GROUP INEQUALITY.

PubMed

Bowles, Samuel; Loury, Glenn C; Sethi, Rajiv

2014-02-01

We explore the combined effect of segregation in social networks, peer effects, and the relative size of a historically disadvantaged group on the incentives to invest in market-rewarded skills and the dynamics of inequality between social groups. We identify conditions under which group inequality will persist in the absence of differences in ability, credit constraints, or labor market discrimination. Under these conditions, group inequality may be amplified even if initial group differences are negligible. Increases in social integration may destabilize an unequal state and make group equality possible, but the distributional and human capital effects of this depend on the demographic composition of the population. When the size of the initially disadvantaged group is sufficiently small, integration can lower the long-run costs of human capital investment in both groups and result in an increase the aggregate skill share. In contrast, when the initially disadvantaged group is large, integration can induce a fall in the aggregate skill share as the costs of human capital investment rise in both groups. We consider applications to concrete cases and policy implications.

A comparative study of perceptions on tobacco in vulnerable populations between India and France.

PubMed

Stoebner-Delbarre, Anne; Aghi, Mira B

2013-12-01

Perceptions of tobacco are a relatively unexplored issue in disadvantaged populations in India and France. The objectives of this study included the following: obtain qualitative information on representations of tobacco use and cessation within two vulnerable populations; identify cultural factors that influence tobacco use and cessation; and acquire information for the development of effective tobacco cessation strategies. A total of 21 focus groups were conducted in India and France. All study participants were disadvantaged adults 18 years old or older. Sixty women resided in South Delhi in India and 163 adults with disabilities resided in the south of France. They were all current tobacco users. Data were collected by focus group and analysed with thematic coding. In both samples, the most relevant reasons of tobacco use were daily life circumstances, which were also a major barrier to quitting. None of the participants reported that quitting difficulties could be due to dependence or nicotine addiction. The data also suggested that whilst some participants wanted to stop, they also anticipated quitting would be extremely challenging. In addition, there were a number of cross-cultural differences between Indian and French disadvantaged people: level of information concerning the health risk related to tobacco use and level of demand for support to quit from health professionals were most often cited. Recommendations are made for a specific approach among disadvantaged people. The paper concludes that in order to facilitate cessation, tobacco control interventions need to focus on coping strategies to deal with feelings of distress, withdrawal symptoms, and the circumstances of everyday life experienced by disadvantaged tobacco users.

Comparing Peer-to-Peer and Individual Learning: Teaching Basic Computer Skills to Disadvantaged Adults

ERIC Educational Resources Information Center

Kelly, Patrick; Katz, Larry

2016-01-01

Peer-to-peer (P2P) learning within two distinct groups of disadvantaged adults was studied during a two-hour computer skills workshop. Of interest was whether or not P2P learning with this population was a viable method for increasing performance and confidence. Two qualified instructors at two locations taught the same introductory…

Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus

PubMed Central

Pottie, Kevin; Hui, Charles; Rahman, Prinon; Ingleby, David; Akl, Elie A.; Russell, Grant; Ling, Li; Wickramage, Kolitha; Mosca, Davide; Brindis, Claire D.

2017-01-01

Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration. Materials and Methods: An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions. Results: Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports. Discussion: Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services. PMID:28165380

Ethics and equity in research priority-setting: stakeholder engagement and the needs of disadvantaged groups.

PubMed

Bhaumik, Soumyadeep; Rana, Sangeeta; Karimkhani, Chante; Welch, Vivian; Armstrong, Rebecca; Pottie, Kevin; Dellavalle, Robert; Dhakal, Purushottam; Oliver, Sandy; Francis, Damian K; Nasser, Mona; Crowe, Sally; Aksut, Baran; Amico, Roberto D

2015-01-01

A transparent and evidence-based priority-setting process promotes the optimal use of resources to improve health outcomes. Decision-makers and funders have begun to increasingly engage representatives of patients and healthcare consumers to ensure that research becomes more relevant. However, disadvantaged groups and their needs may not be integrated into the priority-setting process since they do not have a "political voice" or are unable to organise into interest groups. Equitable priority-setting methods need to balance patient needs, values, experiences with population-level issues and issues related to the health system.

Australian population trends and disparities in cholinesterase inhibitor use, 2003 to 2010.

PubMed

Zilkens, Renate R; Duke, Janine; Horner, Barbara; Semmens, James B; Bruce, David G

2014-05-01

The Australian Pharmaceutical Benefits Scheme (PBS) first subsidized cholinesterase inhibitors (CEIs) for Alzheimer's disease in 2001, introducing a novel therapy for a previously untreatable common condition. This study aims to determine Australian rates of CEI use and to assess equality of access to treatment based on socioeconomic status and geographic remoteness. Pharmaceutical claims records were used to identify all Australians prescribed CEIs between January 2003 and December 2010. Age-standardized and sex-adjusted index prescription rates were derived using the total Australian population as the denominator to examine temporal trends and the impacts of socioeconomic and geographic disadvantage on CEI index prescription rates. Index prescription rates peaked in 2004 at 92.5 per 100,000 person-years, declining to between 70.2 and 73.5 for years 2006 to 2010. Rates were highest in the 85- to 89-year age group and 2.6-fold higher in the least socioeconomic disadvantaged population when compared with the most disadvantaged population. In major cities in Australia, index prescription rates were 1.4 to 1.7 times greater compared with remote areas. Increasing geographic remoteness and socioeconomic disadvantage are associated with lower CEI index prescription rates, indicating inequities in the management of Alzheimer's disease in Australia. Copyright © 2014 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Hispanic Older Adult Health & Longevity in the United States: Current Patterns & Concerns for the Future.

PubMed

Hummer, Robert A; Hayward, Mark D

2015-01-01

The Hispanic population aged sixty-five and over - the most socioeconomically disadvantaged subset of America's elderly - is projected to quintuple between 2012 and 2050. While current longevity patterns for Hispanics relative to whites are favorable, old-age functioning and disability patterns for Hispanics are unfavorable and have serious implications for caregivers; families; and local, state, and federal governments. Troubling signs for the future Hispanic population (which are shared to varying degrees with other vulnerable groups) include the unresolved legal status of unauthorized immigrants, continued low levels of insurance coverage even after health care reform, some unfavorable trends in health behaviors, and continued disadvantages in educational attainment and income relative to whites. We urge policy-makers to deal with these potentially problematic health and well-being issues. Not doing so could have detrimental consequences for the future of the Hispanic population as well as other at-risk groups and, by extension, the U.S. elderly population as a whole.

Conducting Intervention Research among Underserved Populations: Lessons Learned and Recommendations for Researchers

PubMed Central

Pyatak, Elizabeth A.; Blanche, Erna I.; Garber, Susan L.; Diaz, Jesus; Blanchard, Jeanine; Florindez, Lucia; Clark, Florence A.

2013-01-01

Randomized controlled trials (RCTs) are considered the gold standard in research design for establishing treatment efficacy. However, the rigorous and highly controlled conditions of RCTs can be difficult to attain when conducting research among individuals living with a confluence of disability, low socioeconomic status, and being a member of a racial/ethnic minority group, who may be more likely to have unstable life circumstances. Research on effective interventions for these groups is urgently needed, as evidence regarding approaches to reduce health disparities and improve health outcomes is lacking. In this methodological paper we discuss the challenges and lessons learned in implementing the Lifestyle Redesign® for Pressure Ulcer Prevention in Spinal Cord Injury (LR-PUPS) study among a highly disadvantaged population. These issues are discussed in terms of strategies to enhance recruitment, retention, and intervention relevance to the target population. Recommendations for researchers seeking to conduct RCTs among socioeconomically disadvantaged, ethnically diverse populations are provided. PMID:23262157

Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study.

PubMed

Morgan, C; Kirkbride, J; Hutchinson, G; Craig, T; Morgan, K; Dazzan, P; Boydell, J; Doody, G A; Jones, P B; Murray, R M; Leff, J; Fearon, P

2008-12-01

Numerous studies have reported high rates of psychosis in the Black Caribbean population in the UK. Recent speculation about the reasons for these high rates has focused on social factors. However, there have been few empirical studies. We sought to compare the prevalence of specific indicators of social disadvantage and isolation, and variations by ethnicity, in subjects with a first episode of psychosis and a series of healthy controls. All cases with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK and a series of community controls were recruited over a 3-year period. Data relating to clinical and social variables were collected from cases and controls. On all indicators, cases were more socially disadvantaged and isolated than controls, after controlling for potential confounders. These associations held when the sample was restricted to those with an affective diagnosis and to those with a short prodrome and short duration of untreated psychosis. There was a clear linear relationship between concentrated disadvantage and odds of psychosis. Similar patterns were evident in the two main ethnic groups, White British and Black Caribbean. However, indicators of social disadvantage and isolation were more common in Black Caribbean subjects than White British subjects. We found strong associations between indicators of disadvantage and psychosis. If these variables index exposure to factors that increase risk of psychosis, their greater prevalence in the Black Caribbean population may contribute to the reported high rates of psychosis in this population.

Socioeconomic, remoteness and sex differences in life expectancy in New South Wales, Australia, 2001-2012: a population-based study.

PubMed

Stephens, Alexandre S; Gupta, Leena; Thackway, Sarah; Broome, Richard A

2017-01-10

Despite being one of the healthiest countries in the world, Australia displays substantial mortality differentials by socioeconomic disadvantage, remoteness and sex. In this study, we examined how these mortality differentials translated to differences in life expectancy between 2001 and 2012. Population-based study using mortality and estimated residential population data from Australia's largest state, New South Wales (NSW), between 2001 and 2012. Age-group-specific death rates by socioeconomic disadvantage quintile, remoteness (major cities vs regional and remote areas), sex and year were estimated via Poisson regression, and inputted into life table calculations to estimate life expectancy. Life expectancy decreased with increasing socioeconomic disadvantage in males and females. The disparity between the most and least socioeconomically deprived quintiles was 3.77 years in males and 2.39 years in females in 2012. Differences in life expectancy by socioeconomic disadvantage were mostly stable over time. Gender gaps in life expectancy ranged from 3.50 to 4.93 years (in 2012), increased with increasing socioeconomic disadvantage and decreased by ∼1 year for all quintiles between 2001 and 2012. Overall, life expectancy varied little by remoteness, but was 1.8 years higher in major cities compared to regional/remote areas in the most socioeconomically deprived regions in 2012. Socioeconomic disadvantage and sex were strongly associated with life expectancy. The disparity in life expectancy across the socioeconomic spectrum was larger in males and was stable over time. In contrast, gender gaps reduced for all quintiles between 2001 and 2012, and a remoteness effect was evident in 2012, but only for those living in the most deprived areas. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Group Cognitive Behavior Therapy Program with Troubled Adolescents: A Learning Experience

ERIC Educational Resources Information Center

Edelman, Sarah; Clin, Louise Remond M.

2005-01-01

Group CBT programs are widely used for assisting teenagers with anxiety, depression and other psychological problems. The majority of reported programs have targeted school or clinical populations however few have specifically targeted adolescents from highly troubled and disadvantaged backgrounds. This paper describes a group CBT program that was…

Kidney Disease in Disadvantaged Populations

PubMed Central

Martins, David; Agodoa, Lawrence; Norris, Keith

2012-01-01

Disadvantaged populations across the globe exhibit a disproportionate burden of chronic kidney disease (CKD) because of differences in CKD occurrence and outcomes. Although many CKD risk factors can be managed and modified to optimize clinical outcomes, the prevailing socioeconomic and cultural factors in disadvantaged populations, more often than not, militate against optimum clinical outcomes. In addition, disadvantaged populations exhibit a broader spectrum of CKD risk factors and may be genetically predisposed to an earlier onset and a more rapid progression of chronic kidney disease. A basic understanding of the vulnerabilities of the disadvantaged populations will facilitate the adaptation and adoption of the kidney disease treatment and prevention guidelines for these vulnerable populations. The purpose of this paper is to examine recent discoveries and data on CKD occurrence and outcomes in disadvantaged populations and explore strategies for the prevention and treatment of CKD in these populations based on the established guidelines. PMID:22567281

Pursuing equity: contact with primary care and specialist clinicians by demographics, insurance, and health status.

PubMed

Ferrer, Robert L

2007-01-01

Long-term shifts in specialty choice and health workforce policy have raised concern about the future of primary care in the United States. The objective of this study was to examine current use of primary and specialty care across the US population for policy-relevant subgroups, such as disadvantaged populations and persons with chronic illness. Data from the Medical Expenditure Panel Survey from 2004 were analyzed using a probability sample patients or other participants from the noninstitutionalized US population in 2004 (N = 34,403). The main and secondary outcome measures were the estimates of the proportion of Americans who accessed different types of primary care and specialty physicians and midlevel practitioners, as well as the fraction of ambulatory visits accounted for by the different clinician types. Data were disaggregated by income, health insurance status, race/ethnicity, rural or urban residence, and presence of 5 common chronic diseases. Family physicians were the most common clinician type accessed by adults, seniors, and reproductive-age women, and they were second to pediatricians for children. Disadvantaged adults with 3 markers of disadvantage (poverty, disadvantaged minority, uninsured) received 45.6% (95% CI, 40.4%-50.7%) of their ambulatory visits from family physicians vs 30.5% (95% CI, 30.0%-32.1%) for adults with no markers. For children with 3 vs 0 markers of disadvantage, the proportion of visits from family physicians roughly doubled from 16.5% (95% CI, 14.4%-18.6%) to 30.1% (95% CI, 18.8%-41.2%). Family physicians constitute the only clinician group that does not show income disparities in access. Multivariate analyses show that patterns of access to family physicians and nurse-practitioners are more equitable than for other clinician types. Primary care clinicians, especially family physicians, deliver a disproportionate share of ambulatory care to disadvantaged populations. A diminished primary care workforce will leave considerable gaps in US health care equity. Health care workforce policy should reflect this important population-level function of primary care.

Vulnerable populations in healthcare.

PubMed

Waisel, David B

2013-04-01

This review is designed to update readers on recent discussions and research regarding vulnerable populations in medicine, including patients who are socioeconomically disadvantaged, queer, in prison or labeled with a stigmatizing complex medical disease. Recent studies have more closely examined the effects of being part of a vulnerable population. Greater societal income inequality impacts those at the lower end of the income curve by increasing mortality and heightening the importance of individual personal situations. Recommendations from an extensive WHO report on the social determinants of health may affect social policy and use of public resources in Europe. Clinicians are undereducated about the lives and concerns of vulnerable populations, including LGBTQI persons, immigrants, physicians, prisoners, and families of patients with diseases considered 'incompatible with life'. Greater understanding of the cause of the health effects of being socioeconomically disadvantaged or being a member of a vulnerable population may be the first steps toward specific policy recommendations. Professional medical organizations and advocacy groups should raise awareness, provide education, publish guidelines and define the goals for the medical care for certain vulnerable populations.Vulnerable populations are at risk for disparate healthcare access and outcomes because of economic, cultural, ethnic or health characteristics. Vulnerable populations include patients who are racial or ethnic minorities, children, elderly, socioeconomically disadvantaged, underinsured or those with certain medical conditions. Members of vulnerable populations often have health conditions that are exacerbated by unnecessarily inadequate healthcare.

Disadvantaged youth and smoking in mature tobacco control contexts: a systematic review and synthesis of qualitative research.

PubMed

Hefler, Marita; Chapman, Simon

2015-09-01

To review qualitative research and synthesise findings about socioeconomically disadvantaged and socially marginalised adolescents and young adults in mature tobacco control contexts. Searches of PubMed and MEDLINE, additional purposive searches in Google Scholar, PsycINFO, grey literature, specialist journals and reference lists for English language articles published after 2000. Search terms were qualitative, youth or adolescent or young adult, smoking/tobacco and vulnerable populations or disadvantage or socioeconomic inequality. The most recent update of the search was undertaken in January 2014. Twenty articles, reporting on 17 studies, from 902 initial records were included. Inclusion criteria were: qualitative study undertaken in a country in the final stage of the tobacco epidemic and with comprehensive tobacco control measures in place, participants were youth who were socioeconomically disadvantaged or members of an identified subgroup with higher smoking prevalence and/or resided in a geographical area of low socioeconomic status. The target age range was 10-24. Data were independently extracted by one author, summarised and reviewed, compared and re-reviewed at multiple time points. The majority of studies were from the UK, with the remainder from the USA, Australia and New Zealand. The review used a thematic analysis approach, and started with an open question: 'what does qualitative research tell us about disadvantaged young people and smoking?' The synthesis provides insights into the social context of smoking for marginalised and disadvantaged young people, group affiliation and identity, the role of smoking in social capital and sources of cigarettes. Surprisingly few qualitative studies focused exclusively on smoking and disadvantaged young people were found. Future qualitative studies on the intersection between specific psychosocial characteristics associated with disadvantage and increased smoking risk would be of use to inform approaches to reduce socioeconomic differentials in smoking prevalence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Neighbourhood Socio Economic Disadvantage Index’s Analysis of the Flood Disasters Area at East Jakarta in 1996 and 2016

NASA Astrophysics Data System (ADS)

Ranti Ristiani, Christina; Rokhmatuloh; Hernina, Revi

2017-12-01

Flood is one of natural disasters that have often happened in East Jakarta. Flood can give several negative impacts and it can affect all aspects of society lives such as economics, political, cultural, socials and others. East Jakarta is an urban area which continuously grows and establishes to become a rapid area. It can be seen from the highest population density in East Jakarta (BPS, 2016) and categorized into a region prone to flooding based on data Prone Flood Map in 1996 and 2016. The higher population exists in East Jakarta, the bigger possibility of the negative effects of disaster it gets. The negative impacts of flood disaster can affect societies especially with socio-economic disadvantage. One of the index to measure socio-economic disadvantage is NSDI (Neighbourhood socio-economic disadvantage index). However, to adjust indicators used in NSDI with Indonesia statistical data compatibility, it needs further assessment and evaluation. Therefore, this paper evaluates previous main indicators used in previous NSDI studies and improves with indicators which more suitable with statistical records in Indonesia. As a result, there will be improved 19 indicators to be used in NSDI, but the groups of indicators remain the same as previous namely; income, education, occupation, housing, and population.

Guidelines for Preparing Economic Analysis (2000)

EPA Pesticide Factsheets

The Guidelines provide guidance on analyzing the economic impacts of regulations and policies, and assessing the distribution of costs and benefits among various segments of the population, with a particular focus on disadvantaged and vulnerable groups.

Neighbourhood disadvantage, geographic remoteness and body mass index among immigrants to Australia: A national cohort study 2006-2014.

PubMed

Menigoz, Karen; Nathan, Andrea; Heesch, Kristiann C; Turrell, Gavin

2018-01-01

Obesity is socioeconomically, geographically and ethnically patterned. Understanding these elements of disadvantage is vital in understanding population obesity trends and the development of effective and equitable interventions. This study examined the relationship between neighbourhood socioeconomic disadvantage and geographic remoteness with prospective trends in mean body mass index (BMI) among immigrants to Australia. Longitudinal data (2006-2014) from a national panel survey of Australian adults was divided into an immigrant-only sample (n = 4,293, 52.6% women and 19,404 person-year observations). The data were analysed using multi-level random effects linear regression modelling that controlled for individual socioeconomic and demographic factors. Male immigrants living in the most disadvantaged neighbourhoods had significantly higher mean BMI compared with those living in the least disadvantaged. Over time, mean BMI increased for all groups except for men living in the least disadvantaged neighbourhoods, for whom mean BMI remained almost static (0.1 kg/m2 increase from 2006 to 2014), effectively widening neighbourhood inequalities. Among women, mean BMI was also significantly higher in the most compared with the least, disadvantaged neighbourhoods (β = 2.08 kg/m2; 95%CI: 1.48, 2.68). Neighbourhood inequalities were maintained over time as mean BMI increased for all groups at a similar rate. Male and female immigrants residing in outer regional areas had significantly higher mean BMI compared with those living in major cities; however, differences were attenuated and no longer significant following adjustment for ethnicity, individual socioeconomic position and neighbourhood disadvantage. Over time, mean BMI increased in all male and female groups with no differences based on geographic remoteness. Obesity prevention policy targeted at immigrant cohorts needs to include area-level interventions that address inequalities in BMI arising from neighbourhood disadvantage, and be inclusive of immigrants living outside Australia's major cities.

Too poor to say no? Health incentives for disadvantaged populations.

PubMed

Voigt, Kristin

2017-03-01

Incentive schemes, which offer recipients benefits if they meet particular requirements, are being used across the world to encourage healthier behaviours. From the perspective of equality, an important concern about such schemes is that since people often do not have equal opportunity to fulfil the stipulated conditions, incentives create opportunity for further unfair advantage. Are incentive schemes that are available only to disadvantaged groups less susceptible to such egalitarian concerns? While targeted schemes may at first glance seem well placed to help improve outcomes among disadvantaged groups and thus reduce inequalities, I argue in this paper that they are susceptible to significant problems. At the same time, incentive schemes may be less problematic when they operate in ways that differ from the 'standard' incentive mechanism; I discuss three such mechanisms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States

PubMed Central

BRESLAU, JOSHUA; KENDLER, KENNETH S.; SU, MAXWELL; GAXIOLA-AGUILAR, SERGIO; KESSLER, RONALD C.

2009-01-01

Background Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Method Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Results Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Conclusions Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups. PMID:15841868

Socioeconomic disadvantage and its implications for population health planning of obesity and overweight, using cross-sectional data from general practices from a regional catchment in Australia.

PubMed

Ghosh, Abhijeet; Charlton, Karen E; Batterham, Marijka J

2016-05-03

To identify smaller geographic and region-specific evidence to inform population health planning for overweight and obesity. Cross-sectional secondary analysis of data. Primary healthcare-17 general practices located in the Illawarra-Shoalhaven region of New South Wales (NSW). A subset (n=36 674) of the Sentinel Practices Data Sourcing project adult persons data set (n=118 794) that included information on disease status of all adult patients who had height and weight measurements recorded in their electronic health records and had visited the included general practices within the Illawarra-Shoalhaven region of NSW between September 2011 and September 2013. Age-adjusted odds ratio (aOR) of overweight and obesity was determined for high and low levels of socioeconomic disadvantage based on Socio-Economic Indexes for Areas (SEIFA)-Index of Relative Socio-Economic Disadvantage (IRSD) scores of patients' residential statistical local area. In men, overweight was lowest in areas of highest socioeconomic disadvantage (aOR=0.910; 95% CI 0.830 to 0.998; p<0.001); but no statistically significant association with socioeconomic score was found for women. Overall obesity was associated with high socioeconomic disadvantage (aOR=1.292; 95% CI 1.210 to 1.379; p<0.001). This type of data analysis reveals multiple layers of evidence that should be assessed for population health approaches to curb the epidemic of obesity and overweight. It strongly highlights the need for preventive health initiatives to be specific to gender and socioeconomic attributes of the target population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

California's digital divide: clinical information systems for the haves and have-nots.

PubMed

Miller, Robert H; D'Amato, Katherine; Oliva, Nancy; West, Christopher E; Adelson, Joel W

2009-01-01

Strong barriers prevent the financing of clinical information systems (CIS) in health care delivery system organizations in market segments serving disadvantaged patients. These segments include community health centers, public hospitals, unaffiliated rural hospitals, and some Medicaid-oriented solo and small-group medical practices. Policy interventions such as loans, grants, pay-for-performance and other reimbursement changes, and support services assistance will help lower these barriers. Without intervention, progress will be slow and worsen health care disparities between the advantaged and disadvantaged populations.

Almajiri education: Policy and practice to meet the learning needs of the nomadic population in Nigeria

NASA Astrophysics Data System (ADS)

Olaniran, Sunday Olawale

2018-02-01

This article explores the provision of education opportunities to a disadvantaged group in Nigeria known as Almajiris. The word Almajiri derives from the Arabic word Almuhajirun, meaning emigrant. The nomadic pastoralists of northern Nigeria constitute a major socio-economic group. According to a recent report released by the Food and Agricultural Organization (FAO), Almajiris own more than 90 per cent of Nigeria's estimated 15.3 million heads of cattle. Beef from their herds constitutes over 45 per cent of the animal protein consumed by Nigerians. However, despite the Almajiris' immense contributions to the economy of Nigeria, these nomads are highly disadvantaged in terms of access to education. To respond to the educational needs of this group, the Nigerian government established the National Commission for Nomadic Education (NCNE) in 1989 to coordinate programmes aimed at improving the lives and livelihood of the Almajiris. This article examines the strategies employed by the NCNE towards making education accessible to nomads. It also highlights some of the challenges facing the Almajiris, and suggests remedies to prioritise education for this and other disadvantaged groups.

The Methodological Quality and Effectiveness of Technology-Based Smoking Cessation Interventions for Disadvantaged Groups: A Systematic Review and Meta-analysis.

PubMed

Boland, Veronica C; Stockings, Emily A; Mattick, Richard P; McRobbie, Hayden; Brown, Jamie; Courtney, Ryan J

2018-02-07

To assess the methodological quality and effectiveness of technology-based smoking cessation interventions in disadvantaged groups. Four databases (EMBASE, Cochrane, Medline, and PsycInfo) were searched for studies conducted from 1980 to May 2016. Randomized controlled trials that compared a behavioral smoking cessation intervention delivered primarily through a technology-based platform (eg, mobile phone) with a no-intervention comparison group among disadvantaged smokers were included. Three reviewers assessed all relevant studies for inclusion, and one reviewer extracted study, participant and intervention-level data, with a subset crosschecked by a second reviewer. Thirteen studies targeting disadvantaged smokers (n =4820) were included. Only one study scored highly in terms of methodological rigor on EPOC criteria for judging risk of bias. Of the 13 studies using a technology-based platform, most utilized websites (n = 5) or computer programs (n = 5), and seven additionally offered nicotine replacement therapy. Technology-based interventions increased the odds of smoking cessation for disadvantaged groups at 1 month (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.10, 2.63), 3 months (OR 1.30, 95% CI 1.07, 1.59), 6 months (OR 1.29, 95% CI 1.03, 1.62), and 18 months post-intervention (OR 1.83, 95% CI 1.11, 3.01). Few methodologically rigorous studies were identified. Mobile phone text-messaging, computer- and website-delivered quit support showed promise at increasing quit rates among Indigenous, psychiatric and inpatient substance use disorder patients. Further research is needed to address the role technology-based interventions have on overcoming health inequalities to meet the needs of disadvantaged groups. This review provides the first quantitative evidence of the effectiveness of a range of technology-based smoking cessation interventions among disadvantaged smokers, with separate estimates on the basis of intervention type, and cessation outcome measure. Providing cost-effective, easily accessible and real-time smoking cessation treatment is needed, and innovative technology-based platforms will help reach this endpoint. These interventions need to be tested in larger scale randomized controlled trial designs and target broader disadvantaged groups. Data collection beyond 6 months is also needed in order to establish the efficacy of these intervention approaches on long-term cessation rates among disadvantaged population groups. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

"Almajiri" Education: Policy and Practice to Meet the Learning Needs of the Nomadic Population in Nigeria

ERIC Educational Resources Information Center

Olaniran, Sunday Olawale

2018-01-01

This article explores the provision of education opportunities to a disadvantaged group in Nigeria known as "Almajiris." The word "Almajiri" derives from the Arabic word "Almuhajirun," meaning emigrant. The nomadic pastoralists of northern Nigeria constitute a major socio-economic group. According to a recent report…

Effect of diabetes on periodontal status of a population with poor oral health.

PubMed

Tanwir, Farzeen; Altamash, Mohammad; Gustafsson, Anders

2009-01-01

Diabetes is a global health problem and its prevalence is increasing worldwide. The objective of the study was to investigate the effect of diabetes on the periodontal status of a Pakistani population with poor oral hygiene. Eighty-eight individuals with diabetes and 80 non-diabetic individuals were recruited from a disadvantaged district in Karachi, Pakistan. The group with diabetes comprised 50 males and 38 females, and the non-diabetic group 43 males and 37 females. All underwent clinical and radiographic examination. The average numbers of teeth in the diabetes and non-diabetes groups were 24 and 26, respectively. The odds ratio (OR) for missing or fewer teeth was 2.3 times higher for diabetics than for non-diabetics (CI 1.32-4.14; p<0.001). Diabetic patients had more sites with plaque than did non-diabetics (OR 1.96, CI 0.99-3.88; p<0.056). Moderate to severe periodontitis was significantly more prevalent among diabetic patients (p<0.01). In this disadvantaged population with poor oral hygiene, diabetes has had a strongly negative influence on oral health: diabetic patients have fewer teeth, more plaque, and a higher prevalence of moderate to severe periodontal disease than non-diabetics.

Knowledge, group-based medical mistrust, future expectations, and perceived disadvantages of medical genetic testing: perspectives of Black African immigrants/refugees.

PubMed

Buseh, A; Kelber, S; Millon-Underwood, S; Stevens, P; Townsend, L

2014-01-01

Reasons for low participation of ethnic minorities in genetic studies are multifactorial and often poorly understood. Based on published literature, participation in genetic testing is low among Black African immigrants/refugees although they are purported to bear disproportionate disease burden. Thus, research involving Black African immigrant/refugee populations that examine their perspectives on participating in genetic studies is needed. This report examines and describes the knowledge of medical genetics, group-based medical mistrust, and future expectations of genetic research and the influence of these measures on the perceived disadvantages of genetic testing among Black African immigrants/refugees. Using a cross-sectional survey design, a nonprobability sample (n = 212) of Black African immigrants/refugees was administered a questionnaire. Participants ranged in age from 18 to 61 years (mean = 38.91, SD = 9.78). The questionnaire consisted of 5 instruments: (a) sociodemographic characteristics, (b) Knowledge of Medical Genetics scale, (c) Group-Based Medical Mistrust Scale, (d) Future Expectations/Anticipated Consequences of Genetics Research scale, and (e) Perceived Disadvantages of Genetic Testing scale. Participants were concerned that genetic research may result in scientists 'playing God,' interfering with the natural order of life. In multivariate analyses, the perceived disadvantages of genetic testing increased as medical mistrust and anticipated negative impacts of genetic testing increased. Increase in genetic knowledge contributed to a decrease in perceived disadvantages. Our findings suggest that recruitment of Black African immigrants/refugees in genetic studies should address potential low knowledge of genetics, concerns about medical mistrust, the expectations/anticipated consequences of genetic research, and the perceived disadvantages of genetic testing.

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output.

PubMed

Courtney, Ryan J; Naicker, Sundresan; Shakeshaft, Anthony; Clare, Philip; Martire, Kristy A; Mattick, Richard P

2015-06-08

Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. A systematic database search was conducted for two time periods: 2000-2004 (TP1) and 2008-2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ²=73.13, p<0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1=23% vs. TP2=33%) or intervention (TP1=77% vs. TP2=67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1=12% vs. TP2=36%). The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy.

Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population.

PubMed

Masi, Christopher M; Hawkley, Louise C; Piotrowski, Z Harry; Pickett, Kate E

2007-12-01

Prior research has established associations between pregnancy outcomes and specific neighborhood characteristics, including economic disadvantage, violent crime, and racial/ethnic segregation. Recently, associations have also been found between various health outcomes and group density, the degree to which an individual is a racial or ethnic majority in his or her local community. The objective of this study was to determine the extent to which census tract economic disadvantage, violent crime rate, and group density are associated with pregnancy outcomes among White, Black, and Hispanic infants in a large metropolitan setting. This cross-sectional study utilized 1990 census data, 1991 crime data, and 1991 birth certificate information for singleton live births in Chicago, Illinois. Results show substantial racial segregation in Chicago, with 35% of census tracts having more than 90% Black residents and 45% of census tracts having fewer than 10% Black residents. After stratifying by maternal race/ethnicity, we used multilevel analyses to model pregnancy outcomes as a function of individual and census tract characteristics. Among all racial/ethnic groups, violent crime rate accounted for most of the negative association between tract economic disadvantage and birth weight. Group density was also associated with birth weight but this association was stronger among Whites and Hispanics than among Blacks. Further analysis revealed that group density was more strongly associated with preterm birth while violent crime rate was more strongly associated with small for gestational age. These results suggest that group density and violent crime may impact birth weight via different mechanisms.

Advancing Community–Based Research with Urban American Indian Populations: Multidisciplinary Perspectives

PubMed Central

Hartmann, William E.; Wendt, Dennis C.; Saftner, Melissa A.; Marcus, John; Momper, Sandra L.

2014-01-01

The U.S. has witnessed significant growth among urban AI populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations. PMID:24659391

Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial.

PubMed

Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

2016-05-01

Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. NCT01123967. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The ethics and regulatory landscape of including vulnerable populations in pragmatic clinical trials

PubMed Central

Welch, Mary Jane; Lally, Rachel; Miller, Jennifer E; Pittman, Stephanie; Brodsky, Lynda; Caplan, Arthur L; Uhlenbrauck, Gina; Louzao, Darcy M; Fischer, James H; Wilfond, Benjamin

2015-01-01

Policies have been developed to protect vulnerable populations in clinical research, particularly the US federal research regulations (45 CFR 46 subparts B, C, and D). These policies generally recognize vulnerable populations to include pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. The aim has been to protect these populations from harm, often by creating regulatory and ethical checks that may limit their participation in many clinical trials. The recent increase in pragmatic clinical trials (PCTs) raises at least two questions about this approach. First, is exclusion itself a harm to vulnerable populations, as these groups may be denied access to understanding how health interventions work for them in clinical settings? Second, are groups considered vulnerable in traditional clinical trials also vulnerable in PCTs? We argue first, that excluding vulnerable subjects from participation in PCTs can be harmful by preventing acquisition of data to meaningfully inform clinical decision-making in the future. Second, we argue that protections for vulnerable subjects in traditional clinical trial settings may not be translatable, feasible, or even ethical to apply in PCTs. We conclude by offering specific recommendations for appropriately protecting vulnerable research subjects in PCTs, focusing on pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. PMID:26374681

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland.

PubMed

Milcarz, Katarzyna; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-04-21

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence ( p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.

Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland

PubMed Central

Milcarz, Katarzyna; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-01-01

This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the “Reducing Social Inequalities in Health” program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes—a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS. PMID:28430128

Socioeconomic disadvantage and kidney disease in the United States, Australia, and Thailand.

PubMed

White, Sarah L; McGeechan, Kevin; Jones, Michael; Cass, Alan; Chadban, Steven J; Polkinghorne, Kevan R; Perkovic, Vlado; Roderick, Paul J

2008-07-01

We sought to determine whether an elevated burden of chronic kidney disease is found among disadvantaged groups living in the United States, Australia, and Thailand. We used data on participants 35 years or older for whom a valid serum creatinine measurement was available from studies in the United States, Thailand, and Australia. We used logistic regression to analyze the association of income, education, and employment with the prevalence of chronic kidney disease (estimated glomerular filtration rate<60 mL/min/1.73 m(2)). Age- and gender-adjusted odds of having chronic kidney disease were increased 86% for US Whites in the lowest income quartile versus the highest quartile (odds ratio [OR] = 1.86; 95% confidence interval [CI] = 1.27, 2.72). Odds were increased 2 times and 6 times, respectively, among unemployed (not retired) versus employed non-Hispanic Black and Mexican American participants (OR=2.89; 95% CI=1.53, 5.46; OR=6.62; 95% CI=1.94, 22.64. respectively). Similar associations were not evident for the Australian or Thai populations. Higher kidney disease prevalence among financially disadvantaged groups in the United States should be considered when chronic kidney disease prevention and management strategies are created. This approach is less likely to be of benefit to the Australian and Thai populations.

Do we have a moral responsibility to compensate for vulnerable groups? A discussion on the right to health for LGBT people.

PubMed

Ekmekci, Perihan Elif

2017-09-01

Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group. Rawls' theory of justice and Norman Daniels' normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels' normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society's duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels' flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence.

Media campaigns to promote smoking cessation among socioeconomically disadvantaged populations: what do we know, what do we need to learn, and what should we do now?

PubMed

Niederdeppe, Jeff; Kuang, Xiaodong; Crock, Brittney; Skelton, Ashley

2008-11-01

Little is known about whether media campaigns are effective strategies to promote smoking cessation among socioeconomically disadvantaged populations or whether media campaigns may unintentionally maintain or widen disparities in smoking cessation by socioeconomic status (SES). This paper presents a systematic review of the literature on the effectiveness of media campaigns to promote smoking cessation among low SES populations in the USA and countries with comparable political systems and demographic profiles such as Canada, Australia and Western European nations. We reviewed 29 articles, summarizing results from 18 studies, which made explicit statistical comparisons of media campaign effectiveness by SES, and 21 articles, summarizing results from 13 studies, which assessed the effectiveness of media campaigns targeted specifically to low SES populations. We find that there is considerable evidence that media campaigns to promote smoking cessation are often less effective, sometimes equally effective, and rarely more effective among socioeconomically disadvantaged populations relative to more advantaged populations. Disparities in the effectiveness of media campaigns between SES groups may occur at any of three stages: differences in meaningful exposure, differences in motivational response, or differences in opportunity to sustain long-term cessation. There remains a need to conduct research that examines the effectiveness of media campaigns by SES; these studies should employ research designs that are sensitive to various ways that SES differences in smoking cessation media effects might occur.

For Which Boys and Which Girls Are Reading Assessment Items Biased Against? Detection of Differential Item Functioning in Heterogeneous Gender Populations

ERIC Educational Resources Information Center

Grover, Raman K.; Ercikan, Kadriye

2017-01-01

In gender differential item functioning (DIF) research it is assumed that all members of a gender group have similar item response patterns and therefore generalizations from group level to subgroup and individual levels can be made accurately. However DIF items do not necessarily disadvantage every member of a gender group to the same degree,…

Addressing an Overlooked Science Outreach Audience: Development of a Science Mentorship Program Focusing on Critical Thinking Skills for Adults Working toward a High School Equivalency Degree

ERIC Educational Resources Information Center

Gagnon, Nicole L.; Komor, Anna J.

2017-01-01

Adult learners seeking a high school equivalency degree are a highly motivated group of students that almost universally meet outreach audience goals of serving minority, low-income, and other disadvantaged populations. Despite the demonstrated need of this population, these students are not commonly served by university-sponsored science outreach…

Using educational games to promote the seeking of a pharmacist and to teach key medication use messages: results from an inner city health party.

PubMed

Burghardt, Kyle J; Bowman, Margo R; Hibino, Maho; Opong-Owusu, Barima K; Pokora, Tiffany D; Reeves, Katherine; Vile, Kellie M

2013-01-01

Low health literacy affects 80-90 million Americans with low-income, minority populations being more vulnerable to this condition. One method of addressing limited literacy that may be particularly well accepted within vulnerable populations is the use of educational board games in order to emphasize seeking health information from reliable sources such as pharmacists. The research objective was to determine if the use of educational board games could impact community pharmacy patron intentions to seek pharmacist advice in an urban, minority, economically-disadvantaged population. Four medication-related educational games were played at an urban community pharmacy under the leadership of pharmacy students in the setting of a health party. Game messages, design, and evaluation processes were uniquely guided by community members' input. A verbally administered questionnaire measured game impact via knowledge and perception questions with responses compared between a non-randomly allocated intervention group and a control group. Ninety-nine adults were included in the intervention (or game) group and 94 adults were in the control group. Game participants were significantly more likely than the control group to indicate they would seek pharmacist medication advice in the future. Educational board games played in the setting of a health party can be a fun and effective way to convey selected health messages within an urban, minority, economically disadvantaged population. Community input into game development and layering multiple strategies for overcoming health literacy barriers were essential components of this initiative. Published by Elsevier Inc.

Colorectal Cancer Screening Uptake's Association with Psychosocial and Sociodemographic Factors among Homeless Blacks and Whites

ERIC Educational Resources Information Center

Rogers, Charles R.; Robinson, Cendrine D.; Arroyo, Cassandra; Obidike, Ogechi Jessica; Sewali, Barrett; Okuyemi, Kolawole S.

2017-01-01

The homeless represent an extremely disadvantaged population that fare worse than minority groups in access to preventive services and health, and minority groups fare worse than Whites. Early detection screening for colorectal cancer (CRC) saves lives, but empirical data about CRC screening practices among homeless Blacks and Whites are limited.…

Epidemiological Profile and Risk Factors for Acquiring HBV and/or HCV in HIV-Infected Population Groups in Nepal.

PubMed

Bhattarai, Manjula; Baniya, Jagat Bahadur; Aryal, Nirmal; Shrestha, Bimal; Rauniyar, Ramanuj; Adhikari, Anurag; Koirala, Pratik; Oli, Pardip Kumar; Pandit, Ram Deo; Stein, David A; Gupta, Birendra Prasad

2018-01-01

HBV and HCV infections are widespread among the HIV-infected individuals in Nepal. The goals of this study were to investigate the epidemiological profile and risk factors for acquiring HBV and/or HCV coinfection in disadvantaged HIV-positive population groups in Nepal. We conducted a retrospective study on blood samples from HIV-positive patients from the National Public Health Laboratory at Kathmandu to assay for HBsAg, HBeAg, and anti-HCV antibodies, HIV viral load, and CD4+ T cell count. Among 579 subjects, the prevalence of HIV-HBV, HIV-HCV, and HIV-HBV-HCV coinfections was 3.62%, 2.93%, and 0.34%, respectively. Multivariate regression analysis indicated that spouses of HIV-positive migrant labourers were at significant risk for coinfection with HBV infection, and an age of >40 years in HIV-infected individuals was identified as a significant risk factor for HCV coinfection. Overall our study indicates that disadvantaged population groups such as intravenous drug users, migrant workers and their spouses, female sex workers, and men who have sex with HIV-infected men are at a high and persistent risk of acquiring viral hepatitis. We conclude that Nepalese HIV patients should receive HBV and HCV diagnostic screening on a regular basis.

Adverse experiences in childhood, adulthood neighbourhood disadvantage and health behaviours.

PubMed

Halonen, Jaana I; Vahtera, Jussi; Kivimäki, Mika; Pentti, Jaana; Kawachi, Ichiro; Subramanian, S V

2014-08-01

Early life adversities may play a role in the associations observed between neighbourhood contextual factors and health behaviours. We examined whether self-reported adverse experiences in childhood (parental divorce, long-term financial difficulties, serious conflicts, serious/chronic illness or alcohol problem in the family, and frequent fear of a family member) explain the association between adulthood neighbourhood disadvantage and co-occurrence of behavioural risk factors (smoking, moderate/heavy alcohol use, physical inactivity). Study population consisted of 31 271 public sector employees from Finland. The cross-sectional associations were analysed using two-level cumulative logistic regression models. Childhood adverse experiences were associated with the sum of risk factors (cumulative OR 1.32 (95% CI 1.25 to 1.40) among those reporting 3-6 vs 0 adversities). Adverse experiences did not attenuate the association between neighbourhood disadvantage and risk factors; this cumulative OR was 1.52 (95% CI 1.43 to 1.62) in the highest versus lowest quartile of neighbourhood disadvantage when not including adversities, and 1.50 (95% CI 1.40 to 1.60) when adjusted for childhood adversities. In adversity-stratified analyses those reporting 3-6 adversities had 1.60-fold (95% CI 1.42 to 1.80) likelihood of risk factors if living in the neighbourhood of the highest disadvantage, while in those with fewer adversities this likelihood was 1.09-1.34-fold (95% CI 0.98 to 1.53) (p interaction 0.07). Childhood adverse experiences and adulthood neighbourhood disadvantage were associated with behavioural risk factors. Childhood experiences did not explain associations between neighbourhood disadvantage and the risk factors. However, those with more adverse experiences may be susceptible for the socioeconomic conditions of neighbourhoods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A systematic review of interventions to improve diabetes care in socially disadvantaged populations.

PubMed

Glazier, Richard H; Bajcar, Jana; Kennie, Natalie R; Willson, Kristie

2006-07-01

To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations. Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions. Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (>10 contact times) delivered over a long duration (>or=6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge. This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up.

Human rights and access to healthcare services for indigenous peoples in Africa.

PubMed

Durojaye, Ebenezer

2017-09-20

In September 2015, the United Nations adopted the sustainable development goals (SDGs) to address among others poverty and inequality within and among countries of the world. In particular, the SDGs aim at ameliorating the position of disadvantaged and vulnerable groups in societies. One of the over-arching goals of the SDGs is to ensure that no one is left behind in the realisation of their access to health care. African governments are obligated under international and regional human rights law to ensure access to healthcare services for everyone, including indigenous populations, on a non-discriminatory basis. This requires the governments to adopt appropriate measures that will remove barriers to healthcare services for disadvantaged and marginalised groups such as indigenous peoples.

Smoking Cessation among Low-Socioeconomic Status and Disadvantaged Population Groups: A Systematic Review of Research Output

PubMed Central

Courtney, Ryan J.; Naicker, Sundresan; Shakeshaft, Anthony; Clare, Philip; Martire, Kristy A.; Mattick, Richard P.

2015-01-01

Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. Methods: A systematic database search was conducted for two time periods: 2000–2004 (TP1) and 2008–2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. Results: 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ² = 73.13, p < 0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1 = 23% vs. TP2 = 33%) or intervention (TP1 = 77% vs. TP2 = 67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1 = 12% vs. TP2 = 36%). Conclusions: The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy. PMID:26062037

Social Determinants of Racial Disparities in CKD

PubMed Central

Norton, Jenna M.; Moxey-Mims, Marva M.; Eggers, Paul W.; Narva, Andrew S.; Star, Robert A.; Rodgers, Griffin P.

2016-01-01

Significant disparities in CKD rates and outcomes exist between black and white Americans. Health disparities are defined as health differences that adversely affect disadvantaged populations, on the basis of one or more health outcomes. CKD is the complex result of genetic and environmental factors, reflecting the balance of nature and nurture. Social determinants of health have an important role as environmental components, especially for black populations, who are disproportionately disadvantaged. Understanding the social determinants of health and appreciating the underlying differences associated with meaningful clinical outcomes may help nephrologists treat all their patients with CKD in an optimal manner. Altering the social determinants of health, although difficult, may embody important policy and research efforts, with the ultimate goal of improving outcomes for patients with kidney diseases, and minimizing the disparities between groups. PMID:27178804

Community covariates of malnutrition based mortality among older adults.

PubMed

Lee, Matthew R; Berthelot, Emily R

2010-05-01

The purpose of this study was to identify community level covariates of malnutrition-based mortality among older adults. A community level framework was delineated which explains rates of malnutrition-related mortality among older adults as a function of community levels of socioeconomic disadvantage, disability, and social isolation among members of this group. County level data on malnutrition mortality of people 65 years of age and older for the period 2000-2003 were drawn from the CDC WONDER system databases. County level measures of older adult socioeconomic disadvantage, disability, and social isolation were derived from the 2000 US Census of Population and Housing. Negative binomial regression models adjusting for the size of the population at risk, racial composition, urbanism, and region were estimated to assess the relationships among these indicators. Results from negative binomial regression analysis yielded the following: a standard deviation increase in socioeconomic/physical disadvantage was associated with a 12% increase in the rate of malnutrition mortality among older adults (p < 0.001), whereas a standard deviation increase in social isolation was associated with a 5% increase in malnutrition mortality among older adults (p < 0.05). Community patterns of malnutrition based mortality among older adults are partly a function of levels of socioeconomic and physical disadvantage and social isolation among older adults. 2010 Elsevier Inc. All rights reserved.

The 'price signal' for health care is loud and clear: A cross-sectional study of self-reported access to health care by disadvantaged Australians.

PubMed

Paul, Christine; Bonevski, Billie; Twyman, Laura; D'Este, Catherine; Siahpush, Mohammad; Guillaumier, Ashleigh; Bryant, Jamie; Fradgley, Elizabeth; Palazzi, Kerrin

2016-04-01

To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. A cross-sectional survey with 906 adult clients of a large community welfare agency in New South Wales. Clients attending the service for emergency assistance completed a touchscreen survey. Inability to access health care in the prior year was reported by more than one-third of the sample (38%), compared to the 5% found for the general population. Dentists (47%), specialists (43%) or GPs (29%) were the least accessible types of health care. The main reason for inability to access health care was cost, accounting for 60% of responses. Almost half (47%) the sample reported delayed or non-use of medicines due to cost. Increasing financial stress was associated with increased inability to access GP or specialist care, medicines and imaging. Higher anxiety scores were associated with inability to access health care, and with cost-related inability to access medicines and imaging. For disadvantaged groups, cost-related barriers to accessing care are prominent and are disproportionately high - particularly regarding dentistry, specialist and GP care. Improvements in health outcomes for disadvantaged groups are likely to require strategies to reduce cost-related barriers to health care. © 2015 Public Health Association of Australia.

Socioeconomic Variation, Number Competence, and Mathematics Learning Difficulties in Young Children

ERIC Educational Resources Information Center

Jordan, Nancy C.; Levine, Susan C.

2009-01-01

As a group, children from disadvantaged, low-income families perform substantially worse in mathematics than their counterparts from higher-income families. Minority children are disproportionately represented in low-income populations, resulting in significant racial and social-class disparities in mathematics learning linked to diminished…

Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study.

PubMed

Elsey, H; Bragg, R; Elings, M; Cade, J E; Brennan, C; Farragher, T; Tubeuf, S; Gold, R; Shickle, D; Wickramasekera, N; Richardson, Z; Murray, J

2014-10-30

Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of care farms in improving health and well-being. Understanding the underlying mechanisms that lead to improvements for different disadvantaged groups is a further gap in the evidence. Participants in this study are offenders serving community orders. Their low socioeconomic status and poor health outcomes relative to the general population exemplifies disadvantage. This paper describes the protocol of a study to understand the impacts of care farms and to pilot the design and tools for a study to assess cost-effectiveness of care farms in improving the quality of life of offenders. As a pilot study, no power calculation has been conducted. However, 150 offenders serving community sentences on care farms and 150 on other probation locations (eg, litter picking, painting) will be recruited over a 1-year period. Changes in quality of life, measured by Clinical Outcome in Routine Evaluation-Outcome Measure, health and reconvictions of offenders at care farms compared to other probation locations will be analysed to inform the sample size calculation for the follow on study. The feasibility of recruitment, retention, collecting cost data and modelling cost-effectiveness will also be assessed. The study will use qualitative methods to explore the experiences of offenders attending care farms and perceptions of probation and care farm staff on the processes and impacts of the intervention. Findings will be published and inform development of a natural experiment and will be disseminated to probation services, care farms and academics. University of Leeds Ethical Review Board approved: SoMREC/13/014. National Offender Management Service (NOMS) approved: 2013-257. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Towards Developing New Teacher Competencies in Response to Mega-Trends in Curriculum Reforms. Report of a Regional Study Group Meeting (Chiang Rai, Thailand, June 25-July 6, 1990).

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

The meeting reported in this document focused on the relevance of education to societal requirements, training of educational personnel, distance education, and ways for teacher education to serve the needs of disadvantaged population groups. Countries represented included: Australia, Bangladesh, China, India, Indonesia, Iran (Islamic Republic),…

The ethics and regulatory landscape of including vulnerable populations in pragmatic clinical trials.

PubMed

Welch, Mary Jane; Lally, Rachel; Miller, Jennifer E; Pittman, Stephanie; Brodsky, Lynda; Caplan, Arthur L; Uhlenbrauck, Gina; Louzao, Darcy M; Fischer, James H; Wilfond, Benjamin

2015-10-01

Policies have been developed to protect vulnerable populations in clinical research, including the US federal research regulations (45 Code of Federal Regulations 46 Subparts B, C, and D). These policies generally recognize vulnerable populations to include pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. The aim has been to protect these populations from harm, often by creating regulatory and ethical checks that may limit their participation in many clinical trials. The recent increase in pragmatic clinical trials raises at least two questions about this approach. First, is exclusion itself a harm to vulnerable populations, as these groups may be denied access to understanding how health interventions work for them in clinical settings? Second, are groups considered vulnerable in traditional clinical trials also vulnerable in pragmatic clinical trials? We argue first that excluding vulnerable subjects from participation in pragmatic clinical trials can be harmful by preventing acquisition of data to meaningfully inform clinical decision-making in the future. Second, we argue that protections for vulnerable subjects in traditional clinical trial settings may not be translatable, feasible, or even ethical to apply in pragmatic clinical trials. We conclude by offering specific recommendations for appropriately protecting vulnerable research subjects in pragmatic clinical trials, focusing on pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. © The Author(s) 2015.

Workplace Diversity and Public Policy: Challenges and Opportunities for Psychology

ERIC Educational Resources Information Center

Fassinger, Ruth E.

2008-01-01

This article outlines both challenges and opportunities for psychology of issues related to diversity in education and work. For the purposes of this discussion, "diverse" populations include four groups currently marginalized and disadvantaged in the U.S. workplace: women, people of color, sexual minorities, and people with disabilities. An…

The Gifted Disadvantaged of Israel.

ERIC Educational Resources Information Center

Shmueli, Eliezer

The immigrant population of Israel falls into two large groups: those of European descent and those from North African and Middle Eastern countries. Families from traditionally agrarian Arab countries generally have a lower socioeconomic status, and their children have difficulty competing in school with children from a more urban, industrialized,…

Racial differences in neighborhood disadvantage, inflammation and metabolic control in black and white pediatric type 1 diabetes patients.

PubMed

Coulon, Sara J; Velasco-Gonzalez, Cruz; Scribner, Richard; Park, Chi L; Gomez, Ricardo; Vargas, Alfonso; Stender, Sarah; Zabaleta, Jovanny; Clesi, Patrice; Chalew, Stuart A; Hempe, James M

2017-03-01

Racial variation in the relationship between blood glucose and hemoglobin A1c (HbA1c) complicates diabetes diagnosis and management in racially mixed populations. Understanding why HbA1c is persistently higher in blacks than whites could help reduce racial disparity in diabetes outcomes. Test the hypothesis that neighborhood disadvantage is associated with inflammation and poor metabolic control in a racially mixed population of pediatric type 1 diabetes patients. Patients (n = 86, 53 white, 33 black) were recruited from diabetes clinics. Self-monitored mean blood glucose (MBG) was downloaded from patient glucose meters. Blood was collected for analysis of HbA1c and C-reactive protein (CRP). Patient addresses and census data were used to calculate a concentrated disadvantage index (CDI). High CDI reflects characteristics of disadvantaged neighborhoods. HbA1c and MBG were higher (p < 0.0001) in blacks [10.4% (90.3 mmol/mol), 255 mg/dL] than whites [8.9% (73.9 mmol/mol), 198 mg/dL). CDI was higher in blacks (p < 0.0001) and positively correlated with HbA1c (r = 0.40, p = 0.0002) and MBG (r = 0.35, p = 0.0011) unless controlled for race. CDI was positively associated with CRP by linear regression within racial groups. CRP was not different between racial groups, and was not correlated with MBG, but was positively correlated with HbA1c when controlled for race (p = 0.04). Neighborhood disadvantage was associated with inflammation and poor metabolic control in pediatric type 1 diabetes patients. Marked racial differences in potential confounding factors precluded differentiation between genetic and environmental effects. Future studies should recruit patients matched for neighborhood characteristics and treatment regimen to more comprehensively assess racial variation in HbA1c. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Socioeconomic Disadvantage and Kidney Disease in the United States, Australia, and Thailand

PubMed Central

White, Sarah L.; McGeechan, Kevin; Jones, Michael; Cass, Alan; Chadban, Steven J.; Polkinghorne, Kevan R.; Perkovic, Vlado; Roderick, Paul J.

