wagstaff Abstract This note explores the implications for measuring socioeconomic inequality in health of choosing one measure of SES rather than another. Three points emerge. First, whilst similar rankings in the two the SES measures will result in similar inequalities, this is a sufficient condition not a necessary one. What matters is whether rank differences are correlated with health , if they are not, the measured degree of inequality will be the same. Second, the statistical importance of choosing one SES measure rather than another can be assessed simply by estimating an artificial regression. Third, in the 19 countries examined here, it seems for the most part to make little difference to the measured degree of socioeconomic inequalities in malnutrition among under-five children whether one measures SES by consumption or by an asset-based wealth index. Copyright © 2003 John Wiley & Sons, Ltd. [source] Social class is an important and independent prognostic factor of breast cancer mortalityINTERNATIONAL JOURNAL OF CANCER, Issue 5 2006Christine Bouchardy Abstract Reasons of the important impact of socioeconomic status on breast cancer prognosis are far from established. This study aims to evaluate and explain the social disparities in breast cancer survival in the Swiss canton of Geneva, where healthcare costs and life expectancy are among the highest in the world. This population-based study included all 3,920 female residents of Geneva, who were diagnosed with invasive breast cancer before the age of 70 years between 1980 and 2000. Patients were divided into 4 socioeconomic groups, according to the woman's last occupation. We used Cox multivariate regression analysis to identify reasons for the socioeconomic inequalities in breast cancer survival. Compared to patients of high social class, those of low social class had an increased risk (unadjusted hazard ratio [HR] 2.4, 95% CI: 1.6,3.5) of dying as a result of breast cancer. These women were more often foreigners, less frequently had screen-detected cancer and were at more advanced stage at diagnosis. They less frequently underwent breast-conserving surgery, hormonal therapy, and chemotherapy, in particular, in case of axillary lymph node involvement. When adjusting for all these factors, patients of low social class still had a significantly increased risk of dying of breast cancer (HR 1.8, 95% CI: 1.2,2.6). Overmortality linked to low SES is only partly explained by delayed diagnosis, unfavorable tumor characteristics and suboptimal treatments. Other factors, not measured in this study, also could play a role. While waiting for the outcome of other researches, we should consider socioeconomic status as an independent prognostic factor and provide intensified support and surveillance to women of low social class. © 2006 Wiley-Liss, Inc. [source] Regional Inequalities and Civil Conflict in Sub-Saharan Africa,INTERNATIONAL STUDIES QUARTERLY, Issue 2 2009Gudrun ØStby The case study literature is ripe with examples of a positive association between inequality and civil war, but systematic country-level studies have largely failed to find a significant relationship. One reason for this discrepancy may be that large-N studies tend to ignore spatial variations in group welfare within countries, although civil wars often take place within limited areas. We address this gap in the literature by applying GIS operations to Demographic and Health Surveys to construct new disaggregated data on welfare and socioeconomic inequalities between and within subnational regions in 22 countries in Sub-Saharan Africa. These measures are coupled with geographical data on the location of conflict zones for the period 1986,2004. We find that conflict onsets are more likely in regions with (1) low levels of education; (2) strong relative deprivation regarding household assets; (3) strong intraregional inequalities; and (4) combined presence of natural resources and relative deprivation. [source] Intellectual Disabilities and Socioeconomic Inequalities in Health: An Overview of ResearchJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2005Hilary Graham Background, There is an enduring association between socioeconomic position and health, both over time and across major causes of death. Children and adults with intellectual disabilities are disproportionately represented among the poorer and less healthy sections of the population. But research on health inequalities, and on the broader societal influences on health, has yet to be integrated into perspectives and policy for people with intellectual disabilities. Methods, The paper reviews evidence on the patterns and causes of socioeconomic inequalities in health. Results, It points to evidence that socioeconomic position is the fundamental determinant of health, drawing on longitudinal studies to highlight how it exerts its influence on health from before birth and across the lifecourse. The factors shaping an individual's socioeconomic position are also discussed. Conclusions, The paper concludes by identifying research and policy challenges. [source] Oral health-related quality of life in a birth cohort of 32-year oldsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2008Herenia P. Lawrence Abstract,,, Objectives:, To describe oral health-related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well-established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services. Methods:, A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). The questionnaire also collected data on each study member's occupation, self-rated oral health and reasons for seeing a dental care provider. SES was determined from each individual's occupation at age 32 years. Results:, The mean total OHIP-14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems ,fairly often' or ,very often'. When the prevalence of impacts ,fairly/very often' was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and ,episodic' dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts. Conclusions:, OHIP-14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age- and sex-standardized estimates from Australia (18.2%) and the UK (15.9%). [source] What difference does the choice of SES make in health inequality measurement?HEALTH ECONOMICS, Issue 10 2003Adam Wagstaff Abstract This note explores the implications for measuring socioeconomic inequality in health of choosing one measure of SES rather than another. Three points emerge. First, whilst similar rankings in the two the SES measures will result in similar inequalities, this is a sufficient condition not a necessary one. What matters is whether rank differences are correlated with health , if they are not, the measured degree of inequality will be the same. Second, the statistical importance of choosing one SES measure rather than another can be assessed simply by estimating an artificial regression. Third, in the 19 countries examined here, it seems for the most part to make little difference to the measured degree of socioeconomic inequalities in malnutrition among under-five children whether one measures SES by consumption or by an asset-based wealth index. Copyright © 2003 John Wiley & Sons, Ltd. [source] Negotiating Inequality Among Adult Siblings: Two Case StudiesJOURNAL OF MARRIAGE AND FAMILY, Issue 2 2007Ingrid Arnet Connidis Qualitative instrumental case study analysis of adult siblings from 2 families explores how socioeconomic inequality among them affects their relationships to one another. Eight middle-aged siblings' observations of childhood, parental expectations, work and family history, lifestyle, and current sibling ties indicate that childhood interdependence, parallel parental treatment, similar intergenerational mobility, greater success of the younger rather than older siblings, and economic success due to other than individual effort facilitate smoother negotiations of material inequality and enhance the negotiation of sibling relationships as important sources of support. These new insights on negotiating sibling ties over time are related to various forms of capital, a life course perspective, and ambivalence, and point to fresh avenues for future research and theory. [source] Democracy and Social Policy in Brazil: Advancing Basic Needs, Preserving Privileged InterestsLATIN AMERICAN POLITICS AND SOCIETY, Issue 2 2009Wendy Hunter ABSTRACT Has democracy promoted poverty alleviation and equity-enhancing reforms in Brazil, a country of striking inequality and destitution? The effects of an open, competitive political system have not been straightforward. Factors that would seem to work toward this goal include the voting power of poor people, the progressive 1988 Constitution, the activism of social movements, and governance since 1995 by presidents affiliated with center-left and left parties. Yet these factors have been counterbalanced by the strong political influence and lobbying power of organized interests with a stake in preexisting arrangements of social protection and human capital formation. An analysis of four key federal sectors, social security, education, health care, and public assistance, illustrates the challenges for social sector reforms that go beyond raising basic living standards to enhancing socioeconomic inequality. [source] Inequality in Life Spans and a New Perspective on Mortality Convergence Across Industrialized CountriesPOPULATION AND DEVELOPMENT REVIEW, Issue 4 2005Ryan D. Edwards The second half of the twentieth century witnessed substantial convergence in life expectancy around the world. We examine differences in the age pattern of mortality in industrialized countries over time to show that inequality in adult life spans, which we measure with the standard deviation of life table ages at death above age 10 years, S10, is increasingly responsible for the remaining divergence in mortality. We report striking differences in level and trend of S10 across industrialized countries since 1960, which cannot be explained by aggregate socioeconomic inequality or differential external-cause mortality. Rather, S10 reflects both within- and between-group inequalities in life spans and conveys new information about their combined magnitudes and trends. These findings suggest that the challenge for health policies in this century is to reduce inequality, not just lengthen life. [source] Rank and health: a conceptual discussion of subjective health and psychological perceptions of social statusPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2006Pierre Morin Abstract The social dimensions of health and illness have been studied extensively from a materialistic angle. The nonmaterial or subjective factors of social experience affecting health have only recently received some attention. This paper introduces a new multidimensional concept of rank, which includes social dimensions as well as nonmaterially based elements of emotional, psychological, and spiritual strength. It proposes that rank is an important addition to the current literature of socioeconomic inequality and health and examines its relevance for the discussion of how social status inequalities affect people's global health. It suggests that rank as a signifier of power contributes to feelings of powerlessness and leads to worsened health outcomes. This paper suggests that perceived rank may play a role in the socioeconomic status (SES) effect on self-reported health. It presents a new conceptual and therapeutic model to address issues of rank-based discrimination in health care. Copyright © 2006 John Wiley & Sons, Ltd. [source] | |||||||||||||