2008-01-01

Objectives. We sought to determine whether an elevated burden of chronic kidney disease is found among disadvantaged groups living in the United States, Australia, and Thailand. Methods. We used data on participants 35 years or older for whom a valid serum creatinine measurement was available from studies in the United States, Thailand, and Australia. We used logistic regression to analyze the association of income, education, and employment with the prevalence of chronic kidney disease (estimated glomerular filtration rate<60 mL/min/1.73 m2). Results. Age- and gender-adjusted odds of having chronic kidney disease were increased 86% for US Whites in the lowest income quartile versus the highest quartile (odds ratio [OR] = 1.86; 95% confidence interval [CI] = 1.27, 2.72). Odds were increased 2 times and 6 times, respectively, among unemployed (not retired) versus employed non-Hispanic Black and Mexican American participants (OR=2.89; 95% CI=1.53, 5.46; OR=6.62; 95% CI=1.94, 22.64. respectively). Similar associations were not evident for the Australian or Thai populations. Conclusions. Higher kidney disease prevalence among financially disadvantaged groups in the United States should be considered when chronic kidney disease prevention and management strategies are created. This approach is less likely to be of benefit to the Australian and Thai populations. PMID:18511730

Strategies to improve adherence to medications for cardiovascular diseases in socioeconomically disadvantaged populations: a systematic review.

PubMed

Laba, Tracey-Lea; Bleasel, Jonathan; Brien, Jo-Anne; Cass, Alan; Howard, Kirsten; Peiris, David; Redfern, Julie; Salam, Abdul; Usherwood, Tim; Jan, Stephen

2013-09-10

Medication non-adherence poses a major barrier to reducing cardiovascular disease (CVD) burden globally, and is increasingly recognised as a socioeconomically determined problem. Strategies promoting CVD medication adherence appear of moderate effectiveness and cost-effectiveness. Potentially, 'one-size-fits-all' measures are ill-equipped to address heterogeneous adherence behaviour between social groups. This review aims to determine the effects of strategies to improve adherence to CVD-related medications in socioeconomically disadvantaged groups. Randomised/quasi-randomised controlled trials (1996-June 2012, English), testing strategies to increase adherence to CVD-related medications prescribed to adult patients who may experience health inequity (place of residence, occupation, education, or socioeconomic position) were reviewed. 772 abstracts were screened, 111 full-text articles retrieved, and 16 full-text articles reporting on 14 studies, involving 7739 patients (age range 41-66 years), were included. Methodological and clinical heterogeneity precluded quantitative data synthesis. Studies were thematically grouped by targeted outcomes; underlying interventions and policies were classified using Michie et al.'s Behaviour Change Wheel. Contrasting with patient or physician/practice strategies, those simultaneously directed at patients and physicians/practices resulted in statistically significant improvements in relative adherence (16-169%). Comparative cost and cost-effectiveness analyses from three studies did not find cost-saving or cost-effective strategies. Unlike much current evidence in general populations, promising evidence exists about what strategies improve adherence in disadvantaged groups. These strategies were generally complex: simultaneously targeting patients and physicians; addressing social, financial, and treatment-related adherence barriers; and supported by broader guidelines, regulatory and communication-based policies. Given their complexity and potential resource implications, comprehensive process evaluations and cost and cost-effectiveness evidence are urgently needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Transplant commercialism and organ trafficking: the Declaration of Istanbul with special relevance to disadvantaged populations living with kidney disease.

PubMed

Levin, Adeera; Muller, Elmi; Alrukhaimi, Mona; Naicker, Saralah; Tibbel, Annika

2015-01-01

This paper provides a historical perspective on organ trafficking and transplant commercialism, an overview of the Declaration of Istanbul [1, 2], and an update on current state. We highlight the importance of this problem pertaining to disadvantaged populations living with or at risk for kidney disease. It was presented during the Kidney Disease in Disadvantaged Populations Satellite Symposium of the World Congress of Nephrology in Hong Kong 2013 (www.theisn.org).

Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial

PubMed Central

Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

2016-01-01

Background Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. Methods The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. Findings The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Interpretation Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. Trial registration number NCT01123967. PMID:26931362

Pathways between Socioeconomic Disadvantage and Childhood Growth in the Scottish Longitudinal Study, 1991-2001.

PubMed

Silverwood, Richard J; Williamson, Lee; Grundy, Emily M; De Stavola, Bianca L

2016-01-01

Socioeconomically disadvantaged children are more likely to be of shorter stature and overweight, leading to greater risk of obesity in adulthood. Disentangling the mediatory pathways between socioeconomic disadvantage and childhood size may help in the development of appropriate policies aimed at reducing these health inequalities. We aimed to elucidate the putative mediatory role of birth weight using a representative sample of the Scottish population born 1991-2001 (n = 16,628). Estimated height and overweight/obesity at age 4.5 years were related to three measures of socioeconomic disadvantage (mother's education, Scottish Index of Multiple Deprivation, synthetic weekly income). Mediation was examined using two approaches: a 'traditional' mediation analysis and a counterfactual-based mediation analysis. Both analyses identified a negative effect of each measure of socioeconomic disadvantage on height, mediated to some extent by birth weight, and a positive 'direct effect' of mother's education and Scottish Index of Multiple Deprivation on overweight/obesity, which was partly counterbalanced by a negative 'indirect effect'. The extent of mediation estimated when adopting the traditional approach was greater than when adopting the counterfactual-based approach because of inappropriate handling of intermediate confounding in the former. Our findings suggest that higher birth weight in more disadvantaged groups is associated with reduced social inequalities in height but also with increased inequalities in overweight/obesity.

Trends in inequalities in child stunting in South Asia.

PubMed

Krishna, Aditi; Mejía-Guevara, Iván; McGovern, Mark; Aguayo, Victor; Subramanian, S V

2017-10-19

We analysed socio-economic inequalities in stunting in South Asia and investigated disparities associated with factors at the individual, caregiver, and household levels (poor dietary diversity, low maternal education, and household poverty). We used time-series analysis of data from 55,459 children ages 6-23 months from Demographic and Health Surveys in Bangladesh, India, Nepal, and Pakistan (1991-2014). Logistic regression models, adjusted for age, sex, birth order, and place of residency, examined associations between stunting and multiple types of socio-economic disadvantage. All countries had high stunting rates. Bangladesh and Nepal recorded the largest reductions-2.9 and 4.1 percentage points per year, respectively-compared to 1.3 and 0.6 percentage points in India and Pakistan, respectively. Socio-economic adversity was associated with increased risk of stunting, regardless of disadvantage type. Poor children with inadequate diets and with poorly educated mothers experienced greater risk of stunting. Although stunting rates declined in the most deprived groups, socio-economic differences were largely preserved over time and in some cases worsened, namely, between wealth quintiles. The disproportionate burden of stunting experienced by the most disadvantaged children and the worsening inequalities between socio-economic groups are of concern in countries with substantial stunting burdens. Closing the gap between best and worst performing countries, and between most and least disadvantaged groups within countries, would yield substantial improvements in stunting rates in South Asia. To do so, greater attention needs to be paid to addressing the social, economic, and political drivers of stunting with targeted efforts towards the populations experiencing the greatest disadvantage and child growth faltering. © 2017 John Wiley & Sons Ltd.

International Collaboration for the Epidemiology of eGFR in Low and Middle Income Populations - Rationale and core protocol for the Disadvantaged Populations eGFR Epidemiology Study (DEGREE).

PubMed

Caplin, Ben; Jakobsson, Kristina; Glaser, Jason; Nitsch, Dorothea; Jha, Vivekanand; Singh, Ajay; Correa-Rotter, Ricardo; Pearce, Neil

2017-01-03

There is an increasing recognition of epidemics of primarily tubular-interstitial chronic kidney disease (CKD) clustering in agricultural communities in low- and middle-income countries (LMICs). Although it is currently unclear whether there is a unified underlying aetiology, these conditions have been collectively termed CKD of undetermined cause (CKDu). CKDu is estimated to have led to the premature deaths of tens to hundreds of thousands of young men and women over the last 2 decades. Thus, there is an urgent need to understand the aetiology and pathophysiology of these condition (s). International comparisons have provided the first steps in understanding many chronic diseases, but such comparisons rely on the availability of standardised tools to estimate disease prevalence. This is a particular problem with CKD, since the disease is asymptomatic until the late stages, and the biases inherent in the methods used to estimate the glomerular filtration rate (GFR) in population studies are highly variable across populations. We therefore propose a simple standardised protocol to estimate the distribution of GFR in LMIC populations - The Disadvantaged Populations eGFR Epidemiology (DEGREE) Study. This involves the quantification of renal function in a representative adult population-based sample and a requirement for standardisation of serum creatinine measurements, along with storage of samples for future measurements of cystatin C and ascertainment of estimates of body composition, in order to obtain valid comparisons of estimated GFR (eGFR) within and between populations. The methodology we present is potentially applicable anywhere, but our particular focus is on disadvantaged populations in LMICs, since these appear to be most susceptible to CKDu. Although the protocol could also be used in specific groups (e.g. occupational groups, thought to be at excess risk of CKDu) the primary aim of the DEGREE project is characterise the population distribution of eGFR in multiple regions so that international comparisons can be performed. It is only with a standardised approach that it will be possible to estimate the scale of, and variation in, impaired kidney function between affected areas. These data should then provide insights into important social, demographic and environmental risk factors for this increasingly recognised disease.

Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

PubMed Central

2012-01-01

Background Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in a primary care setting. ACSCs are used extensively as indicators of accessibility and effectiveness of primary health care. We examined the association between patient characteristics and hospitalisation for ACSCs in the adult and paediatric population in Victoria, Australia, 2003/04. Methods Hospital admissions data were merged with two area-level socioeconomic indexes: Index of Socio-Economic Disadvantage (IRSED) and Accessibility/Remoteness Index of Australia (ARIA). Univariate and multiple logistic regressions were performed for both adult (age 18+ years) and paediatric (age <18 years) groups, reporting odds ratios (OR) and 95% confidence intervals (CI) for a number of predictors of ACSCs admissions compared to non-ACSCs admissions. Results Predictors were much more strongly associated with ACSCs admissions compared to non-ACSCs admissions in the adult group than for the paediatric group with the exception of rurality. Significant adjusted ORs in the adult group were 1.06, 1.15, 1.13, 1.06 and 1.11 for sex, rurality, age, IRSED and ARIA variables, and 1.34, 1.04 and 1.09 in the paediatric group for rurality, IRSED and ARIA, respectively. Conclusions Disadvantaged paediatric and adult population experience more need of hospital care for ACSCs. Access barriers to primary care are plausible causes for the observed disparities. Understanding the characteristics of individuals experiencing access barriers to primary care will be useful for developing targeted interventions meeting the unique ambulatory needs of the population. PMID:23259969

Making It in America: Social Mobility in the Immigrant Population

ERIC Educational Resources Information Center

Borjas, George J.

2006-01-01

In his survey of research on social mobility and U.S. immigration, George Borjas underscores two insights. First, most immigrants are at a sizable earnings disadvantage, relative to nativeborn workers. Second, the earnings of different groups of immigrants vary widely. The children of immigrants "catch up" to native-born workers slowly.…

The Developmental Education Program at Tacoma Community College.

ERIC Educational Resources Information Center

Spangler, Richard C.; Simonson, Carolyn

Tacoma Community College (TCC) is a comprehensive institution serving 7,000 students per quarter out of the 200,000 residents of Tacoma-Pierce County. Statistics show that 20% of the student population have not graduated from high school; 21% are from minority groups; and an estimated 60% are academically, educationally, or socially disadvantaged.…

Nursery Annexes and Parent Involvement in Hillfields, Coventry, England.

ERIC Educational Resources Information Center

Dermy, Janet M.

This paper tells the story of the implementation of the first inner city Community Education Project in the disadvantaged Hillfields area of Coventry, England. The population of the "ghetto-like" Hillfields, numbering 20,000, was made up largely of families from Asia with small groups from the West Indies, Ireland and Europe. A survey…

Using biomedical engineering and "hidden capital" to provide educational outreach to disadvantaged populations.

PubMed

Drazan, John F; Scott, John M; Hoke, Jahkeen I; Ledet, Eric H

2014-01-01

A hands-on learning module called "Science of the Slam" is created that taps into the passions and interests of an under-represented group in the fields of Science, Technology, Engineering and Mathematics (STEM). This is achieved by examining the use of the scientific method to quantify the biomechanics of basketball players who are good at performing the slam dunk. Students already have an intrinsic understanding of the biomechanics of basketball however this "hidden capital" has never translated into the underlying STEM concepts. The effectiveness of the program is rooted in the exploitation of "hidden capital" within the field of athletics to inform and enhance athletic performance. This translation of STEM concepts to athletic performance provides a context and a motivation for students to study the STEM fields who are traditionally disengaged from the classic engineering outreach programs. "Science of the Slam" has the potential to serve as a framework for other researchers to engage under-represented groups in novel ways by tapping into shared interests between the researcher and disadvantaged populations.

HIV Issues and Mapuches in Chile.

PubMed

Cianelli, Rosina; Ferrer, Lilian; Cabieses, Báltica; Araya, Alejandra; Matsumoto, Cristina; Miner, Sarah

2008-01-01

Chile is a country with an incipient HIV epidemic. Just as in other countries, disadvantaged groups in Chile are contributing to the increased incidence of the disease. The Mapuche indigenous population is one such group that has been affected by the spread of HIV. However, no prevention programs are tailored to the culturally specific needs of this community. In recognition of this discrepancy, an academic-community partnership was formed to develop an HIV educational module for a Mapuche community. The module was developed for use as part of an already established health-related program. The aims of the module were to identify perceptions about HIV among Mapuches and present information specific to HIV and its prevention. Focus was placed on cultural sensitivity. A total of 16 Mapuches participated voluntarily and showed some knowledge regarding HIV, but they lacked an overall understanding as to how it is transmitted and why prevention strategies are effective. Continued collaboration between academia and affected communities as well as incorporating HIV information into established programs are effective strategies for delivering prevention information to disadvantaged populations and for further understanding their perceptions and health care needs.

Is ethnic density associated with risk of child pedestrian injury? A comparison of inter-census changes in ethnic populations and injury rates.

PubMed

Steinbach, Rebecca; Green, Judith; Kenward, Michael G; Edwards, Phil

2016-01-01

Research on inequalities in child pedestrian injury risk has identified some puzzling trends: although, in general, living in more affluent areas protects children from injury, this is not true for those in some minority ethnic groups. This study aimed to identify whether 'group density' effects are associated with injury risk, and whether taking these into account alters the relationship between area deprivation and injury risk. 'Group density' effects exist when ethnic minorities living in an area with a higher proportion of people from a similar ethnic group enjoy better health than those who live in areas with a lower proportion, even though areas with dense minority ethnic populations can be relatively more materially disadvantaged. This study utilised variation in minority ethnic densities in London between two census periods to identify any associations between group density and injury risk. Using police data on road traffic injury and population census data from 2001 to 2011, the numbers of 'White,' 'Asian' and 'Black' child pedestrian injuries in an area were modelled as a function of the percentage of the population in that area that are 'White,' 'Asian' and 'Black,' controlling for socio-economic disadvantage and characteristics of the road environment. There was strong evidence (p < 0.001) of a negative association between 'Black' population density and 'Black' child pedestrian injury risk [incidence (of injury) rate ratios (IRR) 0.575, 95% CI 0.515-0.642]. There was weak evidence (p = 0.083) of a negative association between 'Asian' density and 'Asian' child pedestrian injury risk (IRR 0.901, 95% CI 0.801-1.014) and no evidence (p = 0.412) of an association between 'White' density and 'White' child pedestrian injury risk (IRR 1.075, 95% CI 0.904-1.279). When group density effects are taken into account, area deprivation is associated with injury risk of all ethnic groups. Group density appears to protect 'Black' children living in London against pedestrian injury risk. These findings suggest that future research should focus on structural properties of societies to explain the relationships between minority ethnicity and risk.

Sociodemographic and geographical inequalities in notifiable infectious diseases in Australia: a retrospective analysis of 21 years of national disease surveillance data.

PubMed

Gibney, Katherine B; Cheng, Allen C; Hall, Robert; Leder, Karin

2017-01-01

Australia is a high-income country with a well established and largely publicly funded health-care system. However, some populations within Australia have shorter life expectancy and worse health outcomes than others. We explored geographical variations and sociodemographic inequities in infectious disease notifications in Australia. In this retrospective study, we analysed National Notifiable Diseases Surveillance System (NNDSS) notifications from 1991-2011 (n=2·4 million). We assessed the effect of socioeconomic disadvantage and remoteness of residence on national notification incidence. We calculated Gini coefficients, adjusted relative risks (aRRs), population attributable fractions (PAFs), and attributable notifications. We reported aRRs for Indigenous status in three jurisdictions with more than 75% completeness of Indigenous status reporting from the Northern Territory, South Australia, and Western Australia. Of the eight most commonly notified diseases from Jan 1, 1991, to Dec 31, 2011, gonococcal infection was the most geographically unequal and campylobacteriosis was the most evenly distributed across the country. Overall, notification incidence was higher in remote and very remote areas than in major cities (aRR 3·37), and higher in the most socioeconomically disadvantaged quintiles compared with less disadvantaged quintiles (aRR 1·15). The PAF for socioeconomic disadvantage was high for blood-borne viral hepatitis but decreased in other disease groups. In 2011, sexually transmitted infections had 11 093 notifications attributed to remoteness and 5597 notifications attributable to socioeconomic disadvantage. Notification incidence was higher in Indigenous than in non-Indigenous Australians (aRR 5·3). All diseases had differing geographical concentration and sociodemographic risk. Overall, sociodemographic inequities in infectious disease notifications have decreased, but remain unacceptably high. National communicable disease control is complex, requiring both targeted and population-wide interventions. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

Generally representative is representative of none: commentary on the pitfalls of IQ test standardization in multicultural settings.

PubMed

Shuttleworth-Edwards, A B

2016-10-01

The aim of this paper is to address the issue of IQ testing within the multicultural context, with a focus on the adequacy of nationwide population-based norms vs. demographically stratified within-group norms for valid assessment purposes. Burgeoning cultural diversity worldwide creates a pressing need to cultivate culturally fair psychological assessment practices. Commentary is provided to highlight sources of test-taking bias on tests of intellectual ability that may incur invalid placement and diagnostic decisions in multicultural settings. Methodological aspects of population vs. within-group norming solutions are delineated and the challenges of culturally relevant norm development are discussed. Illustrative South African within-group comparative data are supplied to support the review. A critical evaluation of the South African WAIS-III and the WAIS-IV standardizations further serves to exemplify the issues. A flaw in both South African standardizations is failure to differentiate between African first language individuals with a background of advantaged education vs. those from educationally disadvantaged settings. In addition, the standardizations merge the performance outcomes of distinct racial/ethnic groups that are characterized by differentially advantaged or disadvantaged backgrounds. Consequently, the conversion tables are without relevance for any one of the disparate South African cultural groups. It is proposed that the traditional notion of a countrywide unitary norming (also known as 'population-based norms') of an IQ test is an unsatisfactory model for valid assessment practices in diverse cultural contexts. The challenge is to develop new solutions incorporating data from finely stratified within-group norms that serve to reveal rather than obscure cross-cultural disparity in cognitive test performance.

IFLA General Conference, 1987. Division of Libraries Serving the General Public. Libraries Serving Disadvantaged Persons Section. Library Services to Multicultural Populations Section. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

Eleven of the 15 papers in this collection discuss library services for disadvantaged persons; the remaining four papers are concerned with services to multicultural populations. The papers from the Section of Libraries Serving Disadvantaged Persons appear first in this list: (1) "The Development and Future of Easy Readers for Adults in the UK"…

A systematic narrative review of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups (2010-2017).

PubMed

Wilson, Amanda; Guillaumier, Ashleigh; George, Johnson; Denham, Alexandra; Bonevski, Billie

2017-08-01

Tobacco remains the key modifiable risk factor for the development of a number of diseases, including cardiovascular disease, cerebrovascular disease, lower respiratory infections, chronic obstructive pulmonary disease, tuberculosis and cancer. Among priority populations, smoking prevalence remains high, smokers tend to relapse more often and earlier and fewer are able to sustain quit attempts. This systematic review provides an update on the literature. Areas covered: Twenty-four randomized controlled trials published from 2010-2017, in English language, were identified after searching on Medline, Ovid, Embase and PsycINFO databases. Studies reported on the effectiveness of smoking cessation interventions among six disadvantaged groups known to have high smoking rates: (i) homeless, (ii) prisoners, (iii) indigenous populations, (iv) at-risk youth, (v) people with low income, and (vi) those with a mental illness. Narrative review and assessment of methodological quality of included papers was undertaken. Expert commentary: There is a growing evidence base of methodologically robust studies evaluating a variety of behavioural smoking cessation interventions for priority populations. Multi-component interventions and those examining behavioural interventions incorporating mindfulness training, financial incentives, motivational interviewing and extended telephone-delivered counseling may be effective in the short-term, particularly for smokers on low incomes and people with a mental illness.

Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study.

PubMed

Cleland, Claire L; Hunter, Ruth F; Tully, Mark A; Scott, David; Kee, Frank; Donnelly, Michael; Prior, Lindsay; Cupples, Margaret E

2014-05-23

There is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such 'hard-to-reach' population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents' and community leaders' perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions. Within an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n = 113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n = 14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework. Three main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an 'exit strategy' were perceived as important factors related to intervention effectiveness. Negative attitudes such as apathy, disappointing experiences, information with no perceived personal relevance and limited access to facilities were barriers to people participating in interventions. These findings illustrate the complexity of influences on a community's participation in PA interventions and support a social-ecological approach to promoting PA. They highlight the need for cross-sector working, effective information exchange, involving residents in bottom-up planning and providing adequate financial and social support. An in-depth understanding of a target population's perspectives is of key importance in translating PA behaviour change theories into practice.

Clinical management of the most common group A β-hemolytic streptococcal infections.

PubMed

Kaplan, Edward L

2013-01-01

Group A streptococcal (Streptococcus pyogenes) infections remain important causes of medical and public health morbidity and mortality even during the early twenty-first century. Although most often concentrated in socially/economically disadvantaged populations, the problems remain significant in both industrializing and industrialized countries. The many M/emm types of GAS contribute to herd immunity in populations and also affect the control of streptococcal infections in these populations. Although this bacterium remains among the most susceptible to most antibiotics, it is evident that antibiotics alone have not solved the group A streptococcal medical and public health problems, even in those places where access to medical care is readily available. It is likely that the current streptococcal problems will remain difficult to manage and will remain essentially unchanged until the broad implementation of a cost-effective group A streptococcal vaccine, likely some years in the future.

An empirical study of the 'underscreened' in organised cervical screening: experts focus on increasing opportunity as a way of reducing differences in screening rates.

PubMed

Williams, Jane H; Carter, Stacy M

2016-10-06

Cervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status (SES). Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like 'equity'. Equity is a poorly defined and understood concept. We aimed to explain experts' perspectives on how cervical screening programs might justifiably respond to 'the underscreened'. This paper reports on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing. Most experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines. Experts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to 'improving equity' taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage.

HIV ISSUES AND MAPUCHES IN CHILE

PubMed Central

Cianelli, Rosina; Ferrer, Lilian; Cabieses, Báltica; Araya, Alejandra; Matsumoto, Cristina; Miner, Sarah

2015-01-01

Chile is a country with an incipient HIV epidemic. Just as in other countries, disadvantaged groups in Chile are contributing to the increased incidence of the disease. The Mapuche indigenous population is one such group that has been affected by the spread of HIV. However, no prevention programs are tailored to the culturally specific needs of this community. In recognition of this discrepancy, an academic-community partnership was formed to develop an HIV educational module for a Mapuche community. The module was developed for use as part of an already established health-related program. The aims of the module were to identify perceptions about HIV among Mapuches and present information specific to HIV and its prevention. Focus was placed on cultural sensitivity. The module was carried out in connection with a first-aid course in an attempt to increase effectiveness of the intervention by working jointly with an established community program. Sixteen (16) Mapuches participated voluntarily and demonstrated some knowledge regarding HIV, but they lacked an overall understanding as to how it is transmitted and why prevention strategies are affective. Participants correctly identified sexual contact as a means of transmission, but when asked why, one person stated, “I just know it, I read it.” There were significant barriers to communication within the group, secondary to cultural practices related to age and gender. Major obstacles in controlling HIV are the lack of prevention strategies targeted to disadvantaged groups. The module developed for this intervention was the first effort of the Academic Community Partnership established between the Pontificia Universidad Católica de Chile and the Mapuche group around HIV prevention. Continued collaboration between academia and affected communities as well as incorporating HIV information into established programs are effective strategies for delivering prevention information to disadvantaged populations and for further understanding their perceptions and healthcare needs. PMID:18457766

Disadvantages of Minority Group Membership: The Perspective of a "Nondeprived" Minority Group

ERIC Educational Resources Information Center

Lavender, Abraham D.

1975-01-01

Utilizing a sample of Jewish undergraduate students, evidence is presented to indicate that a minority group which is not deprived materially can nonetheless perceive itself as receiving disadvantages from its minority group status. The most frequently perceived disadvantages (as well as advantages) are enumerated and discussed. (EH)

Transportation needs of disadvantaged populations : where, when, and how?

DOT National Transportation Integrated Search

2013-02-01

Transportation needs of disadvantaged populations (persons with disabilities, older adults, and the poor) are explored, and a methodology to address transit markets is examined to determine where, when, and how to provide for basic mobility needs ass...

Primary source of income is associated with differences in HIV risk behaviors in street-recruited samples.

PubMed

Essien, E James; Ross, Michael W; Williams, Mark L; Meshack, Angela F; Fernández-Esquer, Maria E; Peters, Ronald J; Ogungbade, GO

2004-06-17

BACKGROUND: The relationship between primary source of income and HIV risk behaviors and the racial/ethnic differences in risk behavior profiles among disadvantaged populations have not been fully explored. This is unusual given that the phenomenon of higher risk in more disadvantaged populations is well-known but the mechanisms remain unclear. We examined the relationship between primary source of income and differences in HIV risk behaviors among four racial/ethnic groups in the southern United States. METHODS: Self-reported data on primary source of income and HIV risk behaviors were collected from 1494 African American, Hispanic, Asian, and White men and women in places of public congregation in Houston, Texas. Data were analyzed using calculation of percentages and by chi-square tests with Yates correction for discontinuity where appropriate. RESULTS: Data revealed that a higher proportion of whites were involved in sex for money exchanges compared to the other racial groups in this sample. The data suggest that similar street sampling approaches are likely to recruit different proportions of people by primary income source and by ethnicity. It may be that the study locations sampled are likely to preferentially attract those involved in illegal activities, specifically the white population involved in sex for drug or money exchanges. Research evidence has shown that people construct highly evolved sexual marketplaces that are localized and most unlikely to cross racial, ethnic, and socioeconomic or geographical boundaries. Thus, the areas that we sampled may have straddled a white sexual marketplace more than that of the other groups, leading to an over-representation of sex exchange in this group. Drug use was highest among those with illegal primary sources of income (sex exchange and drug dealing and theft), and they were also those most likely to have injected drugs rather than administered them by any other route (p < 0.001). In addition, bisexual or homosexual identification was reported by more respondents in the sex exchange as primary source of income category. The number of sexual partners in the last three months followed a similar pattern, with those whose primary source of income was drug dealing or theft reporting relatively high partner numbers. CONCLUSIONS: These data suggest that social disadvantage is associated with HIV risk in part by its association with drug and sex work for survival, and offers one variable that may be associated with the concentration of disease among those at greatest disadvantage by having an illegal and unstable primary income source.

American Indians in Transition. Agricultural Economic Report No. 283.

ERIC Educational Resources Information Center

Johnson, Helen W.

The American Indian population is in a period of transition. It is young, growing, and becoming more urban. There were some improvements in income, housing, education, and health in the 1960-70 decade, but Indians remain the most disadvantaged of the minority ethnic groups in the United States. By most of the above measures, Indians, especially…

The Combined Effect of Individual and Neighborhood Socioeconomic Status on Cancer Survival Rates

PubMed Central

Lai, Ning-Sheng; Huang, Kuang-Yung; Chien, Sou-Hsin; Chang, Yu-Han; Lian, Wei-Cheng; Hsu, Ta-Wen; Lee, Ching-Chih

2012-01-01

Background This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES) and mortality rates for major cancers in Taiwan. Methods A population-based follow-up study was conducted with 20,488 cancer patients diagnosed in 2002. Each patient was traced to death or for 5 years. The individual income-related insurance payment amount was used as a proxy measure of individual SES for patients. Neighborhood SES was defined by income, and neighborhoods were grouped as living in advantaged or disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding and risk factors. Results After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation and adjuvant therapy), and hospital characteristics (ownership and teaching level), colorectal cancer, and head and neck cancer patients under 65 years old with low individual SES in disadvantaged neighborhoods conferred a 1.5 to 2-fold higher risk of mortality, compared with patients with high individual SES in advantaged neighborhoods. A cross-level interaction effect was found in lung cancer and breast cancer. Lung cancer and breast cancer patients less than 65 years old with low SES in advantaged neighborhoods carried the highest risk of mortality. Prostate cancer patients aged 65 and above with low SES in disadvantaged neighborhoods incurred the highest risk of mortality. There was no association between SES and mortality for cervical cancer and pancreatic cancer. Conclusions Our findings indicate that cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group. PMID:22957007

The gender gap in accrued pension rights - an indicator of women's accumulated disadvantage over the course of working life. The Hordaland Health Study (HUSK).

PubMed

Skogen, Jens Christoffer; Hensing, Gunnel; Øverland, Simon; Knudsen, Ann Kristin; Sivertsen, Børge; Vahtera, Jussi; Tell, Grethe S; Haukenes, Inger

2018-05-01

Economic gender equality is one of the goals of the Nordic Welfare states. Despite this, there is a considerable gender gap in pensionable income in the European Union, and an unmet need for measures that absorb more of the complexity associated with accumulated (dis)advantages across gender and population groups. The aims of the present study were to examine the gender difference in association between average earned pension points and 1) education and 2) current occupational prestige, and to discuss pension points as a possible indicator of accumulated disadvantages. We linked a community-based survey, the Hordaland Health study (HUSK), to the national register of insurance benefits (FD-trygd). This made it possible to trace gendered patterns of economic (dis)advantages associated with educational level, career development and gainful work over the life course for 17,275 individuals. We found profound differences in earned accrued pension rights between men and women across socioeconomic strata, and a significant interaction between pension rights and gender in the association with education and occupational prestige. Our findings indicate that men, as a group, may have lower educational attainment and occupational prestige than women, and still earn more pension points throughout their career. These differences place women at risk for future economic strain and deprivation over and above their similarly educated and positioned male counterparts. We suggest that accrued pension rights may be a relevant measure of accumulated (dis)advantages over the course of working life, and a useful indicator when gender equality is measured and discussed.

Providing Higher Education to Socially Disadvantaged Populations.

ERIC Educational Resources Information Center

Guri-Rosenblit, Sarah

1989-01-01

An examination of the philosophy and implementation of two special programs offered by the Open University of Israel to socially and educationally disadvantaged populations focuses on whether both values of quality and equity can be achieved in higher education. (Author/MSE)

Mind-Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review.

PubMed

Burnett-Zeigler, Inger; Schuette, Stephanie; Victorson, David; Wisner, Katherine L

2016-02-01

Mind-body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind-body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind-body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind-body interventions among disadvantaged populations found evidence for the efficacy of mind-body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

PubMed Central

Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve

2016-01-01

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey.

PubMed

Driezen, Pete; Abdullah, Abu S; Nargis, Nigar; Hussain, A K M Ghulam; Fong, Geoffrey T; Thompson, Mary E; Quah, Anne C K; Xu, Steve

2016-08-25

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011-2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco's harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO's Framework Convention on Tobacco Control.

Theme: Teaching Academically Disadvantaged Students.

ERIC Educational Resources Information Center

Iverson, Maynard J.; And Others

1993-01-01

Includes "Will We Serve the Academically Disadvantaged?" (Iverson); "Using Centers of Learning to Reach Academically Disadvantaged Students" (Gentry); "Georgia's Special Lamb Project Adoption Program" (Farmer); "Teacher Expectations" (Powers); "Providing Instruction for Special Populations" (Jewell); and "The Educational Reform Movement and…

[Health inequality among vulnerable groups in Mexico: older adults, indigenous people, and migrants].

PubMed

Juárez-Ramírez, Clara; Márquez-Serrano, Margarita; Salgado de Snyder, Nelly; Pelcastre-Villafuerte, Blanca Estela; Ruelas-González, María Guadalupe; Reyes-Morales, Hortensia

2014-04-01

Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a dynamic condition arising from the confluence of multiple social determinants. This article attempts to describe the health situation of three vulnerable groups in Mexico-older adults, indigenous people, and migrants-and, after defining the needs of each, explore measures that could contribute to the design and implementation of public health policies better tailored to their respective needs.

How can health systems research reach the worst-off? A conceptual exploration.

PubMed

Pratt, Bridget; Hyder, Adnan A

2016-11-15

Health systems research is increasingly being conducted in low and middle-income countries (LMICs). Such research should aim to reduce health disparities between and within countries as a matter of global justice. For such research to do so, ethical guidance that is consistent with egalitarian theories of social justice proposes it ought to (amongst other things) focus on worst-off countries and research populations. Yet who constitutes the worst-off is not well-defined. By applying existing work on disadvantage from political philosophy, the paper demonstrates that (at least) two options exist for how to define the worst-off upon whom equity-oriented health systems research should focus: those who are worst-off in terms of health or those who are systematically disadvantaged. The paper describes in detail how both concepts can be understood and what metrics can be relied upon to identify worst-off countries and research populations at the sub-national level (groups, communities). To demonstrate how each can be used, the paper considers two real-world cases of health systems research and whether their choice of country (Uganda, India) and research population in 2011 would have been classified as amongst the worst-off according to the proposed concepts. The two proposed concepts can classify different countries and sub-national populations as worst-off. It is recommended that health researchers (or other actors) should use the concept that best reflects their moral commitments-namely, to perform research focused on reducing health inequalities or systematic disadvantage more broadly. If addressing the latter, it is recommended that they rely on the multidimensional poverty approach rather than the income approach to identify worst-off populations.

Systematic reviews need to consider applicability to disadvantaged populations: inter-rater agreement for a health equity plausibility algorithm

PubMed Central

2012-01-01

Background Systematic reviews have been challenged to consider effects on disadvantaged groups. A priori specification of subgroup analyses is recommended to increase the credibility of these analyses. This study aimed to develop and assess inter-rater agreement for an algorithm for systematic review authors to predict whether differences in effect measures are likely for disadvantaged populations relative to advantaged populations (only relative effect measures were addressed). Methods A health equity plausibility algorithm was developed using clinimetric methods with three items based on literature review, key informant interviews and methodology studies. The three items dealt with the plausibility of differences in relative effects across sex or socioeconomic status (SES) due to: 1) patient characteristics; 2) intervention delivery (i.e., implementation); and 3) comparators. Thirty-five respondents (consisting of clinicians, methodologists and research users) assessed the likelihood of differences across sex and SES for ten systematic reviews with these questions. We assessed inter-rater reliability using Fleiss multi-rater kappa. Results The proportion agreement was 66% for patient characteristics (95% confidence interval: 61%-71%), 67% for intervention delivery (95% confidence interval: 62% to 72%) and 55% for the comparator (95% confidence interval: 50% to 60%). Inter-rater kappa, assessed with Fleiss kappa, ranged from 0 to 0.199, representing very low agreement beyond chance. Conclusions Users of systematic reviews rated that important differences in relative effects across sex and socioeconomic status were plausible for a range of individual and population-level interventions. However, there was very low inter-rater agreement for these assessments. There is an unmet need for discussion of plausibility of differential effects in systematic reviews. Increased consideration of external validity and applicability to different populations and settings is warranted in systematic reviews to meet this need. PMID:23253632

Systematic reviews need to consider applicability to disadvantaged populations: inter-rater agreement for a health equity plausibility algorithm.

PubMed

Welch, Vivian; Brand, Kevin; Kristjansson, Elizabeth; Smylie, Janet; Wells, George; Tugwell, Peter

2012-12-19

Systematic reviews have been challenged to consider effects on disadvantaged groups. A priori specification of subgroup analyses is recommended to increase the credibility of these analyses. This study aimed to develop and assess inter-rater agreement for an algorithm for systematic review authors to predict whether differences in effect measures are likely for disadvantaged populations relative to advantaged populations (only relative effect measures were addressed). A health equity plausibility algorithm was developed using clinimetric methods with three items based on literature review, key informant interviews and methodology studies. The three items dealt with the plausibility of differences in relative effects across sex or socioeconomic status (SES) due to: 1) patient characteristics; 2) intervention delivery (i.e., implementation); and 3) comparators. Thirty-five respondents (consisting of clinicians, methodologists and research users) assessed the likelihood of differences across sex and SES for ten systematic reviews with these questions. We assessed inter-rater reliability using Fleiss multi-rater kappa. The proportion agreement was 66% for patient characteristics (95% confidence interval: 61%-71%), 67% for intervention delivery (95% confidence interval: 62% to 72%) and 55% for the comparator (95% confidence interval: 50% to 60%). Inter-rater kappa, assessed with Fleiss kappa, ranged from 0 to 0.199, representing very low agreement beyond chance. Users of systematic reviews rated that important differences in relative effects across sex and socioeconomic status were plausible for a range of individual and population-level interventions. However, there was very low inter-rater agreement for these assessments. There is an unmet need for discussion of plausibility of differential effects in systematic reviews. Increased consideration of external validity and applicability to different populations and settings is warranted in systematic reviews to meet this need.

Decreasing Caregivers' Positive Attitudes Toward Spanking.

PubMed

Burkhart, Kimberly; Knox, Michele; Hunter, Kimberly; Pennewitt, Deanna; Schrouder, Karyssa

2018-02-19

The Play Nicely program is a multimedia training program designed to teach caregivers and health care professionals how to manage early childhood aggression and to use positive parenting practices. The aim of this article is to help the practicing clinician determine whether the Play Nicely program should be incorporated into his/her practice and to evaluate whether the program is effective at decreasing positive attitudes toward spanking in a socioeconomically disadvantaged population in both a resident pediatric clinic and a community center. Thirty-three caregivers of children aged 2 to 5 years viewed the Play Nicely program and completed pre- and post-training questionnaires. Decreased positive attitudes toward spanking were reported after training. Favorable attitudes toward spanking were associated with increased use of harsher discipline and higher child externalizing behavior. This study provides support that this brief intervention is effective in a socioeconomically disadvantaged population, is portable, and can be used in a group setting. This program may serve as a prevention and population-based approach to addressing the adverse childhood experience of spanking. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

The PhD Conundrum in South African Academia

ERIC Educational Resources Information Center

Breier, Mignonne; Herman, Chaya

2017-01-01

South African universities need more academics with PhDs, from historically disadvantaged population groups in particular, but they face a conundrum. In order to have more staff with PhDs, they need to produce more PhD graduates. But in order to produce more PhD graduates, they need more staff with PhDs to supervise. This article explores this…

A Report to the U.S. Department of Education on Educational Challenges and Technical Assistance Needs for the Northwest Region

ERIC Educational Resources Information Center

CNA Corporation, 2005

2005-01-01

Currently, the need is growing to address the student achievement gap among racial/ethnic groups as well as for economically disadvantaged students. Minority students represent 24 percent of the Northwest's Region total student enrollment. American Indian and/or Alaskan Native students comprise 25 percent of Alaska's student population and 11…

The Impact of Adolescent Stuttering on Educational and Employment Outcomes: Evidence from a Birth Cohort Study

ERIC Educational Resources Information Center

McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

2012-01-01

Purpose: In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter. Method: A secondary analysis of a British…

Ethnic and gender earning gaps in a liberalized economy: The case of Israel.

PubMed

Bental, Benjamin; Kraus, Vered; Yonay, Yuval

2017-03-01

During the 1990s and the 2000s Israel, a country ethnically divided into a dominant Jewish majority and a disadvantaged mostly Muslim Palestinian minority, underwent a transition from a heavily regulated to a neo-liberal economy. This paper makes use of the Israeli case to shed light on the effect of liberalization on earning gaps in the public and private sectors across dominant and disadvantaged population groups. The data, drawn from the 1995 and 2008 censuses-years that encompass the transition period, enable a dynamic investigation of the liberalization process by comparing labor market outcomes for Israeli Jews and Muslims of both genders working in the public or private sector. Liberalization reduced the protective role of the public sector, especially hurting women of both ethnic groups. In the private sector this process improved the position of the strongest group of Jewish men and of the weakest group of Muslim women. Discrimination against Jewish women and Muslim men in the private sector increased. Copyright © 2016 Elsevier Inc. All rights reserved.

Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage.

PubMed

Hyndman, J C; Holman, C D

2001-12-01

The accessibility and spatial distribution of health services provided by the main source of primary medical care in Australia--the general practice surgery--was investigated by level of social disadvantage of local catchment areas. All 459 general practice surgeries in Perth, an Australian city of 1.2 million residents, were surveyed with a 94% response. Amount of service provision was measured using weekly doctor-hours, available from consulting rooms during opening hours, and associated nurse-hours of service. Access factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, ease of making a same day appointment, bulk-billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hours of service provision were also greater (41.0 h/1,000 most disadvantaged vs. 37.9 h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas compared with least disadvantaged areas (61 vs. 38%). However, populations living in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%), to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs. 51%). While the overall picture of accessibility was favourable, there was considerable variation in the type of services provided to different socioeconomic groups. Health care planners should investigate the reasons for these differences and advise Government to ensure that access factors affecting publicly funded services are equitably distributed.

Prevalence of food insecurity among food bank users in Germany and its association with population characteristics.

PubMed

Depa, Julia; Gyngell, Fiona; Müller, Annalena; Eleraky, Laila; Hilzendegen, Carolin; Stroebele-Benschop, Nanette

2018-03-01

The prevalence of food insecurity (FI) among food bank users in many European countries is unknown. The study aims to examine FI prevalence and associated population characteristics among this particular group of disadvantaged people in Germany. Food insecurity status was assessed among 1033 adult food bank users with a mean age of 53 years (57% female, 43% male) in Germany in 2015 using the food insecurity experience scale (FIES). About half of the participants (55.8%) were single with no children and born in Germany. Over 37% had a self-reported BMI of 30 kg/m 2 or above and 37.4% indicated to smoke. Over 70% of the food bank users can be described as food insecure. Of those, about 35% were considered mildly food insecure. Almost 30% were categorized as moderately food insecure while over 7% were categorized as severely food insecure. Significant associations with food insecurity were found for gender, age, subjective health status, smoking, duration of food bank use, school education and family type. Among this socially disadvantaged population, food insecurity is highly prevalent and public health efforts should be focusing on this vulnerable population taken into account the identified population and behavioral characteristics associated with food insecurity.

Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study

PubMed Central

Elsey, H; Bragg, R; Elings, M; Cade, J E; Brennan, C; Farragher, T; Tubeuf, S; Gold, R; Shickle, D; Wickramasekera, N; Richardson, Z; Murray, J

2014-01-01

Introduction Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of care farms in improving health and well-being. Understanding the underlying mechanisms that lead to improvements for different disadvantaged groups is a further gap in the evidence. Participants in this study are offenders serving community orders. Their low socioeconomic status and poor health outcomes relative to the general population exemplifies disadvantage. Methods and analysis This paper describes the protocol of a study to understand the impacts of care farms and to pilot the design and tools for a study to assess cost-effectiveness of care farms in improving the quality of life of offenders. As a pilot study, no power calculation has been conducted. However, 150 offenders serving community sentences on care farms and 150 on other probation locations (eg, litter picking, painting) will be recruited over a 1-year period. Changes in quality of life, measured by Clinical Outcome in Routine Evaluation–Outcome Measure, health and reconvictions of offenders at care farms compared to other probation locations will be analysed to inform the sample size calculation for the follow on study. The feasibility of recruitment, retention, collecting cost data and modelling cost-effectiveness will also be assessed. The study will use qualitative methods to explore the experiences of offenders attending care farms and perceptions of probation and care farm staff on the processes and impacts of the intervention. Ethics and dissemination Findings will be published and inform development of a natural experiment and will be disseminated to probation services, care farms and academics. University of Leeds Ethical Review Board approved: SoMREC/13/014. National Offender Management Service (NOMS) approved: 2013-257. PMID:25358678

Toxoplasma and reaction time: role of toxoplasmosis in the origin, preservation and geographical distribution of Rh blood group polymorphism.

PubMed

Novotná, M; Havlícek, J; Smith, A P; Kolbeková, P; Skallová, A; Klose, J; Gasová, Z; Písacka, M; Sechovská, M; Flegr, J

2008-09-01

The RhD protein which is the RHD gene product and a major component of the Rh blood group system carries the strongest blood group immunogen, the D-antigen. This antigen is absent in a significant minority of the human population (RhD-negatives) due to RHD deletion or alternation. The origin and persistence of this RhD polymorphism is an old evolutionary enigma. Before the advent of modern medicine, the carriers of the rarer allele (e.g. RhD-negative women in the population of RhD-positives or RhD-positive men in the population of RhD-negatives) were at a disadvantage as some of their children (RhD-positive children born to pre-immunized RhD-negative mothers) were at a higher risk of foetal or newborn death or health impairment from haemolytic disease. Therefore, the RhD-polymorphism should be unstable, unless the disadvantage of carriers of the locally less abundant allele is counterbalanced by, for example, higher viability of the heterozygotes. Here we demonstrated for the first time that among Toxoplasma-free subjects the RhD-negative men had faster reaction times than Rh-positive subjects and showed that heterozygous men with both the RhD plus and RhD minus alleles were protected against prolongation of reaction times caused by infection with the common protozoan parasite Toxoplasma gondii. Our results suggest that the balancing selection favouring heterozygotes could explain the origin and stability of the RhD polymorphism. Moreover, an unequal prevalence of toxoplasmosis in different countries could explain pronounced differences in frequencies of RhD-negative phenotype in geographically distinct populations.

Access to Higher Education for Disadvantaged Groups in China: A Summary Report

ERIC Educational Resources Information Center

Hong, Shen

2004-01-01

This article discusses a summary report of the disadvantaged groups' access to higher education in China. In this article, the author discusses the definition of "disadvantaged groups" as defined by economists, jurists, and sociologists. The author also discusses the analysis of the direct and indirect causes for China's disadvantaged…

Tweens at risk: examining car safety practices in four economically disadvantaged urban elementary schools in Virginia.

PubMed

Will, Kelli England; Dunaway, Krystall E; Lorek, Edward J

2013-09-01

Children aged 8- to 12-years-old ("tweens") are at high risk for crash injury, and motor vehicle crashes are their leading cause of death. Data are presented from behavioral observations (N=243), surveys (N=677), and focus groups (N=26) conducted with tweens attending four urban elementary schools in Virginia. The populations assessed were predominantly black (77.9%) and economically disadvantaged (61.9%). Focus groups revealed a number of inconsistencies in and misconceptions about safety practices. Among the 677 tweens who completed anonymous surveys, the majority (58.1%) reported wearing their seat belts "not very much at all" or "never." Many students (47.8%) reported usually sitting in the front seat or sitting in the front and back seats equally. This is despite the fact that most (92.0%) knew that the back seat was the safest place to sit. Of the 243 tweens observed in vehicles, 65.0% were unrestrained and 60.1% were seated in the front passenger seat. Findings of this study shed light on the great disparity between the national rates for child safety practices and those of children living in an economically disadvantaged urban school district. Additional intervention programs that are culturally appropriate and specifically target this age group are needed. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Gender differences in asthma prevalence: variations with socioeconomic disadvantage.

PubMed

Chittleborough, Catherine R; Taylor, Anne W; Dal Grande, Eleonora; Gill, Tiffany K; Grant, Janet F; Adams, Robert J; Wilson, David H; Ruffin, Richard E

2010-01-01

Socioeconomic inequalities in health have been shown to vary for different diseases and by gender. This study aimed to examine gender differences in associations between asthma and socioeconomic disadvantage. Socioeconomic variables were assessed among men and women in the North West Adelaide Health Study, a representative population cohort (n = 4060) aged 18 years and over in metropolitan South Australia. Asthma was determined from spirometry and self-reported doctor diagnosis. The prevalence of asthma was 12.0% (95% CI: 11.1-13.1), and was significantly higher among women (13.5%) than men (10.5%). For participants aged 18-64 years a higher prevalence of asthma was associated with an education level of secondary school or lower, or not being in the paid labour force among men, and with a gross annual household income of $20,000 or less among women. Among socioeconomically advantaged groups, the prevalence of asthma was significantly higher among women than men. Socioeconomic disadvantage was associated with higher asthma prevalence, although this varied by gender depending on the indicator of socioeconomic position used. Men with low education or those not employed in the paid labour force had higher asthma prevalence than more socioeconomically advantaged men. Women with low income had higher asthma prevalence than those with higher income. Among all socioeconomically advantaged groups, and also the low-income group, women experienced a higher prevalence of asthma than men.

Psychosocial working conditions in a representative sample of working Australians 2001-2008: an analysis of changes in inequalities over time.

PubMed

LaMontagne, A D; Krnjacki, L; Kavanagh, A M; Bentley, R

2013-09-01

A number of widely prevalent job stressors have been identified as modifiable risk factors for common mental and physical illnesses such as depression and cardiovascular disease, yet there has been relatively little study of population trends in exposure to job stressors over time. The aims of this paper were to assess: (1) overall time trends in job control and security and (2) whether disparities by sex, age, skill level and employment arrangement were changing over time in the Australian working population. Job control and security were measured in eight annual waves (2000-2008) from the Australian nationally-representative Household Income and Labour Dynamics of Australia panel survey (n=13 188 unique individuals for control and n=13 182 for security). Observed and model-predicted time trends were generated. Models were generated using population-averaged longitudinal linear regression, with year fitted categorically. Changes in disparities over time by sex, age group, skill level and employment arrangement were tested as interactions between each of these stratifying variables and time. While significant disparities persisted for disadvantaged compared with advantaged groups, results suggested that inequalities in job control narrowed among young workers compared with older groups and for casual, fixed-term and self-employed compared with permanent workers. A slight narrowing of disparities over time in job security was noted for gender, age, employment arrangement and occupational skill level. Despite the favourable findings of small reductions in disparities in job control and security, significant cross-sectional disparities persist. Policy and practice intervention to improve psychosocial working conditions for disadvantaged groups could reduce these persisting disparities and associated illness burdens.

Children's perceptions of the factors helping them to be 'resilient' to sedentary lifestyles.

PubMed

Veitch, Jenny; Arundell, Lauren; Hume, Clare; Ball, Kylie

2013-08-01

Despite the increased risk of sedentary lifestyles associated with socioeconomic disadvantage, some children living in disadvantaged areas display 'resilience' to unhealthy behaviours whereby they manage to engage in regular physical activity and avoid high levels of screen time. It is important to understand what is helping these children to do well. This qualitative study explored the perceptions of 'resilient' children regarding factors that assist them to engage in high levels of physical activity and low screen time. In-depth face-to-face interviews were conducted with 38 children (7-13 years) living in disadvantaged neighbourhoods in urban and rural areas of Victoria, Australia. Themes that emerged relating to physical activity included: parental support and encouragement of physical activity, having a supportive physical environment and having friends to be active with. Themes relating to screen time included: individual preferences to be active, knowledge of health risks associated with sedentary behaviour, having a home environment supportive of physical activity and parental rules. The results provide valuable insights regarding factors that may help children living in disadvantaged neighbourhoods to be physically active and reduce their screen time and may inform future studies targeting this important population group.

Evidence for an apartheid-like social structure in early Anglo-Saxon England.

PubMed

Thomas, Mark G; Stumpf, Michael P H; Härke, Heinrich

2006-10-22

The role of migration in the Anglo-Saxon transition in England remains controversial. Archaeological and historical evidence is inconclusive, but current estimates of the contribution of migrants to the English population range from less than 10000 to as many as 200000. In contrast, recent studies based on Y-chromosome variation posit a considerably higher contribution to the modern English gene pool (50-100%). Historical evidence suggests that following the Anglo-Saxon transition, people of indigenous ethnicity were at an economic and legal disadvantage compared to those having Anglo-Saxon ethnicity. It is likely that such a disadvantage would lead to differential reproductive success. We examine the effect of differential reproductive success, coupled with limited intermarriage between distinct ethnic groups, on the spread of genetic variants. Computer simulations indicate that a social structure limiting intermarriage between indigenous Britons and an initially small Anglo-Saxon immigrant population provide a plausible explanation of the high degree of Continental male-line ancestry in England.

Evidence for an apartheid-like social structure in early Anglo-Saxon England

PubMed Central

Thomas, Mark G; Stumpf, Michael P.H; Härke, Heinrich

2006-01-01

The role of migration in the Anglo-Saxon transition in England remains controversial. Archaeological and historical evidence is inconclusive, but current estimates of the contribution of migrants to the English population range from less than 10 000 to as many as 200 000. In contrast, recent studies based on Y-chromosome variation posit a considerably higher contribution to the modern English gene pool (50–100%). Historical evidence suggests that following the Anglo-Saxon transition, people of indigenous ethnicity were at an economic and legal disadvantage compared to those having Anglo-Saxon ethnicity. It is likely that such a disadvantage would lead to differential reproductive success. We examine the effect of differential reproductive success, coupled with limited intermarriage between distinct ethnic groups, on the spread of genetic variants. Computer simulations indicate that a social structure limiting intermarriage between indigenous Britons and an initially small Anglo-Saxon immigrant population provide a plausible explanation of the high degree of Continental male-line ancestry in England. PMID:17002951

Educational Reform for Disadvantaged Students: An Emerging Crisis.

ERIC Educational Resources Information Center

Levin, M.

Addressing the problems of the educationally disadvantaged requires specifically focused educational reforms. This paper: (1) describes the population of disadvantaged students in terms of its composition, growth, and educational performance; (2) reviews the dire consequences of ignoring the educational needs of these students; (3) discusses the…

Special Education and Programs for Disadvantaged Children and Youth.

ERIC Educational Resources Information Center

Tannenbaum, Abraham J. Ed.

Nine conference papers consider the application of knowledge and methods known to special education to the instruction of disadvantaged children. Edmund W. Gordon views the disadvantaged population; Frank B. Wilderson discusses behavior disorders in children from deprived backgrounds; Harriet Green Kopp describes problems of perception and…

Does conurbation affect the risk of poor mental health? A population based record linkage study.

PubMed

Maguire, A; O'Reilly, D

2015-07-01

To determine if urban residence is associated with an increased risk of anxiety/depression independent of psychosocial stressors, concentrated disadvantage or selective migration between urban and rural areas, this population wide record-linkage study utilised data on receipt of prescription medication linked to area level indicators of conurbation and disadvantage. An urban/rural gradient in anxiolytic and antidepressant use was evident that was independent of variation in population composition. This gradient was most pronounced amongst disadvantaged areas. Migration into increasingly urban areas increased the likelihood of medication. These results suggest increasing conurbation is deleterious to mental health, especially amongst residents of deprived areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

PubMed Central

2014-01-01

Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships. PMID:24669751

Spectrum of MTHFR gene SNPs C677T and A1298C: a study among 23 population groups of India.

PubMed

Saraswathy, Kallur Nava; Asghar, Mohammad; Samtani, Ratika; Murry, Benrithung; Mondal, Prakash Ranjan; Ghosh, Pradeep Kumar; Sachdeva, Mohinder Pal

2012-04-01

Elevated homocysteine is a risk factor for many complex disorders. The role of methylenetetrahydrofolate reductase (MTHFR) gene in methylation of homocysteine makes it one of the most important candidate genes for these disorders. Considering the heterogeneity in its distribution in world populations, we screened MTHFR C677T and A1298C single nucleotide polymorphisms in a total of 23 Indian caste, tribal and religious population groups from five geographical regions of India and belonging to four major linguistic groups. The frequencies of MTHFR 677T and 1298C alleles were found to be 10.08 and 20.66%, respectively. MTHFR homozygous genotype 677TT was absent in eight population groups and homozygous 1298CC was absent in two population groups. 677T allele was found to be highest among north Indian populations with Indo-European tongue and 1298C was high among Dravidian-speaking tribes of east India and south India. The less common mutant haplotype 677T-1298C was observed among seven population groups and overall the frequency of this haplotype was 0.008, which is similar to that of African populations. cis configuration of 677T and 1298C was 0.94%. However, we could not find any individual with four mutant alleles which supports the earlier observation that presence of more than two mutant alleles may decrease the viability of foetus and possibly be a selective disadvantage in the population.

Renegotiating Relations among Teacher, Community, and Students: A Case Study of Teaching Roma Students in a Second Chance Program

ERIC Educational Resources Information Center

Stoilescu, Dorian; Carapanait, Greta

2011-01-01

Prejudice and systematic discrimination have often been mentioned as major causes for the chronic underachievement of Roma students. In this paper we present a case study of a Romanian teacher involved in Second Chance, an educational program implemented in Romania in 2004 for the benefit of disadvantaged groups such as the Roma population. Since…

Content Analysis of Advantages and Disadvantages of Drinking Among Individuals With the Lived Experience of Homelessness and Alcohol Use Disorders.

PubMed

Collins, Susan E; Taylor, Emily; Jones, Connor; Haelsig, Laura; Grazioli, Véronique S; Mackelprang, Jessica L; Holttum, Jessica; Koker, Molly; Hatsukami, Alyssa; Baker, Madeline; Clifasefi, Seema L

2018-01-02

Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment services, however, are not effective at engaging and treating this population. To better tailor treatment services to their needs, it is imperative we understand this population's perceptions of their alcohol use. The aim of this study was to provide description and relative rankings of the advantages and disadvantages of alcohol use from this population's perspectives. Participants were 44 individuals with lived experiences of AUDs and homelessness who received services at community-based agencies in Seattle, Washington. Open-ended prompts were used in interviews conducted in 2013-2014 to assess the perceived role of alcohol in participants' lives, including participants' perceptions of the advantages and disadvantages of their current drinking, and a conventional content analysis was conducted. The most frequently mentioned advantages of drinking included positively and negatively reinforcing psychological reasons, perceived control over drinking, and social benefits. Physical effects, concerns about dependence on alcohol, and health problems were the most commonly mentioned disadvantages. Conclusions/importance: By documenting the perceived advantages and disadvantages of drinking among people with the lived experience of homelessness and AUDs, this study supplies information providers may use to better tailor treatment services to this multimorbid, high service-utilizing population's needs and interests.

Ethnic-group socioeconomic status as an indicator of community-level disadvantage: A study of overweight/obesity in Asian American adolescents.

PubMed

Cook, Won Kim; Tseng, Winston; Tam, Christina; John, Iyanrick; Lui, Camillia

2017-07-01

Asian American children and adolescents are an under-investigated subpopulation in obesity research. Informed by a wide socioeconomic diversity among Asian American ethnic groups, this study explored ethnic-group socioeconomic status (SES) as an indicator of community-level disadvantage that may influence overweight/obesity in Asian American adolescents. We hypothesized that ethnic-group SES was inversely associated with overweight/obesity in Asian American adolescents. Multiple logistic regression models were fitted using a sample of 1525 Asian American adolescents ages 12-17 from pooled 2007-2012 California Health Interview Survey (CHIS) data. Age, gender, nativity, individual-level SES (income and education), and two lifestyle variables (fast food consumption and physical activity) were controlled for. We found that adolescents in high- or middle-level SES ethnic groups were far less likely to be overweight/obese than those in low-SES ethnic groups. Further, these relationships were more pronounced for foreign-born adolescents but not significant for U.S.-born adolescents. Ethnic-group SES may be a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans and, potentially, other populations with high proportions of immigrants of diverse socioeconomic and ethnic backgrounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Simultaneous Effects of Socioeconomic Disadvantage and Child Health on Children’s Cognitive Development

PubMed Central

Lee, Dohoon; Jackson, Margot

2018-01-01

Family socioeconomic status (SES) and child health are so strongly related that scholars have speculated child health to be an important pathway through which a “cycle of poverty” is reproduced across generations. Despite increasing recognition that SES and health work reciprocally and dynamically over the life course to produce inequality, however, existing research has yet to address how these two pathways simultaneously shape children’s development. Using longitudinal data from the Fragile Families and Child Wellbeing Study and marginal structural models, we ask three questions: 1) how does the reciprocal relationship between socioeconomic disadvantage and child health affect estimates of each circumstance on children’s cognitive development?; 2) how do their respective effects vary with age?; and 3) do family SES and child health have differential effects on cognitive development across population subgroups? The results show that the negative effects of socioeconomic disadvantage and poor health are insensitive to their reciprocal relationships over time. We find divergent effects of socioeconomic disadvantage and poor health on children’s cognitive trajectories, with a widening pattern for family SES effects and a leveling-off pattern for child health effects. Finally, the effects of socioeconomic disadvantage are similar across all racial/ethnic groups, while the effects of child health are largely driven by white children. We discuss theoretical and policy implications of these findings for future research. PMID:28836169

Multiple Levels of Social Disadvantage and Links to Obesity in Adolescence and Young Adulthood

PubMed Central

Harris, Kathleen Mullan; Lee, Joyce

2013-01-01

Background The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This paper examines the role of disadvantage at the family-, peer-, school- and neighborhood-level, to determine which contexts are related to obesity in adolescence and young adulthood. Methods We analyzed longitudinal data from Waves I (1994-95), II (1996), and III (2001-02) of the National Longitudinal Study of Adolescent Health, a nationally-representative population-based sample of adolescents in grades 7-12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family-, peer-, school-, and neighborhood-level using multilevel logistic regression. Results When all levels of disadvantage were modeled simultaneously, school-level disadvantage was significantly associated with obesity in adolescence for males and females and family-level disadvantage was significantly associated with obesity in young adulthood for females. Conclusions Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations. PMID:23343314

Multiple levels of social disadvantage and links to obesity in adolescence and young adulthood.

PubMed

Lee, Hedwig; Harris, Kathleen M; Lee, Joyce

2013-03-01

The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family-, peer-, school-, and neighborhood-level, to determine which contexts are related to obesity in adolescence and young adulthood. We analyzed longitudinal data from Waves I (1994-1995), II (1996), and III (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative population-based sample of adolescents in grades 7-12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family-, peer-, school-, and neighborhood-level using multilevel logistic regression. When all levels of disadvantage were modeled simultaneously, school-level disadvantage was significantly associated with obesity in adolescence for males and females and family-level disadvantage was significantly associated with obesity in young adulthood for females. Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations. © 2013, American School Health Association.

Proceedings of a National Multicultural Seminar on Mental Retardation among Minority Disadvantaged Populations (Norfolk, Virginia, October 10-12, 1977).

ERIC Educational Resources Information Center

President's Committee on Mental Retardation, Washington, DC.

The National Multicultural Seminar on Mental Retardation among Minority Disadvantaged Populations was initiated in response to concern about the root causes of mental retardation especially in mild forms which tend to be more prevalent and more devastating among persons living in depressed, disrupted, and impoverished environments. Nineteen papers…

7 CFR 761.208 - Target participation rates for socially disadvantaged groups.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Target participation rates for socially disadvantaged... Farm Loan Programs Funds to State Offices § 761.208 Target participation rates for socially disadvantaged groups. (a) General. (1) The Agency establishes target participation rates for providing FO, CL...

Billboard advertising: an avenue for communicating healthcare information and opportunities to disadvantaged populations.

PubMed

Elrod, James K; Fortenberry, John L

2017-12-13

Healthcare communications directed toward the disadvantaged have the potential to elevate the health status of these underprivileged and highly-challenged individuals. From conveying advice which encourages healthy lifestyles to communicating the location and availability of various medical resources, healthier lives and communities can be realized. Success on this front first requires establishing an effective communications link, something that is made more difficult as communications options available to the disadvantaged are more limited than those available to advantaged populations. One avenue which shows exceptional promise for successfully engaging the disadvantaged is that of billboard advertising. Willis-Knighton Health System's experiences and insights indicate that the characteristics and qualities of billboards, paired with the environmental circumstances typically faced by the less fortunate, create unique combinations which amplify consumption of billboard advertising content. Further, research suggests that the less privileged place greater reliance on the medium than do their more privileged counterparts, escalating the value and impact potential of billboard advertising directed toward the disadvantaged. Given the value afforded by health and wellness information successfully reaching the disadvantaged, opportunities to better distribute content to targeted audiences could very well improve community health. Billboard advertising appears to be well suited to engage the less fortunate, providing a productive pathway for the conveyance of helpful, supportive details, yielding healthier populations, enhanced opportunities, and better communities.

The Relationship between Teachers' Collective Efficacy and Student Achievement at Economically Disadvantaged Middle School Campuses

ERIC Educational Resources Information Center

Sandoval, Juan Manuel; Challoo, Linda B.; Kupczynski, Lori

2011-01-01

The purpose of this study was to examine the relationship between the collective efficacy of teachers and student achievement at economically disadvantaged middle school campuses. The population of the study consisted of Texas campuses that served economically disadvantaged students and received a campus rating of Exemplary or Academically…

Kagan Cooperative Learning Model and Mathematics Achievement of Economically Disadvantaged Middle School Students

ERIC Educational Resources Information Center

Mourning, Erica

2014-01-01

Economically disadvantaged students are being outperformed by their non-disadvantaged peers in middle school mathematics. This problem is evidenced by 2013 data from a national middle school mathematics assessment which revealed an achievement gap of 27 scale score points. Closing this gap is important to schools with high populations of…

Empowering Adult Education in Namibia and South Africa during and after Apartheid

NASA Astrophysics Data System (ADS)

Hopfer, Christiane

1997-01-01

After more than 40 years of education for Apartheid, the development of empowering adult education with the formerly disadvantaged population groups is one of the major challenges for the democratically elected governments in South Africa and Namibia. One of the strongest forces that sustained Apartheid in Namibia until 1990, and in South Africa until 1994, was an education system with different schools and resources for the different population groups. Despite the strict implementation of the Bantu Education System by the white government, some groups of people could still organise alternative education projects aiming at participants' gaining more control over their own lifes. Groups of women in the Western Cape initiated autonomous pre-school projects and took part in in-service training for pre-school teachers in the 1980s. A similar process took place with adult literacy learners in the National Literacy Programme in Namibia.

Targeting cessation: understanding barriers and motivations to quitting among urban adult daily tobacco smokers.

PubMed

Rosenthal, Lisa; Carroll-Scott, Amy; Earnshaw, Valerie A; Sackey, Naa; O'Malley, Stephanie S; Santilli, Alycia; Ickovics, Jeannette R

2013-03-01

Many people continue to smoke tobacco products despite known negative health consequences, including increased risk of chronic disease and death. Disparities exist in rates of smoking and chronic disease, underscoring the importance of understanding the barriers and motivations to smoking cessation among vulnerable populations, such as socioeconomically disadvantaged people of color. This study uses data from a cross-sectional randomized household survey conducted in six low-income neighborhoods in New Haven, Connecticut, USA (N=1205). The objectives were to examine barriers and motivations to quitting smoking among daily tobacco smokers (31.6% of respondents) and sociodemographic differences in endorsement of barriers and motivations. The two most common barriers to quitting were perceiving it to be too difficult and not wanting to quit. Financial costs, social support, and social influence were themes endorsed highly across both barriers and motivations to quitting. Sociodemographic differences were found, such as women and Black participants being more likely to be interested in a free quitline or quit website; women and Latinos being more likely to be afraid of gaining weight; and women, participants with less education, and older participants being more likely to be concerned about the cost of cessation products. Understanding barriers and motivations to quitting among disadvantaged populations is crucial. Financial issues, social support, and social norms should be targeted in promoting cessation among disadvantaged, urban populations. Programs, interventions, and policies can also use research about specific barriers and motivations for sociodemographic sub-groups to be tailored, targeted, and more effective. Copyright © 2012 Elsevier Ltd. All rights reserved.

Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008-2013.

PubMed

Elstad, Jon Ivar

2016-07-07

The association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis. Six waves of EU-SILC surveys (2008-2013) from 30 European countries were analyzed. Foregone medical care, defined as self-reported unmet need for medical care due to costs, waiting lists, or travel difficulties, was examined among respondents aged 30-59 years (N = 1.24 million). Countries' macro-economic situation was measured by Real Gross Domestic Product (GDP) per capita. The S80/S20 ratio indicated the country's level of income inequality. Equity issues were highlighted by separate analyses of disadvantaged respondents with limited economic resources and relatively poor health. Cross-tabulations and multilevel linear probability regression models were utilized. Foregone medical care increased 2008-2013 in the majority of the 30 countries, especially among the disadvantaged parts of the population. For the disadvantaged, unmet need for medical care tended to be higher in countries with larger income inequalities, regardless of the average economic standard in terms of GDP per capita. Both for disadvantaged and for other parts of the samples, a decline in GDP had more severe effects on access in inegalitarian countries than in countries with less income inequality. During The Great Recession, unmet need for medical care increased in Europe, and social inequalities in foregone medical care widened. Overall, countries with a more egalitarian income distribution have been more able to protect their populations, and especially disadvantaged groups, against deteriorated access to medical care when the country is confronted with an economic crisis.

Value Preferences are More Strongly Associated With Social Class Than With Sex or Race. Illinois Studies of the Economically Disadvantaged, Technical Report Number 17.

ERIC Educational Resources Information Center

Malpass, Roy S.; Symonds, John D.

Preferences for 92 values, obtained from a survey of cross-cultural studies of values, were obtained from two separate and geographically distant sets of groups consisting of black and white males and females of lower- and middle-Class status. The middle-class black population was of insufficient size to include, however. Value preferences were…

A Randomized Trial of a Diet and Exercise Intervention for Overweight and Obese Women from Economically Disadvantaged Neighborhoods: Sisters Taking Action for Real Success (STARS)

PubMed Central

Wilcox, Sara; Sharpe, Patricia A.; Parra-Medina, Deborah; Granner, Michelle; Hutto, Brent

2011-01-01

Background Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight loss studies target this population. Objectives STARS tests a culturally-appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods. Design A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes. Methods Participants 25–50 years who had a BMI ≥ 25 kg/m2 and a waist circumference ≥ 88 cm were recruited from 18 census tracts in Columbia, SC with high rates of poverty between November 2008 and November 2010. All participants received a dietary and exercise counseling session. Intervention participants then receive 16 theoretically-based and tailored weekly group sessions followed by 8 weeks of telephone maintenance counseling. Control participants receive 16 weekly health education mailings. Measurements correspond to baseline, post-group intervention, and post-telephone counseling, and for intervention participants, after a 12-week no-contact period. Measurement staff was blinded to group assignment. Results Participants (N=155; n=80 intervention, n=75 minimal intervention control) were primarily African American (86.5%) and averaged 38.9 years with a mean BMI of 40.1 kg/m2 and waist circumference of 115.4 cm. Food insecurity was reported by 43% of participants. Summary STARS targets an underserved population with an innovative, tailored, and theoretically-grounded, group-based intervention followed by telephone maintenance. If effective, the approach has the potential to be feasible and cost-effective for community delivery. PMID:21864718

Potential roles of high salt intake and maternal malnutrition in the development of hypertension in disadvantaged populations.

PubMed

Thrift, Amanda G; Srikanth, Velandai; Fitzgerald, Sharyn M; Kalyanram, Kartik; Kartik, Kamakshi; Hoppe, Chantal C; Walker, Karen Z; Evans, Roger G

2010-02-01

1. It has been argued that all major risk factors for cardiovascular disease have been identified. Yet, epidemiological studies undertaken to identify risk factors have largely focused on populations in developed nations or on the urban or relatively affluent rural populations of developing countries. Poor rural populations are seldom studied. 2. Somewhat different risk factors may operate in poor rural populations. Evidence for this is provided by the finding that, in disadvantaged rural India, the prevalence of hypertension is greater than would be expected based on established risk factors in these populations. One risk factor to be considered is a poor intrauterine environment. 3. In animals, maternal macro- and micronutrient malnutrition can lead to reduced nephron endowment. Nephron deficiency, in turn, can render blood pressure salt sensitive. The combination of nephron deficiency and excessive salt intake will predispose to hypertension. 4. Human malnutrition may have similar effects, particularly in regions of the world where malnutrition is endemic and where women are disadvantaged by existing social practices. 5. Moreover, high salt intake is endemic in many parts of Asia, including India. Therefore, we propose that maternal malnutrition (leading to reduced nephron endowment), when combined with excessive salt intake postnatally, will account, at least in part, for the unexpectedly high prevalence of hypertension in disadvantaged rural communities in India and elsewhere.

Utility of Respondent Driven Sampling to Reach Disadvantaged Emerging Adults for Assessment of Substance Use, Weight, and Sexual Behaviors.

PubMed

Tucker, Jalie A; Simpson, Cathy A; Chandler, Susan D; Borch, Casey A; Davies, Susan L; Kerbawy, Shatomi J; Lewis, Terri H; Crawford, M Scott; Cheong, JeeWon; Michael, Max

2016-01-01

Emerging adulthood often entails heightened risk-taking with potential life-long consequences, and research on risk behaviors is needed to guide prevention programming, particularly in under-served and difficult to reach populations. This study evaluated the utility of Respondent Driven Sampling (RDS), a peer-driven methodology that corrects limitations of snowball sampling, to reach at-risk African American emerging adults from disadvantaged urban communities. Initial "seed" participants from the target group recruited peers, who then recruited their peers in an iterative process (110 males, 234 females; M age = 18.86 years). Structured field interviews assessed common health risk factors, including substance use, overweight/obesity, and sexual behaviors. Established gender-and age-related associations with risk factors were replicated, and sample risk profiles and prevalence estimates compared favorably with matched samples from representative U.S. national surveys. Findings supported the use of RDS as a sampling method and grassroots platform for research and prevention with community-dwelling risk groups.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed

Jaafar, Nasruddin; Hakim, Hina; Mohd Nor, Nor Azlida; Mohamed, Asma; Saub, Roslan; Esa, Rashidah; Doss, Jennifer; Mohd Yusof, Zamros Yuzadi; Ab-Murat, Norintan; Abu Kassim, Noor Lide; Majid, Hazreen Abdul

2014-01-01

The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group.

Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

PubMed Central

2014-01-01

Background The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. Methods A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). Results The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. Conclusions The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group. PMID:25438162

Chronic disease as risk multiplier for disadvantage.

PubMed

Stutzin Donoso, Francisca

2018-03-06

This paper starts by establishing a prima facie case that disadvantaged groups or individuals are more likely to get a chronic disease and are in a disadvantaged position to adhere to chronic treatment despite access through Universal Health Coverage. However, the main aim of this paper is to explore the normative implications of this claim by examining two different but intertwined argumentative lines that might contribute to a better understanding of the ethical challenges faced by chronic disease health policy. The paper develops the argument that certain disadvantages which may predispose to illness might overlap with disadvantages that may hinder self-management, potentially becoming disadvantageous in handling chronic disease. If so, chronic diseases may be seen as disadvantages in themselves, describing a reproduction of disadvantage among the chronically ill and a vicious circle of disadvantage that could both predict and shed light on the catastrophic health outcomes among disadvantaged groups-or individuals-dealing with chronic disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

CKD in disadvantaged populations.

PubMed

Garcia-Garcia, Guillermo; Jha, Vivekanand

2015-02-01

The increased burden of CKD in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health-care disparities and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expansion of the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expansion of deceased-donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increased community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.

Inequity in maternal health care utilization in Vietnam

PubMed Central

2012-01-01

Introduction Vietnam has succeeded in reducing maternal mortality in the last decades. Analysis of survey data however indicate that large inequities exist between different segments of the population. We have analyzed utilization of antenatal care and skilled birth attendance among Vietnamese women of reproductive age in relation to social determinants with the aim to reveal health inequities and identify disadvantaged groups. Method Data on maternal health care utilization and social determinants were derived from the Multiple Indicator Cluster Survey (MICS) conducted in Vietnam in 2006, and analyzed through stratified logistic regressions and g-computation. Results Inequities in maternal health care utilization persist in Vietnam. Ethnicity, household wealth and education were all significantly associated with antenatal care coverage and skilled birth attendance, individually and in synergy. Although the structural determinants included in this study were closely related to each other, analysis revealed a significant effect of ethnicity over and above wealth and education. Within the group of mothers from poor households ethnic minority mothers were at a three-fold risk of not attending any antenatal care (OR 3.06, 95% CI 1.27–7.41) and six times more likely not to deliver with skilled birth attendance (OR 6.27, 95% CI 2.37–16.6). The association between ethnicity and lack of antenatal care and skilled birth attendance was even stronger within the non-poor group. Conclusions In spite of policies to out rule health inequities, ethnic minority women constitute a disadvantaged group in Vietnam. More efficient ways to target disadvantaged groups, taking synergy effects between multiple social determinants into consideration, are needed in order to assure safe motherhood for all. PMID:22587740

7 CFR 1291.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., telephone networks, information technology equipment and systems, reproduction and printing equipment, and... disadvantaged group. A “Socially Disadvantaged Group” is a group whose members have been subject to...

7 CFR 2500.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... socially disadvantaged group. (See 7 U.S.C. 2279(e)(2)). Socially disadvantaged group means a group whose members have been subjected to racial or ethnic prejudice because of their identity as members of a group..., band, nation, or other organized group or community, including any Alaska Native village or regional or...

7 CFR 2500.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... socially disadvantaged group. (See 7 U.S.C. 2279(e)(2)). Socially disadvantaged group means a group whose members have been subjected to racial or ethnic prejudice because of their identity as members of a group..., band, nation, or other organized group or community, including any Alaska Native village or regional or...

Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis

PubMed Central

2012-01-01

Background A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge. PMID:23176397

Conducting Ethical Evaluations with Disadvantaged and Minority Target Groups.

ERIC Educational Resources Information Center

English, Brian

1997-01-01

This paper examines issues involved in conducting evaluations when participation by the target groups, typically minorities and disadvantaged groups, may put them in jeopardy. Argues that participation by target groups as cooperative partners throughout the evaluation is a way of addressing this dilemma. (SLD)

Tripartite Governance: Enabling Successful Implementations with Vulnerable Populations.

PubMed

Kennedy, Margaret Ann

2016-01-01

Vulnerable populations are often at a distinct disadvantage when it comes to the implementation of health information systems in an equitable, appropriate, and timely manner. The disadvantages experienced by vulnerable populations are innumerable and include lack of representation, lack of appropriate levels of funding, lack of resources and capacity, and lack of representation. Increasingly, models of representation for complex implementations involve a tripartite project governance model. This tripartite partnership distributes accountability across all partners, and ensures that vulnerable populations have an equitable contribution to the direction of implementation according to their needs. This article shares lessons learned and best practices from complex tripartite partnerships supporting implementations with vulnerable populations in Canada.

Perspective Taking Explains Gender Differences in Late Adolescents' Attitudes Toward Disadvantaged Groups.

PubMed

Smith, Colin Tucker; Shepperd, James A; Miller, Wendi A; Graber, Julia A

2016-07-01

Adolescents' attitudes toward disadvantaged groups are surprisingly understudied. What we know from these few studies is that adolescents' attitudes tend to become more favorable over time and that adolescent girls display more favorable attitudes than do adolescent boys. However, researchers have not offered explanations for why these effects occur. We proposed that changes in social-cognitive abilities that accompany adolescent development increase perspective taking and that the increased perspective taking facilitates more favorable attitudes toward disadvantaged groups. Because girls develop social-cognitive abilities earlier than boys, girls should show greater perspective taking and thus more positive attitudes toward disadvantaged groups than should boys. Importantly, we propose that these more positive attitudes are explained better by perspective taking than by gender. Participants were late adolescents (n = 803, 53.3 % female, ages 15-19) from high schools in north-central Florida (United States) participating in an ongoing, multi-wave study. Participants completed a measure of perspective-taking and reported their attitudes toward three disadvantaged groups (Black, gay, and poor people) during their third year of high school and, again, 6 months later during their fourth year of high school. Our findings provided strong support for our theorizing. Girls generally reported warmer attitudes than did boys toward disadvantaged groups, with the gender differences in warmth tending to diminish across time. Similarly, girls were higher than boys in perspective-taking abilities at both time points, although boys increased over time whereas girls did not. Crucially, perspective taking mediated observed gender differences in attitudes, suggesting that perspective taking is a mechanism for improving attitudes toward disadvantaged groups during late adolescence.

Australia’s first national level quantitative environmental justice assessment of industrial air pollution

NASA Astrophysics Data System (ADS)

Chakraborty, Jayajit; Green, Donna

2014-04-01

This study presents the first national level quantitative environmental justice assessment of industrial air pollution in Australia. Specifically, our analysis links the spatial distribution of sites and emissions associated with industrial pollution sources derived from the National Pollution Inventory, to Indigenous status and social disadvantage characteristics of communities derived from Australian Bureau of Statistics indicators. Our results reveal a clear national pattern of environmental injustice based on the locations of industrial pollution sources, as well as volume, and toxicity of air pollution released at these locations. Communities with the highest number of polluting sites, emission volume, and toxicity-weighted air emissions indicate significantly greater proportions of Indigenous population and higher levels of socio-economic disadvantage. The quantities and toxicities of industrial air pollution are particularly higher in communities with the lowest levels of educational attainment and occupational status. These findings emphasize the need for more detailed analysis in specific regions and communities where socially disadvantaged groups are disproportionately impacted by industrial air pollution. Our empirical findings also underscore the growing necessity to incorporate environmental justice considerations in environmental planning and policy-making in Australia.

Prioritizing vulnerable children: why should we address inequity?

PubMed

Joshua, P; Zwi, K; Moran, P; White, L

2015-11-01

Children and young people from vulnerable population groups, including Indigenous Australians, those in out of home care, those with disabilities and those from refugee families, have difficulties in accessing health services and are at high risk of adverse outcomes, driving population health inequity. Although heterogeneous, these groups face common disadvantage and shared challenges in health service utilization. This study aims to analyse the demographics of vulnerable child populations in NSW, the rationale for focussing on their health needs and strategies for addressing population health inequity. A literature review was undertaken on vulnerable child populations and successful strategies for improving their health outcomes. NSW data on vulnerable children were collated. Vulnerable children in NSW are estimated to comprise 10-20% of the childhood population. Efforts to improve their health and well-being can be justified based on child rights, a focus on equity and effectiveness of care, public opinion and the evidence base supporting such interventions. Targeted (subpopulation specific) interventions and delivery of universally applied (population wide) strategies that disproportionately benefit vulnerable populations have been shown to be effective in reducing healthcare disparities. Most available information relates to specific vulnerable population groups. However, some effective strategies and key principles are broadly applicable to the vulnerable child population as a whole. Vulnerable children should be a key focus of healthcare interventions if inequities are to be addressed. © 2015 John Wiley & Sons Ltd.

Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.

PubMed

Halonen, Jaana I; Kivimäki, Mika; Pentti, Jaana; Kawachi, Ichiro; Virtanen, Marianna; Martikainen, Pekka; Subramanian, S V; Vahtera, Jussi

2012-01-01

The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03-1.24) and 1.75 (95% CI, 1.54-1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.

I Don't Think You Like Me Very Much: Child Minority Status and Disadvantage Predict Relationship Quality With Teachers

ERIC Educational Resources Information Center

Fitzpatrick, Caroline; Côté-Lussier, Carolyn; Pagani, Linda S.; Blair, Clancy

2015-01-01

Even when accounting for past performance, academic achievement can be influenced by teacher expectations, which are lower for disadvantaged and visible ethnic minority children. We use a Quebec (Canada) population-based sample (N = 1,311) to examine whether ethnicity and teacher-perceived signs of disadvantage in kindergarten predict child…

The relationship between out-of-home care and the quality of infant-mother attachment in an economically disadvantaged population.

PubMed

Vaughn, B E; Gove, F L; Egeland, B

1980-12-01

The effects of routine daily separations occasioned by out-of-home care on the formation and maintenance of infant-mother attachment relationships were examined in a population of economically disadvantaged mothers. 3 groups were constituted on the basis of the time in the infant's life when out-of-home care began: (1) before 12 months; (2) between 12 and 18 months; (3) home-care controls. The infant-mother pairs were observed in the Ainsworth strange situation at both 12 and 18 months, and were classified as secure, anxious-avoidant, or anxious-resistant. Because previous research has implicated the psychological accessibility of the mother to the infant in the development of anxious-avoidant attachments during the first year of life, the hypothesis that physical inaccessibility due to out-of-home care would also be associated with anxious-avoidant attachments was tested. The data support this hypothesis. At 12 months 47% of the infants whose mothers had returned to work/school were classified in the anxious-avoidant group, while the other 2 groups did not differ significantly in the proportions of infants assigned to the 3 attachment classifications. At 18 months, differences among the 3 work status groups also showed a large portion of anxious-avoidant infants (41%) in this early working group. However, infants whose out-of-home care began after 12 months did not show an increase in the proportion of anxious attachments. Additional analyses of variables related to mother's return to work indicated that single mothers were more likely to return to work/school, that mothers who worked reported higher levels of life stress than mothers who stayed home with the infants, and that, by 18 months, both anxious-avoidant and anxious-resistant attachments were also associated with non-intact families.

Children Rectify Inequalities for Disadvantaged Groups

PubMed Central

Elenbaas, Laura; Killen, Melanie

2016-01-01

Children’s decisions regarding the allocation of societal resources in the context of preexisting inequalities were investigated. African-American and European-American children ages 5–6 years (n = 91) and 10–11 years (n = 94) judged the acceptability of a medical resource inequality on the basis of race, allocated medical supplies, evaluated different resource allocation strategies, and completed a measure of status awareness based on race. With age, children were increasingly aware of wealth status disparities between African-Americans and European-Americans, and judged a medical resource inequality between groups more negatively. Further, with age, children rectified the resource inequality over perpetuating it, but only when African-American children were disadvantaged. With age, children also referenced rights when reasoning about their judgments concerning the disadvantaged African-American group. When European-American children were disadvantaged, children did not systematically allocate more resources to one group over another. The results are discussed in terms of social inequalities, disadvantaged status, moral judgments, and intergroup attitudes. PMID:27455190

Change in neighborhood disadvantage and change in smoking behaviors in adults: a longitudinal, within-individual study

PubMed Central

Halonen, Jaana I; Pulakka, Anna; Stenholm, Sari; Pentti, Jaana; Kawachi, Ichiro; Kivimäki, Mika; Vahtera, Jussi

2017-01-01

Background Evidence for an association between neighborhood disadvantage and smoking is mixed and mainly based on cross-sectional studies. To shed light on the causality of this association we examined whether change in neighborhood socioeconomic disadvantage is associated with within-individual change in smoking behaviors. Methods The study population comprised participants of the Finnish Public Sector study who reported a change in their smoking behavior between surveys in 2008/09 and 2012/13. We linked participants’ residential addresses to a total population database on neighborhood disadvantage with 250×250m resolution. The outcome variables were changes in smoking status (being a smoker vs. not) as well as the intensity (heavy/moderate vs. light smoker). We used longitudinal case-crossover design, a method that accounts for time-invariant confounders by design. We adjusted models for time-varying covariates. Results Of the 3443 participants, 1714 quit while 967 began to smoke between surveys. Smoking intensity increased among 398 and decreased among 364 participants. The level of neighborhood disadvantage changed for 1078 participants because they moved residence. Increased disadvantage was associated with increased odds of being a smoker (odds ratio (OR) of taking up smoking 1.23 (95% CI 1.04-1.47) per 1 standard deviation (SD) increase in standardized national disadvantage score). OR for being a heavy/moderate (vs. light) smoker was 1.14 (95% CI 0.85-1.52) when disadvantage increased by 1 SD. Conclusions These within-individual results link an increase in neighborhood socioeconomic disadvantage, due to move in residence, with subsequent smoking behaviors. PMID:27337178

Anti-tobacco mass media and socially disadvantaged groups: a systematic and methodological review.

PubMed

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Chris

2012-07-01

Only a limited amount of research has been conducted to explore whether there are socioeconomic status differences in responses to mass media. However, the methodological quality of this evidence has not been assessed, limiting confidence in conclusions that can be drawn regarding study outcomes. A systematic review of the effectiveness of anti-tobacco mass media campaigns with socially disadvantaged groups was conducted, and the methodological quality of included studies was assessed. Medline, The Cochrane Library, PsycInfo, Embase and Web of Science were searched using MeSH and keywords for quantitative studies conducted in Western countries prior to March 2012. A methodological quality assessment and narrative analysis of included studies was undertaken. Seventeen relevant studies (reported in 18 papers) were identified; however, weak study designs and selection bias were common characteristics, limiting strong conclusions about effectiveness. Using predominantly non-cessation related outcome measures reviewed papers indicated mixed results for mass media tobacco control campaign effectiveness among various social groups. Most studies assessed mass media impact on low socioeconomic status groups rather than highly socially disadvantaged groups. Methodological rigour of evaluations in this field must be improved to aid understanding regarding the effectiveness of mass media campaigns in driving cessation among disadvantaged groups. The results of this review indicate a gap in methodologically rigorous research into the effectiveness of mass media campaigns among socially disadvantaged groups, particularly the highly disadvantaged. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Introduction of a guide to enhance risk communication among low-income and minority populations: a grassroots community engagement approach.

PubMed

Rowel, Randy; Sheikhattari, Payam; Barber, Tanyka M; Evans-Holland, Myrtle

2012-01-01

Low-income populations, especially those belonging to minority groups, are among the most vulnerable groups before, during, and after a natural disaster. One of the factors that can be attributed to their vulnerability is the ineffectiveness of traditional risk communication systems in reaching this population. Many low-income populations are distrustful of government agencies and those who typically communicate risk messages. Consequently, traditional systems are not as effective in reaching these communities. Furthermore, traditional systems have been based on the social media that the general population uses and not based on social networks of disadvantaged populations which are more important than formal channels in these communities for dissemination of information. To bridge the gap, an approach is needed that relies on trusted agencies and leaders to educate and warn low-income communities about possible public health threats. A grassroots approach can enhance the capacity of the risk communication systems to more effectively reach vulnerable populations by engaging grassroots organizations in risk communication activities. The Guide to Enhance Grassroots Risk Communication Among Low-Income Populations provides strategies and guidance that can assist agencies in upgrading their systems for risk communication by building partnerships with local community stakeholders.

A multilevel analysis on the relationship between neighbourhood poverty and public hospital utilization: is the high Indigenous morbidity avoidable?

PubMed Central

2011-01-01

Background The estimated life expectancy at birth for Indigenous Australians is 10-11 years less than the general Australian population. The mean family income for Indigenous people is also significantly lower than for non-Indigenous people. In this paper we examine poverty or socioeconomic disadvantage as an explanation for the Indigenous health gap in hospital morbidity in Australia. Methods We utilised a cross-sectional and ecological design using the Northern Territory public hospitalisation data from 1 July 2004 to 30 June 2008 and socio-economic indexes for areas (SEIFA) from the 2006 census. Multilevel logistic regression models were used to estimate odds ratios and confidence intervals. Both total and potentially avoidable hospitalisations were investigated. Results This study indicated that lifting SEIFA scores for family income and education/occupation by two quintile categories for low socio-economic Indigenous groups was sufficient to overcome the excess hospital utilisation among the Indigenous population compared with the non-Indigenous population. The results support a reframing of the Indigenous health gap as being a consequence of poverty and not simplistically of ethnicity. Conclusions Socio-economic disadvantage is a likely explanation for a substantial proportion of the hospital morbidity gap between Indigenous and non-Indigenous populations. Efforts to improve Indigenous health outcomes should recognise poverty as an underlying determinant of the health gap. PMID:21951514

The New Destination Disadvantage: Disparities in Hispanic Health Insurance Coverage Rates in Metropolitan and Nonmetropolitan New and Established Destinations

PubMed Central

Monnat, Shannon M.

2016-01-01

Hispanics have the lowest health insurance rates of any racial/ethnic group, but rates vary significantly across the U.S. The unprecedented growth of the Hispanic population since 1990 in rural areas with previously small or non-existent Hispanic populations raises questions about disparities in access to health insurance coverage. Identifying spatial disparities in Hispanic health insurance rates can illuminate the specific contexts within which Hispanics are least likely to have health care access and inform policy approaches for increasing coverage in different spatial contexts. Using county-level data from the 2009/2013 American Community Survey, I find that early new destinations (i.e., those that experienced rapid Hispanic population growth during the 1990s) have the lowest Hispanic adult health insurance coverage rates, with little variation by metropolitan status. Conversely, among the most recent new destinations that experienced significant Hispanic population growth during the 2000s, metropolitan counties have Hispanic health insurance rates that are similar to established destinations, but rural counties have Hispanic health insurance rates that are significantly lower than those in established destinations. Findings demonstrate that the new destination disadvantage is driven entirely by higher concentrations of immigrant non-citizen Hispanics in these counties, but labor market conditions were salient drivers of the spatially uneven distribution of foreign-born non-citizen Hispanics to new destinations, particularly in rural areas. PMID:28479612

Considering health equity when moving from evidence-based guideline recommendations to implementation: a case study from an upper-middle income country on the GRADE approach

PubMed Central

Mosquera, Paola; Alzate, Juan Pablo; Pottie, Kevin; Welch, Vivian; Akl, Elie A; Jull, Janet; Lang, Eddy; Katikireddi, Srinivasa Vittal; Morton, Rachel; Thabane, Lehana; Shea, Bev; Stein, Airton T; Singh, Jasvinder; Florez, Ivan D; Guyatt, Gordon; Schünemann, Holger; Tugwell, Peter

2017-01-01

Abstract The availability of evidence-based guidelines does not ensure their implementation and use in clinical practice or policy making. Inequities in health have been defined as those inequalities within or between populations that are avoidable, unnecessary and also unjust and unfair. Evidence-based clinical practice and public health guidelines (‘guidelines’) can be used to target health inequities experienced by disadvantaged populations, although guidelines may unintentionally increase health inequities. For this reason, there is a need for evidence-based clinical practice and public health guidelines to intentionally target health inequities experienced by disadvantaged populations. Current guideline development processes do not include steps for planned implementation of equity-focused guidelines. This article describes nine steps that provide guidance for consideration of equity during guideline implementation. A critical appraisal of the literature followed by a process to build expert consensus was undertaken to define how to include consideration of equity issues during the specific GRADE guideline development process. Using a case study from Colombia we describe nine steps that were used to implement equity-focused GRADE recommendations: (1) identification of disadvantaged groups, (2) quantification of current health inequities, (3) development of equity-sensitive recommendations, (4) identification of key actors for implementation of equity-focused recommendations, (5) identification of barriers and facilitators to the implementation of equity-focused recommendations, (6) development of an equity strategy to be included in the implementation plan, (7) assessment of resources and incentives, (8) development of a communication strategy to support an equity focus and (9) development of monitoring and evaluation strategies. This case study can be used as model for implementing clinical practice guidelines, taking into account equity issues during guideline development and implementation. PMID:29029068

Workplace diversity and public policy: challenges and opportunities for psychology.

PubMed

Fassinger, Ruth E

2008-01-01

This article outlines both challenges and opportunities for psychology of issues related to diversity in education and work. For the purposes of this discussion, "diverse" populations include four groups currently marginalized and disadvantaged in the U.S. workplace: women, people of color, sexual minorities, and people with disabilities. An overview of employment participation patterns for these groups is presented, workplace barriers arising from marginalized status are highlighted, and the article concludes with a discussion of work-related legislative and public policy fronts that can be informed and influenced by the contributions of psychologists. Copyright (c) 2008 APA, all rights reserved.

IVHS: Potential Impact On Disadvantaged Communities, IVHS Draft

DOT National Transportation Integrated Search

1994-06-01

THIS PAPER EXPLORES THE IMPACT OF TRANSPORTATION TECHNOLOGIES ON THE SOCIAL AND ECONOMIC WELL-BEING OF CENTRAL CITY RESIDENTS AND DISADVANTAGED POPULATIONS. THOUGH MEMBERS OF POOR COMMUNITIES HAVE LITTLE POLITICAL POWER OR INPUT INTO THE DECISION-MAK...

More than a snapshot in time: pathways of disadvantage over childhood.

PubMed

Goldfeld, Sharon; O'Connor, Meredith; O'Connor, Elodie; Chong, Shiau; Badland, Hannah; Woolfenden, Sue; Redmond, Gerry; Williams, Katrina; Azpitarte, Francisco; Cloney, Dan; Mensah, Fiona

2018-06-05

Disadvantage rarely manifests as a single event, but rather is the enduring context in which a child's development unfolds. We aimed to characterize patterns of stability and change in multiple aspects of disadvantage over the childhood period, in order to inform more precise and nuanced policy development. Participants were from the Longitudinal Study of Australian Children birth cohort (n = 5107). Four lenses of disadvantage (sociodemographic, geographic environment, health conditions and risk factors), and a composite of these representing average exposure across all lenses, were assessed longitudinally from 0 to 9 years of age. Trajectory models identified groups of children with similar patterns of disadvantage over time for each of these lenses and for composite disadvantage. Concurrent validity of these trajectory groups was examined through associations with academic performance at 10-11 years. We found four distinct trajectories of children's exposure to composite disadvantage, which showed high levels of stability over time. In regard to the individual lenses of disadvantage, three exhibited notable change over time (the sociodemographic lens was the exception). Over a third of children (36.3%) were exposed to the 'most disadvantaged' trajectory in at least one lens. Trajectories of disadvantage were associated with academic performance, providing evidence of concurrent validity. Children's overall level of composite disadvantage was stable over time, whereas geographic environments, health conditions and risk factors changed over time for some children. Measuring disadvantage as uni-dimensional, at a single time point, is likely to understate the true extent and persistence of disadvantage.

Assessment Results and Student Achievement; a Correlation Study Regarding Ability Grouping

ERIC Educational Resources Information Center

Slonaker, Richard V.

2013-01-01

School leaders face increased pressure to identify instructional and administrative practices that increase student achievement. However, achievement gaps persist between disadvantaged and non-disadvantaged student groups. This study highlighted relationships between ability grouping and academic achievement in a suburban school district.…

Accountability for the Education of Disadvantaged Groups through the Disadvantaged Schools Program.

ERIC Educational Resources Information Center

Randell, Shirley K.

Financial, educational, and political accountability issues involved in the Disadvantaged Schools Program, initiated by the Schools Commission to improve the learning outcomes of children from educationally disadvantaged backgrounds in Australia, are the focus of this paper. Consideration is given to the views of the Commission in its published…

To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?

PubMed

Tinghög, Petter; Hemmingsson, Tomas; Lundberg, Ingvar

2007-12-01

Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden. The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI). Immigrants' excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants' higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced. The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.

Breast cancer in ethnic minority groups in developed nations: Case studies of the United Kingdom and Australia.

PubMed

Brennan, Meagan

2017-05-01

Recent research from the United Kingdom (UK) has highlighted some of the differences in breast cancer presentations between women of different ethnic groups. Analysis of a large database showed that Black women of African or Caribbean heritage living in England and Wales are more likely to present with stage 3 or 4 cancer than White British women and less likely to have their cancer detected through screening. In many countries around the world, migrant and cultural minority groups experience social and economic disadvantage and this is reflected in their health outcomes. With world migration at record levels, it is timely to reflect on ethnic disparities and to consider how developed nations can care for their minority groups, which are increasing in number and diversity. These issues and challenges are discussed, using the UK's migrant population and Australia's Indigenous and migrant populations as case studies. Copyright © 2017 Elsevier B.V. All rights reserved.

An Analysis of Mathematics Achievement Disparities between Black and White Students and Socioeconomically Disadvantaged and Advantaged Students across Content Strands by Elementary and Middle School Level in a Diverse Virginia School District

ERIC Educational Resources Information Center

Lewis, Benjamin L.

2013-01-01

Student achievement gaps between Black and White students, and socioeconomically disadvantaged and advantaged students, have been observed and formally documented since the National Assessment of Educational Progress (NAEP) began in the 1970s. In particular, the mathematics achievement gap between these historically disadvantaged populations has…

Clinical research with economically disadvantaged populations

PubMed Central

Denny, Colleen C; Grady, Christine

2007-01-01

Concerns about exploiting the poor or economically disadvantaged in clinical research are widespread in the bioethics community. For some, any research that involves economically disadvantaged individuals is de facto ethically problematic. The economically disadvantaged are thought of as “venerable” to exploitation, impaired decision making, or both, thus requiring either special protections or complete exclusion from research. A closer examination of the worries about vulnerabilities among the economically disadvantaged reveals that some of these worries are empirically or logically untenable, while others can be better resolved by improved study designs than by blanket exclusion of poorer individuals from research participation. The scientific objective to generate generalisable results and the ethical objective to fairly distribute both the risks and benefits of research oblige researchers not to unnecessarily bar economically disadvantaged subjects from clinical research participation. PMID:17601862

Transportation-disadvantaged populations : some coordination efforts among programs providing transportation services, but obstacles persist

DOT National Transportation Integrated Search

2003-06-01

Millions of Americans are unable to provide their own transportation-or even use public transportation-for Medicaid appointments, Head Start classes, job training, or other services. Such transportation-disadvantaged" persons are often disabled, elde...

Disparities in child mortality trends: what is the evidence from disadvantaged states in India? the case of Orissa and Madhya Pradesh.

PubMed

Nguyen, Kim-Huong; Jimenez-Soto, Eliana; Dayal, Prarthna; Hodge, Andrew

2013-06-27

The Millennium Development Goals prompted renewed international efforts to reduce under-five mortality and measure national progress. However, scant evidence exists about the distribution of child mortality at low sub-national levels, which in diverse and decentralized countries like India are required to inform policy-making. This study estimates changes in child mortality across a range of markers of inequalities in Orissa and Madhya Pradesh, two of India's largest, poorest, and most disadvantaged states. Estimates of under-five and neonatal mortality rates were computed using seven datasets from three available sources--sample registration system, summary birth histories in surveys, and complete birth histories. Inequalities were gauged by comparison of mortality rates within four sub-state populations defined by the following characteristics: rural-urban location, ethnicity, wealth, and district. Trend estimates suggest that progress has been made in mortality rates at the state levels. However, reduction rates have been modest, particularly for neonatal mortality. Different mortality rates are observed across all the equity markers, although there is a pattern of convergence between rural and urban areas, largely due to inadequate progress in urban settings. Inter-district disparities and differences between socioeconomic groups are also evident. Although child mortality rates continue to decline at the national level, our evidence shows that considerable disparities persist. While progress in reducing under-five and neonatal mortality rates in urban areas appears to be levelling off, policies targeting rural populations and scheduled caste and tribe groups appear to have achieved some success in reducing mortality differentials. The results of this study thus add weight to recent government initiatives targeting these groups. Equitable progress, particularly for neonatal mortality, requires continuing efforts to strengthen health systems and overcome barriers to identify and reach vulnerable groups.

Mechanisms of racial inequalities in prevalence of diarrhoea in South Africa.

PubMed

Choi, Susanne Y P

2003-09-01

Decades of apartheid policies have resulted in marked racial inequalities in health in South Africa. The black:white rate ratio of diarrhoea among children aged less than five years, one of the five most common causes of infant and child deaths, stood at 6.5 in 1998. Using data from the 1998 South African Demographic and Health Survey, this paper examines the mechanisms of this racial disparity. The research confirms the presence of persistent racial inequalities in access to safe drinking-water and sanitation and in maternal education and household wealth, with the black population constituting the most disadvantaged group. While the living environment and access to safe drinking-water explain the excessive risk of diarrhoea among the black population compared to the coloured and Indian populations, the excessive risk of diarrhoea among the black population compared to the white population cannot be explained by disparities in the living environment, hygiene levels, and socioeconomic factors.

Understanding Mental Illness Stigma Toward Persons With Multiple Stigmatized Conditions: Implications of Intersectionality Theory.

PubMed

Oexle, Nathalie; Corrigan, Patrick W

2018-05-01

People with mental illness are often members of multiple stigmatized social groups. Therefore, experienced disadvantage might not be determined solely by mental illness stigma. Nevertheless, most available research does not consider the effects and implications of membership in multiple stigmatized social groups among people with mental illness. Reflecting on intersectionality theory, the authors discuss two intersectional effects determining disadvantage among people with mental illness who are members of multiple stigmatized social groups, namely double disadvantage and prominence. To be effective, interventions to reduce disadvantage experienced by people with mental illness need to be flexible and targeted rather than universal in order to address the implications of intersectionality. Whereas education-based approaches usually assume homogeneity and use universal strategies, contact-based interventions consider diversity among people with mental illness.

Do Schools Reinforce or Reduce Learning Gaps between Advantaged and Disadvantaged Students? Evidence from Vietnam and Peru

PubMed Central

Glewwe, Paul; Krutikova, Sofya; Rolleston, Caine

2018-01-01

This paper examines – for two developing countries, Vietnam and Peru – whether disadvantaged children learn less than advantaged children when both types of children are enrolled in the same school. This is done by estimating education production functions that contain two school fixed effects for each school, one for advantaged children and one for disadvantaged children. The paper examines six different definitions of advantage, based on household wealth, cognitive skills at age 5, gender, ethnicity (Peru only), maternal education, and nutritional status. The results show no sign that schools are less effective for disadvantaged groups in Vietnam; indeed if anything one traditionally advantaged group, males, seems to do worse in school than the corresponding disadvantaged group, females. In contrast, in Peru ethnic minority students and students who enter primary school with low cognitive skills appear to learn less in school than ethnic majority students and students with relatively high cognitive skills, respectively, who are enrolled in the same school.

Development of Literacy Follow-Up Materials for Women and Other Disadvantaged Population. Final Report of the Regional Workshop on the Preparation of Literacy Follow-Up Materials in Asia and the Pacific (9th, Islamabad, Pakistan, November 2-13, 1991).

ERIC Educational Resources Information Center

Ministry of Education, Islamabad (Pakistan).

This report contains materials from a workshop to provide training in audiovisual materials development for women and other disadvantaged populations, such as slum dwellers, minorities, and migrants. The proceedings section contains an introduction, objective, and summaries of opening, workshop, and other presentations. Chapter 1 provides details…

Relation of Health Condition and Quality of Life: Examination of the Quality of Life of the Disadvantaged Population in Nyíregyháza by the FT Quality of Life Index

ERIC Educational Resources Information Center

Jávorné-Erdei, Renáta; Takács, Péter; Fábián, Gergely

2015-01-01

Improving the health of the population, stopping and changing the disadvantage trends have long been one of the health policy objectives in the regions. Unfortunately, in spite of the declared goals Hungary is far away from giving priority to health issues as they are not given proper attention either on individual or societal level. In modern…

The impact of having a sibling with an intellectual disability: parental perspectives in two disorders.

PubMed

Mulroy, S; Robertson, L; Aiberti, K; Leonard, H; Bower, C

2008-03-01

The potential effects on other children when there is a child with intellectual disability (ID) in the family are being increasingly recognized. This study describes the impact of having a sibling with Down syndrome or Rett syndrome using a questionnaire completed by parents. The parents of 186 Western Australian children with Down syndrome and 141 Australian girls and women with Rett syndrome participated in the study. Patterns of reporting disadvantages and/or benefits were compared across a number of child and family variables (age, functional ability and birth order of the affected child, number of siblings and number of parents in the family home) and by socio-economic status as measured by the index of relative socio-economic disadvantage and by area of residence. Parents' responses to open-ended questions about the benefits and/or disadvantages for siblings of their child were analysed for themes. The majority of parents in the Rett syndrome and Down syndrome groups reported both disadvantages and benefits for siblings. In the Rett syndrome group, families from outer regional areas were the least likely to mention disadvantages and those with a smaller family more likely to note disadvantages. In both groups, more socio-economically advantaged families were more likely to report disadvantages. In the Down syndrome group, benefits were also more commonly reported by parents who were socio-economically advantaged, and by larger and two-parent families. Major disadvantages for siblings centred around parental and personal time constraints, relationships and socializing, restrictions, parental emotion and burden of helping. Major benefits were related to personality characteristics. Parents identified both benefits and disadvantages to the siblings of their child with either Rett syndrome or Down syndrome. It is important that these findings are incorporated into any discussion around the impact on the family of a child diagnosed with an ID.

Investment case for improving maternal and child health: results from four countries

PubMed Central

2013-01-01

Background Without addressing the constraints specific to disadvantaged populations, national health policies such as universal health coverage risk increasing equity gaps. Health system constraints often have the greatest impact on disadvantaged populations, resulting in poor access to quality health services among vulnerable groups. Methods The Investment Cases in Indonesia, Nepal, Philippines, and the state of Orissa in India were implemented to support evidence-based sub-national planning and budgeting for equitable scale-up of quality MNCH services. The Investment Case framework combines the basic setup of strategic problem solving with a decision-support model. The analysis and identification of strategies to scale-up priority MNCH interventions is conducted by in-country planners and policymakers with facilitation from local and international research partners. Results Significant variation in scaling-up constraints, strategies, and associated costs were identified between countries and across urban and rural typologies. Community-based strategies have been considered for rural populations served predominantly by public providers, but this analysis suggests that the scaling-up of maternal, newborn, and child health services requires health system interventions focused on 'getting the basics right'. These include upgrading or building facilities, training and redistribution of staff, better supervision, and strengthening the procurement of essential commodities. Some of these strategies involve substantial early capital expenditure in remote and sparsely populated districts. These supply-side strategies are not only the 'best buys', but also the 'required buys' to ensure the quality of health services as coverage increases. By contrast, such public supply strategies may not be the 'best buys' in densely populated urbanised settings, served by a mix of public and private providers. Instead, robust regulatory and supervisory mechanisms are required to improve the accessibility and quality of services delivered by the private sector. They can lead to important maternal mortality reductions at relatively low costs. Conclusions National strategies that do not take into consideration the special circumstances of disadvantaged areas risk disempowering local managers and may lead to a “business-as-usual” acceptance of unreachable goals. To effectively guide health service delivery at a local level, national plans should adopt typologies that reflect the different problems and strategies to scale up key MNCH interventions. PMID:23800035

Resource and competitive dynamics shape the benefits of public goods cooperation in a plant pathogen

PubMed Central

Platt, Thomas G.; Fuqua, Clay; Bever, James D.

2012-01-01

Cooperative benefits depend on a variety of ecological factors. Many cooperative bacteria increase the population size of their groups by making a public good available. Increased local population size can alleviate the constraints of kin competition on the evolution of cooperation by enhancing the between-group fitness of cooperators. The cooperative pathogenesis of Agrobacterium tumefaciens causes infected plants to exude opines—resources that provide a nearly exclusive source of nutrient for the pathogen. We experimentally demonstrate that opines provide cooperative A. tumefaciens cells a within-group fitness advantage over saprophytic agrobacteria. Our results are congruent with a resource-consumer competition model, which predicts that cooperative, virulent agrobacteria are at a competitive disadvantage when opines are unavailable, but have an advantage when opines are available at sufficient levels. This model also predicts that freeloading agrobacteria that catabolize opines but cannot infect plants competitively displace the cooperative pathogen from all environments. However, we show that these cooperative public goods also promote increased local population size. A model built from the Price Equation shows that this effect on group size can contribute to the persistence of cooperative pathogenesis despite inherent kin competition for the benefits of pathogenesis. PMID:22671559

School-Based Influenza Vaccination: Parents’ Perspectives

PubMed Central

Lind, Candace; Russell, Margaret L.; MacDonald, Judy; Collins, Ramona; Frank, Christine J.; Davis, Amy E.

2014-01-01

Background School-age children are important drivers of annual influenza epidemics yet influenza vaccination coverage of this population is low despite universal publicly funded influenza vaccination in Alberta, Canada. Immunizing children at school may potentially increase vaccine uptake. As parents are a key stakeholder group for such a program, it is important to consider their concerns. Purpose We explored parents’ perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools, and obtained suggestions for structuring such a program. Participants Forty-eight parents of children aged 5-18 years participated in 9 focus groups. Participants lived in urban areas of the Alberta Health Services Calgary Zone. Findings Three major themes emerged: Advantages of school-based influenza vaccination (SBIV), Disadvantages of SBIV, and Implications for program design & delivery. Advantages were perceived to occur for different populations: children (e.g. emotional support), families (e.g. convenience), the community (e.g. benefits for school and multicultural communities), the health sector (e.g. reductions in costs due to burden of illness) and to society at large (e.g. indirect conduit of information about health services, building structure for pandemic preparedness, building healthy lifestyles). Disadvantages, however, might also occur for children (e.g. older children less likely to be immunized), families (e.g. communication challenges, perceived loss of parental control over information, choices and decisions) and the education sector (loss of instructional time). Nine second-level themes emerged within the major theme of Implications for program design & delivery: program goals/objectives, consent process, stakeholder consultation, age-appropriate program, education, communication, logistics, immunizing agent, and clinic process. Conclusions Parents perceived advantages and disadvantages to delivering annual seasonal influenza immunizations to children at school. Their input gives a framework of issues to address in order to construct robust, acceptable programs for delivering influenza or other vaccines in schools. PMID:24686406

Proportionate universalism in practice? A quasi-experimental study (GoWell) of a UK neighbourhood renewal programme's impact on health inequalities.

PubMed

Egan, Matt; Kearns, Ade; Katikireddi, Srinivasa V; Curl, Angela; Lawson, Kenny; Tannahill, Carol

2016-03-01

Recommendations to reduce health inequalities frequently emphasise improvements to socio-environmental determinants of health. Proponents of 'proportionate universalism' argue that such improvements should be allocated proportionally to population need. We tested whether city-wide investment in urban renewal in Glasgow (UK) was allocated to 'need' and whether this reduced health inequalities. We identified a longitudinal cohort (n = 1006) through data linkage across surveys conducted in 2006 and 2011 in 14 differentially disadvantaged neighbourhoods. Each neighbourhood received renewal investment during that time, allocated on the basis of housing need. We grouped neighbourhoods into those receiving 'higher', 'medium' or 'lower' levels of investment. We compared residents' self-reported physical and mental health between these three groups over time using the SF-12 version 2 instrument. Multiple linear regression adjusted for baseline gender, age, education, household structure, housing tenure, building type, country of birth and clustering. Areas receiving higher investment tended to be most disadvantaged in terms of baseline health, income deprivation and markers of social disadvantage. After five years, mean mental health scores improved in 'higher investment' areas relative to 'lower investment' areas (b = 4.26; 95% CI = 0.29, 8.22; P = 0.036). Similarly, mean physical health scores declined less in high investment compared to low investment areas (b = 3.86; 95% CI = 1.96, 5.76; P < 0.001). Relative improvements for medium investment (compared to lower investment) areas were not statistically significant. Findings suggest that investment in housing-led renewal was allocated according to population need and this led to modest reductions in area-based inequalities in health after five years. Study limitations include a risk of selection bias. This study demonstrates how non-health interventions can, and we believe should, be evaluated to better understand if and how health inequalities can be reduced through strategies of allocating investment in social determinants of health according to need. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

ITS applications for coordinating and improving human services transportation : a cross-cutting study : improving service for the transportation disadvantaged

DOT National Transportation Integrated Search

2006-08-01

Older adults, persons with disabilities, and individuals with lower incomes frequently do not have access to transportation or their access to transportation is limited. These populations, called "transportation disadvantaged," need flexible yet depe...

All-cause and cause-specific mortality of social assistance recipients in Norway: a register-based follow-up study.

PubMed

Naper, Sille Ohrem

2009-11-01

To investigate the mortality among social assistance recipients, who are among the most marginalized people in Norway. Cause-specific mortality was analysed in an attempt to explain the excess mortality. Previous research has suggested that social disadvantage leads to higher mortality from all causes, whereas others have found substantial variation when studying separate causes. The impact of the various causes will influence policy recommendations. Data were compiled through linking between Norwegian administrative records. The entire population born between 1935 and 1974 (2,297,621 people) was followed with respect to social assistance and death from 1993 to 2003. Cause-specific, age-standardized mortality rates for social assistance recipients and the rest of the population were calculated, and both the absolute (rate difference) and relative (rate ratio) rates were measured. The rate ratio for total mortality was 3.1 for men and 2.5 for women for the comparison between social assistance recipients and the general population. The mortality among social assistance recipients was higher for all causes, but the magnitude differed considerably, depending on the cause. The rate ratio for men ranged from 1.2 for non-smoking-related cancer to 18.8 for alcohol- and drug-related causes. Alcohol-and drug-related and violent causes together contributed to half of the excess mortality for men and one-third for women. The mortality of this socially disadvantaged group was considerably higher than that of the general population, and this difference reflected mainly drug-related causes.

Neglected Infections of Poverty in the United States of America

PubMed Central

Hotez, Peter J.

2008-01-01

In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty. Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations. The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis. These diseases occur predominantly in people of color living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US–Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia. Preliminary disease burden estimates of the neglected infections of poverty indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans harbor these chronic infections, which represent some of the greatest health disparities in the United States. Specific policy recommendations include active surveillance (including newborn screening) to ascertain accurate population-based estimates of disease burden; epidemiological studies to determine the extent of autochthonous transmission of Chagas disease and other infections; mass or targeted treatments; vector control; and research and development for new control tools including improved diagnostics and accelerated development of a vaccine to prevent congenital CMV infection and congenital toxoplasmosis. PMID:18575621

The association between physical environment and health: indicating the direction of effects using German panel data.

PubMed

Baar, Johanna; Romppel, Matthias; Igel, Ulrike; Brähler, Elmar; Grande, Gesine

2016-01-01

A growing body of research has identified an association between health and physical residential environmental characteristics. However, the direction of effects remains unclear, and further research is needed to determine whether the residential environment influences health. To specify the direction of the association between environmental disadvantage and self-reported health. Longitudinal data were obtained from the German Socioeconomic Panel and were examined at two points in time. Participants were grouped by relocation status assessed across a five-year period. Structural equation modeling was used to examine the effect of baseline environmental disadvantage on baseline health and on health five years later. In both groups, environmental disadvantage was cross-sectionally correlated with poor health. Only among people who did not relocate was baseline environmental disadvantage significantly related to health five years later in bivariate analyses. Results from the structural equation model found that environmental disadvantage was no longer significantly related to poor health five years later within the group of non-movers (β = -.02, p = .052). In addition, there was no effect in this direction within the group of movers (β = .02, p = .277). Our results suggest the existence of a weak contextual effect as group differences in longitudinal associations indicated the direction of ecological effects.

Ethnicity and Child Health in Northern Tanzania: Maasai Pastoralists Are Disadvantaged Compared to Neighbouring Ethnic Groups

PubMed Central

Lawson, David W.; Borgerhoff Mulder, Monique; Ghiselli, Margherita E.; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G. M.; Hartwig, Kari; James, Susan

2014-01-01

The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy. PMID:25353164

Smoking and Ill Health: Does Lay Epidemiology Explain the Failure of Smoking Cessation Programs Among Deprived Populations?

PubMed Central

Lawlor, Debbie A; Frankel, Stephen; Shaw, Mary; Ebrahim, Shah; Smith, George Davey

2003-01-01

The resistance of disadvantaged groups to anti-smoking advice is remarkable. In relation to the study of differing cultures, there is a long-standing academic tradition assuming that behavior that may otherwise be difficult to understand is indeed rational within particular cultural contexts. Persistent smoking among the most deprived members of society may represent a rational response to their life chances informed by a lay epidemiology. Health promotion initiatives designed to reduce smoking among members of these groups may continue to fail unless the general health and life chances of such individuals are first improved. PMID:12554581

[Characteristics of growth and development in children from families at social risk].

PubMed

Stojadinović, A

2001-01-01

Body height and weight are important indicators of children's health status. There are many evidences that children from disadvantaged families have lower height and weight than children of the same age from families without social risk. The aim of this study was to investigate characteristics of growth and development of children from economically disadvantaged families. The study was partly retrospective and partly prospective. The retrospective study included 509 children from disadvantaged families hospitalized at the Institute of Child and Adolescent Health Care in Novi Sad, during a five-year period. The prospective study included 90 children from disadvantaged families (experimental group) and 132 children from families without social risk (control group) hospitalized at the Institute during a six month period. Height/length, weight, head circumference, and psychomotor/intellectual development have been examined. In the retrospective study results were compared with theoretically expected values, whereas the prospective study results of experimental and control group were compared. In the retrospective study that included only children from disadvantaged families, 136 (26.7%) children had height/length, 173 (34%) had weight, and 86 (16.9%) children had head circumference below 10th percentile. Delay in psychomotor/intellectual development was established in 177 (34.8%) children. Children from families with social risk have significantly more often height/length, weight, head circumference and developmental delay than theoretically expected. In the prospective study 40 (44.4%) children from experimental group had height/length, 29 (32.2%) had weight, 20 (22.2%) children had head circumference below 10th percentile, and 17 (26.2%) had delay in psychomotor/intellectual development. Children from disadvantaged families (experimental group) significantly more often had delay in growth and development comparing with children from families without social risk (control group). Children from disadvantaged families significantly more often exhibit delay in growth and development, comparing with children of the same age from families without social risk. Therefore, pediatricians should consider social risk factors whenever treating children with growth or developmental delay.

Long-term impact of childhood disadvantage on late-life functional decline among older Japanese: Results from the JAGES prospective cohort study.

PubMed

Murayama, Hiroshi; Fujiwara, Takeo; Tani, Yukako; Amemiya, Airi; Matsuyama, Yusuke; Nagamine, Yuiko; Kondo, Katsunori

2017-09-11

Increasing evidence suggests an impact of childhood disadvantage on late-life functional impairment in Western countries. However, the processes by which childhood disadvantage affects functional capacity are influenced by several factors unique to particular societies. We examined the impact of childhood disadvantage on functional decline among older Japanese, using a large-scale prospective cohort study. Data came from surveys conducted in 2010 and 2013 as part of the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study targeting community-dwelling people aged 65 years and over. Childhood disadvantage included subjective childhood socioeconomic status (SES), body height and educational level. The sample was stratified by age at baseline (65-69 y, 70-74 y, 75-79 y, and ≥ 80 y). A total of 11,601 respondents were analyzed. In the 65-69 y group, lower childhood SES was associated with functional decline, but this association was mediated by adult SES. In contrast, childhood SES was independently associated with functional decline in the older cohort. In the 75-79 y group, lower childhood SES was associated with functional decline. However, in the ≥ 80 y group, people with higher childhood SES were more likely to experience functional decline. Shorter height was associated with functional decline in the 70-74 y group. Higher education was related to functional decline in all age groups except the ≥ 80 y group. These findings suggest that childhood disadvantage affects functional decline, but its effect varies by age cohort. The mechanisms underlying the association between childhood disadvantage and functional decline may be influenced by social and historical context. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process.

PubMed

Pottie, Kevin; Welch, Vivian; Morton, Rachael; Akl, Elie A; Eslava-Schmalbach, Javier H; Katikireddi, Vittal; Singh, Jasvinder; Moja, Lorenzo; Lang, Eddy; Magrini, Nicola; Thabane, Lehana; Stanev, Roger; Matovinovic, Elizabeth; Snellman, Alexandra; Briel, Matthias; Shea, Beverly; Tugwell, Peter; Schunemann, Holger; Guyatt, Gordon; Alonso-Coello, Pablo

2017-10-01

The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup. Copyright © 2017 Elsevier Inc. All rights reserved.

The Trump Administration's assault on health and social programs: potential consequences for older Hispanics.

PubMed

Angel, Jacqueline L; Berlinger, Nancy

2018-04-10

Health and social welfare policy proposals put forth by the Trump administration and Republican-controlled Congress could have huge impacts on low-income groups. This paper focuses on older Hispanics, with an emphasis on the Mexican-origin population who form the largest Hispanic subgroup. A demographic portrait is presented that indicates that Mexican-origin individuals have less wealth and lower incomes than do non-Hispanic Whites. Given rising health care costs, lower use of nursing homes, and greater propensity to live with grown children, prevailing economic disadvantage has serious consequences for this population. More restrictive immigration policies aimed at limiting family reunification could have intergenerational caregiving consequences. In addition, because of labor-force disadvantages, low-income Mexican-origin adults are less likely to have private insurance compared to non-Hispanic Whites as they approach retirement. Consequently, Mexican-origin older adults tend to rely on Medicaid when eligible; in contrast, late-life migrants-who do not qualify for federally funded benefits for at least five years-and unauthorized migrants-who are excluded from federally funded benefits-have extremely limited access to safety net provisions. The potential effects of proposed cutbacks in health care financing on older Hispanics are discussed.

Consistent response of bird populations to climate change on two continents

USGS Publications Warehouse

Stephens, Philip A.; Mason, Lucy R.; Green, Rhys E.; Gregory, Richard D.; Sauer, John R.; Alison, Jamie; Aunins, Ainars; Brotons, Lluís; Butchart, Stuart H.M.; Campedelli, Tommaso; Chodkiewicz, Tomasz; Chylarecki, Przemyslaw; Crowe, Olivia; Elts, Jaanus; Escandell, Virginia; Foppen, Ruud P.B.; Heldbjerg, Henning; Herrando, Sergi; Husby, Magne; Jiguet, Frédéric; Lehikoinen, Aleksi; Lindström, Åke; Noble, David G.; Paquet, Jean-Yves; Reif, Jiri; Sattler, Thomas; Szép, Tibor; Teufelbauer, Norbert; Trautmann, Sven; Van Strien, Arco; van Turnhout, Chris A.M.; Vorisek, Petr; Willis, Stephen G.

2016-01-01

Global climate change is a major threat to biodiversity. Large-scale analyses have generally focused on the impacts of climate change on the geographic ranges of species and on phenology, the timing of ecological phenomena. We used long-term monitoring of the abundance of breeding birds across Europe and the United States to produce, for both regions, composite population indices for two groups of species: those for which climate suitability has been either improving or declining since 1980. The ratio of these composite indices, the climate impact indicator (CII), reflects the divergent fates of species favored or disadvantaged by climate change. The trend in CII is positive and similar in the two regions. On both continents, interspecific and spatial variation in population abundance trends are well predicted by climate suitability trends.

[Impact of social disadvantages and time perspective on smoking cessation].

PubMed

Merson, Frédéric; Perriot, Jean

2012-02-01

Smoking addiction and tobacco dependence are related to social deprivation and time perspective. The objective of this study was to understand how these factors influenced the results of smoking cessation in order to optimize the care of this population. We included 200 patients from our outpatient clinic from March 1, 2009 to June 30, 2010. This study focused on the impact of social disadvantages and time perspective on smoking cessation. Time perspective was measured with the short version of the Zimbardo Time Perspective Inventory, social disadvantages with Epices scale. Information on each individual's characteristics, smoking addiction, and smoking cessation was collected. One hundred and ninety-two patients (of whom 45% were socially disadvantaged) participated. Socially disadvantaged people tend to lean towards dimensions "Past Negative" (P<0.0001), "Present Fatalistic" (P<0.0001) and are less likely to foresee themselves in the future (P<0.0002) compared with the rest of the population. Their decision to stop smoking reveals they are more motivated for financial reasons (P<0.0001) and their attempts more often end in failure (P=0.006). In addition, they have, more frequently, anxiodepressive problems (P<0.0001) and a higher level of nicotine dependence (P<0.0001). The results highlight the importance of taking into account the social disadvantages and time perspective in helping these addicted patients to stop smoking. Copyright © 2011. Published by Elsevier Masson SAS.

Assessing the Consequences of Implementing Graphic Warning Labels on Cigarette Packs for Tobacco-Related Health Disparities.

PubMed

Gibson, Laura; Brennan, Emily; Momjian, Ani; Shapiro-Luft, Dina; Seitz, Holli; Cappella, Joseph N

2015-08-01

Population-level communication interventions, such as graphic warning labels (GWLs) on cigarette packs, have the potential to reduce or exacerbate tobacco-related health disparities depending on their effectiveness among disadvantaged sub-populations. This study evaluated the likely impact of nine GWLs proposed by the US Food and Drug Administration on (1) African American and (2) Hispanic smokers, who disproportionately bear the burden of tobacco-related illness, and (3) low education smokers, who have higher smoking rates. Data were collected online from current smokers randomly assigned to see GWLs (treatment) or the current text-only warning labels (control). Participants were stratified by age (18-25; 26+) in each of four groups: general population (n = 1246), African Americans (n = 1200), Hispanics (n = 1200), and low education (n = 1790). We tested the effectiveness of GWLs compared to text-only warning labels using eight outcomes that are predictive of quitting intentions or behaviors including negative emotion, intentions to hold back from smoking, intentions to engage in avoidance behaviors, and intentions to quit. Across all outcomes, GWLs were significantly more effective than text-only warning labels more often than expected by chance. Results suggested that African Americans, Hispanics and smokers with low education did not differ from the general population of smokers in their reactions to any of the nine individual GWLs. The nine GWLs were similarly effective for disadvantaged sub-populations and the general population of smokers. Implementation of GWLs is therefore unlikely to reduce or exacerbate existing tobacco-related health disparities, but will most likely uniformly increase intentions and behaviors predictive of smoking cessation. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessing the Consequences of Implementing Graphic Warning Labels on Cigarette Packs for Tobacco-Related Health Disparities

PubMed Central

Brennan, Emily; Momjian, Ani; Shapiro-Luft, Dina; Seitz, Holli; Cappella, Joseph N.

2015-01-01

Introduction: Population-level communication interventions, such as graphic warning labels (GWLs) on cigarette packs, have the potential to reduce or exacerbate tobacco-related health disparities depending on their effectiveness among disadvantaged sub-populations. This study evaluated the likely impact of nine GWLs proposed by the US Food and Drug Administration on (1) African American and (2) Hispanic smokers, who disproportionately bear the burden of tobacco-related illness, and (3) low education smokers, who have higher smoking rates. Methods: Data were collected online from current smokers randomly assigned to see GWLs (treatment) or the current text-only warning labels (control). Participants were stratified by age (18–25; 26+) in each of four groups: general population (n = 1246), African Americans (n = 1200), Hispanics (n = 1200), and low education (n = 1790). We tested the effectiveness of GWLs compared to text-only warning labels using eight outcomes that are predictive of quitting intentions or behaviors including negative emotion, intentions to hold back from smoking, intentions to engage in avoidance behaviors, and intentions to quit. Results: Across all outcomes, GWLs were significantly more effective than text-only warning labels more often than expected by chance. Results suggested that African Americans, Hispanics and smokers with low education did not differ from the general population of smokers in their reactions to any of the nine individual GWLs. Conclusions: The nine GWLs were similarly effective for disadvantaged sub-populations and the general population of smokers. Implementation of GWLs is therefore unlikely to reduce or exacerbate existing tobacco-related health disparities, but will most likely uniformly increase intentions and behaviors predictive of smoking cessation. PMID:26180214

RETENTION IN READING OF DISADVANTAGED MEXICAN-AMERICAN CHILDREN DURING THE SUMMER MONTHS.

ERIC Educational Resources Information Center

ARNOLD, RICHARD D.

THREE GROUPS OF DISADVANTAGED MEXICAN-AMERICAN CHILDREN WERE TESTED TO DETERMINE CHANGES IN READING ACHIEVEMENT BETWEEN SECOND AND THIRD GRADE. DURING THE SCHOOL YEAR, AN ORAL-AURAL ENGLISH GROUP OF 102 CHILDREN WERE GIVEN INTENSIVE ENGLISH LANGUAGE INSTRUCTION WHILE AN ORAL-AURAL SPANISH GROUP OF 67 CHILDREN WERE GIVEN INTENSIVE SPANISH LANGUAGE…

Tobacco control approaches and inequity--how far have we come and where are we going?

PubMed

Purcell, Kate R; O'Rourke, Kerryn; Rivis, Maya

2015-09-01

Despite Australia's success in reducing smoking rates, substantial inequities persist--with high smoking prevalence among disadvantaged groups. This article uses Fair Foundations: The VicHealth framework for health equity to identify promising strategies for promoting equity within tobacco control policies and programmes. A rapid review of the Australian and international literature was conducted in March 2014 using Pubmed, ISI web of Science and Scopus, Cochrane library and Google Scholar. A search of the grey literature was conducted to identify promising policy interventions. Population health surveys suggest that tobacco-related inequities in Victoria are beginning to decline. Data from the Victorian Smoking Survey shows that the inequity gap is narrowing, and in recent years, the prevalence of regular smoking declined fastest among disadvantaged smokers. Future approaches to accelerate reductions in tobacco-related inequities include: (i) continue proven population-based tobacco control policies--especially increasing the price of tobacco (while remaining cognisant of the increased economic burden for those smokers who do not quit), and continuing mass media campaigns; (ii) strengthening social policies to promote equity in early child development; educational experiences; quality of local environments; employment and working conditions; (iii) identifying and investing in targeted approaches to influence social norms and more effectively identify and support disadvantaged smokers to quit; (iv) within tobacco control programmes, give greatest priority to interventions focused on adult smokers (including pregnant women and their partners). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Solidarity through shared disadvantage: Highlighting shared experiences of discrimination improves relations between stigmatized groups.

PubMed

Cortland, Clarissa I; Craig, Maureen A; Shapiro, Jenessa R; Richeson, Jennifer A; Neel, Rebecca; Goldstein, Noah J

2017-10-01

Intergroup relations research has largely focused on relations between members of dominant groups and members of disadvantaged groups. The small body of work examining intraminority intergroup relations, or relations between members of different disadvantaged groups, reveals that salient experiences of ingroup discrimination promote positive relations between groups that share a dimension of identity (e.g., 2 different racial minority groups) and negative relations between groups that do not share a dimension of identity (e.g., a racial minority group and a sexual minority group). In the present work, we propose that shared experiences of discrimination between groups that do not share an identity dimension can be used as a lever to facilitate positive intraminority intergroup relations. Five experiments examining relations among 4 different disadvantaged groups supported this hypothesis. Both blatant (Experiments 1 and 3) and subtle (Experiments 2, 3, and 4) connections to shared experiences of discrimination, or inducing a similarity-seeking mindset in the context of discrimination faced by one's ingroup (Experiment 5), increased support for policies benefiting the outgroup (Experiments 1, 2, and 4) and reduced intergroup bias (Experiments 3, 4, and 5). Taken together, these experiments provide converging evidence that highlighting shared experiences of discrimination can improve intergroup outcomes between stigmatized groups across dimensions of social identity. Implications of these findings for intraminority intergroup relations are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The impact of geographic unit of analysis on socioeconomic inequalities in cancer survival and distant summary stage - a population-based study.

PubMed

Tervonen, Hanna E; Morrell, Stephen; Aranda, Sanchia; Roder, David; You, Hui; Niyonsenga, Theo; Walton, Richard; Baker, Deborah; Currow, David

2016-12-13

When using area-level disadvantage measures, size of geographic unit can have major effects on recorded socioeconomic cancer disparities. This study examined the extent of changes in recorded socioeconomic inequalities in cancer survival and distant stage when the measure of socioeconomic disadvantage was based on smaller Census Collection Districts (CDs) instead of Statistical Local Areas (SLAs). Population-based New South Wales Cancer Registry data were used to identify cases diagnosed with primary invasive cancer in 2000-2008 (n=264,236). Logistic regression and competing risk regression modelling were performed to examine socioeconomic differences in odds of distant stage and hazard of cancer death for all sites combined and separately for breast, prostate, colorectal and lung cancers. For all sites collectively, associations between socioeconomic disadvantage and cancer survival and distant stage were stronger when the CD-based socioeconomic disadvantage measure was used compared with the SLA-based measure. The CD-based measure showed a more consistent socioeconomic gradient with a linear upward trend of risk of cancer death/distant stage with increasing socioeconomic disadvantage. Site-specific analyses provided similar findings for the risk of death but less consistent results for the likelihood of distant stage. The use of socioeconomic disadvantage measure based on the smallest available spatial unit should be encouraged in the future. Implications for Public Health: Disadvantage measures based on small spatial units can more accurately identify socioeconomic cancer disparities to inform priority settings in service planning. © 2016 Public Health Association of Australia.

Trends in educational differentials in suicide mortality between 1993-2006 in Korea.

PubMed

Lee, Weon Young; Khang, Young-Ho; Noh, Manegseok; Ryu, Jae-In; Son, Mia; Hong, Yeon-Pyo

2009-08-31

This study aims to examine how inequalities in suicide by education changed during and after macroeconomic restructuring following the economic crisis of 1997 in South Korea. Using Korea's 1995, 2000, and 2005 census data aggregately linked to mortality data (1993-2006), relative and absolute differentials in suicide mortality by education were calculated by gender and age among Korean population aged 35 and over. Average annual suicide mortality rates have steadily increased from 1993-1997 to 2003-2006 in almost all sociodemographic groups stratified by gender, age, and education. Based on the relative index of inequality (RII) and slope index of inequality (SII), educational differentials in suicide mortality generally increased over time in men and women aged 45 years+. Although RII did not increase with year among men and women aged 35 - 44 years, SII showed a significantly increasing trend in this age group. These worsening absolute inequalities in suicide mortality indicate that the governmental suicide prevention policy should be directed toward socially disadvantaged groups of the Korean population.

Innovative strategies to improve diabetes outcomes in disadvantaged populations.

PubMed

Ruddock, J S; Poindexter, M; Gary-Webb, T L; Walker, E A; Davis, N J

2016-06-01

Diabetes disproportionately affects disadvantaged populations. Eighty percent of deaths directly caused by diabetes occurred in low- and middle-income countries. In high-income countries, there are marked disparities in diabetes control among racial/ethnic minorities and those with low socio-economic status. Innovative, effective and cost-effective strategies are needed to improve diabetes outcomes in these populations. Technological advances, peer educators and community health workers have expanded methodologies to reach, educate and monitor individuals with diabetes. In the present manuscript we review the outcomes of these strategies, and describe the barriers to and facilitators of these approaches for improving diabetes outcomes. © 2016 Diabetes UK.

Impact of a Household Environmental Intervention Delivered by Lay Health Workers on Asthma Symptom Control in Urban, Disadvantaged Children With Asthma

PubMed Central

Kurian, Cizely; Guo, Rong; Zhao, Hauqing

2009-01-01

Objectives. We examined whether a home-based educational and environmental intervention delivered by lay health educators would improve asthma symptom control in inner-city children with asthma. Methods. Children 2 to 16 years of age with diagnosed asthma and at least 1 asthma-related hospitalization or 2 emergency visits in the prior year were randomly assigned into 2 groups (immediate and delayed intervention) in a crossover study. Each group participated in the active phase (intervention) and the inactive phase. Outcomes included asthma symptoms, albuterol use, emergency department visits, hospitalizations, and trigger reduction. Results. A total of 264 primarily Black (94%) children were enrolled. The mean number of emergency visits decreased by 30% and inpatient visits decreased by 53% (P < .001) after the intervention. Reductions were seen in pests, presence of carpets in bedrooms, and dust. Nighttime wheezing was significantly reduced after the intervention in both groups (P < .001). Conclusions. Lay health educators effectively reduced asthma triggers and increased caregiver asthma knowledge, which resulted in reduced emergency department visits, hospitalizations, and asthma symptoms. The relationships formed between the caregivers and the lay health educators appeared to positively impact asthma outcomes in this disadvantaged population. PMID:19890172

Socio-economic determinants of micronutrient intake and status in Europe: a systematic review.

PubMed

Novaković, Romana; Cavelaars, Adriënne; Geelen, Anouk; Nikolić, Marina; Altaba, Iris Iglesia; Viñas, Blanca Roman; Ngo, Joy; Golsorkhi, Mana; Medina, Marisol Warthon; Brzozowska, Anna; Szczecinska, Anna; de Cock, Diederik; Vansant, Greet; Renkema, Marianne; Majem, Lluís Serra; Moreno, Luis Aznar; Glibetić, Maria; Gurinović, Mirjana; van't Veer, Pieter; de Groot, Lisette C P G M

2014-05-01

To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for intake. MEDLINE and Embase databases were searched to collect original studies that: (i) were published from 1990 to 2011; (ii) involved >100 subjects; (iii) had assessed dietary intake at the individual level; and/or (iv) included best practice biomarkers reflecting micronutrient status. We estimated relative differences in mean micronutrient intake and/or status between the lowest and highest socio-economic groups to: (i) evaluate variation in intake and status between socio-economic groups; and (ii) report on data availability. Europe. Children, adults and elderly. Data from eighteen publications originating primarily from Western Europe showed that there is a positive association between indicators of socio-economic status and micronutrient intake and/or status. The largest differences were observed for intake of vitamin C in eleven out of twelve studies (5-47 %) and for vitamin D in total of four studies (4-31 %). The positive association observed between micronutrient intake and socio-economic status should complement existing evidence on socio-economic inequalities in diet-related diseases among disadvantaged populations in Europe. These findings could provide clues for further research and have implications for public health policy aimed at improving the intake of micronutrients and diet-related diseases.

The Intergenerational Continuity of Fathers' Absence in a Socioeconomically Disadvantaged Sample

ERIC Educational Resources Information Center

Pougnet, Erin; Serbin, Lisa A.; Stack, Dale M.; Ledingham, Jane E.; Schwartzman, Alex E.

2012-01-01

Fathers' absence is a pattern that shows intergenerational continuity, most notably within disadvantaged populations. The process whereby this pattern is repeated across generations is not well understood. Using data from the Concordia Longitudinal Risk Project, the authors investigated pathways between fathers' absence in 1 generation and the…

ShopSmart 4 Health: results of a randomized controlled trial of a behavioral intervention promoting fruit and vegetable consumption among socioeconomically disadvantaged women.

PubMed

Ball, Kylie; McNaughton, Sarah A; Le, Ha Nd; Abbott, Gavin; Stephens, Lena D; Crawford, David A

2016-08-01

Behavioral interventions show potential for promoting increased fruit and vegetable consumption in the general population. However, little is known about their effectiveness or cost-effectiveness among socioeconomically disadvantaged groups, who are less likely to consume adequate fruit and vegetables. This study investigated the effects and costs of a behavior change intervention for increasing fruit and vegetable purchasing and consumption among socioeconomically disadvantaged women. ShopSmart 4 Health was a randomized controlled trial involving a 3-mo retrospective baseline data collection phase [time (T) 0], a 6-mo intervention (T1-T2), and a 6-mo no-intervention follow-up (T3). Socioeconomically disadvantaged women who were primary household shoppers in Melbourne, Australia, were randomly assigned to either a behavior change intervention arm (n = 124) or a control arm (n = 124). Supermarket transaction (sales) data and surveys measured the main outcomes: fruit and vegetable purchases and self-reported fruit and vegetable consumption. An analysis of supermarket transaction data showed no significant intervention effects on vegetable or fruit purchasing at T2 or T3. Participants in the behavior change intervention arm reported consumption of significantly more vegetables during the intervention (T2) than did controls, with smaller intervention effects sustained at 6 mo postintervention (T3). Relative to controls, vegetable consumption increased by ∼0.5 serving · participant(-1) · d(-1) from baseline to T2 and remained 0.28 servings/d higher than baseline at T3 among those who received the intervention. There was no intervention effect on reported fruit consumption. The behavior change intervention cost A$3.10 (in Australian dollars) · increased serving of vegetables(-1) · d(-1)CONCLUSIONS: This behavioral intervention increased vegetable consumption among socioeconomically disadvantaged women. However, the lack of observed effects on fruit consumption and on both fruit and vegetable purchasing at intervention stores suggests that further investigation of effective nutrition promotion approaches for this key target group is required. The ShopSmart 4 Health trial was registered at www.isrctn.com as ISRCTN48771770. © 2016 American Society for Nutrition.

Transport and land-use policies in Delhi.

PubMed Central

Tiwari, Geetam

2003-01-01

Current transportation policies in mega-cities worldwide lead to major threats to health through traffic injuries, air pollution, noise, reduction in physical activities, and adverse impact on urban quality of life. In addition, a large section of the population in cities in low-income countries has to live in informal-sector, substandard housing. Many transportation policies fail to take enough account of their impacts on poverty and social exclusion, and they neglect the access and transportation demands of the more economically disadvantaged groups of society, who rely mostly on public transportation, walking, and cycling. Delhi, the capital city of India, is an interesting case because failure to consider the broad spectrum of health effects that may result from transport and land-use policies and investments has resulted in decisions that penalize the least affluent groups of the population and make it more difficult for them to get to jobs, education, health care, amenities, and services. PMID:12894330

Neighborhood socioeconomic disadvantage is not associated with wound healing in diabetic foot ulcer patients treated in a multidisciplinary setting.

PubMed

Hicks, Caitlin W; Canner, Joseph K; Mathioudakis, Nestoras; Sherman, Ronald L; Hines, Kathryn; Lippincott, Christopher; Black, James H; Abularrage, Christopher J

2018-04-01

Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most). Predictors of wound healing were assessed using Cox proportional hazards models accounting for patient demographics, wound characteristics, and ADI category. Six hundred twenty-one wounds were evaluated, including 59% ADI-0, 7% ADI-1, 12% ADI-2, and 22% ADI-3. After accounting for patient demographics and wound characteristics, the likelihood of wound healing was similar between groups (ADI-3 versus ADI-0: hazards ratio [HR] 1.03 [95% confidence interval 0.76-1.41]). Independent predictors of poor wound healing included peripheral arterial disease (HR 0.75), worse wound stage (stage 4: HR 0.48), larger wound area (HR 0.99), and partially dependent functional status (HR 0.45) (all, P < 0.05). In a multidisciplinary setting, wound healing was largely dependent on wound characteristics and vascular status rather than patient demographics or neighborhood socioeconomic disadvantage. Use of a multidisciplinary approach to the management of DFU may overcome the negative effects of socioeconomic disadvantage frequently described in the diabetic population. Copyright © 2017 Elsevier Inc. All rights reserved.

Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations

PubMed Central

2012-01-01

Background Health economics is increasingly used to inform resource allocation decision-making, however, there is comparatively little evidence relevant to minority groups. In part, this is due to lack of cost and effectiveness data specific to these groups upon which economic evaluations can be based. Consequently, resource allocation decisions often rely on mainstream evidence which may not be representative, resulting in inequitable funding decisions. This paper describes a method to overcome this deficiency for Australia’s Indigenous population. A template has been developed which can adapt mainstream health intervention data to the Indigenous setting. Methods The ‘Indigenous Health Service Delivery Template’ has been constructed using mixed methods, which include literature review, stakeholder discussions and key informant interviews. The template quantifies the differences in intervention delivery between best practice primary health care for the Indigenous population via Aboriginal Community Controlled Health Services (ACCHSs), and mainstream general practitioner (GP) practices. Differences in costs and outcomes have been identified, measured and valued. This template can then be used to adapt mainstream health intervention data to allow its economic evaluation as if delivered from an ACCHS. Results The template indicates that more resources are required in the delivery of health interventions via ACCHSs, due to their comprehensive nature. As a result, the costs of such interventions are greater, however this is accompanied by greater benefits due to improved health service access. In the example case of the polypill intervention, 58% more costs were involved in delivery via ACCHSs, with 50% more benefits. Cost-effectiveness ratios were also altered accordingly. Conclusions The Indigenous Health Service Delivery Template reveals significant differences in the way health interventions are delivered from ACCHSs compared to mainstream GP practices. It is important that these differences are included in the conduct of economic evaluations to ensure results are relevant to Indigenous Australians. Similar techniques would be generalisable to other disadvantaged minority populations. This will allow resource allocation decision-makers access to economic evidence that more accurately represents the needs and context of disadvantaged groups, which is particularly important if addressing health inequities is a stated goal. PMID:22954136

15 CFR 1400.4 - Evidence of social or economic disadvantage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Evidence of social or economic... ASSISTANCE § 1400.4 Evidence of social or economic disadvantage. (a) The representatives of the group requesting formal designation should establish social or economic disadvantage by a preponderance of the...

15 CFR 1400.4 - Evidence of social or economic disadvantage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Evidence of social or economic... ASSISTANCE § 1400.4 Evidence of social or economic disadvantage. (a) The representatives of the group requesting formal designation should establish social or economic disadvantage by a preponderance of the...

15 CFR 1400.4 - Evidence of social or economic disadvantage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Evidence of social or economic... ASSISTANCE § 1400.4 Evidence of social or economic disadvantage. (a) The representatives of the group requesting formal designation should establish social or economic disadvantage by a preponderance of the...

15 CFR 1400.4 - Evidence of social or economic disadvantage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Evidence of social or economic... ASSISTANCE § 1400.4 Evidence of social or economic disadvantage. (a) The representatives of the group requesting formal designation should establish social or economic disadvantage by a preponderance of the...

15 CFR 1400.4 - Evidence of social or economic disadvantage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Evidence of social or economic... ASSISTANCE § 1400.4 Evidence of social or economic disadvantage. (a) The representatives of the group requesting formal designation should establish social or economic disadvantage by a preponderance of the...

[RIU project: perceived changes by health agents and professionals after a health intervention in an urban area of socioeconomic disadvantage].

PubMed

Aviñó, Dory; Paredes-Carbonell, Joan J; Peiró-Pérez, Rosana; La Parra Casado, Daniel; Álvarez-Dardet, Carlos

2014-12-01

To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Raval (Algemesí-Valencia) We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. RIU increases the capabilities of the participants, their social recognition and improves access and use of health services. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Environmental justice implications of industrial hazardous waste generation in India: a national scale analysis

NASA Astrophysics Data System (ADS)

Basu, Pratyusha; Chakraborty, Jayajit

2016-12-01

While rising air and water pollution have become issues of widespread public concern in India, the relationship between spatial distribution of environmental pollution and social disadvantage has received less attention. This lack of attention becomes particularly relevant in the context of industrial pollution, as India continues to pursue industrial development policies without sufficient regard to its adverse social impacts. This letter examines industrial pollution in India from an environmental justice (EJ) perspective by presenting a national scale study of social inequities in the distribution of industrial hazardous waste generation. Our analysis connects district-level data from the 2009 National Inventory of Hazardous Waste Generating Industries with variables representing urbanization, social disadvantage, and socioeconomic status from the 2011 Census of India. Our results indicate that more urbanized and densely populated districts with a higher proportion of socially and economically disadvantaged residents are significantly more likely to generate hazardous waste. The quantity of hazardous waste generated is significantly higher in more urbanized but sparsely populated districts with a higher proportion of economically disadvantaged households, after accounting for other relevant explanatory factors such as literacy and social disadvantage. These findings underscore the growing need to incorporate EJ considerations in future industrial development and waste management in India.

Why the Disadvantaged Drop Out: The Administrators' View.

ERIC Educational Resources Information Center

Morrison, James L.; Ferrante, Reynolds

A report focusing on the academically disadvantaged minority group students is presented. Perceptions of administrators in public two-year colleges as to the major reasons for attrition of this group are examined. A pre-coded questionnaire was developed to gather information concerning programs of compensatory education in two-year colleges. It…

Who Attends Physical Activity Programmes in Deprived Neighbourhoods?

ERIC Educational Resources Information Center

Withall, J.; Jago, R.; Fox, K. R.

2011-01-01

Objective: Physical activity can reduce the risk of several chronic diseases. Such diseases are most prevalent in economically-disadvantaged groups where physical activity levels are consistently lower. There is a need to engage disadvantaged groups in programmes to increase physical activity. This case study examined programmes on offer in a…

Managing Asthma in Low-Income, Underrepresented Minority, and Other Disadvantaged Pediatric Populations: Closing the Gap.

PubMed

Louisias, Margee; Phipatanakul, Wanda

2017-09-15

In this article, we review current understanding of the epidemiology and etiology of disparities in asthma. We also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors. However, multifaceted, innovative interventions that are sustainable and scalable are key to improving outcomes.

What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study).

PubMed

Falster, Kathleen; Jorm, Louisa; Eades, Sandra; Lynch, John; Banks, Emily; Brownell, Marni; Craven, Rhonda; Einarsdóttir, Kristjana; Randall, Deborah

2015-05-18

Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What's in a Name: "Education and the Disadvantaged American" (1962)

ERIC Educational Resources Information Center

Urban, Wayne J.

2009-01-01

"Education and the Disadvantaged American" represented an attempt by the leaders of the American elementary and secondary education enterprise to come to terms with the failure to learn of a significant portion of the school population. The dimension of race surrounded the discussion leading to publication, but it was never addressed…

The Impact of an Economically Disadvantaged Student Population on School Climate

ERIC Educational Resources Information Center

Null, Curtis F.

2012-01-01

The purpose of this study was to determine the relationship between student poverty levels, defined by the number of students identified as economically disadvantaged by qualifying for free and reduced lunch and school climate. The literature review examined school climate and culture, effects of student socioeconomic (SES) status on education,…

Coordinating Human Services: A Sociological Study of an Interorganizational Network. Research Series, Number 6.

ERIC Educational Resources Information Center

Benson, J. Kenneth; And Others

Interagency relationships have an important bearing upon the effectiveness with which public services are provided to disadvantaged populations. The present study examines interagency interactions and service delivery to the disadvantaged from both an empirical and a theoretical perspective. The findings may be helpful both in the formulation of…

Who Falls Behind: Defining the "At-Risk" Population--Current Dimensions and Future Trends.

ERIC Educational Resources Information Center

Pallas, Aaron M.; And Others

Using recent research on the causes of educational disadvantage in order to arrive at a working definition of educationally disadvantaged children, this paper considers the educational experiences of children at home, in the community, and at school. Thus, families and communities may be viewed as educationally deficient without necessarily being…

The Intellectual Disability Mortality Disadvantage: Diminishing with Age?

ERIC Educational Resources Information Center

Landes, Scott D.

2017-01-01

On average, adults with intellectual disability (ID) have higher mortality risk than their peers in the general population. However, the effect of age on this mortality disadvantage has received minimal attention. Using data from the 1986-2011 National Health Interview Survey-Linked Mortality Files (NHIS-LMF), discrete time hazard models were used…

The Social-Emotional Impact of Instrumental Music Performance on Economically Disadvantaged South African Students

ERIC Educational Resources Information Center

Devroop, Karendra

2012-01-01

Within the literature there exists a large volume of research studies attesting to the positive relationships between studying music and various psychological and sociological variables. A close examination of these studies reveals that only a handful were conducted on disadvantaged populations. Accordingly, it remains unclear to what extent these…

Children in an aging society.

PubMed

Uhlenberg, Peter

2009-06-01

This article explores ways in which population aging in the United States between 2010 and 2030 might impact the well-being of children, with a distinction made between advantaged and disadvantaged children. A variety of economic and demographic statistics are used to describe the changing age structure of the population and changing public spending on older people and children. Data from the 1985 General Social Survey and Wave 2 of the National Survey of Families and Households are also used to examine connections between older people and children. In recent decades, there has been a graying of the federal budget, and programs for children have received a declining proportion of domestic spending. These trends will be exaggerated between 2010 and 2030 unless structural changes occur. Grandparents may provide increasing resources for their grandchildren. Age segregation results in relatively few older people being directly involved with children not related to them by kinship. The implications of population aging for children are relevant primarily for disadvantaged children. Disadvantaged children have grandparents with fewest resources and are most in need of public spending. As costs of supporting the older population increase, intentional social changes will be needed to prevent growing inequality among children.

That's what friends are for: how intergroup friendships promote historically disadvantaged groups' substantive political representation.

PubMed

Kokkonen, Andrej; Karlsson, David

2017-12-01

The interests of historically disadvantaged groups risk being overlooked if they are not present in the decision-making process. However, a mere presence in politics does not guarantee political success. Often groups need allies to promote their interests successfully. We argue that one way to identify such allies is to judge politicians by whether they have friends in historically disadvantaged groups, as intergroup friendships have been shown to make people understand and feel empathy for outgroups. In other words, intergroup friendships may function as an important complement to descriptive representation. We test our argument with a unique survey that asks all elected political representatives in Sweden's 290 municipalities (response rate 79 per cent) about their friendship ties to, and their representation of, five historically disadvantaged groups: women, immigrants, youths, pensioners and blue-collar workers. We find a strong correlation between representatives' friendship ties to these groups and their commitment to represent them. The correlation is especially strong for youths and blue-collar workers, which likely can be explained by the fact that these groups usually lack crucial political resources (such as experience and education). We conclude that friendship ties function as an important complement to descriptive representation for achieving substantive representation. © London School of Economics and Political Science 2017.

Persons With Disabilities as an Unrecognized Health Disparity Population

PubMed Central

Walker, Deborah Klein; Correa-De-Araujo, Rosaly

2015-01-01

Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. PMID:25689212

Resistance of Aedes aegypti to temephos and adaptive disadvantages

PubMed Central

Diniz, Morgana Michele Cavalcanti de Souza Leal; Henriques, Alleksandra Dias da Silva; Leandro, Renata da Silva; Aguiar, Dalvanice Leal; Beserra, Eduardo Barbosa

2014-01-01

OBJECTIVE To evaluate the resistance of Aedes aegypti to temephos Fersol 1G (temephos 1% w/w) associated with the adaptive disadvantage of insect populations in the absence of selection pressure. METHODS A diagnostic dose of 0.28 mg a.i./L and doses between 0.28 mg a.i./L and 1.40 mg a.i./L were used. Vector populations collected between 2007 and 2008 in the city of Campina Grande, state of Paraíba, were evaluated. To evaluate competition in the absence of selection pressure, insect populations with initial frequencies of 20.0%, 40.0%, 60.0%, and 80.0% resistant individuals were produced and subjected to the diagnostic dose for two months. Evaluation of the development of aquatic and adult stages allowed comparison of the life cycles in susceptible and resistant populations and construction of fertility life tables. RESULTS No mortality was observed in Ae. aegypti populations subjected to the diagnostic dose of 0.28 mg a.i./L. The decreased mortality observed in populations containing 20.0%, 40.0%, 60.0%, and 80.0% resistant insects indicates that temephos resistance is unstable in the absence of selection pressure. A comparison of the life cycles indicated differences in the duration and viability of the larval phase, but no differences were observed in embryo development, sex ratio, adult longevity, and number of eggs per female. CONCLUSIONS The fertility life table results indicated that some populations had reproductive disadvantages compared with the susceptible population in the absence of selection pressure, indicating the presence of a fitness cost in populations resistant to temephos. PMID:25372168

[Progress on Individual Stature Estimation in Forensic Medicine].

PubMed

Wu, Rong-qi; Huang, Li-na; Chen, Xin

2015-12-01

Individual stature estimation is one of the most important contents of forensic anthropology. Currently, it has been used that the regression equations established by the data collected by direct measurement or radiological techniques in a certain group of limbs, irregular bones, and anatomic landmarks. Due to the impact of population mobility, human physical improvement, racial and geographic differences, estimation of individual stature should be a regular study. This paper reviews the different methods of stature estimation, briefly describes the advantages and disadvantages of each method, and prospects a new research direction.

The use of Facebook for virtual asynchronous focus groups in qualitative research.

PubMed

Biedermann, Narelle

2018-02-01

The Internet and the development of more user-engaging applications have opened a whole new world for researchers as a means of recruitment and data collection source. This paper describes the methodological approach of a research study that explored the experiences of Australian military spouses who packed up their family and home to accompany their spouse on an overseas posting. The study used Facebook as a recruitment tool and then as a data source through the conduct of an asynchronous virtual focus group. This paper outlines the advantages and disadvantages of this unique data source as a means of capturing the voices of a hard-to-reach population.

Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities

PubMed Central

Smith, Caren E.; Fullerton, Stephanie M.; Dookeran, Keith A.; Hampel, Heather; Tin, Adrienne; Maruthur, Nisa M.; Schisler, Jonathan C.; Henderson, Jeffrey A.; Tucker, Katherine L.; Ordovás, José M.

2016-01-01

Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization. PMID:27503959

Neighborhood socioeconomic disadvantage and 30-day rehospitalization: a retrospective cohort study.

PubMed

Kind, Amy J H; Jencks, Steve; Brock, Jane; Yu, Menggang; Bartels, Christie; Ehlenbach, William; Greenberg, Caprice; Smith, Maureen

2014-12-02

Measures of socioeconomic disadvantage may enable improved targeting of programs to prevent rehospitalizations, but obtaining such information directly from patients can be difficult. Measures of U.S. neighborhood socioeconomic disadvantage are more readily available but are rarely used clinically. To evaluate the association between neighborhood socioeconomic disadvantage at the census block group level, as measured by the Singh validated area deprivation index (ADI), and 30-day rehospitalization. Retrospective cohort study. United States. Random 5% national sample of Medicare patients discharged with congestive heart failure, pneumonia, or myocardial infarction between 2004 and 2009 (n = 255,744). Medicare data were linked to 2000 census data to construct an ADI for each patient's census block group, which were then sorted into percentiles by increasing ADI. Relationships between neighborhood ADI grouping and 30-day rehospitalization were evaluated using multivariate logistic regression models, controlling for patient sociodemographic characteristics, comorbid conditions and severity, and index hospital characteristics. The 30-day rehospitalization rate did not vary significantly across the least disadvantaged 85% of neighborhoods, which had an average rehospitalization rate of 21%. However, within the most disadvantaged 15% of neighborhoods, rehospitalization rates increased from 22% to 27% with worsening ADI. This relationship persisted after full adjustment, with the most disadvantaged neighborhoods having a rehospitalization risk (adjusted risk ratio, 1.09 [95% CI, 1.05 to 1.12]) similar to that of chronic pulmonary disease (adjusted risk ratio, 1.06 [CI, 1.04 to 1.08]) and greater than that of uncomplicated diabetes (adjusted risk ratio, 0.95 [CI, 0.94 to 0.97]). No direct markers of care quality or access. Residence within a disadvantaged U.S. neighborhood is a rehospitalization predictor of magnitude similar to chronic pulmonary disease. Measures of neighborhood disadvantage, such as the ADI, could potentially be used to inform policy and care after hospital discharge. National Institute on Aging and University of Wisconsin School of Medicine and Public Health's Institute for Clinical and Translational Research and Health Innovation Program.

Rural-urban differences of neonatal mortality in a poorly developed province of China.

PubMed

Yi, Bin; Wu, Li; Liu, Hong; Fang, Weimin; Hu, Yang; Wang, Youjie

2011-06-18

The influence of rural-urban disparities in children's health on neonatal death in disadvantaged areas of China is poorly understood. In this study of rural and urban populations in Gansu province, a disadvantaged province of China, we describe the characteristics and mortality of newborn infants and evaluated rural-urban differences of neonatal death. We analyzed all neonatal deaths in the data from the Surveillance System of Child Death in Gansu Province, China from 2004 to 2009. We calculated all-cause neonatal mortality rates (NMR) and cause-specific death rates for infants born to rural or urban mothers during 2004-09. Rural-urban classifications were determined based on the residence registry system of China. Chi-square tests were used to compare differences of infant characteristics and cause-specific deaths by rural-urban maternal residence. Overall, NMR fell in both rural and urban populations during 2004-09. Average NMR for rural and urban populations was 17.8 and 7.5 per 1000 live births, respectively. For both rural and urban newborn infants, the four leading causes of death were birth asphyxia, preterm or low birth weight, congenital malformation, and pneumonia. Each cause-specific death rate was higher in rural infants than in urban infants. More rural than urban neonates died out of hospital or did not receive medical care before death. Neonatal mortality declined dramatically both in urban and rural groups in Gansu province during 2004-09. However, profound disparities persisted between rural and urban populations. Strategies that address inequalities of accessibility and quality of health care are necessary to improve neonatal health in rural settings in China.

Improving the use of research evidence in guideline development: 12. Incorporating considerations of equity.

PubMed

Oxman, Andrew D; Schünemann, Holger J; Fretheim, Atle

2006-12-05

The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 12th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. We reviewed the literature on incorporating considerations of equity in guidelines and recommendations. We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. We found few directly relevant empirical methodological studies. These answers are based largely on logical arguments. When and how should inequities be addressed in systematic reviews that are used as background documents for recommendations? The following question should routinely be considered: Are there plausible reasons for anticipating differential relative effects across disadvantaged and advantaged populations? If there are plausible reasons for anticipating differential effects, additional evidence should be included in a review to inform judgments about the likelihood of differential effects. What questions about equity should routinely be addressed by those making recommendations on behalf of WHO? The following additional questions should routinely be considered: How likely is it that the results of available research are applicable to disadvantaged populations and settings? How likely are differences in baseline risk that would result in differential absolute effects across disadvantaged and advantaged populations? How likely is it that there are important differences in trade-offs between the expected benefits and harms across disadvantaged and advantaged populations? Are there different implications for disadvantaged and advantaged populations, or implications for addressing inequities? What context specific information is needed to inform adaptation and decision making in a specific setting with regard to impacts on equity? Those making recommendations on behalf of WHO should routinely consider and offer advice about the importance of the following types of context specific data that might be needed to inform adaptation and decision making in a specific setting: Effect modifiers for disadvantaged populations and for the likelihood of differential effects. Baseline risk in relationship to social and economic status. Utilization and access to care in relationship to social and economic status. Costs in relationship to social and economic status. Ethics and laws that may impact on strategies for addressing inequities. Availability of resources to address inequities. What implementation strategies are likely be needed to ensure that recommendations are implemented equitably? Organisational changes are likely to be important to address inequities. While it may only be possible to consider these in relationship to specific settings, consideration should be given to how best to provide support for identifying and addressing needs for organisational changes. In countries with pervasive inequities institutional, cultural and political changes may first be needed. Appropriate indicators of social and economic status should be used to monitor the effects of implementing recommendations on disadvantaged populations and on changes in social and economic status.

Pathways to suicidality across ethnic groups in Canadian adults: the possible role of social stress.

PubMed

Clarke, D E; Colantonio, A; Rhodes, A E; Escobar, M

2008-03-01

Ethnicity is an important determinant of mental health outcomes including suicidality (i.e. suicidal ideation and suicide attempt). Understanding ethnic differences in the pathways to suicidality is important for suicide prevention efforts in ethnically diverse populations. These pathways can be conceptualized within a social stress framework. The study examines ethnic differences in the pathways to suicidality in Canada within a social stress framework. Using data from the Canadian Community Health Survey Cycle 1.1 (CCHS 1.1) and path analysis, we examined the hypotheses that variations in (1) socio-economic status (SES), (2) sense of community belonging (SCB), (3) SES and SCB combined, and (4) SES, SCB and clinical factors combined can explain ethnic differences in suicidality. Francophone whites and Aboriginals were more likely to report suicidality compared to Anglophone whites whereas visible minorities and Foreign-born whites were least likely. Disadvantages in income, income and education, income and its combined effect with depression and alcohol dependence/abuse led to high rates even among the low-risk visible minority group. Indirect pathways for Asians differed from that of Blacks and South Asians, specifically through SCB. With the exception of SCB, Aboriginals were most disadvantaged, which exacerbated their risk for suicidality. However, their strong SCB buffered the risk for suicidality across pathways. Disadvantages in education, income and SCB were associated with the high risk for suicidality in Francophone whites. Francophone whites and Aboriginals had higher odds of suicidality compared to Anglophone whites; however, some pathways differed, indicating the need for targeted program planning and prevention efforts.

The prevalence of dental caries and fissure sealants in 12 year old children by disadvantaged status in Dublin (Ireland).

PubMed

Sagheri, D; McLoughlin, J; Clarkson, J J

2009-03-01

The aim was to record dental caries levels and the presence of fissure sealants in 12-year-old schoolchildren whose domestic water supply had been fluoridated since birth in Dublin (Ireland). Cross-sectional study. Participants A representative, random sample of 12-year-old schoolchildren in north-west Dublin. Dental caries levels were recorded using WHO criteria and fissure sealant was recorded when sealant was detectable on a permanent molar tooth. Medical card ownership, as a surrogate for disadvantage, was recorded by use of a questionnaire. Three-hundred and thirty-two (332) children were examined. The mean DMFT was 0.80 (SD 1.24). Analysis (Mann-Whitney U test) based on stratification of the sample according to medical-card status revealed no statistically significant difference between DMFT median scores of children of medical-card holders (i.e., social disadvantage background) and non medical-card holders (p-value = 0.23). However, the data revealed a social gradient in the presence of at least one fissure sealant. Approximately 10% more children in the group of medical-card holders had no fissure sealants present. Fisher's exact test was used to examine the association between the absence of fissure sealants and at least one fissure sealant between the two groups and was considered to be statistically significant (p-value = 0.04). This study demonstrated a social gradient in the presence of fissure sealants, but no such gradient in dental caries levels. This demonstrates the importance of population-based measures in the prevention of dental caries, such as water fluoridation, in reducing oral health inequalities.

Intergenerational transmission of neighbourhood poverty: an analysis of neighbourhood histories of individuals

PubMed Central

van Ham, Maarten; Hedman, Lina; Manley, David; Coulter, Rory; Östh, John

2014-01-01

The extent to which socioeconomic (dis)advantage is transmitted between generations is receiving increasing attention from academics and policymakers. However, few studies have investigated whether there is a spatial dimension to this intergenerational transmission of (dis)advantage. Drawing on the concept of neighbourhood biographies, this study contends that there are links between the places individuals live with their parents and their subsequent neighbourhood experiences as independent adults. Using individual-level register data tracking the whole Stockholm population from 1990 to 2008, and bespoke neighbourhoods, this study is the first to use sequencing techniques to construct individual neighbourhood histories. Through visualisation methods and ordered logit models, we demonstrate that the socioeconomic composition of the neighbourhood children lived in before they left the parental home is strongly related to the status of the neighbourhood they live in 5, 12 and 18 years later. Children living with their parents in high poverty concentration neighbourhoods are very likely to end up in similar neighbourhoods much later in life. The parental neighbourhood is also important in predicting the cumulative exposure to poverty concentration neighbourhoods over a long period of early adulthood. Ethnic minorities were found to have the longest cumulative exposure to poverty concentration neighbourhoods. These findings imply that for some groups, disadvantage is both inherited and highly persistent. PMID:26074624

Intergenerational transmission of neighbourhood poverty: an analysis of neighbourhood histories of individuals.

PubMed

van Ham, Maarten; Hedman, Lina; Manley, David; Coulter, Rory; Östh, John

2014-07-01

The extent to which socioeconomic (dis)advantage is transmitted between generations is receiving increasing attention from academics and policymakers. However, few studies have investigated whether there is a spatial dimension to this intergenerational transmission of (dis)advantage. Drawing on the concept of neighbourhood biographies, this study contends that there are links between the places individuals live with their parents and their subsequent neighbourhood experiences as independent adults. Using individual-level register data tracking the whole Stockholm population from 1990 to 2008, and bespoke neighbourhoods, this study is the first to use sequencing techniques to construct individual neighbourhood histories. Through visualisation methods and ordered logit models, we demonstrate that the socioeconomic composition of the neighbourhood children lived in before they left the parental home is strongly related to the status of the neighbourhood they live in 5, 12 and 18 years later. Children living with their parents in high poverty concentration neighbourhoods are very likely to end up in similar neighbourhoods much later in life. The parental neighbourhood is also important in predicting the cumulative exposure to poverty concentration neighbourhoods over a long period of early adulthood. Ethnic minorities were found to have the longest cumulative exposure to poverty concentration neighbourhoods. These findings imply that for some groups, disadvantage is both inherited and highly persistent.

Promotion of Primary Education for Girls and Disadvantaged Groups.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

This report presents the results of a meeting of education officials from Bangladesh, China, India, Japan, Nepal, Pakistan, and Thailand to discuss the promotion of primary education for girls and other disadvantaged groups in developing Asian countries. Chapter 1 serves as an introduction, discussing the goals and results of the meeting. Chapter…

7 CFR 760.107 - Socially disadvantaged, limited resource, or beginning farmer or rancher.

Code of Federal Regulations, 2010 CFR

2010-01-01

... disadvantaged, limited resource, or beginning farmer or rancher. (a) Risk management purchase requirements, as... members of a group without regard to their individual qualities. Gender is not included as a covered group... Agricultural Statistics Service (NASS), and (ii) A producer whose total household income is at or below the...

7 CFR 761.208 - Target participation rates for socially disadvantaged groups.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for State and County levels annually. (3) When distributing loan funds in counties within Indian... in the county who are members of socially disadvantaged ethnic groups. (d) Women farmers. (1) The target participation rate for women farmers in each: (i) State is equal to the percent of farmers in the...

Intervening against "Racial" Disadvantage: Educational Policy and Labor-Market Outcomes in the United Kingdom.

ERIC Educational Resources Information Center

Jenkins, Richard

1988-01-01

Argues that education can not guarantee social or occupational mobility, or even work, for minority groups in the United Kingdom. Presents evidence that labor market disadvantage for minority groups arises from direct racist discrimination, ethnocentric notions of "acceptability," and word-of-mouth recruitment of employees. Contains 54…

Relevance of a neurophysiological marker of attention allocation for children's learning-related behaviors and academic performance.

PubMed

Willner, Cynthia J; Gatzke-Kopp, Lisa M; Bierman, Karen L; Greenberg, Mark T; Segalowitz, Sidney J

2015-08-01

Learning-related behaviors are important for school success. Socioeconomic disadvantage confers risk for less adaptive learning-related behaviors at school entry, yet substantial variability in school readiness exists within socioeconomically disadvantaged populations. Investigation of neurophysiological systems associated with learning-related behaviors in high-risk populations could illuminate resilience processes. This study examined the relevance of a neurophysiological measure of controlled attention allocation, amplitude of the P3b event-related potential, for learning-related behaviors and academic performance in a sample of socioeconomically disadvantaged kindergarteners. The sample consisted of 239 children from an urban, low-income community, approximately half of whom exhibited behavior problems at school entry (45% aggressive/oppositional; 64% male; 69% African American, 21% Hispanic). Results revealed that higher P3b amplitudes to target stimuli in a go/no-go task were associated with more adaptive learning-related behaviors in kindergarten. Furthermore, children's learning-related behaviors in kindergarten mediated a positive indirect effect of P3b amplitude on growth in academic performance from kindergarten to 1st grade. Given that P3b amplitude reflects attention allocation processes, these findings build on the scientific justification for interventions targeting young children's attention skills in order to promote effective learning-related behaviors and academic achievement within socioeconomically disadvantaged populations. (c) 2015 APA, all rights reserved).

Hispanic Baby Boomers: Health Inequities Likely to Persist in Old Age

PubMed Central

Villa, Valentine M.; Wallace, Steven P.; Bagdasaryan, Sofya; Aranda, Maria P.

2012-01-01

Purpose: As the Baby-Boom generation enters the ranks of the elderly adults over the next 4 decades, the United States will witness an unprecedented growth in racial/ethnic diversity among the older adult population. Hispanics will comprise 20% of the next generation of older adults, representing the largest minority population aged 65 years and older, with those of Mexican-origin comprising the majority of Hispanics. Little is known about the health status of this population. Data/Methods: Data are for Baby Boomers born between 1946 and 1964 (ages 43–61) in the 2007 California Health Interview Survey. Logistic regression estimates the odds of diabetes, hypertension, obesity, fair/poor self-rated health (SRH), and functional difficulties among U.S.-born non-Hispanic Whites (NHW), U.S.-born Mexicans, naturalized Mexican immigrants, and noncitizen Mexican immigrants. Results: The Mexican-origin populations are disadvantaged relative to NHW for all socioeconomic status (SES) and several health outcomes. The Mexican origin disadvantage in health attenuates when controlling for SES and demographics, but the disadvantage remains for diabetes, obesity, and fair/poor SRH. Implications: Baby Boomers of Mexican origin do not share the advantages of health, income, and educational attainment enjoyed by U.S.-born NHW. As this cohort moves into old age, the cumulative disadvantage of existing disparities are likely to result in continued or worse health disparities. Reductions in federal entitlement programs for the elderly adults that delay eligibility, scale back programs and services, or increase costs to consumers may exacerbate those inequities. PMID:22399578

Racial and Ethnic Disparities in Structural Disadvantage and Crime: White, Black, and Hispanic Comparisons*

PubMed Central

Ulmer, Jeffery T.; Harris, Casey T.; Steffensmeier, Darrell

2014-01-01

Objectives The objective of this study is to advance knowledge on racial/ethnic disparities in violence and the structural sources of those disparities. We do so by extending scarce and limited research exploring the relationship between race/ethnic gaps in disadvantage and differences in violent crime across groups. Methods Using census place-level data from California and New York, we construct White, Black, and Hispanic “gap” measures that take as a given the existence of disparities across race/ethnic groups in structural disadvantage and crime and subsequently utilize seemingly unrelated regression models to assess the extent to which gaps in disadvantage are predictive of gaps in homicide and index violence. Results Our results suggest that (1) there is considerable heterogeneity in the size of White-Black, White-Hispanic, and Black-Hispanic gaps in structural disadvantage and crime and (2) that race/ethnic disparities in structural disadvantage, particularly poverty and female headship, are positively associated with race/ethnic gaps in homicide and index violence. Conclusion In light of recent scholarship on the racial invariance hypothesis and on the relationship between structural inequality and crime, the current study demonstrates that disparities in disadvantage, particularly family structure and poverty, are important in driving racial and ethnic disparities in crime. PMID:25035523

Racial and Ethnic Disparities in Obesity during the Transition to Adulthood: The Contingent and Nonlinear Impact of Neighborhood Disadvantage

ERIC Educational Resources Information Center

Nicholson, Lisa M.; Browning, Christopher R.

2012-01-01

Neighborhood disadvantage in early adolescence may help explain racial and ethnic disparities in obesity during the transition to adulthood; however the processes may work differently for males and females and for minority groups compared to Whites. The present study examines the relationship between neighborhood disadvantage and young adult…

A PRELIMINARY INVESTIGATION TO ESTABLISH A REGIONAL CENTER FOR EDUCATIONAL DEVELOPMENTAL STUDIES OF DISADVANTAGED PRESCHOOL CHILDREN. FINAL REPORT.

ERIC Educational Resources Information Center

LEVINE, LOUIS S.

THIS REPORT DESCRIBES SEVERAL STEPS UNDERTAKEN BY A RESEARCH GROUP FROM SAN FRANCISCO STATE COLLEGE PRELIMINARY TO THE PROPOSED CREATION OF A RESEARCH CENTER FOR STUDIES OF DISADVANTAGED PRESCHOOL CHILDREN. THE PLANS ANTICIPATE FORMATION OF A COMPREHENSIVE SERVICE, RESEARCH, AND TRAINING CENTER FOR DISADVANTAGED CHILDREN AND THEIR FAMILIES. THE…

A Career and Learning Transitional Model for Those Experiencing Labour Market Disadvantage

ERIC Educational Resources Information Center

Cameron, Roslyn

2009-01-01

Research investigating the learning and career transitions of those disadvantaged in the labour market has resulted in the development of a four-component model to enable disadvantaged groups to navigate learning and career transitions. The four components of the model include: the self-concept; learning and recognition; career and life planning;…

40 CFR 33.202 - How does an entity qualify as an MBE or WBE under EPA's 8% statute?

Code of Federal Regulations, 2013 CFR

2013-07-01

... identity as a member of a group without regard to his or her individual qualities and as further defined by... establish that it is owned or controlled by socially and economically disadvantaged individuals who are of... Hawaiian Organizations). (b) Socially disadvantaged individual. A socially disadvantaged individual is a...

40 CFR 33.202 - How does an entity qualify as an MBE or WBE under EPA's 8% statute?

Code of Federal Regulations, 2014 CFR

2014-07-01

... identity as a member of a group without regard to his or her individual qualities and as further defined by... establish that it is owned or controlled by socially and economically disadvantaged individuals who are of... Hawaiian Organizations). (b) Socially disadvantaged individual. A socially disadvantaged individual is a...

40 CFR 33.202 - How does an entity qualify as an MBE or WBE under EPA's 8% statute?

Code of Federal Regulations, 2012 CFR

2012-07-01

... identity as a member of a group without regard to his or her individual qualities and as further defined by... establish that it is owned or controlled by socially and economically disadvantaged individuals who are of... Hawaiian Organizations). (b) Socially disadvantaged individual. A socially disadvantaged individual is a...

Enhanced activity of carbohydrate- and lipid-metabolizing enzymes in insecticide-resistant populations of the maize weevil, Sitophilus zeamais.

PubMed

Araújo, R A; Guedes, R N C; Oliveira, M G A; Ferreira, G H

2008-08-01

Insecticide resistance is frequently associated with fitness disadvantages in the absence of insecticides. However, intense past selection with insecticides may allow the evolution of fitness modifier alleles that mitigate the cost of insecticide resistance and their consequent fitness disadvantages. Populations of Sitophilus zeamais with different levels of susceptibility to insecticides show differences in the accumulation and mobilization of energy reserves. These differences may allow S. zeamais to better withstand toxic compounds without reducing the beetles' reproductive fitness. Enzymatic assays with carbohydrate- and lipid-metabolizing enzymes were, therefore, carried out to test this hypothesis. Activity levels of trehalase, glycogen phosphorylase, lipase, glycosidase and amylase were determined in two insecticide-resistant populations showing (resistant cost) or not showing (resistant no-cost) associated fitness cost, and in an insecticide-susceptible population. Respirometry bioassays were also carried out with these weevil populations. The resistant no-cost population showed significantly higher body mass and respiration rate than the other two populations, which were similar. No significant differences in glycogen phosphorylase and glycosidase were observed among the populations. Among the enzymes studied, trehalase and lipase showed higher activity in the resistant cost population. The results obtained in the assays with amylase also indicate significant differences in activity among the populations, but with higher activity in the resistant no-cost population. The inverse activity trends of lipases and amylases in both resistant populations, one showing fitness disadvantage without insecticide exposure and the other not showing it, may underlay the mitigation of insecticide resistance physiological costs observed in the resistant no-cost population. The higher amylase activity observed in the resistant no-cost population may favor energy storage, preventing potential trade-offs between insecticide resistance mechanisms and basic physiological processes in this population, unlike what seems to take place in the resistant cost population.

Medical school applicants from ethnic minority groups: identifying if and when they are disadvantaged.

PubMed Central

McManus, I. C.; Richards, P.; Winder, B. C.; Sproston, K. A.; Styles, V.

1995-01-01

OBJECTIVE--To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. DESIGN--Prospective study of a national cohort of medical school applicants. SETTING--All 28 medical schools in the United Kingdom. SUBJECTS--6901 subjects who had applied through the Universities' Central Council on Admissions in 1990 to study medicine. MAIN OUTCOME MEASURES--Offers and acceptance at medical school by ethnic group. RESULTS--Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. CONCLUSIONS--People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate's surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees' estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known. PMID:7888888

Reaching and Helping Unorganized and Disadvantaged People. Courier No. 33.

ERIC Educational Resources Information Center

ASPBAE Courier, 1985

1985-01-01

The articles in this issue are mainly concerned with how to reach the poorest and most disadvantaged sections of the population and how best to help once contact has been made. "Nijera Kori in Retrospect: In Search of an Organization of the Rural Poor" (Mohiuddin Ahmad) provides extracts from an evaluation of this grassroots,…

Socioeconomic Disadvantage Is Associated with a Higher Incidence of Aneurysmal Subarachnoid Hemorrhage.

PubMed

Nichols, Linda; Stirling, Christine; Otahal, Petr; Stankovich, Jim; Gall, Seana

2018-03-01

Aneurysmal subarachnoid hemorrhage (aSAH) incidence is not well studied. Varied definitions of "subarachnoid hemorrhage" have led to a lack of clarity regarding aSAH incidence. The impact of area-level socioeconomic disadvantage and geographical location on the incidence of aSAH also remains unclear. Using a population-based statewide study, we examined the incidence of aSAH in relation to socioeconomic disadvantage and geographical location. A retrospective cohort study of nontraumatic subarachnoid hemorrhages from 2010 to 2014 was undertaken. Researchers manually collected data from multiple overlapping sources including statewide administrative databases, individual digital medical records, and death registers. Age-standardized rates (ASRs) per 100,000 person years were calculated using the 2001 Australian population. Differences in incidence rate ratios were calculated by age, sex, area-level socioeconomic status, and geographical location using Poisson regression. The cohort of 237 cases (mean age, 61.0 years) with a female predominance of 166 (70.04%) included 159 confirmed aSAH, 52 community-based deaths, and 26 probable cases. The ASR for aSAH was 9.99 (95% confidence interval [CI], 8.69-11.29). A significant association between area-level socioeconomic disadvantage and incidence was observed, with the rate of aSAH in disadvantaged geographical areas being 1.40 times higher than that in advantaged areas (95% CI, 1.11-1.82; P = .012). This study uses a comprehensive search of multiple data sources to define a new baseline of aSAH within an Australian population. This study presents a higher incidence rate of aSAH with socioeconomic variations. As a key risk factor that may explain this paradox, addressing socioeconomic inequalities is important for effective prevention and management interventions. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Exploring the pathways leading from disadvantage to end-stage renal disease for indigenous Australians.

PubMed

Cass, Alan; Cunningham, Joan; Snelling, Paul; Wang, Zhiqiang; Hoy, Wendy

2004-02-01

Indigenous Australians are disadvantaged, relative to other Australians, over a range of socio-economic and health measures. The age- and sex-adjusted incidence of end-stage renal disease (ESRD)--the irreversible preterminal phase of chronic renal failure--is almost nine times higher amongst Indigenous than it is amongst non-indigenous Australians. A striking gradient exists from urban to remote regions, where the standardised ESRD incidence is from 20 to more than 30 times the national incidence. We discuss the profound impact of renal disease on Indigenous Australians and their communities. We explore the linkages between disadvantage, often accompanied by geographic isolation, and both the initiation of renal disease, and its progression to ESRD. Purported explanations for the excess burden of renal disease in indigenous populations can be categorised as: primary renal disease explanations;genetic explanations;early development explanations; and socio-economic explanations. We discuss the strengths and weaknesses of these explanations and suggest a new hypothesis which integrates the existing evidence. We use this hypothesis to illuminate the pathways between disadvantage and the human biological processes which culminate in ESRD, and to propose prevention strategies across the life-course of Indigenous Australians to reduce their ESRD risk. Our hypothesis is likely to be relevant to an understanding of patterns of renal disease in other high-risk populations, particularly indigenous people in the developed world and people in developing countries. Furthermore, analogous pathways might be relevant to other chronic diseases, such as diabetes and cardiovascular disease. If we are able to confirm the various pathways from disadvantage to human biology, we will be better placed to advocate evidence-based interventions, both within and beyond the scope of the health-care system, to address the excess burden of renal and other chronic diseases among affected populations.

Relationship between haemophilia and social status.

PubMed

Holstein, Katharina; Eifrig, Barbara; Langer, Florian

2014-11-01

The impact of haemophilia and its treatment on social status has not been well studied, although research into the quality of life of patients with haemophilia has shed some light on aspects of social and role functioning. Studies conducted before the advent of safe and effective coagulation factor replacement therapy suggest that the haemophilia population was predominantly of low socioeconomic status with many social disadvantages, including high rates of disability and unemployment and low rates of marriage. Since the availability of purified factor VIII concentrates that could be used in a home-care setting and as prophylaxis, most research suggests that social status and well-being amongst children, adolescents, and adults with haemophilia is not compromised, and is comparable to that of the general population. Children and adolescents with haemophilia do not generally feel disadvantaged, although haemophilia-related issues at school and amongst peer groups do arise. Recent studies in adults show higher than average rates of marriage and cohabitation and the attainment of a generally good educational status, but, as in the past, employment rates remain comparatively lower. Social status amongst the elderly with haemophilia who may have developed severe disability as a result of their condition is poorly defined and has never been formally studied. Additional research is recommended. © 2013.

Health equity in humanitarian emergencies: a role for evidence aid.

PubMed

Pottie, Kevin

2015-02-01

Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Educational differentials in disability vary across and within welfare regimes: a comparison of 26 European countries in 2009.

PubMed

Cambois, Emmanuelle; Solé-Auró, Aïda; Brønnum-Hansen, Henrik; Egidi, Viviana; Jagger, Carol; Jeune, Bernard; Nusselder, Wilma J; Van Oyen, Herman; White, Chris; Robine, Jean-Marie

2016-04-01

Social differentials in disability prevalence exist in all European countries, but their scale varies markedly. To improve understanding of this variation, the article focuses on each end of the social gradient. It compares the extent of the higher disability prevalence in low social groups (referred to as disability disadvantage) and of the lower prevalence in high social groups (disability advantage); country-specific advantages/disadvantages are discussed regarding the possible influence of welfare regimes. Cross-sectional disability prevalence is measured by longstanding health-related activity limitation (AL) in the 2009 European Statistics on Income and Living Conditions (EU-SILC) across 26 countries classified into four welfare regime groups. Logistic models adjusted by country, age and sex (in all 30-79 years and in three age-bands) measured the country-specific ORs across education, representing the AL-disadvantage of low-educated and AL-advantage of high-educated groups relative to middle-educated groups. The relative AL-disadvantage of the low-educated groups was small in Sweden (eg, 1.2 (1.0-1.4)), Finland, Romania, Bulgaria and Spain (youngest age-band), but was large in the Czech Republic (eg, 1.9 (1.7-2.2)), Denmark, Belgium, Italy and Hungary. The high-educated groups had a small relative AL-advantage in Denmark (eg, 0.9 (0.8-1.1)), but a large AL-advantage in Lithuania (eg, 0.5 (0.4-0.6)), half of the Baltic and Eastern European countries, Norway and Germany (youngest age-band). There were notable differences within welfare regime groups. The country-specific disability advantages/disadvantages across educational groups identified here could help to identify determining factors and the efficiency of national policies implemented to tackle social differentials in health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Neighborhood Disadvantage and Adult Alcohol Outcomes: Differential Risk by Race and Gender

PubMed Central

Karriker-Jaffe, Katherine J.; Zemore, Sarah E.; Mulia, Nina; Jones-Webb, Rhonda; Bond, Jason; Greenfield, Thomas K.

2012-01-01

Objective: We examined whether relationships of neighborhood disadvantage with drinker status, heavy drinking, alcohol-related consequences, and dependence differed by race and/or gender. We hypothesized that neighborhood disadvantage would be negatively associated with drinker status but positively associated with heavy and problem drinking, with more pronounced relationships among African American and Hispanic men than other groups. Method: Data consisted of nationally representative, randomly selected, cross-sectional samples of White, African American, and Hispanic adults (N = 13,864, of which 52% were female; with 7,493 drinkers, of which 48% were female) from the 2000 and 2005 National Alcohol Surveys merged with 2000 Census data. Analyses included logistic and linear regression using weights to adjust for sampling and nonresponse. Results: Hypotheses were partly supported. Bivariate relationships were in the expected direction. Multivariate main effect models showed that neighborhood disadvantage was significantly associated with increased abstinence and marginally associated with increased negative consequences experienced by drinkers, but race/ethnicity and gender modified these associations. Disadvantage was significantly associated with increased abstinence for all groups except African American and Hispanic men. Among drinkers, disadvantage was significantly negatively associated with heavy drinking by Whites but significantly positively associated with heavy drinking by African Americans. Disadvantage also was associated with elevated alcohol-related consequences for White women and African American men. Conclusions: The findings have implications for the development of targeted interventions to reduce the unequal impacts of neighborhood disadvantage on alcohol outcomes. Future research should examine the contribution of multiple types of disadvantage to heavy drinking and alcohol problems. PMID:23036203

Risk factors for child maltreatment in an Australian population-based birth cohort.

PubMed

Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie

2017-02-01

Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Socioeconomic Inequalities in Neglected Tropical Diseases: A Systematic Review

PubMed Central

Houweling, Tanja A. J.; Karim-Kos, Henrike E.; Kulik, Margarete C.; Stolk, Wilma A.; Haagsma, Juanita A.; Lenk, Edeltraud J.; Richardus, Jan Hendrik; de Vlas, Sake J.

2016-01-01

Background Neglected tropical diseases (NTDs) are generally assumed to be concentrated in poor populations, but evidence on this remains scattered. We describe within-country socioeconomic inequalities in nine NTDs listed in the London Declaration for intensified control and/or elimination: lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiasis (STH), trachoma, Chagas’ disease, human African trypanosomiasis (HAT), leprosy, and visceral leishmaniasis (VL). Methodology We conducted a systematic literature review, including publications between 2004–2013 found in Embase, Medline (OvidSP), Cochrane Central, Web of Science, Popline, Lilacs, and Scielo. We included publications in international peer-reviewed journals on studies concerning the top 20 countries in terms of the burden of the NTD under study. Principal findings We identified 5,516 publications, of which 93 met the inclusion criteria. Of these, 59 papers reported substantial and statistically significant socioeconomic inequalities in NTD distribution, with higher odds of infection or disease among poor and less-educated people compared with better-off groups. The findings were mixed in 23 studies, and 11 studies showed no substantial or statistically significant inequality. Most information was available for STH, VL, schistosomiasis, and, to a lesser extent, for trachoma. For the other NTDs, evidence on their socioeconomic distribution was scarce. The magnitude of inequality varied, but often, the odds of infection or disease were twice as high among socioeconomically disadvantaged groups compared with better-off strata. Inequalities often took the form of a gradient, with higher odds of infection or disease each step down the socioeconomic hierarchy. Notwithstanding these inequalities, the prevalence of some NTDs was sometimes also high among better-off groups in some highly endemic areas. Conclusions While recent evidence on socioeconomic inequalities is scarce for most individual NTDs, for some, there is considerable evidence of substantially higher odds of infection or disease among socioeconomically disadvantaged groups. NTD control activities as proposed in the London Declaration, when set up in a way that they reach the most in need, will benefit the poorest populations in poor countries. PMID:27171166

Identity and collective action among European Kurds.

PubMed

Ufkes, Elze G; Dovidio, John F; Tel, Gulizar

2015-03-01

This research investigated the role of group-based anger and efficacy in explaining the effects of subgroup (ethnic) and common (European) identity on collective action among Kurds in Europe responding to different types of disadvantage. Whereas stronger Kurdish identity positively predicted intentions for collective action (mediated by anger and efficacy), stronger common ingroup identity was negatively related to collective action intentions. This effect occurred primarily when structural disadvantage was salient, not when attention was drawn to a specific incident of disadvantage, and was mediated by anger but not efficacy. The findings complement recent work demonstrating that intergroup harmony can undermine social change, suggesting that stronger common-group identification reduces collective action by reducing minority-group members' sensitivity to potential bias against them. © 2014 The British Psychological Society.

Enhanced mobility for aging populations using automated vehicles.

DOT National Transportation Integrated Search

2015-12-01

Automated vehicles (AV) offer a unique opportunity to improve the safety and efficiency of the transportation : system and enhance the mobility of aging and transportation disadvantaged populations simultaneously. : However, before this potential can...

Clinical efficacy of low-temperature radiofrequency ablation of pharyngolaryngeal cyst in 84 Chinese infants.

PubMed

Wang, Zhinan; Zhang, Yamin; Ye, Yuhua; Yao, Wei; Xu, Zhongqiang; Xia, Zhongfang; Wang, Shufen; Zhou, Chengyong

2017-11-01

The aim of the study is to investigate the advantages and disadvantages of low-temperature radiofrequency ablation of pharyngolaryngeal cyst.The study population was composed of 84 children diagnosed with pharyngolaryngeal cyst who underwent surgical treatment at the Department of Otolaryngology, Wuhan Children's Hospital, Wuhan, China, between January 1984 and December 2013. All patients were operated using a self-retaining laryngoscope and were divided into 3 groups: traditional cystectomy group (N = 9), dynamic cutting system group (N = 18), and low-temperature radiofrequency ablation group (N = 57). Clinical outcomes were analyzed to assess the efficacy of low-temperature radiofrequency ablation in treatment of pharyngolaryngeal cyst.Compared with traditional cystectomy group or dynamic cutting system group, operation time was shorter, bleeding was less and one-year recurrence rate was much lower in low-temperature radiofrequency ablation group. However, operation time and bleeding was not statistically different between traditional cystectomy and dynamic cutting system group.Low-temperature radiofrequency ablation may be an effective substitute for treating pharyngolaryngeal cyst.

Social Disadvantage: Cause or Consequence of Impending Psychosis?

PubMed Central

Stilo, Simona A.

2013-01-01

Background: An association between social disadvantage and established psychosis is well documented in the literature, but there remains a lack of data on the social circumstances of patients before they became ill. We investigated whether social disadvantage at, and prior to, first contact with psychiatric services, is associated with psychosis. Method: We collected information on social disadvantage in childhood and adulthood from 278 cases presenting with their first episode of psychosis to the South London and Maudsley National Health Service Foundation Trust and from 226 controls recruited from the local population. Three markers of childhood social disadvantage and 3 markers of disadvantage in adulthood were analyzed. Results: Long term separation from, and death of, a parent before the age of 17 years were both strongly associated with a 2- to 3-fold-increased odds of psychosis. Cases were also significantly more likely to report 2 or more markers of adult social disadvantage than healthy controls (OR = 9.03) at the time of the first presentation with psychosis, independent of a number of confounders. When we repeated these analyses for long-standing adult social disadvantage, we found that the strength of the association decreased but still remained significant for 1 year (OR = 5.67) and 5 years (OR = 2.57) prior to the first contact. Conclusions: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood. PMID:23091267

Nutritional and dental issues in patients with intellectual and developmental disabilities.

PubMed

Ziegler, Jane; Spivack, Evan

2018-04-01

People with intellectual and developmental disabilities are among the most disadvantaged and underserved groups of dental patients. Considerable health care disparities for this population have been identified, particularly oral and dental health as well as access to dental care services. People with Down syndrome and cerebral palsy have a variety of nutritional and dental considerations. These people have a higher prevalence of untreated caries and periodontal disease than the general population and may have higher rates of obesity, edentulism, and chronic oral and systemic diseases. Diet choices may affect the oral health and may play an important role in the systemic health of these people. Suggestions to improve and affect dietary intake are provided. Health issues within this population require a holistic approach to care. Concerns about oral health and diet must be addressed to support optimal health. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

Qualitative methods to ensure acceptability of behavioral and social interventions to the target population

PubMed Central

Ayala, Guadalupe X.; Elder, John P.

2013-01-01

This paper introduces qualitative methods for assessing the acceptability of an intervention. Acceptability refers to determining how well an intervention will be received by the target population and the extent to which the new intervention or its components might meet the needs of the target population and organizational setting. In this paper, we focus on two common qualitative methods for conducting acceptability research and their advantages and disadvantages: focus groups and interviews. We provide examples from our own research and other studies to demonstrate the use of these methods for conducting acceptability research and how one might adapt this approach for oral health research. Finally, we present emerging methods for conducting acceptability research, including the use of community-based participatory research, as well as the utility of conducting acceptability research for assessing the appropriateness of measures in intervention research. PMID:21656958

Consistent response of bird populations to climate change on two continents.

PubMed

Stephens, Philip A; Mason, Lucy R; Green, Rhys E; Gregory, Richard D; Sauer, John R; Alison, Jamie; Aunins, Ainars; Brotons, Lluís; Butchart, Stuart H M; Campedelli, Tommaso; Chodkiewicz, Tomasz; Chylarecki, Przemysław; Crowe, Olivia; Elts, Jaanus; Escandell, Virginia; Foppen, Ruud P B; Heldbjerg, Henning; Herrando, Sergi; Husby, Magne; Jiguet, Frédéric; Lehikoinen, Aleksi; Lindström, Åke; Noble, David G; Paquet, Jean-Yves; Reif, Jiri; Sattler, Thomas; Szép, Tibor; Teufelbauer, Norbert; Trautmann, Sven; van Strien, Arco J; van Turnhout, Chris A M; Vorisek, Petr; Willis, Stephen G

2016-04-01

Global climate change is a major threat to biodiversity. Large-scale analyses have generally focused on the impacts of climate change on the geographic ranges of species and on phenology, the timing of ecological phenomena. We used long-term monitoring of the abundance of breeding birds across Europe and the United States to produce, for both regions, composite population indices for two groups of species: those for which climate suitability has been either improving or declining since 1980. The ratio of these composite indices, the climate impact indicator (CII), reflects the divergent fates of species favored or disadvantaged by climate change. The trend in CII is positive and similar in the two regions. On both continents, interspecific and spatial variation in population abundance trends are well predicted by climate suitability trends. Copyright © 2016, American Association for the Advancement of Science.

Childhood disadvantage, education, and psychological distress in adulthood: A three-wave population-based study.

PubMed

Sheikh, Mashhood Ahmed

2018-03-15

We assessed the mediating role of education in the association between childhood disadvantage and psychological distress in adulthood using longitudinal data collected in three waves, from 1994 to 2008, in the framework of the Tromsø Study (N = 4530), a cohort that is representative of men and women from Tromsø. Education was measured at a mean age of 54.7 years, and psychological distress in adulthood was measured at a mean age of 61.7 years. Ordinary least square regression analysis was used to assess the associations between childhood disadvantage, education, and psychological distress in adulthood. The indirect effects and the proportion (%) of indirect effects of childhood disadvantage (via education) on psychological distress in adulthood were assessed by mediation analysis. Childhood disadvantage was associated with lower education and higher psychological distress in adulthood (p < 0.05). Lower education was associated with a higher psychological distress in adulthood (p < 0.05). A minor proportion (7.51%, p < 0.05) of the association between childhood disadvantage and psychological distress in adulthood was mediated by education. Childhood disadvantages were measured retrospectively. The association between childhood disadvantage and psychological distress in adulthood is primarily independent of education. Copyright © 2017 Elsevier B.V. All rights reserved.

Mobile Technologies & Socio-Economic Opportunities for Disadvantaged Women: A Study of Information Behavior in a Developing Nation Context

ERIC Educational Resources Information Center

Potnis, Devendra Dilip

2010-01-01

Information and communication technologies (ICTs) have been championed by the United Nations and others as one of the key media to open up socio-economic opportunities for disadvantaged populations. Studies lead us to believe that after being introduced to ICTs, users' information behavior changes, enabling them to benefit from socio-economic…

Relationships Between Selected Family Variables and Maternal and Infant Behavior in a Disadvantaged Population. A Supplementary Report.

ERIC Educational Resources Information Center

Gordon, Ira J.; And Others

This pamphlet contains a series of studies that grew out of the parent education project of the Institute for Development of Human Resources. The objectives and general design of the project consisted of instruction of 200 environmentally disadvantaged mothers by parent educators using a sequence of infant stimulation exercises conducted in the…

Nurture thru Nature: Creating Natural Science Identities in Populations of Disadvantaged Children through Community Education Partnership

ERIC Educational Resources Information Center

Camasso, Michael J.; Jagannathan, Radha

2018-01-01

In this article we describe the development, implementation, and some of the early impacts of Nurture thru Nature (NtN), an American after-school and summer program designed to introduce elementary school students in disadvantaged, urban public schools to natural science and environmental education. The program, which began operations in 2010 as a…

Trends in Educational Differentials in Suicide Mortality between 1993 - 2006 in Korea

PubMed Central

Lee, Weon Young; Khang, Young-Ho; Noh, Manegseok; Ryu, Jae-In; Son, Mia

2009-01-01

Purpose This study aims to examine how inequalities in suicide by education changed during and after macroeconomic restructuring following the economic crisis of 1997 in South Korea. Materials and Methods Using Korea's 1995, 2000, and 2005 census data aggregately linked to mortality data (1993 - 2006), relative and absolute differentials in suicide mortality by education were calculated by gender and age among Korean population aged 35 and over. Results Average annual suicide mortality rates have steadily increased from 1993 - 1997 to 2003 - 2006 in almost all sociodemographic groups stratified by gender, age, and education. Based on the relative index of inequality (RII) and slope index of inequality (SII), educational differentials in suicide mortality generally increased over time in men and women aged 45 years +. Although RII did not increase with year among men and women aged 35 - 44 years, SII showed a significantly increasing trend in this age group. Conclusion These worsening absolute inequalities in suicide mortality indicate that the governmental suicide prevention policy should be directed toward socially disadvantaged groups of the Korean population. PMID:19718395

Socioeconomic Disadvantage and Other Risk Factors for Using Higher-Nicotine/Tar-Yield (Regular Full-Flavor) Cigarettes.

PubMed

Higgins, Stephen T; Redner, Ryan; Priest, Jeff S; Bunn, Janice Y

2017-11-07

Use of machine-estimated higher nicotine/tar yield (regular full-flavor) cigarettes is associated with increased risk of nicotine dependence. The present study examined risk factors for using full-flavor versus other cigarette types, including socioeconomic disadvantage and other risk factors for tobacco use or tobacco-related adverse health impacts. Associations between use of full-flavor cigarettes and risk of nicotine dependence were also examined. Data were obtained from nationally representative samples of adult cigarette smokers from the US National Survey on Drug Use and Health. Logistic regression and classification and regression tree modeling were used to examine associations between use of full-flavor cigarettes and educational attainment, poverty, race/ethnicity, age, sex, mental illness, alcohol abuse/dependence, and illicit drug abuse/dependence. Logistic regression was used to examine risk for nicotine dependence. Each of these risk factors except alcohol abuse/dependence independently predicted increased odds of using full-flavor cigarettes (p < .001), with lower educational attainment the strongest predictor, followed by poverty, male sex, younger age, minority race/ethnicity, mental illness, and drug abuse/dependence, respectively. Use of full-flavor cigarettes was associated with increased odds of nicotine dependence within each of these risk factor groupings (p < .01). Cart modeling identified how prevalence of full-flavor cigarette use can vary from a low of 25% to a high of 66% corresponding to differing combinations of these independent risk factors. Use of full-flavor cigarettes is overrepresented in socioeconomically disadvantaged and other vulnerable populations, and associated with increased risk of nicotine dependence. Greater regulation of this cigarette type may be warranted. Greater regulation of commercially available Regular Full-Flavor Cigarettes may be warranted. Use of this type of cigarette is overrepresented in socioeconomically disadvantaged and other vulnerable populations and associated with increased risk for nicotine dependence. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Defining equity in health.

PubMed

Braveman, P; Gruskin, S

2003-04-01

To propose a definition of health equity to guide operationalisation and measurement, and to discuss the practical importance of clarity in defining this concept. Conceptual discussion. Setting, Patients/Participants, and Main results: not applicable. For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage-that is, wealth, power, or prestige. Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health.

The Impact of Neighborhood, Family, and Individual Risk Factors on Toddlers’ Disruptive Behavior

PubMed Central

Heberle, Amy E.; Thomas, Yolanda M.; Wagmiller, Robert L.; Briggs-Gowan, Margaret J.; Carter, Alice S.

2014-01-01

Disadvantaged neighborhoods confer risk for behavior problems in school aged children but their impact in toddlerhood is unknown. Relations between toddlers’ disruptive behavior and neighborhood disadvantage, family disadvantage, violence or conflict exposure, parent depressive symptoms, and parenting behavior were examined using multilevel, multi-group (girl/boy) models. Participants were 1204 families (mean child age = 24.7 months). Unique associations between disruptive behavior and all risk factors were observed, but the effect of neighborhood disadvantage was negligible when all of the more proximal factors were accounted for. The results suggest both that children in disadvantaged neighborhoods are at greater risk of behavior problems than children in non-disadvantaged neighborhoods and that optimal prevention/intervention work with these children will attend to proximal risk factors. PMID:24773306

Supervision on Social Media: Use and Perception of Facebook as a Research Education Tool in Disadvantaged Areas

ERIC Educational Resources Information Center

Pimmer, Christoph; Chipps, Jennifer; Brysiewicz, Petra; Walters, Fiona; Linxen, Sebastian; Gröhbiel, Urs

2016-01-01

This exploratory study investigates how a typically disadvantaged user group of older, female learners from rural, low-tech settings used and perceived a Facebook group as a research supervision and distance learning tool over time. The within-stage mixed-model research was carried out in a module of a part-time, advanced midwifery education…

REPORT ON THE ARTICULATORY AND INTELLIGIBILITY STATUS OF SOCIALLY DISADVANTAGED PRE-SCHOOL CHILDREN.

ERIC Educational Resources Information Center

FRIEDLANDER, GEORGE H.

THIS STUDY OF THE ARTICULATORY AND INTELLIGIBILITY LEVEL OF A SOCIALLY DISADVANTAGED GROUP OF CHILDREN IN THE HEAD START PROGRAM INVOLVED 150 CHILDREN, 4 1/2 - 6 YEARS OF AGE, WITH EQUAL NUMBERS OF BOYS AND GIRLS. THIS GROUP WAS COMPOSED OF CHILDREN OF FAMILIES WITH SPANISH LANGUAGE BACKGROUND, OF CHILDREN OF NATIVE NEGRO FAMILIES, AND OF CHILDREN…

A Comparison Study of Personality and Vocational Interests of Disadvantaged and Advantaged Youths.

ERIC Educational Resources Information Center

Soares, Anthony T.; Soares, Louise M.

In comparing the personality traits of disadvantaged youths to advantaged from an urban high school, as indicated on the IPAT Jr.-Sr. HSPQ, it was found that both groups of boys tended toward a pattern of group-dependency and restraint. They tended to be somewhat detached, less oriented to intellectual pursuits, showing a zest for action and…

The Use of Orff-Based Music Activities for Educational and Therapeutic Purposes with Disadvantaged Group of Romani Children

ERIC Educational Resources Information Center

Eren, Bilgehan; Gül, Gülnihal

2017-01-01

"Romani people" are a disadvantaged group of people due to their socio-cultural and socio-economic conditions. This situation makes them poor and thus cannot afford education. As Romani people have the tendency to love music, it is considered that music activities may encourage their children who generally have negative attitudes towards…

Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review

PubMed Central

Cyril, Sheila; Smith, Ben J.; Possamai-Inesedy, Alphia; Renzaho, Andre M. N.

2015-01-01

Background Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. Design The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. Results Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. Conclusions The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way. PMID:26689460

The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland.

PubMed

Rask, Shadia; Suvisaari, Jaana; Koskinen, Seppo; Koponen, Päivikki; Mölsä, Mulki; Lehtisalo, Riikka; Schubert, Carla; Pakaslahti, Antti; Castaneda, Anu Emilia

2016-05-01

Research demonstrates that migrants are more vulnerable to poor mental health than general populations, but population-based studies with distinct migrant groups are scarce. We aim to (1) assess the prevalence of mental health symptoms in Russian, Somali and Kurdish origin migrants in Finland; (2) compare the prevalence of mental health symptoms in these migrant groups to the Finnish population; (3) determine which socio-demographic factors are associated with mental health symptoms. We used data from the Finnish Migrant Health and Wellbeing Study and Health 2011 Survey. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25), and 1.75 was used as cut-off for clinically significant symptoms. Somatization was measured using the Symptom Checklist-90 (SCL-90) somatization scale. The age-adjusted prevalence of mental health symptoms in the studied groups was calculated by gender using predicted margins. Logistic regression analysis was used to determine which socio-demographic factors are associated with mental health symptoms in the studied population groups. The prevalence of depressive and anxiety symptoms was higher in Russian women (24%) and Kurdish men (23%) and women (49%) than in the Finnish population (9-10%). These differences were statistically significant (p<.001). Socioeconomic disadvantage (e.g. unemployment and poor economic situation) and migration-related factors (e.g. poor language proficiency and short time since migration) significantly increased the odds for depressive and anxiety symptoms. Mental health symptoms are highly prevalent particularly in Kurdish migrants in Finland. Holistic interventions and co-operation between integration and mental health services are acutely needed. © 2015 the Nordic Societies of Public Health.

Intrinsic rewards experienced by a group of dentists working with underserved populations.

PubMed

Gardner, S P; Roberts-Thomson, K F; Winning, T A; Peterson, R

2014-09-01

The aim of this study was to explore, using qualitative methods, the intrinsic reasons why dentists work with underserved groups. Minority and marginalized groups of Australians suffer a greater burden of dental disease than the general population due to disparities in accessing care. Recruitment and retention of dentists to care for underserved groups is problematic due to personal, professional and structural reasons. What drives dentists to work with underserved groups is not widely known. Sixteen dentists were recruited using 'snowball' purposeful sampling. Semi-structured in-depth interviews were conducted. Thematic analysis was conducted on the transcriptions to identify themes. Five key themes emerged: (1) 'tapped on the shoulder', being personally approached or invited; (2) 'dental school experience', the challenges faced as a student; (3) 'empathic concern', the non-judgemental expressions of care toward others; (4) 'resilience', the ability to bounce back after setbacks; (5) 'intrinsic reward', the personal gain and satisfaction received. This study focuses on the intrinsic rewards which were found to be simple, unexpected, and associated with relieving pain, community engagement and making a difference. Emphasizing personal fulfilment and intrinsic reward could be useful when promoting dentistry as a career and when encouraging graduates to consider working with disadvantaged groups. © 2014 Australian Dental Association.

Time trends in socio-economic inequalities for women and men with disabilities in Australia: evidence of persisting inequalities.

PubMed

Kavanagh, Anne M; Krnjacki, Lauren; Beer, Andrew; Lamontagne, Anthony D; Bentley, Rebecca

2013-08-29

The socio-economic circumstances and health of people with disabilities has been relatively ignored in public health research, policy and practice in Australia and internationally. This is despite emerging evidence that the socio-economic circumstances that people with disabilities live in contributes to their poorer health. Compared to other developed countries, Australians with disabilities are more likely to live in disadvantaged circumstances, despite being an economically prosperous country; it is therefore likely that the socio-economic disadvantage experienced by Australians with disabilities makes a significant contribution to their health. Despite the importance of this issue Australia does not routinely monitor the socio-economic inequalities for people with disabilities. This paper addresses this gap by describing time trends in socio-economic conditions for Australians with and without disabilities according to the severity of the disability and sex. Cross-sectional analyses of the Australian Bureau of Statistics Survey of Disability, Ageing and Carers were carried out at three time points (1998, 2003 and 2009) to estimate the proportions of women and men (aged between 25 and 64 years) who were living on low incomes, had not completed year 12, were not in paid work, living in private rental and experiencing multiple disadvantage (three or more of the indicators). People with disabilities are less likely to have completed year 12, be in paid work and are more likely to be living on low incomes and experiencing multiple disadvantage. These conditions worsened with increasing severity of disability and increased or persisted over time, with most of the increase between 1998 and 2003. While women with milder disabilities tended to fare worse than men, the proportions were similar for those with moderate and severe/profound disabilities. People with disabilities experience high levels of socio-economic disadvantage which has increased or persisted over time and these are likely to translate into poorer health outcomes. A large proportion experience multiple forms of disadvantage, reinforcing the need to tackle disadvantage in a coordinated way across sectors.People with disabilities should be a priority population group for public health. Monitoring socio-economic conditions of people with disabilities is critical for informing policy and assessing the impact of disability reforms.

Time trends in socio-economic inequalities for women and men with disabilities in Australia: evidence of persisting inequalities

PubMed Central

2013-01-01

Introduction The socio-economic circumstances and health of people with disabilities has been relatively ignored in public health research, policy and practice in Australia and internationally. This is despite emerging evidence that the socio-economic circumstances that people with disabilities live in contributes to their poorer health. Compared to other developed countries, Australians with disabilities are more likely to live in disadvantaged circumstances, despite being an economically prosperous country; it is therefore likely that the socio-economic disadvantage experienced by Australians with disabilities makes a significant contribution to their health. Despite the importance of this issue Australia does not routinely monitor the socio-economic inequalities for people with disabilities. This paper addresses this gap by describing time trends in socio-economic conditions for Australians with and without disabilities according to the severity of the disability and sex. Methods Cross-sectional analyses of the Australian Bureau of Statistics Survey of Disability, Ageing and Carers were carried out at three time points (1998, 2003 and 2009) to estimate the proportions of women and men (aged between 25 and 64 years) who were living on low incomes, had not completed year 12, were not in paid work, living in private rental and experiencing multiple disadvantage (three or more of the indicators). Results People with disabilities are less likely to have completed year 12, be in paid work and are more likely to be living on low incomes and experiencing multiple disadvantage. These conditions worsened with increasing severity of disability and increased or persisted over time, with most of the increase between 1998 and 2003. While women with milder disabilities tended to fare worse than men, the proportions were similar for those with moderate and severe/profound disabilities. Conclusion People with disabilities experience high levels of socio-economic disadvantage which has increased or persisted over time and these are likely to translate into poorer health outcomes. A large proportion experience multiple forms of disadvantage, reinforcing the need to tackle disadvantage in a coordinated way across sectors. People with disabilities should be a priority population group for public health. Monitoring socio-economic conditions of people with disabilities is critical for informing policy and assessing the impact of disability reforms. PMID:23985044

Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop.

PubMed

Engelgau, Michael M; Narayan, K M Venkat; Ezzati, Majid; Salicrup, Luis A; Belis, Deshiree; Aron, Laudan Y; Beaglehole, Robert; Beaudet, Alain; Briss, Peter A; Chambers, David A; Devaux, Marion; Fiscella, Kevin; Gottlieb, Michael; Hakkinen, Unto; Henderson, Rain; Hennis, Anselm J; Hochman, Judith S; Jan, Stephen; Koroshetz, Walter J; Mackenbach, Johan P; Marmot, M G; Martikainen, Pekka; McClellan, Mark; Meyers, David; Parsons, Polly E; Rehnberg, Clas; Sanghavi, Darshak; Sidney, Stephen; Siega-Riz, Anna Maria; Straus, Sharon; Woolf, Steven H; Constant, Stephanie; Creazzo, Tony L; de Jesus, Janet M; Gavini, Nara; Lerner, Norma B; Mishoe, Helena O; Nelson, Cheryl; Peprah, Emmanuel; Punturieri, Antonello; Sampson, Uchechukwu; Tracy, Rachael L; Mensah, George A

2018-04-28

Four decades ago, U.S. life expectancy was within the same range as other high-income peer countries. However, during the past decades, the United States has fared worse in many key health domains resulting in shorter life expectancy and poorer health-a health disadvantage. The National Heart, Lung, and Blood Institute convened a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders. Recommendations for National Heart, Lung, and Blood Institute consideration were made in several areas including understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally enhancing and fostering a research workforce for implementation research. Key recommendations included exploring why the United States is doing better for health indicators in a few areas compared with peer countries; targeting populations across the entire socioeconomic spectrum with interventions at all levels in order to prevent missing a substantial proportion of the disadvantage; assuring partnership have high-level goals that can create systemic change through collective impact; and finally, increasing opportunities for implementation research training to meet the current needs. Connecting with the research community at large and building on ongoing research efforts will be an important strategy. Broad partnerships and collaboration across the social, political, economic, and private sectors and all civil society will be critical-not only for implementation research but also for implementing the findings to have the desired population impact. Developing the relevant knowledge to tackle the U.S. health disadvantage is the necessary first step to improve U.S. health outcomes. Published by Elsevier B.V.

Obesity and socioeconomic disadvantage in midlife female public sector employees: a cohort study.

PubMed

Hiilamo, Aapo; Lallukka, Tea; Mänty, Minna; Kouvonen, Anne

2017-10-24

The two-way relationship between obesity and socioeconomic disadvantage is well established but previous studies on social and economic consequences of obesity have primarily focused on relatively young study populations. We examined whether obesity is associated with socioeconomic disadvantage through the 10-12-year follow-up, and how obesity-related socioeconomic inequalities develop during midlife among women. Baseline data were derived from the female population of the Helsinki Health Study cohort, comprising 40-60 -year-old employees of the City of Helsinki, Finland in 2000-2002 (n = 6913, response rate 69%). The follow-up surveys were carried out in 2007 (n = 5810) and 2012 (n = 5400). Socioeconomic disadvantage was measured by five dichotomous measures. Repeated logistic regression analyses utilising generalized estimating equations (GEE) were used to test the association between baseline self-reported obesity and the likelihood of socioeconomic disadvantage through all phases. The effect of time on the development of inequalities was examined by time interaction terms in random effect logistic regression models. After adjustment for educational level, baseline obesity was associated with repeated poverty (OR = 1.23; 95% CI; 1.05-1.44), frequent economic difficulties (OR = 1.74; 95% CI; 1.52-1.99), low household net income (OR = 1.23; 95% CI; 1.07-1.41), low household wealth (OR = 1.90; 95% CI; 1.59-2.26) and low personal income (OR = 1.22; 95% CI; 1.03-1.44). The differences in poverty rate and low personal income between the participants with obesity and participants with normal weight widened during the follow-up. Living without a partner and early exit from paid employment explained the widening of inequalities. Weight status inequalities in socioeconomic disadvantage persisted or widened during the late adulthood.

Chronic kidney disease in disadvantaged populations.

PubMed

Garcia-Garcia, Guillermo; Jha, Vivekanand

2015-01-01

The increased burden of CKD in disadavantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities, and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.

Inadequacy of cervical cancer screening among urban recent immigrants: a population-based study of physician and laboratory claims in Toronto, Canada.

PubMed

Lofters, Aisha; Glazier, Richard H; Agha, Mohammad M; Creatore, Maria I; Moineddin, Rahim

2007-06-01

In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemographic factors are related to cervical cancer screening in Toronto, Canada. Pap smears were identified using fee and laboratory codes in Ontario physician service claims for 3 years (2000-2002 inclusive) for women aged 18-66. Area-level socioeconomic factors were derived from the 2001 census. At the individual level, recent registrants for health coverage, over 80% of whom are expected to be recent immigrants, were identified as women first registering after January 1, 1993. Among 724,584 women, 55.4% had Pap smears within 3 years. Recent immigration, visible minority, foreign language, low income and low education were all associated with significantly lower area rates. Recent registrants had much lower rates than non-recent registrants (36.9% versus 60.9%). Pap smear rates in Toronto fall below those dictated by evidence-based practice. Recent registrants, a largely immigrant group, have particularly low rates. Efforts to improve coverage need to emphasize women who recently immigrated and those with socioeconomic disadvantage.

Early Childhood Caries: Prevalence, Risk Factors, and Prevention

PubMed Central

Anil, Sukumaran; Anand, Pradeep S.

2017-01-01

Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC. PMID:28770188

The Relative Roles Played by Structural and Pragmatic Language Skills in Relation to Behaviour in a Population of Primary School Children from Socially Disadvantaged Backgrounds

ERIC Educational Resources Information Center

Law, J.; Rush, R.; McBean, K.

2014-01-01

Considerable evidence supports the association between language learning difficulties and behaviour in young children and this is likely to be particularly true of children raised in social disadvantage. Less is known about the way that different aspects of language, specifically pragmatics, interact with behaviour. This study examines the extent…

Younger Children Experience Lower Levels of Language Competence and Academic Progress in the First Year of School: Evidence from a Population Study

ERIC Educational Resources Information Center

Norbury, Courtenay Frazier; Gooch, Debbie; Baird, Gillian; Charman, Tony; Simonoff, Emily; Pickles, Andrew

2016-01-01

Background: The youngest children in an academic year are reported to be educationally disadvantaged and overrepresented in referrals to clinical services. In this study we investigate for the first time whether these disadvantages are indicative of a mismatch between language competence at school entry and the academic demands of the classroom.…

Eight Americas: investigating mortality disparities across races, counties, and race-counties in the United States.

PubMed

Murray, Christopher J L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

2006-09-01

The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the "eight Americas," to explore the causes of the disparities that can inform specific public health intervention policies and programs. The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15-44 y) and middle-aged (45-59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States

PubMed Central

Murray, Christopher J. L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

2006-01-01

Background The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs. Methods and Findings The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15–44 y) and middle-aged (45–59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Conclusions Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries. PMID:16968116

Intergroup Contact and Social Change: Implications of Negative and Positive Contact for Collective Action in Advantaged and Disadvantaged Groups.

PubMed

Reimer, Nils Karl; Becker, Julia C; Benz, Angelika; Christ, Oliver; Dhont, Kristof; Klocke, Ulrich; Neji, Sybille; Rychlowska, Magdalena; Schmid, Katharina; Hewstone, Miles

2017-01-01

Previous research has shown that (a) positive intergroup contact with an advantaged group can discourage collective action among disadvantaged-group members and (b) positive intergroup contact can encourage advantaged-group members to take action on behalf of disadvantaged outgroups. Two studies investigated the effects of negative as well as positive intergroup contact. Study 1 ( n = 482) found that negative but not positive contact with heterosexual people was associated with sexual-minority students' engagement in collective action (via group identification and perceived discrimination). Among heterosexual students, positive and negative contacts were associated with, respectively, more and less LGB (lesbian, gay, bisexual) activism. Study 2 ( N = 1,469) found that only negative contact (via perceived discrimination) predicted LGBT (lesbian, gay, bisexual, and transgender) students' collective action intentions longitudinally while only positive contact predicted heterosexual/cisgender students' LGBT activism. Implications for the relationship between intergroup contact, collective action, and social change are discussed.

Teachers and Group Size as Variables in Stimulating Oral Language Development with Grade One Disadvantaged Children. IMRID, Volume III, No. 1.

ERIC Educational Resources Information Center

Dunn, Lloyd M.; And Others

The purpose of this study was to evaluate both the relative effectiveness of different instructional personnel and the effect of differences in group size upon oral language acquisition for educationally disadvantaged first grade children. Involved in the treatment program were 23 classes in eight schools, all serving lower class areas of a…

Self-Exempting Beliefs and Intention to Quit Smoking within a Socially Disadvantaged Australian Sample of Smokers

PubMed Central

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine; D’Este, Catherine; Twyman, Laura; Palazzi, Kerrin; Oldmeadow, Christopher

2016-01-01

An investigation of beliefs used to rationalise smoking will have important implications for the content of anti-smoking programs targeted at socioeconomically disadvantaged groups, who show the lowest rates of cessation in the population. This study aimed to assess the types of self-exempting beliefs reported by a sample of socioeconomically disadvantaged smokers, and identify associations between these beliefs and other smoking-related factors with quit intentions. A cross-sectional survey was conducted from March–December 2012 with smokers seeking welfare assistance in New South Wales (NSW), Australia (n = 354; response rate 79%). Responses to a 16-item self-exempting beliefs scale and intention to quit, smoker identity, and enjoyment of smoking were assessed. Most participants earned

Physical Activity Experiences of Young People in an Area of Disadvantage: "There's Nothing There for Big Kids, Like Us"

ERIC Educational Resources Information Center

McEvoy, Eileen; MacPhail, Ann; Enright, Eimear

2016-01-01

Through an examination of the experiences of young people in one disadvantaged area, this paper adds to an emerging body of knowledge focused on what place physical activity occupies in the lives of young people in areas of disadvantage. A total of 40 young people (21 males, 19 females) participated in focus group interviews. The research question…

Culturally Competent MMPI Assessment of Hispanic Populations.

ERIC Educational Resources Information Center

Dana, Richard H.

1995-01-01

Describes culturally competent assessment practice as a context for discussing advantages and disadvantages of various "corrections" currently available for the Minnesota Multiphasic Personality Inventory with Hispanic populations. Corrections include moderator variables, special scales, special norms, translations, and aids to…

Utility and limitations of measures of health inequities: a theoretical perspective

PubMed Central

Alonge, Olakunle; Peters, David H.

2015-01-01

Summary box What is already known on this subject? Various measures have been used in quantifying health inequities among populations in recent times; most of these measures were derived to capture the socioeconomic inequalities in health. These different measures do not always lend themselves to common interpretation by policy makers and health managers because they each reflect limited aspects of the concept of health inequities. What does this study add? To inform a more appropriate application of the different measures currently used in quantifying health inequities, this article explicates common theories underlying the definition of health inequities and uses this understanding to show the utility and limitations of these different measures. It also suggests some key features of an ideal indicator based on the conceptual understanding, with the hope of influencing future efforts in developing more robust measures of health inequities. The article also provides a conceptual ‘product label’ for the common measures of health inequities to guide users and ‘consumers’ in making more robust inferences and conclusions. This paper examines common approaches for quantifying health inequities and assesses the extent to which they incorporate key theories necessary for explicating the definition of health inequity. The first theoretical analysis examined the distinction between inter-individual and inter-group health inequalities as measures of health inequities. The second analysis considered the notion of fairness in health inequalities from different philosophical perspectives. To understand the extent to which different measures of health inequities incorporate these theoretical explanations, four criteria were used to assess each measure: 1) Does the indicator demonstrate inter-group or inter-individual health inequalities or both; 2) Does it reflect health inequalities in relation to socioeconomic position; 3) Is it sensitive to the absolute transfer of health (outcomes, services, or both) or income/wealth between groups; 4) Could it be used to capture inequalities in relation to other population groupings (other than socioeconomic status)? The measures assessed include: before and after measures within only the disadvantaged population, range, Gini coefficient, Pseudo-Gini coefficient, index of dissimilarity, concentration index, slope and relative indices of inequality, and regression techniques. None of these measures satisfied all the four criteria, except the range. Whereas each measure quantifies a different perspective in health inequities, using a measure within only the disadvantaged population does not measure health inequities in a meaningful way, even using before and after changes. For a more complete assessment of how programs affect health inequities, it may be useful to use more than one measure. PMID:26361347

Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

PubMed

Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

2012-04-30

The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

An Implication of Health Sector Reform for Disadvantaged Women's Struggle for Birth Control: A Case of Kurdish Rural-Urban Migrant Women in Van, Turkey.

PubMed

Him, Miki Suzuki; Hoşgör, Ayşe Gündüz

2015-09-01

In this article, we examine how socioeconomically disadvantaged women are affected by health sector reform and family planning policy changes in Turkey through a case study of Kurdish women's struggles for birth control. In Turkey, a family planning program became relatively marginalized in primary health care services as a result of health sector reform as well as a shift of population policy toward a moderately pronatal approach. We argue that an emerging health care system would leave disadvantaged women unable to benefit from contraceptives and would perpetuate reproductive health inequalities between women in the country.

'They all supported me but I felt like I suddenly didn't belong anymore': an exploration of perceived disadvantages to online support seeking.

PubMed

Malik, Sumaira; Coulson, Neil S

2010-09-01

In recent years, there has been a significant rise in the number of online support communities dedicated to issues surrounding infertility. The aim of this study was to focus on investigating the perceived disadvantages of online infertility support communities from the perspective of those who access and participate in them. A total of 295 participants completed an online questionnaire about their use of online support communities. Responses were analysed using inductive content analysis. Since the majority of respondents were women, the results of the study largely reflect the experiences of the female population. Over half of the sample (57.9%) reported experiencing disadvantages to online support. Content analysis revealed that the most commonly cited disadvantages were reading about negative experiences (10.9%), reading about other peoples pregnancies (8.8%), inaccurate information (7.8%) and its addictive (5.8%). These results suggest that there are many perceived disadvantages to online infertility support communities. While some of these disadvantages reflect fears commonly cited in the literature, there are also unique disadvantages associated with the experience of infertility and its treatment. The study highlights a number of important areas in which health professionals and community moderators could intervene to better support and improve the online experiences of patients experiencing infertility.

Access to primary healthcare services for the Roma population in Serbia: a secondary data analysis

PubMed Central

2011-01-01

Background Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail so as to provide a context for their current vulnerable position. Methods Disaggregated data were analyzed from three population groups in Serbia; the general population, the Roma population, and the poorest quintile of the general population not including the Roma. The effective coverage framework, which incorporates availability, affordability, accessibility, acceptability, and effectiveness of health services, was used to structure the secondary data analysis. Acute respiratory infection (ARI) in children less than five years of age was used as an example as this is the leading cause of death in children under 5 years old in Serbia. Results Roma children were significantly more likely to experience an ARI than either the general population or the poorest quintile of the general population, not including the Roma. All three population groups were equally likely to not receive the correct treatment regime of antibiotics. An analysis of the factors that affect quality of access to health services reveal that personal documentation is a statistically significant problem; availability of health services is not an issue that disproportionately affects the Roma; however the geographical accessibility and affordability are substantive issues that disproportionately affect the Roma population. Affordability of services affected the Roma and the poorest quintile and affordability of medications significantly affected all three population groups. With regards to acceptability, mothers from all three population groups are equally likely to recognize the importance of seeking treatment. Conclusions The Roma should be assisted in applying for personal documentation, the geographical accessibility of clinics needs to be addressed, and the costs of healthcare visits and medications should be reviewed. Areas for improvement specific to ARI are the costs of antibiotics and the diagnostic accuracy of providers. A range of policy recommendations are outlined. PMID:21851632

Cluster (School) RCT of ParentCorps: Impact on Kindergarten Academic Achievement

PubMed Central

Dawson-McClure, Spring; Calzada, Esther J.; Huang, Keng-Yen; Kamboukos, Dimitra; Palamar, Joseph J.; Petkova, Eva

2013-01-01

OBJECTIVE: To evaluate the impact of an early childhood, family-centered, school-based intervention on children’s kindergarten academic achievement. METHODS: This was a cluster (school) randomized controlled trial with assessments from pre-kindergarten (pre-k) entry through the end of kindergarten. The setting was 10 public elementary schools with 26 pre-k classes in 2 school districts in urban disadvantaged neighborhoods serving a largely black, low-income population. Participants were 1050 black and Latino, low-income children (age 4; 88% of pre-k population) enrolled in 10 schools over 4 years. Universal intervention aimed to promote self-regulation and early learning by strengthening positive behavior support and effective behavior management at home and school, and increasing parent involvement in education. Intervention included after-school group sessions for families of pre-k students (13 2-hour sessions; co-led by pre-k teachers) and professional development for pre-k and kindergarten teachers. The outcome measures were standardized test scores of kindergarten reading, writing, and math achievement by independent evaluators masked to intervention condition (primary outcome); developmental trajectories of teacher-rated academic performance from pre-k through kindergarten (secondary outcome). RESULTS: Relative to children in control schools, children in intervention schools had higher kindergarten achievement test scores (Cohen’s d = 0.18, mean difference = 2.64, SE = 0.90, P = .03) and higher teacher-rated academic performance (Cohen’s d = 0.25, mean difference = 5.65, SE = 2.34, P = .01). CONCLUSIONS: Early childhood population-level intervention that enhances both home and school environments shows promise to advance academic achievement among minority children from disadvantaged, urban neighborhoods. PMID:23589806

Cluster (school) RCT of ParentCorps: impact on kindergarten academic achievement.

PubMed

Brotman, Laurie Miller; Dawson-McClure, Spring; Calzada, Esther J; Huang, Keng-Yen; Kamboukos, Dimitra; Palamar, Joseph J; Petkova, Eva

2013-05-01

To evaluate the impact of an early childhood, family-centered, school-based intervention on children's kindergarten academic achievement. This was a cluster (school) randomized controlled trial with assessments from pre-kindergarten (pre-k) entry through the end of kindergarten. The setting was 10 public elementary schools with 26 pre-k classes in 2 school districts in urban disadvantaged neighborhoods serving a largely black, low-income population. Participants were 1050 black and Latino, low-income children (age 4; 88% of pre-k population) enrolled in 10 schools over 4 years. Universal intervention aimed to promote self-regulation and early learning by strengthening positive behavior support and effective behavior management at home and school, and increasing parent involvement in education. Intervention included after-school group sessions for families of pre-k students (13 2-hour sessions; co-led by pre-k teachers) and professional development for pre-k and kindergarten teachers. The outcome measures were standardized test scores of kindergarten reading, writing, and math achievement by independent evaluators masked to intervention condition (primary outcome); developmental trajectories of teacher-rated academic performance from pre-k through kindergarten (secondary outcome). Relative to children in control schools, children in intervention schools had higher kindergarten achievement test scores (Cohen's d = 0.18, mean difference = 2.64, SE = 0.90, P = .03) and higher teacher-rated academic performance (Cohen's d = 0.25, mean difference = 5.65, SE = 2.34, P = .01). Early childhood population-level intervention that enhances both home and school environments shows promise to advance academic achievement among minority children from disadvantaged, urban neighborhoods.

Heterogeneity in the Strehler-Mildvan general theory of mortality and aging.

PubMed

Zheng, Hui; Yang, Yang; Land, Kenneth C

2011-02-01

This study examines and further develops the classic Strehler-Mildvan (SM) general theory of mortality and aging. Three predictions from the SM theory are tested by examining the age dependence of mortality patterns for 42 countries (including developed and developing countries) over the period 1955-2003. By applying finite mixture regression models, principal component analysis, and random-effects panel regression models, we find that (1) the negative correlation between the initial adulthood mortality rate and the rate of increase in mortality with age derived in the SM theory exists but is not constant; (2) within the SM framework, the implied age of expected zero vitality (expected maximum survival age) also is variable over time; (3) longevity trajectories are not homogeneous among the countries; (4) Central American and Southeast Asian countries have higher expected age of zero vitality than other countries in spite of relatively disadvantageous national ecological systems; (5) within the group of Central American and Southeast Asian countries, a more disadvantageous national ecological system is associated with a higher expected age of zero vitality; and (6) larger agricultural and food productivities, higher labor participation rates, higher percentages of population living in urban areas, and larger GDP per capita and GDP per unit of energy use are important beneficial national ecological system factors that can promote survival. These findings indicate that the SM theory needs to be generalized to incorporate heterogeneity among human populations.

The evolution of prompt reaction to adverse ties.

PubMed

Van Segbroeck, Sven; Santos, Francisco C; Nowé, Ann; Pacheco, Jorge M; Lenaerts, Tom

2008-10-17

In recent years it has been found that the combination of evolutionary game theory with population structures modelled in terms of dynamical graphs, in which individuals are allowed to sever unwanted social ties while keeping the good ones, provides a viable solution to the conundrum of cooperation. It is well known that in reality individuals respond differently to disadvantageous interactions. Yet, the evolutionary mechanism determining the individuals' willingness to sever unfavourable ties remains unclear. We introduce a novel way of thinking about the joint evolution of cooperation and social contacts. The struggle for survival between cooperators and defectors leads to an arms race for swiftness in adjusting social ties, based purely on a self-regarding, individual judgement. Since defectors are never able to establish social ties under mutual agreement, they break adverse ties more rapidly than cooperators, who tend to evolve stable and long-term relations. Ironically, defectors' constant search for partners to exploit leads to heterogeneous networks that improve the survivability of cooperators, compared to the traditional homogenous population assumption. When communities face the prisoner's dilemma, swift reaction to adverse ties evolves when competition is fierce between cooperators and defectors, providing an evolutionary basis for the necessity of individuals to adjust their social ties. Our results show how our innate resilience to change relates to mutual agreement between cooperators and how "loyalty" or persistent social ties bring along an evolutionary disadvantage, both from an individual and group perspective.

Demographic indicators of trust in federal, state and local government: implications for Australian health policy makers.

PubMed

Meyer, Samantha B; Mamerow, Loreen; Taylor, Anne W; Henderson, Julie; Ward, Paul R; Coveney, John

2013-02-01

To provide baseline findings regarding Australians' trust in federal, state and local government. A computer-assisted telephone interviewing (CATI) survey was administrated during October to December 2009 to a random sample (n=1109) across Australia (response rate 41.2%). Binary logistic regression analyses were carried out by means of SPSS. Age, household size, household income, IRSD and ARIA were found to be significant indicators for trust in federal, state and local government. Trust in state government is lower for older respondents and respondents living in inner and outer regional areas. Trust in local council is lower in respondents living in inner regional areas, respondents living in disadvantaged areas, and respondents in the income bracket of $60001 to $100000. Trust in federal government is lower for older respondents and respondents living in disadvantaged areas. Of note is diminished trust in government among older, regional and lower income ($30001-$60000) respondents. Trust in all levels of government was found to be the lowest in population groups that are identified by empirical research and media to have the poorest access to government services. As a consequence, improved access to services for these populations may increase trust in health policy. Increased trust in health governance may in turn, ensure effective dissemination and implementation of health policies and that existing inequities are not perpetuated through distrust of health information and policy initiatives.

Socioeconomic disadvantage and schizophrenia in migrants under mental health detention orders.

PubMed

Bulla, Jan; Hoffmann, Klaus; Querengässer, Jan; Ross, Thomas

2017-09-01

Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia. This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders. Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI). For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses. Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children.

PubMed

Brown, Vicki; Ananthapavan, Jaithri; Veerman, Lennert; Sacks, Gary; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

2018-05-15

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M⁻AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m²). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372⁻25,155); total cost-savings AUD126.3M (95% UI AUD58.7M⁻196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812⁻15,679); total cost-savings AUD90.9M (95% UI AUD44.3M⁻136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.

Educational attainment, gender and health inequalities among older adults in Catalonia (Spain).

PubMed

Solé-Auró, Aïda; Alcañiz, Manuela

2016-08-04

Health expectancies vary worldwide according to socioeconomic status (SES), with health disadvantages being evident among lower SES groups. Using educational attainment as a proxy of SES, we seek to identify trends in SES differentials in health by gender, with a particular focus on individuals with low educational attainment in the adult Catalan population (Spain) aged 55 or older. Using cross-sectional data for 1994 and 2010-2014 drawn from the Catalan Health Survey, we examined three health indicators to document social health inequalities: self-perceived health, functional limitations, and restrictions on activities of daily living (ADL). We applied logistic models for each indicator, controlling for sociodemographic characteristics, health coverage and health behaviours. Among the less-educated, females presented a greater improvement in their self-perceived health over time than did their male counterparts, there being no significant variations among the medium/high educated. Regardless of education, males showed an increase in the prevalence of functional problems (as did the women, but the increase was not statistically significant). Both genders presented a higher prevalence of limitations when performing ADL in the second time period. The gender health gap was reduced slightly both for the low and the medium/high educated, expect in the case of ADL restrictions. Health and functioning differences by education level persisted, but showed significant signs of reduction. Less-educated females constitute the most disadvantaged group in terms of health and personal autonomy, though there are encouraging signs that the gap is closing both in terms of gender and level of education. Health policymakers need to devote particular attention to the aging population with low SES, especially to women. Public programmes promoting greater protection and equity, while fostering preventive and healthy practices, need to target the most underprivileged.

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

PubMed Central

Veerman, Lennert; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

2018-01-01

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M–AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m2). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372–25,155); total cost-savings AUD126.3M (95% UI AUD58.7M–196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812–15,679); total cost-savings AUD90.9M (95% UI AUD44.3M–136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP. PMID:29762517

Socio-Economic Differences in the Association between Self-Reported and Clinically Present Diabetes and Hypertension: Secondary Analysis of a Population-Based Cross-Sectional Study.

PubMed

Tompkins, Gerald; Forrest, Lynne F; Adams, Jean

2015-01-01

Diabetes and hypertension are key risk factors for coronary heart disease. Prevalence of both conditions is socio-economically patterned. Awareness of presence of the conditions may influence risk behaviour and use of preventative services. Our aim was to examine whether there were socio-economic differences in awareness of hypertension and diabetes in a UK population. Data from the Scottish Health Survey was used to compare self-reported awareness of hypertension and diabetes amongst those found on examination to have these conditions, by socioeconomic position (SEP) (measured by occupation, education and income). Odds ratios of self-reported awareness against presence, and the sensitivity, specificity and predictive value of self-reporting as a measure of the presence of the condition, were calculated. Presence and self-reported awareness of both conditions increased as SEP decreased, on most measures. There was only one significant difference in awareness by SEP once other factors had been taken into account. Sensitivity showed that those in the most disadvantaged groups were most likely to self-report awareness of their hypertension, and specificity showed that those in the least disadvantaged groups were most likely to self-report awareness of its absence. There were few differences of note for diabetes. We found no consistent pattern in the associations between SEP and the presence and self-reported awareness of hypertension and diabetes amongst those with these conditions. Without evidence of differences, it is important that universal approaches continue to be applied to the identification and management of those at risk of these and other conditions that underpin cardiovascular disease.

Incentives, equity and the Able Chooser Problem.

PubMed

Grill, Kalle

2017-03-01

Health incentive schemes aim to produce healthier behaviours in target populations. They may do so both by making incentivised options more salient and by making them less costly. Changes in costs only result in healthier behaviour if the individual rationally assesses the cost change and acts accordingly. Not all people do this well. Those who fail to respond rationally to incentives will typically include those who are least able to make prudent choices more generally. This group will typically include the least advantaged more generally, since disadvantage inhibits one's effective ability to choose well and since poor choices tend to cause or aggravate disadvantage. Therefore, within the target population, health benefits to the better off may come at the cost of aggravated inequity. This is one instance of a problem I name the Able Chooser Problem, previously emphasised by Richard Arneson in relation to coercive paternalism. I describe and discuss this problem by distinguishing between policy options and their effects on the choice situation of individuals. Both positive and negative incentives, as well as mandates that are less than perfectly effective, require some sort of rational deliberation and action and so face the Able Chooser Problem. In contrast, effective restriction of what options are physically available, as well as choice context design that makes some options more salient or appealing, does not demand rational agency. These considerations provide an equity-based argument for preferring smart design of our choice and living environment to incentives and mandates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Family Factors Related to Competence in Young, Disadvantaged Mexican-American Children. Part of the Final Report on Head Start Evaluation and Research: 1968-69 to the Office of Economic Opportunity.

ERIC Educational Resources Information Center

Stedman, James M.; McKenzie, Richard E.

As part of the continuing search for the environmental antecedents of competence in young children, this study investigated several parameters of a population of disadvantaged Mexican-American children. The factors of child competence on which this study focused were behavioral adjustment and linguistic ability. The antecedents of competence were…

Associating Mathematical Stories That Are Written by the 8th Grade Students Who Are Studying at Advantageous and Disadvantageous Regions' Schools with Their Mathematical Perceptions: Istanbul Case

ERIC Educational Resources Information Center

Bahadir, Elif

2017-01-01

In this study, mathematical stories written by 50 middle school students were analyzed. The study group consisted of two different student groups who were living in advantageous and disadvantageous regions in Istanbul. At the first stage, the students were presented a mathematical story called "My Fractal Tree", then told about what the…

Social Media Use for Deaf and Hard of Hearing Students in Educational Settings: A Systematic Review of Literature

ERIC Educational Resources Information Center

Toofaninejad, Ehsan; Zaraii Zavaraki, Esmaeil; Dawson, Shane; Poquet, Oleksandra; Sharifi Daramadi, Parviz

2017-01-01

The pedagogical benefits of the social media may be most pronounced when they impact groups of learners who are at a disadvantage in conventional face-to-face contexts. Among such disadvantaged groups are the deaf or hard of hearing (DHH) students who may experience new opportunities with the help of the social media. This paper stems from the…

Modeling selective pressures on phytoplankton in the global ocean.

PubMed

Bragg, Jason G; Dutkiewicz, Stephanie; Jahn, Oliver; Follows, Michael J; Chisholm, Sallie W

2010-03-10

Our view of marine microbes is transforming, as culture-independent methods facilitate rapid characterization of microbial diversity. It is difficult to assimilate this information into our understanding of marine microbe ecology and evolution, because their distributions, traits, and genomes are shaped by forces that are complex and dynamic. Here we incorporate diverse forces--physical, biogeochemical, ecological, and mutational--into a global ocean model to study selective pressures on a simple trait in a widely distributed lineage of picophytoplankton: the nitrogen use abilities of Synechococcus and Prochlorococcus cyanobacteria. Some Prochlorococcus ecotypes have lost the ability to use nitrate, whereas their close relatives, marine Synechococcus, typically retain it. We impose mutations for the loss of nitrogen use abilities in modeled picophytoplankton, and ask: in which parts of the ocean are mutants most disadvantaged by losing the ability to use nitrate, and in which parts are they least disadvantaged? Our model predicts that this selective disadvantage is smallest for picophytoplankton that live in tropical regions where Prochlorococcus are abundant in the real ocean. Conversely, the selective disadvantage of losing the ability to use nitrate is larger for modeled picophytoplankton that live at higher latitudes, where Synechococcus are abundant. In regions where we expect Prochlorococcus and Synechococcus populations to cycle seasonally in the real ocean, we find that model ecotypes with seasonal population dynamics similar to Prochlorococcus are less disadvantaged by losing the ability to use nitrate than model ecotypes with seasonal population dynamics similar to Synechococcus. The model predictions for the selective advantage associated with nitrate use are broadly consistent with the distribution of this ability among marine picocyanobacteria, and at finer scales, can provide insights into interactions between temporally varying ocean processes and selective pressures that may be difficult or impossible to study by other means. More generally, and perhaps more importantly, this study introduces an approach for testing hypotheses about the processes that underlie genetic variation among marine microbes, embedded in the dynamic physical, chemical, and biological forces that generate and shape this diversity.

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review.

PubMed

Laws, Rachel; Campbell, Karen J; van der Pligt, Paige; Russell, Georgina; Ball, Kylie; Lynch, John; Crawford, David; Taylor, Rachael; Askew, Deborah; Denney-Wilson, Elizabeth

2014-08-01

Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families. Searches of major electronic databases identified articles published from 1993-2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity. Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m(2) to -0.54 kg/m(2) for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3-5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery. There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required. PROSPERO Registration no: CRD42013006536.

Working in disadvantaged communities: What additional competencies do we need?

PubMed Central

Harris, Elizabeth; Harris, Mark F; Madden, Lynne; Wise, Marilyn; Sainsbury, Peter; MacDonald, John; Gill, Betty

2009-01-01

Background Residents of socioeconomically disadvantaged locations are more likely to have poor health than residents of socioeconomically advantaged locations and this has been comprehensively mapped in Australian cities. These inequalities present a challenge for the public health workers based in or responsible for improving the health of people living in disadvantaged localities. The purpose of this study was to develop a generic workforce needs assessment tool and to use it to identify the competencies needed by the public health workforce to work effectively in disadvantaged communities. Methods A two-step mixed method process was used to identify the workforce needs. In step 1 a generic workforce needs assessment tool was developed and applied in three NSW Area Health Services using focus groups, key stakeholder interviews and a staff survey. In step 2 the findings of this needs assessment process were mapped against the existing National Health Training Package (HLT07) competencies, gaps were identified, additional competencies described and modules of training developed to fill identified gaps. Results There was a high level of agreement among the AHS staff on the nature of the problems to be addressed but less confidence indentifying the work to be done. Processes for needs assessments, community consultations and adapting mainstream programs to local needs were frequently mentioned as points of intervention. Recruiting and retaining experienced staff to work in these communities and ensuring their safety were major concerns. Workforce skill development needs were seen in two ways: higher order planning/epidemiological skills and more effective working relationships with communities and other sectors. Organisational barriers to effective practice were high levels of annual compulsory training, balancing state and national priorities with local needs and giving equal attention to the population groups that are easy to reach and to those that are difficult to engage. A number of additional competency areas were identified and three training modules developed. Conclusion The generic workforce needs assessment tool was easy to use and interpret. It appears that the public health workforce involved in this study has a high level of understanding of the relationship between the social determinants and health. However there is a skill gap in identifying and undertaking effective intervention. PMID:19393091

Techniques and results of nongame bird monitoring in North America

USGS Publications Warehouse

Robbins, C.S.; Bystrak, D.; Geissler, P.H.; Oelke, H.

1980-01-01

Long-term bird population trends based on accumulated ratios (proportional change) sometimes give a very misleading view of population change. Alternate methods of representing population change, based on the weighted means for the individual years, avoid the dangers of using ratios. Some advantages and disadvantages of various weighting techniques are discussed.

The decade of Roma Inclusion: did it make a difference to health and use of health care services?

PubMed

Sándor, János; Kósa, Zsigmond; Boruzs, Klára; Boros, Julianna; Tokaji, Ildikó; McKee, Martin; Ádány, Róza

2017-09-01

We investigated whether the severely disadvantaged health of Hungarian Roma adults living in segregated settlements changed by the Decade of Roma Inclusion program. We compared the results of two paired health interview surveys that we carried out using the same methodology before and after the Decade, on the general Hungarian and Roma populations. Self-perceived health status of younger Roma worsened, while it improved among older Roma. Reported experience of discrimination reduced considerably and health care utilization improved in general. Positive changes in smoking and nutrition, and negative changes in alcohol consumption and overweight were observed. Many of observed changes can plausibly be linked to various government policies, including a quadrupling of public works expenditure, banning smoking in public places, restricting marketing of tobacco products, increasing cigarette prices, and a new tax on unhealthy foods. Liberalization of rules on alcohol distillation coincided with worsening alcohol consumption. We have shown that Roma remain severely disadvantaged and present an innovative sampling method which can be used to monitor changes in groups where identification is a challenge.

[Interventions for smoking cessation among low socioeconomic status smokers: a literature review].

PubMed

Guignard, Romain; Nguyen-Thanh, Viêt; Delmer, Olivier; Lenormand, Marie-Camille; Blanchoz, Jean-Marie; Arwidson, Pierre

In most western countries, smoking appears to be highly differentiated according to socio-economic level. Two systematic reviews published in 2014 showed that most of the recommended interventions for smoking cessation, particularly individual interventions, tend to increase social inequalities in health. An analysis of the most recent literature was carried out in order to provide policy makers and stakeholders with a set of evidence on the modalities of interventions to encourage and help disadvantaged smokers quit smoking. This review was based on articles published between January 2013 and April 2016. Only studies conducted in European countries or countries in stage 4 of the tobacco epidemic (USA, Canada, Australia, New Zealand) were included. Selected articles were double-screened. Twenty-three studies were identified, including evaluation of media campaigns, face-to-face behavioural support, phone- and web-based support or awareness of passive smoking among children. Some interventions adapted to precarious populations have been shown to be effective. Some characteristics would facilitate access and improve the support of disadvantaged groups, including a local intervention, a proactive approach and co-construction with targeted smokers.

Health and beyond…strategies for a better India: using the "prison window" to reach disadvantaged groups in primary care.

PubMed

Bhaumik, Soumyadeep; Mathew, Rebecca J

2015-01-01

As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the "prison window" provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all.

Sexual Violence in the Backlands: Toward a Macro-Level Understanding of Rural Sex Crimes.

PubMed

Braithwaite, Jeremy

2015-10-01

This research focuses on structural covariates of sex crimes in rural communities (using urban and urbanizing communities as comparison groups), with particular analysis on exploring how the magnitude and direction of such covariates differ with respect to type of sex crime. Using 2000 sex crime data from the National Incident-Based Reporting System (NIBRS) for the population of reporting U.S. cities, negative binomial and logistic regression procedures were used to explore the relationship between resource disadvantage, local investment, and economic inequality and sex crime subtypes. For sex crimes that occurred almost exclusively in the home, urban and urbanizing community rates were largely influenced by resource disadvantage and local investment, while these measures did not reach significance for explaining rural rates. Conversely, local investment was a significant predictor of sex crimes that occurred outside the home in rural communities. This research indicates that a structural analysis of sexual victimization (widely absent from the scientific literature) does yield significant findings and that disaggregation of crime into subtypes allows for a more detailed differentiation between urban and rural communities. © The Author(s) 2014.

Considerations for the Telehealth Systems of Tomorrow: An Analysis of Student Perceptions of Telehealth Technologies

PubMed Central

Bull, Tyler Preston; Malvey, Donna M; Szalma, James Leo

2016-01-01

Background While much is known about factors that facilitate telehealth adoption, less is known about why adoption does or does not occur in specific populations, such as students. Objective This study aims to examine the perceptions of telehealth systems within a large student sample. Methods Undergraduate students (N=315) participated in a survey of the perceived advantages and disadvantages of telehealth technologies. The responses to the survey were analyzed using thematic analysis. Results We found that students were likely to adopt telehealth systems for the following reasons: (1) the system worked efficiently, (2) the convenience of telehealth, and (3) to gain access to health services. Students also perceived several disadvantages to telehealth systems, such as issues of trust (ie, security, privacy), the impersonal nature of telehealth systems, and they were concerned about the potential for major system errors. Conclusion By understanding the current barriers to telehealth adoption in a cohort of students, we can not only better anticipate the future needs of this group, but also incorporate such needs into the design of future telehealth systems. PMID:27731865

Shared Decision Making With Vulnerable Populations in the Emergency Department.

PubMed

Castaneda-Guarderas, Ana; Glassberg, Jeffrey; Grudzen, Corita R; Ngai, Ka Ming; Samuels-Kalow, Margaret E; Shelton, Erica; Wall, Stephen P; Richardson, Lynne D

2016-12-01

The emergency department (ED) occupies a unique position within the healthcare system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status, or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs, and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes, and lack of cultural competence, as well as patient mistrust and the consequences of their social and economic disenfranchisement. A research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses is proposed to address the following questions: 1) What are the best processes/formats for SDM among racial, ethnic, cultural, religious, linguistic, social, or otherwise vulnerable groups who experience disadvantage in the healthcare system? 2) What organizational or systemic changes are needed to support SDM in the ED whenever appropriate? 3) What competencies are needed to enable emergency providers to consider patients' situation/context in an unbiased way? 4) How do we teach these competencies to students and residents? 5) How do we cultivate these competencies in practicing emergency physicians, nurses, and other clinical providers who lack them? The authors also identify the importance of using accurate, group-specific data to inform risk estimates for SDM decision aids for vulnerable populations and the need for increased ED-based care coordination and transitional care management capabilities to create additional care options that align with the needs and preferences of vulnerable populations. © 2016 by the Society for Academic Emergency Medicine.

Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study.

PubMed

Moore, Hannah C; Fathima, Parveen; Gidding, Heather F; de Klerk, Nicholas; Liu, Bette; Sheppeard, Vicky; Effler, Paul V; Snelling, Thomas L; McIntyre, Peter; Blyth, Christopher C

2018-05-31

Reported infant vaccination coverage at age 12 months in Australia is >90%. On-time coverage of the 2-4-6 month schedule and coverage in specific populations is rarely reported. We conducted a population-based cohort study of 1.9 million Australian births, 1996-2012, combining individual birth and perinatal records with immunisation records through probabilistic linkage. We assessed on-time coverage across 13 demographic and perinatal characteristics of diphtheria-tetanus-pertussis vaccines (DTP) defined as vaccination 14 days prior to the scheduled due date, to 30 days afterwards. On-time DTP vaccination coverage in non-Aboriginal infants was 88.1% for the 2-month dose, 82.0% for 4-month dose, and 76.7% for 6-month dose; 3-dose coverage was 91.3% when assessed at 12 months. On-time DTP coverage for Aboriginal infants was 77.0%, 66.5%, and 61.0% for the 2-4-6 month dose; 3-dose coverage at 12 months was 79.3%. Appreciable differences in on-time coverage were observed across population subgroups. On-time coverage in non-Aboriginal infants born to mothers with ≥3 previous pregnancies was 62.5% for the 6-month dose (47.9% for Aboriginal infants); up to 23.5 percentage points lower than for first-borns. Infants born to mothers who smoked during pregnancy had coverage 8.7-10.3 percentage points lower than infants born to non-smoking mothers for the 4- and 6-month dose. A linear relationship was apparent between increasing socio-economic disadvantage and decreasing on-time coverage. On-time coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk. Aboriginal infants, multiparous mothers, and those who are socio-economically disadvantaged are key groups most likely to benefit from targeted programs addressing vaccine timeliness. Copyright © 2018. Published by Elsevier Ltd.

The enemy as animal: Symmetric dehumanization during asymmetric warfare.

PubMed

Bruneau, Emile; Kteily, Nour

2017-01-01

Historically, dehumanization has enabled members of advantaged groups to 'morally disengage' from disadvantaged group suffering, thereby facilitating acts of intergroup aggression such as colonization, slavery and genocide. But is blatant dehumanization exclusive to those at the top 'looking down', or might disadvantaged groups similarly dehumanize those who dominate them? We examined this question in the context of intergroup warfare in which the disadvantaged group shoulders a disproportionate share of casualties and may be especially likely to question the humanity of the advantaged group. Specifically, we assessed blatant dehumanization in the context of stark asymmetric conflict between Israelis (Study 1; N = 521) and Palestinians (Study 2; N = 354) during the 2014 Gaza war. We observed that (a) community samples of Israelis and Palestinians expressed extreme (and comparable) levels of blatant dehumanization, (b) blatant dehumanization was uniquely associated with outcomes related to outgroup hostility for both groups, even after accounting for political ideologies known to strongly predict outgroup aggression, and (c) the strength of association between blatant dehumanization and outcomes was similar across both groups. This study illuminates the striking potency and symmetry of blatant dehumanization among those on both sides of an active asymmetric conflict.

The enemy as animal: Symmetric dehumanization during asymmetric warfare

PubMed Central

2017-01-01

Historically, dehumanization has enabled members of advantaged groups to ‘morally disengage’ from disadvantaged group suffering, thereby facilitating acts of intergroup aggression such as colonization, slavery and genocide. But is blatant dehumanization exclusive to those at the top ‘looking down’, or might disadvantaged groups similarly dehumanize those who dominate them? We examined this question in the context of intergroup warfare in which the disadvantaged group shoulders a disproportionate share of casualties and may be especially likely to question the humanity of the advantaged group. Specifically, we assessed blatant dehumanization in the context of stark asymmetric conflict between Israelis (Study 1; N = 521) and Palestinians (Study 2; N = 354) during the 2014 Gaza war. We observed that (a) community samples of Israelis and Palestinians expressed extreme (and comparable) levels of blatant dehumanization, (b) blatant dehumanization was uniquely associated with outcomes related to outgroup hostility for both groups, even after accounting for political ideologies known to strongly predict outgroup aggression, and (c) the strength of association between blatant dehumanization and outcomes was similar across both groups. This study illuminates the striking potency and symmetry of blatant dehumanization among those on both sides of an active asymmetric conflict. PMID:28746412

Integrated Medical Curriculum: Advantages and Disadvantages

PubMed Central

Quintero, Gustavo A.; Vergel, John; Arredondo, Martha; Ariza, María-Cristina; Gómez, Paula; Pinzon-Barrios, Ana-Maria

2016-01-01

Most curricula for medical education have been integrated horizontally and vertically–-vertically between basic and clinical sciences. The Flexnerian curriculum has disappeared to permit integration between basic sciences and clinical sciences, which are taught throughout the curriculum. We have proposed a different form of integration where the horizontal axis represents the defined learning outcomes and the vertical axis represents the teaching of the sciences throughout the courses. We believe that a mere integration of basic and clinical sciences is not enough because it is necessary to emphasize the importance of humanism as well as health population sciences in medicine. It is necessary to integrate basic and clinical sciences, humanism, and health population in the vertical axis, not only in the early years but also throughout the curriculum, presupposing the use of active teaching methods based on problems or cases in small groups. PMID:29349303

Reductions in Parental Use of Corporal Punishment on Pre-School Children Following Participation in the Moms' Empowerment Program.

PubMed

Grogan-Kaylor, Andrew; Galano, Maria M; Howell, Kathryn H; Miller-Graff, Laura; Graham-Bermann, Sandra A

2016-06-09

Corporal punishment is a widely used and widely endorsed form of parental discipline. Inter-partner violence places enormous stress upon women. The rate of corporal punishment is higher in homes where other types of domestic violence are also occurring. This study compares two groups: those who participated in an intervention for women exposed to intimate partner violence (The Moms' Empowerment Program [MEP]) and those in a comparison group. Using standardized measures, women in both groups were assessed at baseline and at the end of the program, 5 weeks later. The 113 mothers who participated in the MEP program had significantly improved their parenting, such that they had less use of physical punishment post-intervention. Findings suggest that a relatively brief community-based intervention program can reduce the use of parental physical punishment even in disadvantaged populations coping with stressful circumstances. © The Author(s) 2016.

[New Ways of Communication - Results of the Working Group 5 of the Forum Future Public Health, Berlin 2016].

PubMed

Ziese, Thomas; Moebus, Susanne

2017-11-01

Good communication is an essential feature of public health. The existing communication channels from sender to receiver are increasingly supplemented or even replaced by new forms of communication such as social media in all areas of life. Public Health must adopt these changes in order to make its concerns and results accessible to different user groups. 1. Many groups of the population (e. g. migrants, socially disadvantaged) are hard to reach for purposes of communication. Different addressees need different forms of communication, including social media. Appropriate access routes must be identified and used for communication. 2. Strategies must be developed on how public health information can be effectively communicated via social media. They must be professionally sound, reliable and quality-assured, and regular updating must ensured. 3. Participation and dialogue are important elements of effective public health communication. © Georg Thieme Verlag KG Stuttgart · New York.

An Online, Moderated Peer-to-Peer Support Bulletin Board for Depression: User-Perceived Advantages and Disadvantages

PubMed Central

Reynolds, Julia; Vassallo, Sara

2015-01-01

Background Online, peer-to-peer support groups for depression are common on the World Wide Web and there is some evidence of their effectiveness. However, little is known about the mechanisms by which Internet support groups (ISGs) might work. Objective This study aimed to investigate consumer perceptions of the benefits and disadvantages of online peer-to-peer support by undertaking a content analysis of the spontaneous posts on BlueBoard, a well-established, moderated, online depression bulletin board. Methods The research set comprised all posts on the board (n=3645) for each of 3 months selected at 4 monthly intervals over 2011. The data were analyzed using content analysis and multiple coders. Results A total of 586 relevant posts were identified, 453 (77.3%) reporting advantages and 133 (22.7%) reporting disadvantages. Positive personal change (335/453, 74.0%) and valued social interactions and support (296/453, 65.3%) emerged as perceived advantages. Other identified benefits were valued opportunities to disclose/express feelings or views (29/453, 6.4%) and advantages of the BlueBoard environment (45/453, 9.9%). Disadvantages were negative personal change (50/133, 37.6%), perceived disadvantages of board rules/moderation (42/133, 31.6%), unhelpful social interactions/contact with other members (40/133, 30.1%), and technical obstacles to using the board (14/133, 10.5%). Conclusions Consumers value the opportunity to participate in an online mutual support group for mental health concerns. Further research is required to better understand how and if these perceived advantages translate into positive outcomes for consumers, and whether the perceived disadvantages of such boards can be addressed without compromising the safety and positive outcomes of the board. PMID:26543919

An Online, Moderated Peer-to-Peer Support Bulletin Board for Depression: User-Perceived Advantages and Disadvantages.

PubMed

Griffiths, Kathleen Margaret; Reynolds, Julia; Vassallo, Sara

2015-01-01

Online, peer-to-peer support groups for depression are common on the World Wide Web and there is some evidence of their effectiveness. However, little is known about the mechanisms by which Internet support groups (ISGs) might work. This study aimed to investigate consumer perceptions of the benefits and disadvantages of online peer-to-peer support by undertaking a content analysis of the spontaneous posts on BlueBoard, a well-established, moderated, online depression bulletin board. The research set comprised all posts on the board (n=3645) for each of 3 months selected at 4 monthly intervals over 2011. The data were analyzed using content analysis and multiple coders. A total of 586 relevant posts were identified, 453 (77.3%) reporting advantages and 133 (22.7%) reporting disadvantages. Positive personal change (335/453, 74.0%) and valued social interactions and support (296/453, 65.3%) emerged as perceived advantages. Other identified benefits were valued opportunities to disclose/express feelings or views (29/453, 6.4%) and advantages of the BlueBoard environment (45/453, 9.9%). Disadvantages were negative personal change (50/133, 37.6%), perceived disadvantages of board rules/moderation (42/133, 31.6%), unhelpful social interactions/contact with other members (40/133, 30.1%), and technical obstacles to using the board (14/133, 10.5%). Consumers value the opportunity to participate in an online mutual support group for mental health concerns. Further research is required to better understand how and if these perceived advantages translate into positive outcomes for consumers, and whether the perceived disadvantages of such boards can be addressed without compromising the safety and positive outcomes of the board.

Clinical efficacy of low-temperature radiofrequency ablation of pharyngolaryngeal cyst in 84 Chinese infants

PubMed Central

Wang, Zhinan; Zhang, Yamin; Ye, Yuhua; Yao, Wei; Xu, Zhongqiang; Xia, Zhongfang; Wang, Shufen; Zhou, Chengyong

2017-01-01

Abstract The aim of the study is to investigate the advantages and disadvantages of low-temperature radiofrequency ablation of pharyngolaryngeal cyst. The study population was composed of 84 children diagnosed with pharyngolaryngeal cyst who underwent surgical treatment at the Department of Otolaryngology, Wuhan Children's Hospital, Wuhan, China, between January 1984 and December 2013. All patients were operated using a self-retaining laryngoscope and were divided into 3 groups: traditional cystectomy group (N = 9), dynamic cutting system group (N = 18), and low-temperature radiofrequency ablation group (N = 57). Clinical outcomes were analyzed to assess the efficacy of low-temperature radiofrequency ablation in treatment of pharyngolaryngeal cyst. Compared with traditional cystectomy group or dynamic cutting system group, operation time was shorter, bleeding was less and one-year recurrence rate was much lower in low-temperature radiofrequency ablation group. However, operation time and bleeding was not statistically different between traditional cystectomy and dynamic cutting system group. Low-temperature radiofrequency ablation may be an effective substitute for treating pharyngolaryngeal cyst. PMID:29095253

An Assessment on the Creation of an Under Secretary of Defense for Business Management and Information

DTIC Science & Technology

2016-04-21

whether the position should be consolidated and elevated, assess the advantages and disadvantages of doing so, and such other matters as the DBB... disadvantages of the legislation, the Task Group worked to: – Understand the existing DoD structure, and how it evolved to-date – Understand private...Board in the public meeting held April 21, 2016. 14 Findings: The Legislation Perceived Disadvantages : (slide 1 of 3)  Talent Considerations

Prevalence of the β(S) gene among scheduled castes, scheduled tribes and other backward class groups in Central India.

PubMed

Shrikhande, Anuradha V; Arjunan, Aishwarya; Agarwal, Amit; Dani, Aarti; Tijare, Jayashri; Gettig, Elizabeth; Krishnamurti, Lakshmanan

2014-01-01

Sickle cell disease is an inherited disorder of the blood, and characterized by vasoocclusive crises (VOC), risks for pneumococcal infections and organ toxicities, is associated with morbidity and premature mortality. India, with a population of 1.2 billion individuals, is estimated to be home to over 50.0% of the world's patients with sickle cell disease. The β(S) gene [β6(A3)Glu→Val; HBB: c.20A>T] has the highest prevalence in three socio-economically disadvantaged ethnic categories: the Scheduled Castes (SC), the Scheduled Tribes (ST), and Other Backward Class (OBC) groups in India. The tradition of endogamy practiced by the ethnic groups in India provides the rationale for the screening of individual populations to better understand the distribution of the β(S) gene, guide counseling and awareness programs and aid development of public policy. We undertook a study to describe the prevalence of the β(S) gene in these ethnic groups in the district of Nagpur, Maharashtra in Central India. Through community screening and subsequent targeted screening of high risk individuals, 35,636 individuals were screened, of whom 5466 were found to have sickle cell trait and 1010 were identified with sickle cell disease. Community screening revealed a sickle cell trait prevalence of 13.0% in the SC, 12.0% in the ST and 3.4% in the OBC population. This study describes the prevalence of the β(S) gene within these groups in Central India determined by large scale community screening. This program has uncovered previously undiagnosed cases, provided detailed information to guide population-based disease counseling, prevention and comprehensive care programs.

Coronary artery bypass surgery: are outcomes influenced by demographics or ability to pay?

PubMed

Mancini, M C; Cush, E M; Sweatman, K; Dansby, J

2001-05-01

To examine the relation of financial status and demographics to the outcomes of coronary artery bypass surgery (CABG) in the public hospital setting. Coronary artery bypass surgery is one of the most expensive and frequently performed surgical procedures in the United States. Considerable controversy surrounds the accessibility to quality cardiac care of indigent and minority populations. This study examines the hypothesis that demographics rather than access to care and economics influences outcomes in CABG. A retrospective review of 1,556 charts of patients who underwent CABG at Louisiana State University Health Sciences Center-Shreveport, a public hospital, during a 10-year period was performed. The parameters analyzed included sex, age, race, education, ejection fraction, comorbidities, surgical parameters, economics, complications, and cost of care. Comparisons were made between the insured and uninsured groups. Univariate statistical analysis was used to assess differences between groups. Kaplan-Meier survival curves were also generated. Two thirds of the patients were uninsured. The mean age of the uninsured patients was significantly lower than that of the insured patients. Ejection fractions were comparable. Comorbidities were similar, with a greater percentage of tobacco use in the uninsured population. Kaplan-Meier survival curves showed that the uninsured group had better overall survival and that the insured group manifested an increased rate of late death. The financially challenged population appears to present for treatment earlier in life with coronary artery disease. Risk factors between the two groups were similar, except that tobacco use appears to be a significant problem in the disadvantaged population. The disease severity in both populations appeared to be similar; however, the uninsured patients had equivalent early survival with better late survival. Access to care in both groups was equal. In the public hospital setting for the disease state described, the financially challenged are afforded access to the current treatment technology with quality results.

Concentrated affluence, concentrated disadvantage, and children's readiness for school: a population-based, multi-level investigation.

PubMed

Carpiano, Richard M; Lloyd, Jennifer E V; Hertzman, Clyde

2009-08-01

A number of studies demonstrates a relationship between neighbourhood concentration of affluence and disadvantage and the health and development of its residents. We contribute to this literature by testing hypotheses about the relationship between neighbourhood-level concentrated affluence/disadvantage and child-level developmental outcomes in a study population of 37,798 Kindergarten children residing in 433 neighbourhoods throughout the province of British Columbia, Canada. We utilise a previously-validated measure of neighbourhood socioeconomic composition--the Index of Concentration at the Extremes (ICE)--which not only allows for more precise estimation of the competing influences of concentrated affluence and disadvantage, but also facilitates examination of the potential impact of neighbourhood-level income inequality. Our findings show that increases in neighbourhood affluence are associated with increases in children's scores on the Early Development Instrument (EDI), a holistic measure of Kindergarteners' readiness for school. Particularly noteworthy is that, for four of the five EDI scales (physical, social, emotional, and communication) and the total score, results indicate a significant curvilinear relationship--whereby the highest average child-level outcomes are not found in locations with the highest concentrations of affluence, but rather in locations with relatively equal proportions of affluent and disadvantaged families. This finding suggests, first, that concentrated affluence may have diminishing rates of return on contributing to enhanced child development, and, second, that children residing in mixed-income neighbourhoods may benefit both from the presence of affluent residents and from the presence of services and institutions aimed at assisting lower-income residents. Implications and future directions are discussed.

A Fresh Perspective on a Familiar Problem: Examining Disparities in Knee Osteoarthritis Using a Markov Model.

PubMed

Karmarkar, Taruja D; Maurer, Anne; Parks, Michael L; Mason, Thomas; Bejinez-Eastman, Ana; Harrington, Melvyn; Morgan, Randall; O'Connor, Mary I; Wood, James E; Gaskin, Darrell J

2017-12-01

Disparities in the presentation of knee osteoarthritis (OA) and in the utilization of treatment across sex, racial, and ethnic groups in the United States are well documented. We used a Markov model to calculate lifetime costs of knee OA treatment. We then used the model results to compute costs of disparities in treatment by race, ethnicity, sex, and socioeconomic status. We used the literature to construct a Markov Model of knee OA and publicly available data to create the model parameters and patient populations of interest. An expert panel of physicians, who treated a large number of patients with knee OA, constructed treatment pathways. Direct costs were based on the literature and indirect costs were derived from the Medical Expenditure Panel Survey. We found that failing to obtain effective treatment increased costs and limited benefits for all groups. Delaying treatment imposed a greater cost across all groups and decreased benefits. Lost income because of lower labor market productivity comprised a substantial proportion of the lifetime costs of knee OA. Population simulations demonstrated that as the diversity of the US population increases, the societal costs of racial and ethnic disparities in treatment utilization for knee OA will increase. Our results show that disparities in treatment of knee OA are costly. All stakeholders involved in treatment decisions for knee OA patients should consider costs associated with delaying and forgoing treatment, especially for disadvantaged populations. Such decisions may lead to higher costs and worse health outcomes.

Population tobacco control interventions and their effects on social inequalities in smoking: systematic review

PubMed Central

Thomas, S; Fayter, D; Misso, K; Ogilvie, D; Petticrew, M; Sowden, A; Whitehead, M; Worthy, G

2008-01-01

Objective: To assess the effects of population tobacco control interventions on social inequalities in smoking. Data sources: Medical, nursing, psychological, social science and grey literature databases, bibliographies, hand-searches and contact with authors. Study selection: Studies were included (n = 84) if they reported the effects of any population-level tobacco control intervention on smoking behaviour or attitudes in individuals or groups with different demographic or socioeconomic characteristics. Data extraction: Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second. Data synthesis: Data were synthesised using graphical (“harvest plot”) and narrative methods. No strong evidence of differential effects was found for smoking restrictions in workplaces and public places, although those in higher occupational groups may be more likely to change their attitudes or behaviour. Smoking restrictions in schools may be more effective in girls. Restrictions on sales to minors may be more effective in girls and younger children. Increasing the price of tobacco products may be more effective in reducing smoking among lower-income adults and those in manual occupations, although there was also some evidence to suggest that adults with higher levels of education may be more price-sensitive. Young people aged under 25 are also affected by price increases, with some evidence that boys and non-white young people may be more sensitive to price. Conclusions: Population-level tobacco control interventions have the potential to benefit more disadvantaged groups and thereby contribute to reducing health inequalities. PMID:18426867

Population tobacco control interventions and their effects on social inequalities in smoking: systematic review.

PubMed

Thomas, S; Fayter, D; Misso, K; Ogilvie, D; Petticrew, M; Sowden, A; Whitehead, M; Worthy, G

2008-08-01

To assess the effects of population tobacco control interventions on social inequalities in smoking. Medical, nursing, psychological, social science and grey literature databases, bibliographies, hand-searches and contact with authors. Studies were included (n = 84) if they reported the effects of any population-level tobacco control intervention on smoking behaviour or attitudes in individuals or groups with different demographic or socioeconomic characteristics. Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second. Data were synthesised using graphical ("harvest plot") and narrative methods. No strong evidence of differential effects was found for smoking restrictions in workplaces and public places, although those in higher occupational groups may be more likely to change their attitudes or behaviour. Smoking restrictions in schools may be more effective in girls. Restrictions on sales to minors may be more effective in girls and younger children. Increasing the price of tobacco products may be more effective in reducing smoking among lower-income adults and those in manual occupations, although there was also some evidence to suggest that adults with higher levels of education may be more price-sensitive. Young people aged under 25 are also affected by price increases, with some evidence that boys and non-white young people may be more sensitive to price. Population-level tobacco control interventions have the potential to benefit more disadvantaged groups and thereby contribute to reducing health inequalities.

BIBLIOGRAPHY ON THE CULTURALLY DISADVANTAGED. SUPPLEMENT III.

ERIC Educational Resources Information Center

Harvard Univ., Cambridge, MA. Graduate School of Education.

THIS BIBLIOGRAPHY SUPPLEMENT LISTS MATERIAL ON VARIOUS ASPECTS OF THE CULTURALLY DISADVANTAGED. APPROXIMATELY 220 UNANNOTATED REFERENCES ARE PROVIDED TO DOCUMENTS DATING FROM 1963 TO 1966. JOURNALS, BOOKS, AND REPORT MATERIALS ARE LISTED. SUBJECT AREAS INCLUDED ARE PRESCHOOL PROGRAMS, NEIGHBORHOOD DEVELOPMENT PROGRAMS, SHORT-TERM GROUP COUNSELING,…

Differential Aging in Place and Depressive Symptoms: Interplay Among Time, Income, and Senior Housing.

PubMed

Park, Sojung; Kim, BoRin; Han, Yoonsun

2018-03-01

We examined cumulative and differential experiences of aging in place. Data came from the 2002 and 2010 wave of the Health Retirement Study. We modeled the trajectory of later-life depressive symptoms, and how senior-housing environments moderate the negative association between economic disadvantages and depressive symptoms. At baseline, economically disadvantaged older adults were more likely to exhibit depressive symptoms. However, detrimental effects of income group (non-low income vs. moderate income; non-low income vs. low income) on depressive symptoms did not significantly change over time. The age-leveler hypothesis may account for nonsignificant effects of disadvantaged income groups over time. Findings suggest that moderate-income seniors may experience positive differentials if they age in place in a supportive senior-housing environment. Moderate-income seniors may have broader opportunities in senior housing compared to private-home peers. Senior housing might partially counter risks such as low mental health, emerging from life-course disadvantage.

Overcoming Challenges to Childhood Immunizations Status.

PubMed

Sabnis, Svapna S; Conway, James H

2015-10-01

Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization. Multiple strategies are needed to improve immunization rates, including improving access to vaccines and minimizing financial barriers to families. Vaccine status should be assessed and vaccines given at all possible opportunities. Copyright © 2015 Elsevier Inc. All rights reserved.

Literacy in Brazil: from Rights to Reality

NASA Astrophysics Data System (ADS)

Ireland, Timothy D.

2008-11-01

At a time when some 24% of the Brazilian population of 182 million are functionally illiterate, the author shows how illiteracy is concentrated in traditionally poor and disadvantaged social and ethnic groups as well as in certain regions of the country. He surveys the changes in legislation, policies and attitudes relating to literacy over the past few decades and describes how literacy is increasingly seen as a continuous process rather than a short-term, low-cost intervention. While there is still a lack of a broad, coordinated policy and adequate funding in this area, and while the challenges remain formidable, the author concludes that Brazil is moving slowly in the right direction.

Group or ungroup - moose behavioural response to recolonization of wolves.

PubMed

Månsson, Johan; Prima, Marie-Caroline; Nicholson, Kerry L; Wikenros, Camilla; Sand, Håkan

2017-01-01

Predation risk is a primary motivator for prey to congregate in larger groups. A large group can be beneficial to detect predators, share predation risk among individuals and cause confusion for an attacking predator. However, forming large groups also has disadvantages like higher detection and attack rates of predators or interspecific competition. With the current recolonization of wolves ( Canis lupus ) in Scandinavia, we studied whether moose ( Alces alces ) respond by changing grouping behaviour as an anti-predatory strategy and that this change should be related to the duration of wolf presence within the local moose population. In particular, as females with calves are most vulnerable to predation risk, they should be more likely to alter behaviour. To study grouping behaviour, we used aerial observations of moose ( n  = 1335, where each observation included one or several moose) inside and outside wolf territories. Moose mostly stayed solitary or in small groups (82% of the observations consisted of less than three adult moose), and this behavior was independent of wolf presence. The results did not provide unequivocal support for our main hypothesis of an overall change in grouping behaviour in the moose population in response to wolf presence. Other variables such as moose density, snow depth and adult sex ratio of the group were overall more influential on grouping behaviour. However, the results showed a sex specific difference in social grouping in relation to wolf presence where males tended to form larger groups inside as compared to outside wolf territories. For male moose, population- and environmentally related variables were also important for the pattern of grouping. The results did not give support for that wolf recolonization has resulted in an overall change in moose grouping behaviour. If indeed wolf-induced effects do exist, they may be difficult to discern because the effects from moose population and environmental factors may be stronger than any change in anti-predator behaviour. Our results thereby suggest that caution should be taken as to generalize about the effects of returning predators on the grouping behaviour of their prey.

Material Resources and Population Health: Disadvantages in Health Care, Housing, and Food Among Adults Over 50 Years of Age

PubMed Central

Soldo, Beth J.; Pagán, José A.; McCabe, John; deBlois, Madeleine; Field, Samuel H.; Asch, David A.; Cannuscio, Carolyn

2009-01-01

Objectives. We examined associations between material resources and late-life declines in health. Methods. We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15 441). Results. Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage. Conclusions. Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone. PMID:19890175

Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana.

PubMed

Danos, Denise M; Ferguson, Tekeda F; Simonsen, Neal R; Leonardi, Claudia; Yu, Qingzhao; Wu, Xiao-Cheng; Scribner, Richard A

2018-05-01

Colorectal cancer (CRC) continues to demonstrate racial disparities in incidence and survival in the United States. This study investigates the role of neighborhood concentrated disadvantage in racial disparities in CRC incidence in Louisiana. Louisiana Tumor Registry and U.S. Census data were used to assess the incidence of CRC diagnosed in individuals 35 years and older between 2008 and 2012. Neighborhood concentrated disadvantage index (CDI) was calculated based on the PhenX Toolkit protocol. The incidence of CRC was modeled using multilevel binomial regression with individuals nested within neighborhoods. Our study included 10,198 cases of CRC. Adjusting for age and sex, CRC risk was 28% higher for blacks than whites (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.22-1.33). One SD increase in CDI was associated with 14% increase in risk for whites (RR = 1.14; 95% CI = 1.10-1.18) and 5% increase for blacks (RR = 1.05; 95% CI = 1.02-1.09). After controlling for differential effects of CDI by race, racial disparities were not observed in disadvantaged areas. CRC incidence increased with neighborhood disadvantage and racial disparities diminished with mounting disadvantage. Our results suggest additional dimensions to racial disparities in CRC outside of neighborhood disadvantage that warrants further research. Copyright © 2018 Elsevier Inc. All rights reserved.

Combined effect of individual and neighbourhood socioeconomic status on mortality of rheumatoid arthritis patients under universal health care coverage system.

PubMed

Chen, Cheng-Hsin; Huang, Kuang-Yung; Wang, Jen-Yu; Huang, Hsien-Bin; Chou, Pesus; Lee, Ching-Chih

2015-02-01

The National Health Insurance program in Taiwan is a public insurance system for the entire population of Taiwan initiated since March 1995. However, the association of socioeconomic status (SES) and prognosis of rheumatoid arthritis (RA) patients under this program has not been identified. Using the National Health Insurance Research Database in Taiwan, we aimed to examine the combined effect of individual and neighbourhood SES on the mortality rates of RA patients under a universal health care coverage system. A study population included patients with RA from 2004 to 2008. The primary end point was the 5-year overall mortality rate. Individual SES was categorized into low, moderate and high levels based on the income-related insurance payment amount. Neighbourhood SES was defined by household income and neighbourhoods were grouped as an 'advantaged' area or a 'disadvantaged' area. The Cox proportional hazards regression model was used to compare outcomes between different SES categories. A two-sided P value < 0.05 was considered statistically significant. Medical data of 23900 RA patients from 2004 to 2008 were reviewed. Analysis of the combined effect of individual SES and neighbourhood SES revealed that 5-year mortality rates were worse among RA patients with a low individual SES compared to those with a high SES (P < 0.001). In the Cox proportional hazards regression model, RA patients with low individual SES in disadvantaged neighbourhoods incurred the highest risk of mortality (Hazard ratio = 1.64; 95% confidence interval, 1.26-2.13, P < 0.001). RA patients with a low SES have a higher overall mortality rate than those with a higher SES, even with a universal health care system. It is crucial that more public policy and health care efforts be put into alleviating the health disadvantages, besides providing treatment payment coverage. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: a population-based data linkage study.

PubMed

Strobel, Natalie A; Peter, Sue; McAuley, Kimberley E; McAullay, Daniel R; Marriott, Rhonda; Edmond, Karen M

2017-01-18

Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. Prospective population-based linked data set. All preterm babies born in Western Australia during 2010 and 2011. All-cause hospitalisations and emergency department presentations. There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22). In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Surplus or shortage? Unraveling the physician supply conundrum.

PubMed Central

Rosenblatt, R. A.; Lishner, D. M.

1991-01-01

Although the supply of physicians in the United States has doubled during the past 20 years, there is still disagreement as to whether we currently have or should expect a significant surplus of physicians. The evidence suggests that despite the rapid expansion in the pool of available physicians, serious physician shortages persist for certain rural populations, ethnic and occupational groups, and other medically disadvantaged segments of the population. Medical students' declining interest in rural practice and primary care specialties suggests that problems of geographic and specialty maldistribution may worsen despite a rising population of physicians. It is unlikely that a significant physician surplus will develop unless there is a conscious attempt to limit the proportion of national wealth expended on medical care. Pockets of shortage can be reduced by broadening the availability of health insurance, lessening large income disparities between different specialties, changing the way teaching institutions are reimbursed for their training costs, and supporting direct governmental service programs such as the National Health Service Corps. PMID:2024510

Who gains, who loses and how: leveraging gender and class intersections to secure health entitlements.

PubMed

Sen, Gita; Iyer, Aditi

2012-06-01

This paper argues that a focus on the middle groups in a multi-dimensional socioeconomic ordering can provide valuable insights into how different axes of advantage and disadvantage intersect with each other. It develops the elements of a framework to analyse the middle groups through an intersectional analysis, and uses it to explore how such groups leverage economic class or gender advantages to secure entitlements to treatment for long-term illness. The study draws upon household survey data on health-seeking for long-term ailments from 60 villages of Koppal district, Karnataka (India). The survey was designed to capture gender, economic class, caste, age and life stage-based inequalities in access to health care during pregnancy and for short and long-term illnesses. There were striking similarities between two important middle groups--non-poor women and poor men--in some key outcomes: their rates of non-treatment when ill, treatment discontinuation and treatment continuation, and the amounts they spent for treatment. These two groups are the obverse of each other in terms of gender and economic class advantage and disadvantage. Non-poor women have an economic advantage and a gender disadvantage, while poor men have the exact opposite. However, despite the similarities in outcomes, the processes by which gender and class advantage were leveraged by each of the groups varied sharply. Similar patterns held for the poorest men except that the class disadvantage they had to overcome was greater, and the results are modified by this. Copyright © 2011 Elsevier Ltd. All rights reserved.

Race, Employment Disadvantages, and Heavy Drinking: A Multilevel Model.

PubMed

Lo, Celia C; Cheng, Tyrone C

2015-01-01

We intended to determine (1) whether stress from employment disadvantages led to increased frequency of heavy drinking and (2) whether race had a role in the relationship between such disadvantages and heavy drinking. Study data came from the National Longitudinal Survey of Youth, a prospective study that has followed a representative sample of youth since 1979. Our study employed data from 11 particular years, during which the survey included items measuring respondents' heavy drinking. Our final sample numbered 10,171 respondents, which generated 75,394 person-waves for data analysis. Both of our hypotheses were supported by results from multilevel mixed-effects linear regression capturing the time-varying nature of three employment disadvantages and of the heavy-drinking outcome. Results show that more-frequent heavy drinking was associated with employment disadvantages, and that disadvantages' effects on drinking were stronger for Blacks and Hispanics than for Whites. That worsening employment disadvantages have worse effects on minority groups' heavy drinking (compared to Whites) probably contributes to the racial health disparities in our nation. Policies and programs addressing such disparities are especially important during economic downturns.

Stimulating the Environment for Disadvantaged and Minority Group Children. Papers Presented at the Annual International Convention of the Council for Exceptional Children (48th, Chicago, Illinois, April 19-25, 1970).

ERIC Educational Resources Information Center

Council for Exceptional Children, Arlington, VA.

Included in the report of the convention of the Council for Exceptional Children, 1970, are speeches on the disadvantaged and minority groups. Discussed are the positive influence on self concept of the new black image by Octavia B. Knight, the special needs of black students by Winifred Tillery, and new programs for talent retrieval in urban…

Physician Participation In ACOs Is Lower In Places With Vulnerable Populations Compared To More Affluent Communities

PubMed Central

Yasaitis, Laura C.; Pajerowski, William; Polsky, Daniel; Werner, Rachel M.

2016-01-01

Early evidence suggested that accountable care organizations (ACOs) could improve health care quality while constraining costs, and ACOs are expanding throughout the United States. However, if disadvantaged patients have unequal access to physicians who participate in ACOs, that expansion may exacerbate health care disparities. We examined the relationship between physician participation in both Medicare and commercial ACOs across the country and the sociodemographic characteristics of their likely patient populations. Physician participation in ACOs varied widely across hospital referral regions, from nearly 0 percent to over 85 percent. After we adjusted for individual physician and practice characteristics, we found that physicians who practiced in ZIP Code Tabulation Areas where a higher percentage of the population was black, living in poverty, uninsured, or disabled or had less than a high school education—compared to other areas—had significantly lower rates of ACO participation than other physicians. Our findings suggest that vulnerable populations may not have as great access as other groups to physicians participating in ACOs, which could exacerbate existing disparities in health care quality. PMID:27503961

Counting the cost of social disadvantage in primary care: retrospective analysis of patient data.

PubMed

Worrall, A; Rea, J N; Ben-Shlomo, Y

1997-01-04

To cost the relation between socioeconomic status and various measures of primary care workload and assess the adequacy of current "deprivation" payments in relation to actual costings for patients living in qualifying areas. Retrospective data on primary care were collected over a 4.5 year period from both computerised and manually filed records. Standardised data on socioeconomic status were obtained by postal questionnaire. Inner city group practice with a socioeconomically diverse population. 382 male and female subjects of all ages, with a total of 1296 person years of observation. Primary care costs resulting from consultations with a general practitioner or a practice nurse and both new and repeat prescriptions. Morbidity, workload, and costs of drug treatment increased with decreasing socioeconomic status. The difference in cost for patients in social classes IV and V combined compared with those in I and II combined was about 150 Pounds per person year at risk (47 Pounds for workload and 103 Pounds for drugs). Deprivation payments met only half the extra workload cost for patients from qualifying wards. The greater workload caused by social disadvantage has been previously underestimated by simple consultation rates. The absolute difference in costs for socially disadvantaged patients increase as more detailed measures of workload and drug treatment are included. Current deprivation payments only partially offset the increased expenditure on workload. This shortfall will have to be addressed to attract general practitioners to, or retain them in, deprived areas.

“Health inequalities in Armenia - analysis of survey results”

PubMed Central

2012-01-01

Introduction Prevailing sociopolitical and economic obstacles have been implicated in the inadequate utilization and delivery of the Armenian health care system. Methods A random survey of 1,000 local residents, from all administrative regions of Armenia, concerned with health care services cost and satisfaction was conducted. Participation in the survey was voluntary and the information was collected using anonymous telephone interviews. Results The utilization of health care services was low, particularly in rural areas. This under-utilization of services correlated with low income of the population surveyed. The state funded health care services are inadequate to ensure availability of free-of-charge services even to economically disadvantaged groups. Continued reliance on direct out-of pocket and illicit payments, for medical services, are serious issues which plague healthcare, pharmaceutical and medical technology sectors of Armenia. Conclusions Restructuring of the health care system to implement a cost-effective approach to the prevention and treatment of diseases, especially disproportionately affect the poor, should be undertaken. Public payments, increasing the amount of subsidies for poor and lower income groups through a compulsory health insurance system should be evaluated and included as appropriate in this health system redesign. Current medical services reimbursement practices undermine the principle of equity in financing and access. Measures designed to improve healthcare access and affordability for poor and disadvantaged households should be enacted. PMID:22695079

Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis.

PubMed

Lal, Anita; Mantilla-Herrera, Ana Maria; Veerman, Lennert; Backholer, Kathryn; Sacks, Gary; Moodie, Marjory; Siahpush, Mohammad; Carter, Rob; Peeters, Anna

2017-06-01

A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011-12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged quintiles in Australia. Whilst those in more disadvantaged areas would pay more SSB tax, the difference between areas is small. The equity of the tax could be further improved if the tax revenue were used to fund initiatives benefiting those with greater disadvantage.

Dental caries and enamel fluorosis among the fluoridated and non-fluoridated populations in the Republic of Ireland in 2002.

PubMed

Whelton, H; Crowley, E; O'Mullane, D; Donaldson, M; Kelleher, V; Cronin, M

2004-03-01

A national survey of oral health of children and adolescents was carried out in the Republic of Ireland (RoI) in 2001/2002. To compare the prevalence of caries between child and adolescent residents in fluoridated and non-fluoridated communities in the RoI whilst controlling for disadvantage. To compare caries levels amongst disadvantaged and non-disadvantaged groups with and without water fluoridation. To report the changes in caries levels between the 1960s and 2002 in RoI. To report the changes in dental fluorosis levels between 1984 and 2002. Cross sectional oral health survey of a representative, random, stratified sample of 17,851 5-, 8-, 12- and 15-year-old children and adolescents in RoI. WHO examination criteria with the addition of visible, non-cavitated dentine caries were used for recording caries. Fluorosis was measured using Dean's Index. In the RoI the mean dmft/DMFT scores for 5-, 8-, 12-, and 15-year-olds were 1.2, 0.3, 1.1 and 2.3. For those with domestic water fluoridation since birth the scores were 1.0, 0.3, 1.1 and 2.1 respectively. In non-fluoridated areas of RoI the mean dmft/DMFT scores for 5-, 8-, 12-, and 15-year-olds was 1.7, 0.3, 1.3 and 3.2, respectively. For 5-, 12- and 15-year-old age groups dental caries levels were lower amongst children with fluoridated domestic water supplies (all p<0.0001). The prevalence of dental fluorosis has increased in RoI since 1984. 23% and 36% of 8- and 15-year olds respectively in fluoridated areas had Dean's Index scores at the questionable or greater level in 2002, compared with 6% and 5% respectively in 1984. Caries levels are lower among children with fluoridated domestic water supplies. Decay levels are much lower in 2002 than they were in 1984 and in the 1960s. The oral health of the less well off is worse than that of the rest of the population. The prevalence of dental fluorosis is higher amongst children and adolescents with fluoridated water supplies. Comparisons with 1984 data show an increase in the prevalence of fluorosis since that time.

The effects of two different incentives on recruitment rates of families into a prevention program.

PubMed

Heinrichs, Nina

2006-07-01

This study experimentally manipulated two incentives for participation (monetary: paid participation for sessions and setting: group vs. individual) in a child behavior problem prevention program to analyze their effects on recruitment and retention of families. A population of 690 eligible families from 15 preschools located in socially disadvantaged neighborhoods was invited to participate in a parent training (PT) program. The study recruited parents by using advertisements that had information describing only the indicated condition (i.e., PT in group-unpaid, or PT individual-unpaid, or PT in group-paid, or PT individual-paid). Results demonstrate significant impact of payment on recruitment and initial attendance. Training setting alone (individual or group) did not significantly influence these rates. Editors' Strategic Implications: A compelling case is made for the utility of monetary incentives to increase proportions of low-income families in prevention research and programs. Evaluators and program designers should note the impressive use of the experimental design and hierarchical linear modeling to test the effects on recruitment.

Social disadvantage and exposure to lower priced alcohol in off-premise outlets.

PubMed

Morrison, Christopher; Ponicki, William R; Smith, Karen

2015-07-01

Greater concentrations of off-premise alcohol outlets are found in areas of social disadvantage, exposing disadvantaged populations to excess risk for problems such as assault, child abuse and intimate partner violence. This study examines whether the outlets to which they are exposed also sell cheaper alcohol, potentially further contributing to income-related health disparities. We conducted unobtrusive observations in 295 off-premise outlets in Melbourne, Australia, randomly selected using a spatial sample frame. In semi-logged linear regression models, we related the minimum purchase price for a 750 mL bottle of wine to a national index of socioeconomic advantage for the census areas in which the outlets were located. Other independent variables characterised outlet features (e.g. volume, chain management) and conditions of the local alcohol market (adjacent outlet characteristics, neighbourhood characteristics). A one decile increase in socioeconomic advantage was related to a 1.3% increase in logged price. Larger outlets, chains, outlets adjacent to chains, outlets in greater proximity to the nearest neighbouring outlet and those located in areas with more students also had cheaper alcohol. Not only are disadvantaged populations exposed to more outlets, the outlets to which they are exposed sell cheaper alcohol. This finding appears to be consistent with the spatial dynamics of typical retail markets. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Social Disadvantage and Exposure to Lower Priced Alcohol in Off-Premise Outlets

PubMed Central

Morrison, Christopher; Ponicki, William R; Smith, Karen

2015-01-01

Introduction and Aims Greater concentrations of off-premise alcohol outlets are found in areas of social disadvantage, exposing disadvantaged populations to excess risk for problems such as assault, child abuse and intimate partner violence. This study examines whether the outlets to which they are exposed also sell cheaper alcohol, potentially further contributing to income-related health disparities. Design and Methods We conducted unobtrusive observations in 295 off-premise outlets in Melbourne, Australia, randomly selected using a spatial sample frame. In semi-logged linear regression models we related the minimum purchase price for a 750ml bottle of wine to a national index of socio-economic advantage for the Census areas in which the outlets were located. Other independent variables characterised outlet features (e.g., volume, chain management) and conditions of the local alcohol market (adjacent outlet characteristics, neighbourhood characteristics). Results A one decile increase in socio-economic advantage was related to a 1.3% increase in logged price. Larger outlets, chains, outlets adjacent to chains, outlets in greater proximity to the nearest neighbouring outlet, those located in areas with more students also had cheaper alcohol. Discussion and Conclusions Not only are disadvantaged populations exposed to more outlets, the outlets to which they are exposed sell cheaper alcohol. This finding appears to be consistent with the spatial dynamics of typical retail markets. PMID:25808717

Resilience among doctors who work in challenging areas: a qualitative study.

PubMed

Stevenson, Alexander D; Phillips, Christine B; Anderson, Katrina J

2011-07-01

Although physician burnout has received considerable attention, there is little research of doctors who thrive while working in challenging conditions. To describe attitudes to work and job satisfaction among Australian primary care practitioners who have worked for more than 5 years in areas of social disadvantage. Semi-structured interviews were conducted with 15 primary health care practitioners working in Aboriginal health, prisons, drug and alcohol medicine, or youth and refugee health. The interviews explored attitudes towards work and professional satisfaction, and strategies to promote resilience. All doctors were motivated by the belief that helping a disadvantaged population is the 'right thing' to do. They were sustained by a deep appreciation and respect for the population they served, an intellectual engagement with the work itself, and the ability to control their own working hours (often by working part-time in the field of interest). In their clinical work, they recognised and celebrated small gains and were not overwhelmed by the larger context of social disadvantage. If organisations want to increase the numbers of medical staff or increase the work commitment of staff in areas of social disadvantage, they should consider supporting doctors to work part-time, allowing experienced doctors to mentor them to model these patient-appreciative approaches, and reinforcing, for novice doctors, the personal and intellectual pleasures of working in these fields.

Reaching Out: Recruiting a Specialized Ethnic Population.

ERIC Educational Resources Information Center

Lycoming County Library System, Williamsport, PA.

This report describes a project intended to address specialized recruitment of a multiethnic drug and alcohol recovery population in Lycoming County, Pennsylvania, who had not availed themselves of adult literacy services. A collaborator would be established within the community to encourage educationally disadvantaged adults who would be…

Cumulative Disadvantage and Youth Well-Being: A Multi-Domain Examination with Life Course Implications

PubMed Central

Nurius, Paula S.; Prince, Dana M.; Rocha, Anita

2015-01-01

Purpose The accumulation of disadvantage has been shown to increase psychosocial stressors that impact life course well-being. This study tests for significant differences, based on disadvantage exposure, on youths’ emotional and physical health, as well as family supports, peer assets, and academic success, which hold potential for resilience and amelioration of negative health outcomes. Methods A 12 item cumulative disadvantage summed index derived from surveys of a racially and socioeconomically diverse sample of urban high school seniors (n=9,658) was used to distinguish youth at low, moderate, and high levels. Results Findings supported hypothesized stepped patterns such that as multiple disadvantages accumulate, a concomitant decline is evident across the assessed outcome variables (except positive academic identity). Post-hoc tests indicated a pattern of groups being significantly different from one another. Discussion Overall, results lend support for an additive stress load associated with stacked disadvantage, with implications for continuing trends into adulthood as well as preventive interventions PMID:26617431

The Big Buy.

ERIC Educational Resources Information Center

Rittner-Heir, Robbin M.

2002-01-01

Describes the advantages and disadvantages of group purchasing. Forty-seven states have laws allowing group purchasing. Includes examples of group purchasing arrangements in Washington, California, New Mexico, and Kentucky. (PKP)

EDUCATIONAL MEDIA AND THE INHUMAN CONDITION.

ERIC Educational Resources Information Center

FROST, JOE L.

SINCE THE DEFICITS OF THE DISADVANTAGED INDIVIDUAL ARE USUALLY INDUCED BY HIS ENVIRONMENT, IT IS ONLY THROUGH A POSITIVE MANIPULATION OF HIS TOTAL ENVIRONMENT THAT THESE DEFICITS CAN BE REMOVED. DISADVANTAGED GROUPS LIVE IN A WORLD ISOLATED FROM THE CULTURAL MAINSTREAM AND ARE, THUS, ALIENATED FROM THE EDUCATIONAL PROCESS AND FROM MIDDLE-CLASS…

Making Sense of the Performance (Dis)Advantage for Immigrant Students across Canada

ERIC Educational Resources Information Center

Volante, Louis; Klinger, Don; Bilgili, Özge; Siegel, Melissa

2017-01-01

International achievement measures such as the Programme for International Student Assessment (PISA) have traditionally reported a significant gap between non-migrant and immigrant student groups--a result that is often referred to as the "immigrant performance disadvantage". This article examines first- and second-generation immigrant…

Transition from School-Based Training in VET

ERIC Educational Resources Information Center

Daehlen, Marianne

2017-01-01

Purpose: This paper assesses the drop-out rate among disadvantaged students within vocational education and training. The purpose of this paper is to examine the probability of dropping out after school-based training for child welfare clients--a particularly disadvantaged group of youth. Child welfare clients' drop-out rate is compared with…

Demography of Disadvantage in Tennessee.

ERIC Educational Resources Information Center

Jones, Lewis W., Comp.; And Others

In this report, demography conceptualizes significant characteristics to serve as a basis for more intensive study, planning, and procedures focusing on the target group. A compilation of the latest reports available and primarily tabular in form, identifies and locates Tennessee's disadvantaged people, ranking the 95 counties on each of 8…

Closing the Education Gap: A Mayo Clinic Approach to Academic Achievement.

ERIC Educational Resources Information Center

Sang, Herb A.

Despite recent efforts to provide equal education, agreement exists that blacks, females, and disadvantaged students as a group are outperformed in mathematics and science by white middle-class students. To help disadvantaged students, the Duval County Public Schools (Jacksonville, Florida) have developed a "Mayo Clinic" approach to…

Improving Participation and Success in VET for Disadvantaged Learners. Research Report

ERIC Educational Resources Information Center

Lamb, Stephen; Maire, Quentin; Walstab, Anne; Newman, Graeme; Doecke, Esther; Davies, Merryn

2018-01-01

Improving the educational outcomes of the various disadvantaged groups, such as Indigenous Australians, people with a disability, learners with low prior educational attainment and individuals from non-English speaking backgrounds, is a focus of many government policy initiatives centred on social inclusion. This research takes a regional approach…

Neighborhood Disadvantage and Variations in Blood Pressure

ERIC Educational Resources Information Center

Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert

2015-01-01

Purpose: To examine the extent to which neighborhood disadvantage accounts for variation in blood pressure. Methods: Demographic, biometric, and self-reported data from 19,261 health screenings were used. Addresses of participants were geocoded and located within census block groups (n = 14,510, 75.3%). Three hierarchical linear models were…

An Evaluation of Health Information and Wellness Priorities among Socioeconomically Disadvantaged Students

ERIC Educational Resources Information Center

Morris-Paxton, Angela A.; Van Lingen, Johanna M.; Elkonin, Diane

2017-01-01

Objective: A critical evaluation of a salutogenic, wellness education programme was conducted with a group of first-year socioeconomically disadvantaged higher education students, in order to assess the value they placed on health information and wellness priorities. Methods: This study took a mixed-methods approach utilising a…

Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre.

PubMed

Bejiqi, Ramush A; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber

2015-02-01

Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded.

Use of healthcare consumer voices to increase empathy in nursing students.

PubMed

Heidke, Penny; Howie, Virginia; Ferdous, Tabassum

2018-03-01

Nurses need to be well prepared to address the needs of a diverse population and facilitate positive experiences in an equitable and inclusive approach to care. The aim of the study was to determine whether the integration of consumer lived experience interviews into the content of a first-year course influenced empathy in nursing students. A one group pre-test, post-test design was used. A convenience sample of first-year undergraduate nursing students (N = 32) from a regional Australian university was recruited for the study. The pre and post tests were conducted using the Kiersma Chen Empathy Scale and t-tests performed to analyse the data. Results showed overall that nursing students demonstrated moderate levels of empathy; pre-test score of (M = 75.53; SD = 5.76). After the intervention the post-test results showed that there was a statistically significant increase in students' empathy towards vulnerable, disadvantaged and stigmatised population groups. The healthcare consumer voice has the potential to strengthen current teaching practices that promote caring behaviours in nursing students. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epidemiology of Taenia solium in Nepal: is it influenced by the social characteristics of the population and the presence of Taenia asiatica?

PubMed

Devleesschauwer, Brecht; Aryal, Arjun; Joshi, Durga Datt; Rijal, Suman; Sherchand, Jeevan Bahadur; Praet, Nicolas; Speybroeck, Niko; Duchateau, Luc; Vercruysse, Jozef; Dorny, Pierre

2012-08-01

The transmission of the zoonotic pork tapeworms Taenia solium and T. asiatica depends on a combination of specific risk factors, such as open defecation, backyard pig raising and the consumption of raw or undercooked pork and viscera. A community-based survey was conducted among 289 households in south-eastern Nepal to study the heterogeneity of these risk factor frequencies as a function of the social composition of the population. The frequency of open defecation, backyard pig raising and pork consumption differed significantly (P < 0.005) among the different coexisting caste and ethnic groups. In the same survey, the taeniosis prevalence was examined among the different groups. Tapeworm carriers were identified at a high prevalence among the Dum, one of the most disadvantaged communities of Nepal. A PCR-RFLP assay revealed that all collected tapeworm specimens were T. asiatica, a species thus far not known to occur in South Asia. These results can help to understand the epidemiology of T. solium in Nepal, which appears to be more complex than thought so far. © 2012 Blackwell Publishing Ltd.

Epidemiology of positive mental health in a national census of children at school entry.

PubMed

Goldfeld, Sharon; Kvalsvig, Amanda; Incledon, Emily; O'Connor, Meredith

2017-03-01

Until now, child mental health promotion efforts have focused primarily on reducing the prevalence and severity of problems; yet the absence of mental health problems does not necessarily imply the presence of healthy psychosocial functioning. We aimed to investigate the epidemiology of child mental health competence in a full national population of school entrants. The data source was the 2012 Australian Early Development Index, a national census of early childhood development completed for school entrants by teachers across Australia (n=275 800). The mental health competence outcome measure was derived from constructs that focused on children's social and emotional strengths. Children with mental health competence scores in the top quintile were compared with the standard population across individual and community characteristics. Average age at assessment was 5 years 7 months. Higher odds of mental health competence were observed for children who lived in more advantaged areas (OR 1.62; 99% CI 1.49 to 1.75), had attended preschool (1.38; 1.25 to 1.51) and demonstrated effective oral communication skills in the classroom (19.01; 15.62 to 23.13). Indigenous children had lower odds compared with non-Indigenous children (0.59; 0.54 to 0.64). Children in disadvantaged areas who attended preschool did not 'catch up' with their more advantaged peers. Mental health competence is unequally distributed across the Australian child population at school entry and is strongly predicted by measures and correlates of disadvantage. Effective oral communication and attendance at preschool warrant further investigation as potentially modifiable factors that may support mental health competence in new school entrants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Smoking Beliefs Among Chinese Secondary School Students: A Theory-Based Qualitative Study.

PubMed

Zhao, Xiang; White, Katherine M; Young, Ross McD; Obst, Patricia L

2018-02-07

China has the world's greatest number of smokers but theory-based smoking interventions are rare. To develop an effective intervention, understanding the determinants of Chinese adolescent smoking is crucial. The Theory of Planned Behavior (TPB) is empirically supported to predict and assist in informing intervention strategies to change health-related behaviors. Based on the TPB, the elicitation of shared smoking beliefs among adolescents can inform future intervention designs among this at-risk population. We investigated the beliefs from six focus groups (N = 30) of one senior secondary school in Kunming, Yunnan Province, China. We used semi-structured questions based on the TPB framework, including prompts about behavioral (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs. Following the Consensual Qualitative Research (CQR) methodology, data were discussed until consensus was reached. Auditing was undertaken by an external researcher. Seven domains (advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images) were examined. Smoking as a gendered behavior, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Data suggested an extended-TPB framework as an appropriate approach to adopt when addressing smoking beliefs among the target population. These beliefs can be utilized to inform future school-based interventions and public health campaigns targeting smoking among Chinese adolescents. A modified TPB approach has potential for future smoking interventions among Chinese adolescents. Beliefs elicited in this study form a strong basis for designing a location- and population-specific antismoking programme. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study.

PubMed

Caban-Martinez, Alberto J; Clarke, Tainya C; Davila, Evelyn P; Fleming, Lora E; Lee, David J

2011-04-01

Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population. In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish) recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost) of the handheld administration method was recorded and compared to approaches available in the extant literature. Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings. Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data. These technological research modalities are useful in the collection and assessment of environmental and occupational research data.

Racial differences in the associations of neighborhood disadvantage, exposure to violence, and criminal recidivism among female juvenile offenders.

PubMed

Chauhan, Preeti; Reppucci, N Dickon; Turkheimer, Eric N

2009-01-01

The current study examined the impact of exposure to violence and neighborhood disadvantage on criminal recidivism among Black (n = 69) and White (n = 53) female juvenile offenders. Participants were girls between the ages of 13 and 19 (M = 16.8; SD = 1.2) who were sentenced to secure custody. Using a multi-method research design, the study assessed neighborhood disadvantage through census level data, exposure to violence through self-report, and criminal recidivism through official records. Results indicated that Black girls were significantly more likely than White girls to live in disadvantaged neighborhoods, but both reported similar levels of parental physical abuse and witnessing neighborhood violence. In structural equation models, neighborhood disadvantage and witnessing neighborhood violence were indicative of future recidivism for the group as a whole. However, multiple group analyses indicated the existence of race specific pathways to recidivism. Witnessing neighborhood violence was associated with recidivism for Black girls while parental physical abuse was associated with recidivism for White girls. Results suggest that characteristics within the neighborhood play a considerable role in recidivism among female juvenile offenders generally and Black female juvenile offenders, specifically. Race specific risk models warrant further investigation, and may help lawmakers and clinicians in addressing racial disparities in the justice system. (c) 2009 John Wiley & Sons, Ltd.

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 5. equity effects for neonates and children.

PubMed

Schleiff, Meike; Kumapley, Richard; Freeman, Paul A; Gupta, Sundeep; Rassekh, Bahie M; Perry, Henry B

2017-06-01

The degree to which investments in health programs improve the health of the most disadvantaged segments of the population-where utilization of health services and health status is often the worst-is a growing concern throughout the world. Therefore, questions about the degree to which community-based primary health care (CBPHC) can or actually does improve utilization of health services and the health status of the most disadvantaged children in a population is an important one. Using a database containing information about the assessment of 548 interventions, projects or programs (referred to collectively as projects) that used CBPHC to improve child health, we extracted evidence related to equity from a sub-set of 42 projects, identified through a multi-step process, that included an equity analysis. We organized our findings conceptually around a logical framework matrix. Our analysis indicates that these CBPHC projects, all of which implemented child health interventions, achieved equitable effects. The vast majority (87%) of the 82 equity measurements carried out and reported for these 42 projects demonstrated "pro-equitable" or "equitable" effects, meaning that the project's equity indicator(s) improved to the same degree or more in the disadvantaged segments of the project population as in the more advantaged segments. Most (78%) of the all the measured equity effects were "pro-equitable," meaning that the equity criterion improved more in the most disadvantaged segment of the project population than in the other segments of the population. Based on the observation that CBPHC projects commonly provide services that are readily accessible to the entire project population and that even often reach down to all households, such projects are inherently likely to be more equitable than projects that strengthen services only at facilities, where utilization diminishes greatly with one's distance away. The decentralization of services and attention to and tracking of metrics across all phases of project implementation with attention to the underserved, as can be done in CBPHC projects, are important for reducing inequities in countries with a high burden of child mortality. Strengthening CBPHC is a necessary strategy for reducing inequities in child health and for achieving universal coverage of essential services for children.

Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users - A Cross-Sectional Study.

PubMed

Bonney, Andrew; Mayne, Darren J; Jones, Bryan D; Bott, Lawrence; Andersen, Stephen E J; Caputi, Peter; Weston, Kathryn M; Iverson, Don C

2015-01-01

Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities. The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable. The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males. It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.

Reducing the social gradient in smoking: initiatives in the United Kingdom.

PubMed

Murray, Rachael L; McNeill, Ann

2012-07-01

To describe initiatives aiming to reduce the social gradient of smoking in the UK. A description of government initiatives to support smokers from low socioeconomic and other key groups, including National Health Service Stop Smoking Services and how they are seeking to support smokers to quit. The UK is employing a number of strategies to reduce smoking prevalence and is currently top of the Tobacco Control Scale in Europe but the health gap does not yet appear to be decreasing (in relation to smoking prevalence in deprived and higher income groups). More recently, efforts have been made to target smokers in more deprived groups to draw more of these smokers into the quitting process. While Stop Smoking Services are a key part of the UK's comprehensive tobacco control strategy and are reaching smokers from low socioeconomic groups, wider population strategies, such as ensuring all contacts with health-care professionals include advice to stop and the prohibition of remaining channels of tobacco marketing, are required to maximise the impact on deprived smokers. While smoking prevalence decreases among the general population are important, reducing smoking among disadvantaged groups is imperative to reduce health inequalities. It is too soon to say whether the new measures recently adopted in the UK will help to achieve this. © 2012 Australasian Professional Society on Alcohol and other Drugs.

The Individual Family Support Plan: A Tool to Assist Special Populations of Gifted Learners.

ERIC Educational Resources Information Center

Damiani, Victoria B.

1996-01-01

This article describes Project Mandela, a federally funded enrichment and family support program for special populations (such as culturally diverse and economically disadvantaged) of gifted learners. Eighty-seven families participated in development of Individual Family Support Plans to enhance children's educational progress. The project found…

Special Populations Grant Report, Fiscal Year 1991. Executive Summary.

ERIC Educational Resources Information Center

Singley, Yvonne

Special population grants to Illinois public community colleges fund services, special programs, and instruction that assist academically and socially disadvantaged students, students with disabilities, and minority students to succeed in college. In fiscal year 1991, grants totaling $9.7 million enabled the Illinois community colleges to provide…

Hospitality Occupational Skills Training Cooperative. Project HOST Curriculum Guide.

ERIC Educational Resources Information Center

Northwest Educational Cooperative, Des Plaines, IL.

This curriculum guide provides instructional materials for an 8-week training program, entitled Hospitality Occupational Skills Training (HOST) Cooperative. It offers an alternative skills training program to meet the needs of disadvantaged, minority populations and of employers who must recruit more highly skilled workers from those populations.…

Characteristics of Effective Secondary Vocational Education Programs for Special Populations.

ERIC Educational Resources Information Center

Parks, Marie A.; And Others

A study examined the characteristics of effective secondary vocational education programs for a variety of special needs populations (disabled, disadvantaged, and limited English proficient individuals; single parents; and persons enrolled in programs to eliminate sex bias and sex stereotyping). The following eight states were studied: California,…

Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

PubMed

Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

2013-09-01

Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.

A Novel Environmental Justice Indicator for Managing Local Air Pollution.

PubMed

Zhao, Jing; Gladson, Laura; Cromar, Kevin

2018-06-14

Environmental justice efforts in the United States seek to provide equal protection from environmental hazards, such as air pollution, to all groups, particularly among traditionally disadvantaged populations. To accomplish this objective, the U.S. EPA has previously required states to use an environmental justice screening tool as part of air quality planning decision-making. The generally utilized approach to assess potential areas of environmental justice concern relies on static comparisons of environmental and demographic information to identify areas where minority and low income populations experience elevated environmental exposures, but does not include any additional information that may inform the trade-offs that sub-populations of varying socio-demographic groups make when choosing where to reside in cities. In order to address this limitation, job accessibility (measured by a mobility index defining the number of jobs available within a set commuting time) was developed as a novel environmental justice indicator of environmental justice priority areas at the local level. This approach is modeled using real-world data in Allegheny County, PA (USA), and identifies areas with relatively high levels of outdoor air pollution and low access to jobs. While traditional tools tend to flag the poorest neighborhoods for environmental justice concerns, this new method offers a more refined analysis, targeting populations suffering from the highest environmental burden without the associated benefits of urban living.

The evolution of prompt reaction to adverse ties

PubMed Central

2008-01-01

Background In recent years it has been found that the combination of evolutionary game theory with population structures modelled in terms of dynamical graphs, in which individuals are allowed to sever unwanted social ties while keeping the good ones, provides a viable solution to the conundrum of cooperation. It is well known that in reality individuals respond differently to disadvantageous interactions. Yet, the evolutionary mechanism determining the individuals' willingness to sever unfavourable ties remains unclear. Results We introduce a novel way of thinking about the joint evolution of cooperation and social contacts. The struggle for survival between cooperators and defectors leads to an arms race for swiftness in adjusting social ties, based purely on a self-regarding, individual judgement. Since defectors are never able to establish social ties under mutual agreement, they break adverse ties more rapidly than cooperators, who tend to evolve stable and long-term relations. Ironically, defectors' constant search for partners to exploit leads to heterogeneous networks that improve the survivability of cooperators, compared to the traditional homogenous population assumption. Conclusion When communities face the prisoner's dilemma, swift reaction to adverse ties evolves when competition is fierce between cooperators and defectors, providing an evolutionary basis for the necessity of individuals to adjust their social ties. Our results show how our innate resilience to change relates to mutual agreement between cooperators and how "loyalty" or persistent social ties bring along an evolutionary disadvantage, both from an individual and group perspective. PMID:18928551

Population policies in Southeast Asia and Australia: the international relevance of domestic affairs.

PubMed

Jones, G W

1984-01-01

There are 2 underlying themes to this paper: national perceptions of population circumstances at home and abroad are the crucial determinants of population policies adopted, and the differences in perceptions help explain why national reactions differ to circumtances which appear similar; and population policy, though an internal matter, has international repercussions and thus can become a sensitive issue in international relations. Until recently, ASEAN countries were united with Vietnam on at least 1 issue: attitudes toward the growth and changing distribution of their populations. The objectives were slower growth through lowered fertility, resistance to immigration from abroad except in very special circumstances, resettlement of population to undeveloped areas with potential for agriculture, and slowing the growth of big cities. The Australian situation differed. As a high income nation populated primarily through immigration and set in a region of far more populous and densely settled nations, Australia's policy favored population growth and used an immigration program as a way to realize this end. Yet, even so, population growth in most postwar years was slower than that of all Southeast Asian nations. And, although immigration was encouraged, the resistance to immigration that characterized Southeast Asian countries was shared by Australia with respect to all but North Western Europeans, an "acceptable" category progressively widened by dint of curcumstances to include Eastern Europeans, then Southern Europeans, then certain Middle Eastern peoples, and finally Asians and Latin Americans. Australia shared with Southeast Asian nations the concern with big-city growth and like the Southeast Asian nations searched for appropriate policies to contain this growth and promote that of smaller cities and towns. This search stopped in the 1970s when the report of the National Population showed that accepted projections of the populations of Sydney and Melbourne had been unrealisticably high. Until 1983 Southeast Asia presented a fairly united front on population policy matters. The momentous break occurred when the Malaysian Prime Minister announced to his current 15 million people a target of 70 million for Malaysia's population and followed this up with pronatalist policies in support of this goal. The key point in the context of this paper, is to emphasize that perceptions of national self-interest have led to the adoption of widely divergent policies in neighboring Malaysia and Singapore. Singapore is offering strong financial incentives for its socioeconomically disadvantaged groups to have fewer children. Malaysia's incentives to have more people will have most impact on the disadvantaged groups. There is little difference between Indonesia, Thailand, the Philippines, and Vietnam on fertility goals, and their perceptions of the problem appear similar. Malaysian population and ethnic policies have had a number of direct effects on Australia. It was ethnic politics that determined Malaysia's hard line attitude toward Vietnamese refugees. Australia's acceptance of large numbers of Vietnamese refugees probably resulted as much from the strong pressure applied by ASEAN nations to do so as from humanitarian grounds. Another aspect of Malaysian ethnic politics which has had direct repercussions on Australia is the discrimination against non-Malay students for places in Malaysian universities.

Healthy weight advantage lost in one generation among immigrant elementary schoolchildren in multi-ethnic, disadvantaged, inner-city neighborhoods in Montreal, Canada.

PubMed

Maximova, Katerina; O'Loughlin, Jennifer; Gray-Donald, Katherine

2011-04-01

We sought to determine if the rate of increase in body mass index (BMI) differs between first generation immigrant children (child and both parents born outside Canada); second generation immigrant children (child born in Canada with at least one parent born outside Canada); and native-born children (child and both parents born in Canada), and if the rate of increase varies across ethnic groups. Data were available from the evaluation of a 5-year heart health promotion program targeted to elementary school children from 24 schools in multi-ethnic, disadvantaged, inner-city neighborhoods in Montreal, Canada. Participants were 6392 children aged 9-12 years born in and outside of Canada. Height and weight were measured annually according to a standardized protocol. BMI increases with age were examined using individual growth models stratified by immigrant status grouping (first generation immigrant, second generation immigrant, native-born). On average, BMI increased by 0.59, 0.73, and 0.82 kg/m2 with each year of age among first generation immigrant, second generation immigrant, and native-born children, respectively. These differences held across four family origin grouping (Europe, Asia, Central/South America, and Other). The protective effect of immigrant status on BMI increases with age dissipated in second generation immigrant children, whose rate of increase was similar to that of native-born children. Because immigrants constitute the fastest growing segment of the Canadian population, it is important to understand the causes of the higher BMI increases with successive generations. Copyright © 2011 Elsevier Inc. All rights reserved.

21 CFR 56.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2014 CFR

2014-04-01

... problems of research involving vulnerable populations, such as children, prisoners, pregnant women..., pregnant women, handicapped, or mentally disabled persons, or economically or educationally disadvantaged...

21 CFR 56.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2012 CFR

2012-04-01

... problems of research involving vulnerable populations, such as children, prisoners, pregnant women..., pregnant women, handicapped, or mentally disabled persons, or economically or educationally disadvantaged...

21 CFR 56.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2011 CFR

2011-04-01

... problems of research involving vulnerable populations, such as children, prisoners, pregnant women..., pregnant women, handicapped, or mentally disabled persons, or economically or educationally disadvantaged...

21 CFR 56.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2013 CFR

2013-04-01

... problems of research involving vulnerable populations, such as children, prisoners, pregnant women..., pregnant women, handicapped, or mentally disabled persons, or economically or educationally disadvantaged...

Ethnic, racial and cultural identity and perceived benefits and barriers related to genetic testing for breast cancer among at-risk women of African descent in New York City.

PubMed

Sussner, K M; Edwards, T A; Thompson, H S; Jandorf, L; Kwate, N O; Forman, A; Brown, K; Kapil-Pair, N; Bovbjerg, D H; Schwartz, M D; Valdimarsdottir, H B

2011-01-01

Due to disparities in the use of genetic services, there has been growing interest in examining beliefs and attitudes related to genetic testing for breast and/or ovarian cancer risk among women of African descent. However, to date, few studies have addressed critical cultural variations among this minority group and their influence on such beliefs and attitudes. We assessed ethnic, racial and cultural identity and examined their relationships with perceived benefits and barriers related to genetic testing for cancer risk in a sample of 160 women of African descent (49% self-identified African American, 39% Black-West Indian/Caribbean, 12% Black-Other) who met genetic risk criteria and were participating in a larger longitudinal study including the opportunity for free genetic counseling and testing in New York City. All participants completed the following previously validated measures: (a) the multi-group ethnic identity measure (including ethnic search and affirmation subscales) and other-group orientation for ethnic identity, (b) centrality to assess racial identity, and (c) Africentrism to measure cultural identity. Perceived benefits and barriers related to genetic testing included: (1) pros/advantages (including family-related pros), (2) cons/disadvantages (including family-related cons, stigma and confidentiality concerns), and (3) concerns about abuses of genetic testing. In multivariate analyses, several ethnic identity elements showed significant, largely positive relationships to perceived benefits about genetic testing for breast and/or ovarian cancer risk, the exception being ethnic search, which was positively associated with cons/disadvantages, in general, and family-related cons/disadvantages. Racial identity (centrality) showed a significant association with confidentiality concerns. Cultural identity (Africentrism) was not related to perceived benefits and/or barriers. Ethnic and racial identity may influence perceived benefits and barriers related to genetic testing for breast and/or ovarian cancer risk among at-risk women of African descent. Genetic counseling services may want to take into account these factors in the creation of culturally-appropriate services which best meet the needs of this heterogenous population. Copyright © 2011 S. Karger AG, Basel.

Socioeconomic status and smoking: a review.

PubMed

Hiscock, Rosemary; Bauld, Linda; Amos, Amanda; Fidler, Jennifer A; Munafò, Marcus

2012-02-01

Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and quit attempts are less likely to be successful. Studies have suggested that this may be the result of reduced social support for quitting, low motivation to quit, stronger addiction to tobacco, increased likelihood of not completing courses of pharmacotherapy or behavioral support sessions, psychological differences such as lack of self-efficacy, and tobacco industry marketing. Evidence of interventions that work among lower socioeconomic groups is sparse. Raising the price of tobacco products appears to be the tobacco control intervention with the most potential to reduce health inequalities from tobacco. Targeted cessation programs and mass media interventions can also contribute to reducing inequalities. To tackle the high prevalence of smoking among disadvantaged groups, a combination of tobacco control measures is required, and these should be delivered in conjunction with wider attempts to address inequalities in health. © 2012 New York Academy of Sciences.

An Approach to Defensible Nondiscriminatory Identification Model for the Gifted.

ERIC Educational Resources Information Center

Long, Robert R.

To develop an approach for a nondiscriminatory identification model for gifted students in Rome (GA) City Schools, mean IQ scores on the Otis-Lennon Mental Ability test were compared for fourth, fifth, and tenth grade students divided into four groups: White advantaged, White disadvantaged, Black advantaged, and Black disadvantaged. A significant…

Rural Parentage and Labor Market Disadvantage in a Sub-Saharan Setting: Sources and Trends

ERIC Educational Resources Information Center

Giroux, Sarah C.

2008-01-01

High unemployment in many developing countries is intensifying job competition and raising concern for the employment prospects of vulnerable groups, including children of rural parents. This paper examines the trends and sources in employment disadvantage associated with rural parentage in Cameroon. In documenting the sources of inequality, the…

MEXICAN-AMERICAN STUDY PROJECT. ADVANCE REPORT 10, MEXICAN AMERICANS IN SOUTHWEST LABOR MARKETS.

ERIC Educational Resources Information Center

FOGEL, WALTER

MEXICAN AMERICANS ARE CLEARLY A DISADVANTAGED GROUP IN THE LABOR MARKETS OF THE SOUTHWEST. ALTHOUGH SUBSTANTIAL GAINS IN INCOME AND OCCUPATIONAL STATUS TAKE PLACE BETWEEN THE FIRST AND SECOND GENERATIONS OF MEXICAN AMERICANS, LITTLE IMPROVEMENT IS EVIDENCED AFTER THE SECOND GENERATION. AS FURTHER EVIDENCE OF DISADVANTAGEMENT, IT HAS BEEN FOUND…

Community Involvement and Adolescent Mental Health: Moderating Effects of Race/Ethnicity and Neighborhood Disadvantage

ERIC Educational Resources Information Center

Hull, Pamela; Kilbourne, Barbara; Reece, Michelle; Husaini, Baqar

2008-01-01

Social development and stress process theories suggest that participation in one's community can function as a protective factor for mental health, especially for youth from socioeconomically disadvantaged areas. However, the effects of community involvement on adolescent mental health could vary across racial/ethnic groups and levels of…

Toward an Effective Educational Program for Disadvantaged Infants.

ERIC Educational Resources Information Center

Dusewicz, Russell A.; Higgins, Martin J.

This study attempted to determine if significant and lasting cognitive gains could be achieved by focusing preschool efforts upon children younger than those now being serviced by traditional programs--children under three years of age. Thirty-six disadvantaged children, 19-28 months of age, were randomly assigned to two groups: a Home Group…

Non-Intellectual Correlates of Attrition Among Disadvantaged Adults.

ERIC Educational Resources Information Center

Wingate, James G.

The study described in this report was conducted in order to determine the effects of self concept and selected demographic and economic variables on attrition. Data are drawn from a group of 74 disadvantaged adult students who enrolled in a college preparatory program at the Syracuse Educational Opportunity Center (S.E.O.C.). Demographic…

Maternal Parenting Style and Delinquency by Race and the Moderating Effect of Structural Disadvantage

ERIC Educational Resources Information Center

Mowen, Thomas J.; Schroeder, Ryan D.

2018-01-01

Contemporary research suggests authoritative parenting is the most effective parenting style in deterring juvenile delinquency. Some research has found there are differences in parenting style between racial groups due to structural disadvantage faced by marginalized individuals. Yet, relatively little is known about how racial differences in…

How Community Development Programmes Can Foster Re-Engagement with Learning in Disadvantaged Communities: Leadership as Process

ERIC Educational Resources Information Center

Millar, Pat; Kilpatrick, Sue

2005-01-01

Family and community capacity building projects in Tasmania are attempting to address the disadvantage of communities marginalised by socio-economic and other influences. Collaborations between the projects, community members and groups, and education and training organisations, have resulted in a leadership process which has fostered reengagement…

Supporting English Second-Language Learners in Disadvantaged Contexts: Learning Approaches That Promote Success in Mathematics

ERIC Educational Resources Information Center

Warren, Elizabeth; Miller, Jodie

2015-01-01

In the Australian context, children living in disadvantaged circumstances, whose second language is English, are one of the groups at risk of failing in mathematics. This paper explores the impact purposely developed learning activities (Representations, Oral Language and Engagement in Mathematics Learning activities) have on pupils' mathematics…

Developing Social Giftedness in Disadvantaged Girls at an Indian School

ERIC Educational Resources Information Center

Sharma, Yukti

2012-01-01

This article describes developmental interactions with a group of female students at an Indian public school situated in a disadvantaged section of the community. Through a series of activities, the author makes an intensive effort to develop social giftedness in these students. The article describes various activities together with the author's…

What's in a Name? Categorising "Disadvantaged Older Workers"

ERIC Educational Resources Information Center

Meyers, Rebecca

2016-01-01

The institutionalised categorisation of adults who are over 55 years of age, unemployed and low-skilled as "older" and "disadvantaged" may adversely affect their employment prospects and their self-esteem. This paper reports on the findings of a study that explored the experiences of a small group of such adults; in particular,…

Equity in Higher Education and Graduate Labour Market Outcomes in Australia

ERIC Educational Resources Information Center

Li, Ian W.; Mahuteau, Stephane; Dockery, Alfred M.; Junankar, P. N.

2017-01-01

The rate of higher education participation in Australia has increased over the past decade for individuals from disadvantaged backgrounds. This study contributes to the knowledge on the outcomes of disadvantaged individuals who complete higher education by looking at the labour market outcomes of university graduates from equity groups. The number…

Gaining Access or Losing Ground? Socioeconomically Disadvantaged Students in Undergraduate Engineering, 1994-2003

ERIC Educational Resources Information Center

Lundy-Wagner, Valerie C.; Veenstra, Cindy P.; Orr, Marisa K.; Ramirez, Nichole M.; Ohland, Matthew W.; Long, Russell A.

2014-01-01

Expanding access to engineering for underrepresented groups has by and large focused on ethnicity/race and gender, with little understanding of socioeconomic disadvantages. In this study, we use economic, human, and cultural capital theories to frame and then describe access to undergraduate engineering degree programs and bachelor's degrees.…

Developing Argument Skills in Severely Disadvantaged Adolescent Males in a Residential Correctional Setting

ERIC Educational Resources Information Center

De Fuccio, MaryAnne; Kuhn, Deanna; Udell, Wadiya; Callender, Kerry

2009-01-01

We investigate whether the intervention designed by Kuhn and Udell (2003) to develop argument skills could be implemented productively among adolescent males in a residential juvenile detention facility--boys who were educationally disengaged and severely disadvantaged academically as well as socially. Compared to a control group from the same…

Economic distress and cause-of-death patterns for black and non-black men in Chicago: reconsidering the relevance of classic epidemiological transition theory.

PubMed

Palazzo, Lorella; Guest, Avery; Almgren, Gunnar

2003-01-01

The mortality disadvantage of African Americans is well documented, but previous studies have not considered its implications for population theory in the general case of industrialized nation states with high levels of income inequality. This paper examines the relevance of classic epidemiological theory to the extremes of income and mortality observed in Chicago, one of America's most racially divided cities. We analyze cause-specific death rates for black and non-black male populations residing in Chicago's community areas by using linked data from the 1990 Census and from 1989-1991 individual death certificates. The same cause-of-death patterns explain much of the mortality of black and non-black men. These two major structures include one, degenerative diseases, the other, "tough-living" causes (accidents, homicides, and liver disease). Community socioeconomic status is strongly related to tough-living deaths within each racial group, and to degenerative deaths for African Americans. Black men's tough-living mortality is much greater than non-blacks', but their younger age structure suppresses their degenerative death rates. Aggregate unemployment and social disorganization account for the most salient disparities in mortality across racial groups. This patterning of mortality along a socioeconomic continuum supports epidemiological theory and extends its applicability to highly unequal populations within industrialized countries.

[Gap between the use of and need for youth care: research in Rotterdam neighbourhoods].

PubMed

Jansen, Wilma; Mieloo, Cathelijne L; Anschutz, Justine; de Zwart, Onno

2015-01-01

To determine the relationship between the need for care and the use of care in the youth care system at neighbourhood level and the relationship with population characteristics, with consideration of the decentralisation of youth care. Descriptive, retrospective study. Data on youth care use, indicators of need for care and population characteristics were gathered from monitors and the records of the municipality, institutions and health insurance companies. Data were grouped on a neighbourhood level (n = 49). For the analyses we used univariate and multivariate regression. We used these to distinguish between neighbourhoods with large and small gaps between youth care use and need for youth care. Differences between these neighbourhoods were analysed with t-tests. A multivariate model showed that the percentage of youths with emotional problems and behavioural problems and the percentage of parents with self-reported need for care were not predictors of youth care use at a neighbourhood level. About two thirds of the variance in youth care use between neighbourhoods could be explained by the population characteristics of a neighbourhood, particularly the percentage of youths originally from non-western countries, the percentage of youths with a low level of education or special training and the percentage of people who received income support. The number of 12-18-year-olds in a neighbourhood was a predictor of youth mental health care, and the percentage of youths in a single-parent family was a predictor of out-patient youth and parenting support. Neighbourhoods with a large gap between the need for and use of youth care were socially more disadvantaged than neighbourhoods with a smaller gap. Population characteristics explain the rate of use of youth care better than the need for youth care in a neighbourhood as measured by municipal monitors. The possible gap between the use of and need for youth care on an individual level in neighbourhoods with many characteristics of disadvantage is an important focus point for future neighbourhood teams.

45 CFR 690.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2014 CFR

2014-10-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

38 CFR 16.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2012 CFR

2012-07-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

38 CFR 16.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2013 CFR

2013-07-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

45 CFR 690.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2011 CFR

2011-10-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

45 CFR 690.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2013 CFR

2013-10-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

38 CFR 16.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2011 CFR

2011-07-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

45 CFR 690.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2012 CFR

2012-10-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

38 CFR 16.111 - Criteria for IRB approval of research.

Code of Federal Regulations, 2014 CFR

2014-07-01

... involving vulnerable populations, such as children, prisoners, pregnant women, mentally disabled persons, or..., prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons...

EXAMINATION OF NEIGHBORHOOD DISADVANTAGE AND SLEEP IN A MULTI-ETHNIC COHORT OF ADOLESCENTS

PubMed Central

Troxel, Wendy M.; Shih, Regina A.; Ewing, Brett; Tucker, Joan S.; Nugroho, Alvin; D’Amico, Elizabeth J.

2017-01-01

Purpose Neighborhood-level socioeconomic disadvantage and lower individual-level socioeconomic status are associated with poorer sleep health in adults. However, few studies have examined the association between neighborhood-level disadvantage and sleep in adolescents, a population at high-risk for sleep disturbances. Methods The current study is the first to examine how objective (i.e. via census tract-level data) and subjective measures of neighborhood disadvantage are associated with sleep in a racially/ ethnically and socioeconomically diverse sample of 2,493 youth [Non-Hispanic White (20%), Hispanic (46%), Asian (21%), and Multiracial/ Other (13%)]. Results Findings indicated that greater perceived neighborhood-level social cohesion and lower neighborhood-level poverty were associated with better sleep outcomes in adolescents. However, there was some evidence that the magnitude of the associations differed according to family-level socioeconomic status and race/ ethnicity. Conclusions Findings suggest that subjective and objective neighborhood characteristics may affect the sleep health of older adolescents, with certain demographic subgroups being particularly vulnerable. PMID:28285183

K–12 Educational Outcomes of Immigrant Youth

PubMed Central

Crosnoe, Robert; López Turley, Ruth N.

2017-01-01

Summary The children from immigrant families in the United States make up a historically diverse population, and they are demonstrating just as much diversity in their experiences in the K–12 educational system. Robert Crosnoe and Ruth López Turley summarize these K–12 patterns, paying special attention to differences in academic functioning across segments of the immigrant population defined by generational status, race and ethnicity, and national origin. A good deal of evidence points to an immigrant advantage in multiple indicators of academic progress, meaning that many youths from immigrant families outperform their peers in school. This apparent advantage is often referred to as the immigrant paradox, in that it occurs despite higher-than-average rates of social and economic disadvantages in this population as a whole. The immigrant paradox, however, is more pronounced among the children of Asian and African immigrants than other groups, and it is stronger for boys than for girls. Furthermore, evidence for the paradox is far more consistent in secondary school than in elementary school. Indeed, school readiness appears to be one area of potential risk for children from immigrant families, especially those of Mexican origin. For many groups, including those from Latin America, any evidence of the immigrant paradox usually emerges after researchers control for family socioeconomic circumstances and youths’ English language skills. For others, including those from Asian countries, it is at least partially explained by the tendency for more socioeconomically advantaged residents of those regions to leave their home country for the United States. Bilingualism and strong family ties help to explain immigrant advantages in schooling; school, community, and other contextual disadvantages may suppress these advantages or lead to immigrant risks. Crosnoe and Turley also discuss several policy efforts targeting young people from immigrant families, especially those of Latin American origin. One is the DREAM Act, proposed federal legislation to create a pathway to citizenship for undocumented youth who meet certain criteria. Another effort includes culturally grounded programs to support the college preparation of immigrant adolescents and the educational involvement of immigrant parents of young children. PMID:21465858

Preventive education and birth order as co-determinants of IQ in disadvantaged 5-year-olds.

PubMed

Boat, B W; Campbell, F A; Ramey, C T

1986-01-01

The effects of preventive education and birth order on IQ scores of 95 economically disadvantaged children at risk for retarded intellectual development were studied. Experimental first- and later-born children participated from birth in a 5-year programme of systematic educational intervention. An equal number of children served as controls and received no systematic intervention. First-borns prevailed as the brighter children in both the educational treatment group and the control group when Wechsler Preschool and Primary Scale of Intelligence (WPPSI) full scale and verbal IQ scores were compared. Furthermore, mothers of first-borns (70% of whom were only-born at age 5) achieved significantly higher WAIS scores than did mothers of later-born children. Results suggest that later-born disadvantaged children are at greatest risk for developmental retardation.

Children have type 2 diabetes too: an historical perspective.

PubMed

Dean, Heather J; Sellers, Elizabeth A C

2015-10-01

Prior to 1985, type 2 diabetes was a disease of adults. Simultaneously with the global epidemic of childhood obesity, type 2 diabetes has increased in children. Initially, the presentation of small case series of type 2 diabetes in children was met with skepticism. As the number and size of the case series grew and the first long-term outcomes of end-stage complications in young adults appeared in the literature, the international community took notice with guarded interest. Type 2 diabetes disproportionately affects the children of specific ethnic groups and from disadvantaged socioeconomic environments, especially Indigenous populations. The past decade has seen unprecedented intense global interest in the etiology, treatment, and prevention of type 2 diabetes in children.

Risky Decision Making Assessed With the Gambling Task in Adults with HIV

PubMed Central

Hardy, David J.; Hinkin, Charles H.; Castellon, Steven A.; Levine, Andrew J.; Lam, Mona N.

2010-01-01

Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV−) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the “risky” or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. PMID:16719628

Socioeconomic variation in incidence of primary and secondary major cardiovascular disease events: an Australian population-based prospective cohort study.

PubMed

Korda, Rosemary J; Soga, Kay; Joshy, Grace; Calabria, Bianca; Attia, John; Wong, Deborah; Banks, Emily

2016-11-21

Cardiovascular disease (CVD) disproportionately affects disadvantaged people, but reliable quantitative evidence on socioeconomic variation in CVD incidence in Australia is lacking. This study aimed to quantify socioeconomic variation in rates of primary and secondary CVD events in mid-age and older Australians. Baseline data (2006-2009) from the 45 and Up Study, an Australian cohort involving 267,153 men and women aged ≥ 45, were linked to hospital and death data (to December 2013). Outcomes comprised first event - death or hospital admission - for major CVD combined, as well as myocardial infarction and stroke, in those with and without prior CVD (secondary and primary events, respectively). Cox regression estimated hazard ratios (HRs) for each outcome in relation to education (and income and area-level disadvantage), separately by age group (45-64, 65-79, and ≥ 80 years), adjusting for age and sex, and additional sociodemographic factors. There were 18,207 primary major CVD events over 1,144,845 years of follow-up (15.9/1000 person-years), and 20,048 secondary events over 260,357 years (77.0/1000 person-years). For both primary and secondary events, incidence increased with decreasing education, with the absolute difference between education groups largest for secondary events. Age-sex adjusted hazard ratios were highest in the 45-64 years group: for major CVDs, HR (no qualifications vs university degree) = 1.62 (95% CI: 1.49-1.77) for primary events, and HR = 1.49 (1.34-1.65) for secondary events; myocardial infarction HR = 2.31 (1.87-2.85) and HR = 2.57 (1.90-3.47) respectively; stroke HR = 1.48 (1.16-1.87) and HR = 1.97 (1.42-2.74) respectively. Similar but attenuated results were seen in older age groups, and with income. For area-level disadvantage, CVD gradients were weak and non-significant in older people (> 64 years). Individual-level data are important for quantifying socioeconomic variation in CVD incidence, which is shown to be substantial among both those with and without prior CVD. Findings reinforce the opportunity for, and importance of, primary and secondary prevention and treatment in reducing socioeconomic variation in CVD and consequently the overall burden of CVD morbidity and mortality in Australia.

Health and beyond…strategies for a better India: using the “prison window” to reach disadvantaged groups in primary care

PubMed Central

Bhaumik, Soumyadeep; Mathew, Rebecca J.

2015-01-01

As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the “prison window” provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all. PMID:26288765

Occurrence and Characteristics of Chronic Pain in a Community-Based Cohort of Indigent Adults Living With HIV Infection

PubMed Central

Miaskowski, Christine; Penko, Joanne M.; Guzman, David; Mattson, Jennifer E.; Bangsberg, David R.; Kushel, Margot B.

2011-01-01

Pain is common among people living with HIV/AIDS (PLWHA), but little is known about chronic pain in socioeconomically disadvantaged HIV-infected populations with high rates of substance abuse in the post-antiretroviral era. This cross-sectional study describes the occurrence and characteristics of pain in a community-based cohort of 296 indigent PLWHA. Participants completed questionnaires about sociodemographics, substance use, depression and pain. Cut-point analysis was used to generate categories of pain severity. Of the 270 participants who reported pain or the use of a pain medication in the past week, 8.2% had mild pain, 38.1% had moderate pain, and 53.7% had severe pain. Female sex and less education were associated with more severe pain. Depression was more common among participants with severe pain than among those with mild pain. Increasing pain severity was associated with daily pain and with chronic pain. Over half of the participants reported having a prescription for an opioid analgesic. Findings from this study suggest that chronic pain is a significant problem in this high risk, socioeconomically disadvantaged group of patients with HIV disease and high rates of previous or concurrent use of illicit drugs. PMID:21684218

Continuous Positive Airway Pressure Device Time to Procurement in a Disadvantaged Population.

PubMed

DelRosso, Lourdes M; Hoque, Romy; Chesson, Andrew L

2015-01-01

Introduction. The management of obstructive sleep apnea (OSA) in patients who cannot afford a continuous positive airway pressure (CPAP) device is challenging. In this study we compare time to CPAP procurement in three groups of patients diagnosed with OSA: uninsured subsidized by a humanitarian grant (Group 1), uninsured unsubsidized (Group 2), and those with Medicare or Medicaid (Group 3). We evaluate follow-up and adherence in Group 1. We hypothesize that additional factors, rather than just the ability to obtain CPAP, may uniquely affect follow-up and adherence in uninsured patients. Methods. 30 patients were in Groups 1 and 2, respectively. 12 patients were in Group 3. Time of CPAP procurement from OSA diagnosis to CPAP initiation was assessed in all groups. CPAP adherence data was collected for Group 1 patients at 1, 3, 6, and 9 months. Results. There were no significant differences between groups in gender, age, body mass index, or apnea hypopnea index. The mean time to procurement in Group 1 was shorter compared to Group 2 but not significant. Compared to both Group 1 and Group 2, Group 3 patients had significantly shorter times to device procurement. Conclusion. Time to procurement of CPAP was significantly shorter in those with Medicaid/Medicare insurance compared to the uninsured.

Fast-food exposure around schools in urban Adelaide.

PubMed

Coffee, Neil T; Kennedy, Hannah P; Niyonsenga, Theo

2016-12-01

To assess whether exposure to fast-food outlets around schools differed depending on socio-economic status (SES). Binary logistic regression was used to investigate the presence and zero-inflated Poisson regression was used for the count (due to the excess of zeroes) of fast food within 1000 m and 15000 m road network buffers around schools. The low and middle SES tertiles were combined due to a lack of significant variation as the 'disadvantaged' group and compared with the high SES tertile as the 'advantaged' group. School SES was expressed using the 2011 Australian Bureau of Statistics, socio-economic indices for areas, index of relative socio-economic disadvantage. Fast-food data included independent takeaway food outlets and major fast-food chains. Metropolitan Adelaide, South Australia. A total of 459 schools were geocoded to the street address and 1000 m and 1500 m road network distance buffers calculated. There was a 1·6 times greater risk of exposure to fast food within 1000 m (OR=1·634; 95 % 1·017, 2·625) and a 9·5 times greater risk of exposure to a fast food within 1500 m (OR=9·524; 95 % CI 3·497, 25·641) around disadvantaged schools compared with advantaged schools. Disadvantaged schools were exposed to more fast food, with more than twice the number of disadvantaged schools exposed to fast food. The higher exposure to fast food near more disadvantaged schools may reflect lower commercial land cost in low-SES areas, potentially creating more financially desirable investments for fast-food developers.

Intellectual Disability in Australia's Aboriginal and Torres Strait Islander Peoples

ERIC Educational Resources Information Center

Journal of Intellectual & Developmental Disability, 2007

2007-01-01

In mid-2001, the Aboriginal and Torres Strait Islander population in Australia was approximately 458,500 people (2.4% of the national population). Aboriginal and Torres Strait Islander peoples in Australia experience disadvantage compared to non-Indigenous Australians in a number of areas, including greater prevalence of health risk factors, early…

Adult Literacy in Rural Pennsylvania.

ERIC Educational Resources Information Center

Askov, Eunice N.

The rural work force has lower basic skills to supply labor for new jobs with higher literacy demands. At all levels of education the rural population is at a disadvantage compared with the urban population. One out of five rural adults in Pennsylvania has not continued education past the eighth grade. Among the costs to businesses from employee…

Network Financial Support and Conflict as Predictors of Depressive Symptoms among a Highly Disadvantaged Population

ERIC Educational Resources Information Center

Knowlton, Amy R.; Latkin, Carl A.

2007-01-01

The study examined multiple dimensions of social support as predictors of depressive symptoms among a highly vulnerable population. Social network analysis was used to assess perceived and enacted dimensions of support (emotional, financial, instrumental), network conflict, closeness, and composition. Participants were 393 current and former…

New England's Disadvantaged Populations Struggle the Most with Student Debt Repayment

ERIC Educational Resources Information Center

Saas, Darcy Rollins

2016-01-01

Regularly reported statistics about high and growing student-loan debt levels, combined with increased rates of delinquency and default, have prompted calls to address the student-debt "crisis." For New England, with its highly educated population and large higher education industry, student-loan debt is an important economic policy…

A Personality Development Interpretation of Employability and Disadvantaged Status with Remedial Implications: Counseling Services Report No. 21.

ERIC Educational Resources Information Center

Conrad, Rowan W.

Tracing problems observed among the Mountain-Plains student population, a trend of apparently improper or arrested personality development emerges. Observations indicate that a majority of the student population does not possess normally developed trust, autonomy, initiative, industry, sense of identity, or ability to develop intimate…

The Subjective Wellbeing of Indigenous Australian Adolescents: Validating the Personal Wellbeing Index-School Children

ERIC Educational Resources Information Center

Tomyn, Adrian J.; Norrish, Jacolyn M.; Cummins, Robert A.

2013-01-01

By almost all measures of objective life quality, Indigenous Australians are disadvantaged relative to the general population. However, no measures of their Subjective Wellbeing (SWB) have been published. This paper presents the first such data, norm-referenced to the general Australian population. A total of 519 Indigenous adolescents, aged…

Group A streptococcal infections of the skin: molecular advances but limited therapeutic progress.

PubMed

Currie, Bart J

2006-04-01

With the sequencing of several Streptococcus pyogenes (group A Streptococcus) genomes have come major advances in understanding the pathogenesis of group A Streptococcus-associated diseases. This review focuses on group A Streptococcus skin infections and summarizes data published in the English language medical literature in 2004 and 2005. Group A Streptococcus shows enormous and evolving molecular diversity driven by horizontal transmission between group A Streptococcus strains and between group A Streptococcus and other streptococci. Acquisition of prophages accounts for much of the diversity, conferring both virulence through phage-associated virulence factors and increased bacterial survival against host defences. Studies of group A Streptococcus isolates outside the US also question the generalizability of classic group A Streptococcus M serotype associations with specific disease entities such as acute rheumatic fever and necrotizing fasciitis. The distinction between throat and skin group A Streptococcus has become blurred. Although there have been few advances in treatment of group A Streptococcus skin infections, developments towards group A Streptococcus vaccines are promising. The diversity of group A Streptococcus remains a challenge for vaccine development. As acute rheumatic fever and streptococcal pyoderma occur predominantly in disadvantaged populations, international funding support will be necessary for any group A Streptococcus vaccine to have a sustained impact on the global burden of disease.

Impacts of Climate Change on Inequities in Child Health.

PubMed

Bennett, Charmian M; Friel, Sharon

2014-12-03

This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world's poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

Designing Tutorial Modalities and Strategies for Digital Games: Lessons from Education

ERIC Educational Resources Information Center

White, Matthew M.

2012-01-01

Contemporary digital games do little to help novice and disadvantaged players wanting to learn to play. The novice-expert divide is a significant barrierfor entry for disadvantaged groups who want to play digital games; this is especially true for women (Jenson, Fisher, & De Castell, 2011). In response to this problem, three new tutorial…

An Intervention Using LEGO® SERIOUS PLAY® on Fostering Narrative Identity among Economically Disadvantaged College Students in Taiwan

ERIC Educational Resources Information Center

Tseng, Wen-Chih

2017-01-01

The effectiveness of an intervention using LEGO® SERIOUS PLAY® (LSP), a reflective tool using LEGO® building bricks, to speed the development of narrative identity in economically disadvantaged college students was studied. A longitudinal experimental study with non equivalent experimental/control groups (N = 45) was conducted to examine whether…

Tobacco Health Warning Messages on Plain Cigarette Packs and in Television Campaigns: A Qualitative Study with Australian Socioeconomically Disadvantaged Smokers

ERIC Educational Resources Information Center

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine

2015-01-01

Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few studies have examined how high smoking prevalence groups respond to these warnings. This study explored how socioeconomically disadvantaged smokers engage with health…

Impact of Intervention on Disadvantaged First Year Students Who Plan To Major in Health Sciences.

ERIC Educational Resources Information Center

Haught, Patricia A.

This report describes a program designed to encourage minority and financially, socially, or educationally disadvantaged incoming, freshman students to pursue health profession career goals. Sixteen at-risk students were selected to participate in a summer intervention program in West Virginia; a control group of 16 pre-medicine or pre-dentistry…

Special Strategies for Educating Disadvantaged Children. Urban and Suburban/Rural. First Year Report.

ERIC Educational Resources Information Center

Stringfield, Sam; And Others

This volume presents methods and first-year findings from the urban and suburban/rural studies of Special Strategies for Educating Disadvantaged Children, a 3-year project that is collecting case study data on 10 different strategies identified as holding promise for educating this group of children. Data collected by Special Strategies involve…

Non-Traditional Educational Trajectories: The Educational Aspirations and Expectations of Women Who Are Educationally Disadvantaged

ERIC Educational Resources Information Center

Coffield, Claudia Ditmar

2012-01-01

This dissertation focuses on the educational aspirations and expectations of a heterogeneous group of women who were enrolled in, or had graduated from, adult education and literacy programs in Boston, Massachusetts. The research questions guiding the inquiry are: (1) Why do educationally disadvantaged women value education--how are these values…

Differentiated Function of School in Socio-Culturally Disadvantaged Context: A Constructivist Grounded Theory Study from Turkey

ERIC Educational Resources Information Center

Caliskan, Zuhal Zeybekoglu; Simsek, Hasan; Kondakci, Yasar

2017-01-01

This study analyses the functioning of a school as a social system in an atypical context with the purpose of generating propositions to tackle educational problems confronted by socially and economically disadvantaged groups attending these schools. Adopting the constructivist grounded theory, the analysis suggests that there is a kind of…

Education for Rural Development - A Portfolio of Studies. Volume 2: Education for Disadvantaged Women.

ERIC Educational Resources Information Center

Naik, Chitra; And Others

The volume contains two studies from India and Thailand on the education of women, and rural women especially, who are deprived or disadvantaged. The Indian study, "Education of Girls and Women in Deprived Groups," presents a viewpoint on deprivation in society in general, and India specifically. The concomitant of deprivation is defined…

Some Can, Some Can't. The Impact of Fees and Charges on Disadvantaged Groups in TAFE. Discussion Paper.

ERIC Educational Resources Information Center

Barnett, Kate

Since 1990, it has been possible to charge fees for all of Australia's Technical and Further Education (TAFE) courses. Although data can be extracted regarding TAFE enrollment patterns before and after the introduction of fees, detailed information about economically disadvantaged students cannot be obtained through the existing data collection…

"Cigarettes Are Priority": A Qualitative Study of How Australian Socioeconomically Disadvantaged Smokers Respond to Rising Cigarette Prices

ERIC Educational Resources Information Center

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine

2015-01-01

Despite substantial modelling research assessing the impact of cigarette taxes on smoking rates across income groups, few studies have examined the broader financial effects and unintended consequences on very low-income smokers. This study explored how socioeconomically disadvantaged smokers in a high-income country manage smoking costs on…

Tackling Disadvantage: What Works in Narrowing the Achievement Gap in Schools

ERIC Educational Resources Information Center

Demie, Feyisa; Mclean, Christabel

2015-01-01

This study examines the success factors behind narrowing the achievement gap of disadvantaged pupils who are entitled to free school meals. A complementary methodological approach including a case study and focus group were used to explore performance and the views of teachers, parents and pupils. The key criteria for the selection of schools were…

Wellness and Academic Outcomes among Disadvantaged Students in South Africa: An Exploratory Study

ERIC Educational Resources Information Center

Morris-Paxton, Angela A.; Van Lingen, Johanna M.; Elkonin, Diane

2017-01-01

Objective: The aim of this study was to measure possible impacts of a salutogenic lifestyle education programme on wellness and academic outcomes in a group of socioeconomically disadvantaged students in the first year of higher education. Setting: University in the Eastern Cape Province, South Africa. Methods: A mixed-methods approach was…

Graduate Education for the 'Disadvantaged' and Black-Oriented University Graduates.

ERIC Educational Resources Information Center

Howard, Lawrence C.

It has been estimated that a total of 1200 to 1500 Negroes have received Ph.Ds in the US, which is approximately the number of degrees awarded ANNUALLY to white students. In 1966 the Danforth Foundation financed experimental graduate programs at 4 white universities for disadvantaged Negro and other minority group students. An evaluation of the…

ADAPTING TEACHER STYLE TO PUPIL DIFFERENCES--TEACHERS FOR DISADVANTAGED CHILDREN.

ERIC Educational Resources Information Center

GOLDBERG, MIRIAM L.

ASSUMPTIONS PRESENTED ARE--THAT A PUPIL'S LEARNING IS MAINLY A FUNCTION OF THE KIND OF TEACHING TO WHICH HE IS EXPOSED, THAT THERE IS NO UNIVERSALLY GOOD TEACHER, BUT RATHER A VARIETY OF GOOD TEACHERS DIFFERENTIALLY SUITED BY TEMPERAMENT AND TRAINING TO TEACHING DIFFERENT GROUPS OF STUDENTS, AND THAT DISADVANTAGED CHILDREN REPRESENT A DESCRIBABLE…

Understanding Heterogeneity in Price Elasticities in the Demand for Alcohol for Older Individuals

PubMed Central

Ayyagari, Padmaja; Deb, Partha; Fletcher, Jason; Gallo, William; Sindelar, Jody L.

2013-01-01

This paper estimates the price elasticity of demand for alcohol using Health and Retirement Study data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price, but the other is unresponsive. The group with greater responsiveness is disadvantaged in multiple domains, including health, financial resources, education and perhaps even planning abilities. These results have policy implications. The unresponsive group drinks more heavily, suggesting that a higher tax would fail to curb the negative alcohol-related externalities. In contrast, the more disadvantaged group is more responsive to price, thus suffering greater deadweight loss, yet this group consumes fewer drinks per day and might be less likely to impose negative externalities. PMID:22162113

Understanding heterogeneity in price elasticities in the demand for alcohol for older individuals.

PubMed

Ayyagari, Padmaja; Deb, Partha; Fletcher, Jason; Gallo, William; Sindelar, Jody L

2013-01-01

This paper estimates the price elasticity of demand for alcohol using Health and Retirement Study data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price, but the other is unresponsive. The group with greater responsiveness is disadvantaged in multiple domains, including health, financial resources, education and perhaps even planning abilities. These results have policy implications. The unresponsive group drinks more heavily, suggesting that a higher tax would fail to curb the negative alcohol-related externalities. In contrast, the more disadvantaged group is more responsive to price, thus suffering greater deadweight loss, yet this group consumes fewer drinks per day and might be less likely to impose negative externalities. Copyright © 2011 John Wiley & Sons, Ltd.

Accounting for group differences in appraisals of social inequality: differential injustice standards.

PubMed

Miron, Anca M; Warner, Ruth H; Branscombe, Nyla R

2011-06-01

We tested whether differential appraisals of inequality are a function of the injustice standards used by different groups. A confirmatory standard of injustice is defined as the amount of evidence needed to arrive at the conclusion that injustice has occurred. Consistent with a motivational shifting of standards view, we found that advantaged and disadvantaged group members set different standards of injustice when judging the magnitude of gender (Study 1) and racial (Study 2) wage inequality. In addition, because advantaged and disadvantaged group members formed - based on their differential standards - divergent appraisals of wage inequality, they experienced differential desire to restore inter-group justice. We discuss the implications of promoting low confirmatory standards for changing perceptions of social reality and for motivating justice-restorative behaviour. ©2011 The British Psychological Society.

Valuing Diversity

PubMed Central

Fryer, Roland G.; Loury, Glenn C.

2014-01-01

This paper explores the economics of diversity-enhancing policies. A model is proposed in which heterogeneous agents, distinguished by skill level and social identity, purchase productive opportunities in a competitive market. We analyze policies designed to raise the status of a disadvantaged identity group. When agent identity is contractible, efficient policy grants preferred access to slots but offers no direct assistance for acquiring skills. When identity is not contractible, efficient policy provides universal subsidies to skill development when the fraction of the disadvantaged group at the skill development margin is larger than their share at the slot assignment margin. PMID:25525280

Differentials in survival for childhood cancer in Australia by remoteness of residence and area disadvantage.

PubMed

Youlden, Danny R; Baade, Peter D; Valery, Patricia C; Ward, Leisa J; Green, Adele C; Aitken, Joanne F

2011-08-01

It is not known whether improvements in cancer survival over recent decades have benefited children from different geographic locations equally. This is the first study to produce national survival estimates for childhood cancer in Australia by remoteness of residence and area-based socioeconomic status. The study utilized population-based data from the Australian Paediatric Cancer Registry for children diagnosed with cancer from 1996 onward who were at risk of mortality between January 2001 and December 2006 (n = 6,289). Remoteness was specified according to the Australian Standard Geographical Classification Remoteness Areas, whereas an index of area disadvantage was obtained from census information. Five-year relative survival estimates were produced by the period method for all cancers and the most common diagnostic groups, with corresponding age-sex adjusted mortality hazard ratios calculated using Poisson regression. Overall, children with cancer from remote/very remote areas had a significantly lower survival rate than their counterparts in major cities (HR = 1.55, 95% CI = 1.08-2.23). Survival was also lower for children with leukemia living in inner regional (HR = 1.52, 95% CI = 1.11-2.08) or outer regional areas (HR = 1.53, 95% CI = 1.03-2.28). There was weak evidence (P(grad) = 0.051) of a trend toward poorer survival by greater area disadvantage for all childhood cancers. Some variation in prognosis by place of residence was present for children with cancer in Australia, particularly among leukemia patients. Treatment, clinical or area-related factors that contribute to these survival differentials need to be identified. ©2011 AACR.

Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: insights from a multicentre registry.

PubMed

Shi, William Y; Yap, Cheng-Hon; Newcomb, Andrew E; Hayward, Philip A; Tran, Lavinia; Reid, Christopher M; Smith, Julian A

2014-08-01

We examined whether socioeconomic status and rurality influenced outcomes after coronary surgery. We identified 14,150 patients undergoing isolated coronary surgery. Socioeconomic and rurality data was obtained from the Australian Bureau of Statistics and linked to patients' postcodes. Outcomes were compared between categories of socioeconomic disadvantage (highest versus lowest quintiles, n= 3150 vs. 2469) and rurality (major cities vs. remote, n=9598 vs. 839). Patients from socioeconomically-disadvantaged areas experienced a greater burden of cardiovascular risk factors including diabetes, obesity and current smoking. Thirty-day mortality (disadvantaged 1.6% vs. advantaged 1.6%, p>0.99) was similar between groups as was late survival (7 years: 83±0.9% vs. 84±1.0%, p=0.79). Those from major cities were less likely to undergo urgent surgery. There was similar 30-day mortality (major cities: 1.6% vs. remote: 1.5%, p=0.89). Patients from major cities experienced improved survival at seven years (84±0.5% vs. 79±2.0%, p=0.010). Propensity-analysis did not show socioeconomic status or rurality to be associated with late outcomes. Patients presenting for coronary artery surgery from different socioeconomic and geographic backgrounds exhibit differences in their clinical profile. Patients from more rural and remote areas appear to experience poorer long-term survival, though this may be partially driven by the population's clinical profile. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

CT colonography: accuracy, acceptance, safety and position in organised population screening.

PubMed

de Haan, Margriet C; Pickhardt, Perry J; Stoker, Jaap

2015-02-01

Colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related deaths in Europe. The introduction of CRC screening programmes using stool tests and flexible sigmoidoscopy, have been shown to reduce CRC-related mortality substantially. In several European countries, population-based CRC screening programmes are ongoing or being rolled out. Stool tests like faecal occult blood testing are non-invasive and simple to perform, but are primarily designed to detect early invasive cancer. More invasive tests like colonoscopy and CT colonography (CTC) aim at accurately detecting both CRC and cancer precursors, thus providing for cancer prevention. This review focuses on the accuracy, acceptance and safety of CTC as a CRC screening technique and on the current position of CTC in organised population screening. Based on the detection characteristics and acceptability of CTC screening, it might be a viable screening test. The potential disadvantage of radiation exposure is probably overemphasised, especially with newer technology. At this time-point, it is not entirely clear whether the detection of extracolonic findings at CTC is of net benefit and is cost effective, but with responsible handling, this may be the case. Future efforts will seek to further improve the technique, refine appropriate diagnostic algorithms and study cost-effectiveness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Curricular Innovations in Tobacco Cessation Education for Prelicensure Baccalaureate Nursing Students.

PubMed

Schwindt, Rhonda G; McNelis, Angela M; Agley, Jon

2016-08-01

Tobacco use is the primary preventable cause of morbidity and mortality in the United States, resulting in enormous health care expenditures. The burden of smoking is higher among disadvantaged populations, such as individuals with mental illness. As the largest group of health care providers, nurses must assume a leading role in tobacco control efforts to decrease the deleterious impact on health outcomes. Investigators used a randomized control group design to assess the effectiveness of a theory-based tobacco education program on the perceived competence and intrinsic motivation of prelicensure BSN students (N = 134) to engage in cessation interventions with patients with mental illness. Students completing the program reported a significant increase in perceived competence, compared with their peers who received standard instruction only. Intrinsic motivation did not increase significantly for either group. Findings suggest that the program improves students' perceived competence, but further research is needed to determine its effect on motivation and its usefulness in other health care contexts. [J Nurs Educ. 2016;55(8):425-431.]. Copyright 2016, SLACK Incorporated.

Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers.

PubMed

Bryant, Jamie; Bonevski, Billie; Paul, Christine; O'Brien, Jon; Oakes, Wendy

2011-06-24

Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.

Targeted Ovarian Cancer Education for Hispanic Women: A Pilot Program in Arizona.

PubMed

Schlumbrecht, Matthew; Yarian, Ranay; Salmon, Kristine; Niven, Christine; Singh, Diljeet

2016-06-01

In disadvantaged populations, including Hispanics, there is a deficit in understanding of cancer risk factors, symptoms, prevention, and treatment. The objective of this study was to assess ovarian cancer knowledge in a population of Hispanic women in Arizona, identify deficiencies, and to evaluate the utility of an educational program developed specifically for this community's needs. A de novo questionnaire about ovarian cancer was distributed to Hispanic women enrolled in family literacy programs at Mesa Public Schools. Following this assessment, a video educational program was developed, with emphasis on areas of greatest knowledge deficits, and post-intervention assessment administered. Chi square, Wilcoxon rank sum, and Kruskal-Wallis tests were used for analysis. 167 questionnaires were completed in the pretest group and 102 in the post-intervention group. Between groups, there were no differences in age (p = 0.49), education (p = 0.68), or annual income (p = 0.26). In the pretest group, 45 % of questions were answered correctly versus 84 % in the post-test group (p < 0.01). 24.2 % of the initial respondents correctly identified ovarian cancer symptoms versus 85.6 of post-test respondents (p < 0.01). With the program, there was an increase in the number of correct post-test responses for each question and symptom (p < 0.01), except those about hereditary risk of ovarian cancer (p = 0.62) and pelvic anatomy (p = 0.16). Following identification of an ovarian cancer knowledge deficit in this cohort of Hispanic women, an educational tool targeting specific deficiencies successfully increased cancer knowledge and awareness of symptoms. Similar efforts in this and other minority populations should be continued.

Heart Lesion After the First Attack of the Rheumatic Fever 22 Years Experience in Single Centre

PubMed Central

Bejiqi, Ramush A.; Retkoceri, Ragip; Zeka, Naim; Bejiqi, Hana; Retkoceri, Arber

2015-01-01

Background: Acute rheumatic fever and its sequels, rheumatic heart diseases, remain major unsolved preventable health problems in Kosovo population, particularly among the disadvantages indigenous Albanian and Egyptians people. In Kosovo, despite of performing secondary prophylaxis with benzathine penicillin, acute rheumatic fever hospitalization rates have remained essentially unchanged for the last 20 years. The role of echocardiography in the diagnosis of acute rheumatic carditis was established over the last 20 years. Aims: In this study we aimed to determine the prevalence of rheumatic heart disease in children from Kosovo population with first attack of acute rheumatic fever. Also, we presented that echocardiography examination detects a greater prevalence of rheumatic heart disease than other diagnostic procedures. We aimed to compare the sensitivity and specificity of cardiac auscultation, ECG record, lab analysis to echocardiography and to determine the feasibility of specific age in this setting. Methods: To optimize accurate diagnosis of rheumatic fever and rheumatic heart disease, we utilized two group models. In the first group of 388 children, hospitalized and treated before 1999, diagnosis of rheumatic fever was decided basing on the clinical and laboratory findings whereas in second group (221 children treated from1999 to 2010) clinical and lab diagnosis were amplified also on the detection by echocardiography. Conclusion: In second group, using echocardiography as a method of diagnosis and assessment children with rheumatic fever, we found high rates of undetected rheumatic heart disease in this high-risk group population. Echocardiographic examination of children with rheumatic fever for rheumatic heart disease may over diagnose rheumatic heart disease unless congenital mitral valve anomalies and physiological regurgitation are excluded. PMID:25870479

[Social deprivation and time perception, the impact on smoking cessation].

PubMed

Merson, Frédéric; Perriot, Jean

2011-01-01

Smoking addiction and smoking behaviour are closely related to social deprivation. The aim of this study was to evaluate the impact of social deprivation and time perspective on smoking cessation in order to improve the support provided to socially deprived persons seeking to quit smoking. The study examined the impact of social disadvantages and time perspective on smoking cessation. 192 patients (including 45% of socially disadvantaged people) participated in the study. Social deprivation was measured using the EPICES scale, while time perspective was measured using the short version of the Zimbardo Time Perspective Inventory. Data relating to individuals' characteristics, smoking addiction, behaviour and smoking cessation were collected as part of this research. Compared to the rest of the population, socially disadvantaged people were found to be more likely to stop smoking for financial reasons (p < 0.0001). The study also found that their attempts to quit smoking are more likely to fail (p = 0,006). In addition, socially disadvantaged people suffer more frequently from anxio-depressive disorders (p < 0.0001) and are also prone to a higher level of nicotine dependence (p < 0.0001). The 'Past-Negative' and ?Present-Fatalistic' dimensions of time perspective, toward which socially disadvantaged people are more likely to lean (p < 0.0001), are associated with failed smoking cessation. The ?Future' dimension, in which socially disadvantaged people are less likely to project themselves (p < 0.0002), is a predictive factor of smoking cessation. The results highlight the importance of taking into account social deprivation and time perspective in helping socially disadvantaged patients to quit smoking.

Emerging Trends Could Exacerbate Health Inequities In The United States.

PubMed

Arcaya, Mariana C; Figueroa, José F

2017-06-01

Health inequities among people of different races and ethnicities, geographical locations, and social classes are not a new phenomenon, although the size of the inequities has changed since researchers first began documenting them. While interventions to improve the health of targeted disadvantaged groups may help combat disparities, broader trends that disproportionately benefit privileged groups or harm vulnerable populations can eclipse the progress made through isolated interventions. These trends threaten equity in health and health care in the United States either through direct effects on health or through impacts on the distribution of resources, risks, and power. We highlight trends in four domains: health care technologies, health reform policies, widening socioeconomic inequality, and environmental hazards. We suggest ways of countering the effects of these trends to promote health equity, focusing on strategies that promise co-benefits across multiple sectors. Project HOPE—The People-to-People Health Foundation, Inc.

The late-stage diagnosis of colorectal cancer: demographic and socioeconomic factors.

PubMed Central

Mandelblatt, J; Andrews, H; Kao, R; Wallace, R; Kerner, J

1996-01-01

OBJECTIVES: This study described factors related to colorectal cancer stage at diagnosis. METHODS: Logistic regression analyses were used on data from the New York State Tumor Registry and US Census area-level social class indicators. RESULTS: After the effects of other predictors were controlled for, the odds of late-stage cancer increased as age decreased; women and African Americans were significantly more likely to have late stage than men and Whites; and individuals living in areas of low socioeconomic status (SES) were significantly more likely to be diagnosed at late stage than those living in higher SES areas. Stratified analyses showed that living in a low SES area was the most important determinant of stage for all age, race, gender and source-of-care groups. CONCLUSIONS: While all populations would benefit from the systematic use of screening socioeconomically disadvantaged groups may also benefit from targeted screening. PMID:9003140

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 5. equity effects for neonates and children

PubMed Central

Schleiff, Meike; Kumapley, Richard; Freeman, Paul A; Gupta, Sundeep; Rassekh, Bahie M; Perry, Henry B

2017-01-01

Background The degree to which investments in health programs improve the health of the most disadvantaged segments of the population—where utilization of health services and health status is often the worst—is a growing concern throughout the world. Therefore, questions about the degree to which community–based primary health care (CBPHC) can or actually does improve utilization of health services and the health status of the most disadvantaged children in a population is an important one. Methods Using a database containing information about the assessment of 548 interventions, projects or programs (referred to collectively as projects) that used CBPHC to improve child health, we extracted evidence related to equity from a sub–set of 42 projects, identified through a multi–step process, that included an equity analysis. We organized our findings conceptually around a logical framework matrix. Results Our analysis indicates that these CBPHC projects, all of which implemented child health interventions, achieved equitable effects. The vast majority (87%) of the 82 equity measurements carried out and reported for these 42 projects demonstrated “pro–equitable” or “equitable” effects, meaning that the project’s equity indicator(s) improved to the same degree or more in the disadvantaged segments of the project population as in the more advantaged segments. Most (78%) of the all the measured equity effects were “pro–equitable,” meaning that the equity criterion improved more in the most disadvantaged segment of the project population than in the other segments of the population. Conclusions Based on the observation that CBPHC projects commonly provide services that are readily accessible to the entire project population and that even often reach down to all households, such projects are inherently likely to be more equitable than projects that strengthen services only at facilities, where utilization diminishes greatly with one’s distance away. The decentralization of services and attention to and tracking of metrics across all phases of project implementation with attention to the underserved, as can be done in CBPHC projects, are important for reducing inequities in countries with a high burden of child mortality. Strengthening CBPHC is a necessary strategy for reducing inequities in child health and for achieving universal coverage of essential services for children. PMID:28685043

Socio-economic position has no effect on improvement in health-related quality of life and patient satisfaction in total hip and knee replacement: a cohort study.

PubMed

Keurentjes, J Christiaan; Blane, David; Bartley, Melanie; Keurentjes, Johan J B; Fiocco, Marta; Nelissen, Rob G

2013-01-01

Considerable evidence suggests that patients with more advantaged Socio-Economic Positions undergo Total Hip and Knee Replacement (THR/TKR) more often, despite having a lower need. We questioned whether more disadvantaged Socio-Economic Position is associated with an lower improvement in Health-Related Quality of Life (HRQoL) and a lower patient satisfaction after THR/TKR. Patients who underwent primary THR/TKR in one academic and three community hospitals between 2005 and 2009, were eligible for inclusion. The highest completed levels of schooling were aggregated to index social class. We compared the improvement in HRQoL and postoperative satisfaction with surgery (measured using the Short-Form 36 (SF36) and an 11-point numeric rating scale of satisfaction) between the aggregated groups of highest completed levels of schooling, using linear mixed model analysis, with center as a random effect and potential confounders (i.e. age, gender, Body Mass Index and Charnley's comorbidity classification) as fixed effects. 586 THR patients and 400 TKR patients (40% of all eligible patients) agreed to participate and completed all questionnaires sufficiently. We found no differences in HRQoL improvement in any dimension of the SF36 in THR patients. Patients with a higher completed level of schooling had a larger improvement in role-physical (9.38 points, 95%-CI:0.34-18.4), a larger improvement in general health (3.67 points, 95%-CI:0.56-6.79) and a smaller improvement in mental health (3.60 points, 95%-CI:0.82-6.38) after TKR. Postoperative patient satisfaction did not differ between different highest completed level of schooling groups. Completed level of schooling has no effect on the improvement in HRQoL and patient satisfaction in a Dutch THR population and a small effect in a similar TKR population. Undertreatment of patients with more disadvantaged Socio-Economic Position cannot be justified, given the similar improvement in HRQoL and postoperative level of satisfaction with surgery between the social groups examined.

A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada.

PubMed

Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

2014-12-17

Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Retrospective population-based study. 140 neighbourhoods in Toronto, Ontario, 2005-2009. Adults aged 20-59 years. Our primary outcome was premature all-cause mortality among adults aged 20-59 years. Across neighbourhoods we explored neighbourhood density, in km(2), of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20-59 years. The overall premature mortality rate was 96.3/10,000 males and 55.9/10,000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Educational inequalities in obesity, abdominal obesity, and metabolic syndrome in seven Latin American cities: the CARMELA Study.

PubMed

Boissonnet, Carlos; Schargrodsky, Herman; Pellegrini, Fabio; Macchia, Alejandro; Marcet Champagne, Beatriz; Wilson, Elinor; Tognoni, Gianni

2011-08-01

Earlier reviews have found that the proportion of inverse associations between socioeconomic status and obesity increased according to the level of development of the studied country. Based on this finding, it has been hypothesized that in low- to middle- income countries the burden of obesity shifts to disadvantaged groups as a country develops. CARMELA is a cross-sectional, population-based observational study that sampled 11,550 women and men age 25-64 from seven major Latin American cities. We analyzed by gender the association of educational attainments (as proxy of socioeconomic status) with body mass index, waist circumference and metabolic syndrome. Participating cities were divided by country Human Development Index (HDI). An inverse gradient between socioeconomic status and body mass index in women was uniformly present in High HDI cities (Buenos Aires, Santiago, Mexico) but not in Medium HDI group (Barquisimeto, Bogota, Lima, Quito), where two cities showed an inverse gradient and two cities did not. In men, no clear socioeconomic gradients were found. Findings regarding waist circumference and metabolic syndrome closely mirrored those about body mass index. In women but not men, these results give support to the hypothesis of obesity shifting to the poor and extend it to the related concepts of abdominal obesity and metabolic syndrome. Obesity should be considered as a socially-generated disease and an indicator of socioeconomic disadvantage, to be approached by comprehensive strategies that bear in mind this perspective.

Ingroup friendship and political mobilization among the disadvantaged.

PubMed

Sengupta, Nikhil K; Milojev, Petar; Barlow, Fiona K; Sibley, Chris G

2015-07-01

This study investigated the effects of ingroup contact in a large, national sample of Māori (a disadvantaged ethnic group; N = 940) on political attitudes relevant to decreasing ethnic inequality in New Zealand. We tested the role of 2 mediating mechanisms-ethnic identification and system justification-to explain the effects of ingroup contact on the dependent variables. Time spent with ingroup friends predicted increased support for the Māori Party and support for symbolic and resource-specific reparative policies benefiting Māori. These effects were partially mediated by increased ethnic identification. Although ingroup contact also reduced levels of system justification among Māori, its effects on policy attitudes and party preference were not mediated by system justification. This suggests that a key antecedent to system challenging political attitudes is an increased sense of identification with a disadvantaged group resulting, in part, from interactions with ingroup friends. (c) 2015 APA, all rights reserved).

Physicians' Participation In ACOs Is Lower In Places With Vulnerable Populations Than In More Affluent Communities.

PubMed

Yasaitis, Laura C; Pajerowski, William; Polsky, Daniel; Werner, Rachel M

2016-08-01

Early evidence suggested that accountable care organizations (ACOs) could improve health care quality while constraining costs, and ACOs are expanding throughout the United States. However, if disadvantaged patients have unequal access to physicians who participate in ACOs, that expansion may exacerbate health care disparities. We examined the relationship between physicians' participation in both Medicare and commercial ACOs across the country and the sociodemographic characteristics of their likely patient populations. Physicians' participation in ACOs varied widely across hospital referral regions, from nearly 0 percent to over 85 percent. After we adjusted for individual physician and practice characteristics, we found that physicians who practiced in ZIP Code Tabulation Areas where a higher percentage of the population was black, living in poverty, uninsured, or disabled or had less than a high school education-compared to other areas-had significantly lower rates of ACO participation than other physicians. Our findings suggest that vulnerable populations' access to physicians participating in ACOs may not be as great as access for other groups, which could exacerbate existing disparities in health care quality. Project HOPE—The People-to-People Health Foundation, Inc.

[Reducing inequality by improving preventing measures].

PubMed

Valsecchi, M

2014-01-01

Terms of inequalities issue in health service are defined and the consolidated scientific acquisitions are recalled. Three prioritary areas of action are defined and described, that Prevention Departments are suggested to activate through focused programs in order to reduce specific inequalities. First area of action: includes three types of vital interventions: vaccinations, contrasting of tuberculosis infection and oncological screening that have to be granted to specific disadvantaged groups of population as Rom communities, immigrant women, prisoners e psychiatric patients. Second area of action: actions on focused urban planning aiming to improve conditions of social housing (with a special focus on thermal insulation, minimal distances to be kept towards streets of havy traffic), increase of increase of urban green spaces enjoyed by the population and contrasting degradation of housing (with particular attention to poisoning by carbon monoxide). Third area of action: actions contrasting cardiovascular diseases, that is the leading cause of death and inequalities in health for the working class population. A coordinated intervention directly in the workplace is proposed, where a particularly high percentage of individuals exposed to specific risk factors is present.

Attitudes of postmenopausal women toward interactive video dance for exercise.

PubMed

Inzitari, Marco; Greenlee, Adam; Hess, Rachel; Perera, Subashan; Studenski, Stephanie A

2009-08-01

Although physical activity (PA) is universally recommended, most adults are not regular exercisers. Interactive video dance is a novel form of PA in widespread use among young adults, but interest among adults is not known. Postmenopausal women are an appropriate target for interventions to promote PA because they have an increased risk of health problems related to sedentary behavior. We explored perceived advantages and disadvantages of video dance as a personal exercise option in postmenopausal women. Forty sedentary postmenopausal women (mean age +/- SD 57 +/- 5 years), were oriented in eight small groups to interactive video dance, which uses a force-sensing pad with directional panels: the player steps on the panels in response to arrows scrolling on a screen, synchronized to music. Perceived advantages and disadvantages were elicited through a nominal group technique (NGT) process. Participants generated 113 advantages and 71 disadvantages. The most frequently cited advantages were "it's fun" and "improves coordination" (seven of eight groups), the fact that challenge encourages progress (five of eight groups), the potential for weight loss (four of eight groups), and the flexibility of exercise conditions (three of eight groups). Concerns were the potentially long and frustrating learning process, cost (six of eight groups), and possible technical issues (two of eight groups). The recreational nature of interactive dance exercise was widely appealing to postmenopausal women and might help promote adherence to PA. Initial support to learn basic technical and movement skills may be needed.

Students' perceptions of the non-academic advantages and disadvantages of participation in Advanced Placement courses and International Baccalaureate programs.

PubMed

Foust, Regan Clark; Hertberg-Davis, Holly; Callahan, Carolyn M

2009-01-01

In-depth interviews of students with qualitative analysis of the responses were used to explore perceptions of the non-academic advantages and disadvantages of Advanced Placement (AP) and International Baccalaureate (IB) program participation, and differences between the AP and IB programs in those perceptions. Results revealed that benefits of participation, including pride in completing more challenging work, similarity and special bonds among participants, better treatment (more respect and responsibility) from teachers, better overall class atmosphere, and preference for AP and IB courses were consistent across schools and between programs. Also consistent were the disadvantages students reported, with marked differences in the intensity of disadvantages between the AP and IB programs. Specifically, as the amount of time students spent in homogeneously grouped settings increased, so did the workload, the intensity of the perceived social/emotional disadvantages of the workload, the perceived range of negative feelings between participants and non-participants, and the perceived negativity of participant strereotypes.

Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England

PubMed Central

Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Brennan, Alan; Holmes, John; Kaner, Eileen; Meier, Petra; Michie, Susan

2016-01-01

Background The Alcohol Harm Paradox refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. Thus this study assessed socioeconomic patterning of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. Method Data were used from the Alcohol Toolkit Study between March and September 2015 on 31,878 adults (16+) living in England. Participants completed the AUDIT which includes alcohol consumption, harm and dependence modules. SES was measured via qualifications, employment, home and car ownership, income and social-grade, plus a composite of these measures. The composite score was coded such that higher scores reflected greater social-disadvantage. Results We observed the Alcohol Harm Paradox for the composite SES measure, with a linear negative relationship between SES and AUDIT-Consumption scores (β = -0.036, p<0.001) and a positive relationship between lower SES and AUDIT-Harm (β = 0.022, p<0.001) and AUDIT-Dependence (β = 0.024, p<0.001) scores. Individual measures of SES displayed different, and non-linear, relationships with AUDIT modules. For example, social-grade and income had a u-shaped relationship with AUDIT-Consumption scores while education had an inverse u-shaped relationship. Almost all measures displayed an exponential relationship with AUDIT-Dependence and AUDIT-Harm scores. We identified moderating effects from age and gender, with AUDIT-Dependence scores increasing more steeply with lower SES in men and both AUDIT-Harm and AUDIT-Dependence scores increasing more steeply with lower SES in younger age groups. Conclusion Different SES measures appear to influence whether the Alcohol Harm Paradox is observed as a linear trend across SES groups or a phenomenon associated particularly with the most disadvantaged. The paradox also appears more concentrated in men and younger age groups. PMID:27682619